Spine
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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.
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A retrospective cohort study consisting of a medical record review and a follow-up telephone survey of patients with lumbar fusion, at least 2 years after their surgery, was performed. ⋯ Outcomes of posterolateral lumbar fusion among compensated workers in Utah are inconsistent. Outcomes can be predicted by presurgical sociodemographic variables. Screening for such presurgical risk factors may be important for prudent surgical decisions and rehabilitation planning.
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Comparative Study
A comparison of symptom checklist 90-revised profiles from patients with chronic pain from whiplash and patients with other musculoskeletal injuries.
A quasi-experimental design was used to compare the Symptom Checklist 90-Revised profiles (SCL-90-R) from a group of patients with whiplash injuries (n = 67) and a group with mixed musculoskeletal pain (n = 91). ⋯ The current study failed to support the validity of a distinctive SCL-90-R profile for patients with whiplash injuries. Instead, the results suggest that the psychological consequences of experiencing chronic pain from whiplash-associated disorders are similar to the psychological consequences of chronic pain from other musculoskeletal injuries.
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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.