Spine
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Randomized Controlled Trial Clinical Trial
The impact of physical function and pain on work status at 1-year follow-up in patients with back pain.
A randomized, controlled trial. ⋯ Return to work was related to physical function and pain. More importance seemed to be attributed to physical performance in the intervention group than in the controls as a basis for returning patients to work.
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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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Description of an operative technique with an illustrative case report. ⋯ A technique of occipitocervical arthrodesis in children is described using autologous rib graft. This procedure was designed to span large defects or to deal with a large protuberant occiput; however, it is also useful for less demanding cases and may offer several advantages compared with procedures relying on iliac crest graft.