Spine
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Randomized Controlled Trial Clinical Trial
A randomized clinical trial of exercise and spinal manipulation for patients with chronic neck pain.
A randomized, parallel-group, single-blinded clinical trial was performed. After a 1-week baseline period, patients were randomized to 11 weeks of therapy, with posttreatment follow-up assessment 3, 6, and 12 months later. ⋯ For chronic neck pain, the use of strengthening exercise, whether in combination with spinal manipulation or in the form of a high-technology MedX program, appears to be more beneficial to patients with chronic neck pain than the use of spinal manipulation alone. The effect of low-technology exercise or spinal manipulative therapy alone, as compared with no treatment or placebo, and the optimal dose and relative cost effectiveness of these therapies, need to be evaluated in future studies.
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One-stage posterior hemivertebra resection and correction using segmental posterior instrumentation.
A retrospective study of 12 patients with congenital kyphoscoliosis caused by a single hemivertebra who underwent one-stage posterior hemivertebra resection and correction by posterior segmental instrumentation. ⋯ This study indicated that correction of kyphoscoliosis caused by a single hemivertebra can be effectively conducted by one-stage posterior hemivertebra resection and correction using segmental posterior instrumentation. The operation was safe, and no associated adverse complications were noted. This procedure is best indicated for adolescent patients with a structural kyphoscoliotic deformity caused by a thoracic or thoracolumbar single hemivertebra.
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Review Meta Analysis
A critical review of reviews on the treatment of chronic low back pain.
Systematic literature review. ⋯ Although the overall quality of systematic reviews was satisfactory, the quality of the individual papers included in the reviews varied considerably. The reviews often provided contradictory evidence on the effectiveness of a wide range of commonly used conservative interventions for chronic nonspecific low back pain. These findings illustrate the pitfalls of systematic reviews where there are a number of low-quality trials and underscore the need for high-quality primary trials that will allow for more conclusive reviews.
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Randomized Controlled Trial Clinical Trial
Prospective randomization of parenteral hyperalimentation for long fusions with spinal deformity: its effect on complications and recovery from postoperative malnutrition.
A prospective randomized study of total parenteral nutrition for long spinal deformity fusions as well as its effect on complications and recovery from postoperative malnutrition was performed. ⋯ The administration of postoperative total parenteral nutrition to patients with spinal deformity is safe. No statistical reduction in complications occurred in the total parenteral nutrition group despite a trend toward more rapid normalization of nutritional parameters and a decrease in postoperative nutritional depletion. The anterior/posterior-staged group with the administration of total parenteral nutrition had a lower overall complication rate and a decreased incidence of postoperative nutritional depletion than the one-stage reconstruction group. The difference in the complication rates between the two groups may relate as much to the staging as to the administration of total parenteral nutrition per se. For certain cases it may be more advisable to stage patients and deliver total parenteral nutrition than to manage the cases in a continuous (i.e., same-day) fashion.
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Comparative Study
Centralization phenomenon as a prognostic factor for chronic low back pain and disability.
Two hundred twenty-three consecutive adults with acute low back pain with or without referred spinal symptoms were treated conservatively and followed prospectively for 1 year. ⋯ Dynamic assessment of change in anatomic pain location during treatment and leg pain at intake were predictors of developing chronic pain and disability.