Spine
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Clinical Trial
Intradiscal electrothermal treatment for chronic discogenic low back pain: prospective outcome study with a minimum 2-year follow-up.
Prospective longitudinal study with a minimum 2-year follow-up. ⋯ A cohort of patients with chronic discogenic low back pain who had failed to improve with comprehensive nonoperative care demonstrated a statistically significant improvement in pain, physical function, and quality of life at 2 years after IDET.
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Patients with low back pain were asked to recall the pain and impaired functioning that they reported 5-10 years previously as part of the National Low Back Pain prospective follow-up study. In 1998, patients completed an additional follow-up. ⋯ "Fair" to "moderate" agreement was found between outcomes determined by recalled versus initial reports. Accuracy was greatest for queries on frequency, location of pain, and activities affecting pain. Discrepancies were noted for queries on severity of pain, with error bias toward less pain when using the recalled data. Careful selection of questions may yield more accurate outcome measures.
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A descriptive study of the associations between different neurophysiologic findings in patients with lumbar spinal stenosis. ⋯ Many patients with lumbar spinal stenosis have difficulties in sensing the lumbar rotational movement, which may indicate impaired proprioceptive abilities. Abnormal motor-evoked potentials and somatosensory-evoked potentials are also frequent in lumbar spinal stenosis but do not necessarily occur in the same patients as the abnormal ability to sense trunk movement. These new findings add to our understanding of the pathophysiology of lumbar spinal stenosis.
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Historical Article
Role of "Bovie" in spinal surgery: historical and analytical perspective.
Several surgeons use electrocautery (Bovie) discreetly or avoid it completely with the fear of increasing the chances of postoperative infection and delaying wound healing. However, the experience of many other surgeons is different. The current authors have used Bovie extensively to perform a broad array of spinal surgeries. Their rate of infection in spinal surgery can be positively compared with the existing literature where Bovie has been used to variable extent. The purpose of this study is to project the authors' concept that the use of Bovie dissection in spinal surgery does not increase the chances of postoperative wound infection. ⋯ The role of Bovie for musculoskeletal surgery in general and spinal surgery in particular is not well defined. A review of the available literature indicates that Bovie delays the wound healing and increases the chances of infection. The authors' experience with the Bovie and this indirect method of analysis suggest that Bovie does not increase the chances of infection. A detailed search of the literature has been presented along with historical and analytical perspectives. More clinical and experimental studies are needed to further substantiate this claim. If future publications describe the exact surgical technique, extent of the use of Bovie, infection containment (antibiotic) method used before, during, and after surgery, length of the operative exposure, duration of the surgery, and rate of infection, then a meta-analysis of the published clinical material from different centers could be performed, which would provide more comprehensive information.
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Clinical Trial
mRNA expression of cytokines and chemokines in herniated lumbar intervertebral discs.
The mRNA expressions of cytokines and chemokines were assessed in herniated lumbar disc specimens. ⋯ Interleukin-8 appears to be associated with development of radicular pain by back extension and to be activated on acute or subacute disc herniations. IL-8 seems to participate in the pathomechanism of nerve root inflammation in lumbar disc herniations, which implies that it may be considered a target for therapeutic intervention.