Spine
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Comparative Study
Corpectomy versus laminoplasty for multilevel cervical myelopathy: an independent matched-cohort analysis.
Matched patient cohorts using retrospective chart and radiographic review with independent clinical and radiographic follow-up were reviewed. ⋯ Both multilevel corpectomy and laminoplasty reliably arrest myelopathic progression in multilevel cervical myelopathy and can lead to significant neurologic recovery and pain reduction in a majority of patients. Surprisingly, the laminoplasty cohort tended to require less pain medication at final follow-up than did the multilevel corpectomy cohort. Given this and the higher prevalence of complications among multilevel corpectomy patients, it is believed that laminoplasty may be the preferred method of treatment for multilevel cervical myelopathy in the absence of preoperative kyphosis.
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A depression screener was used to determine positive responses amongst patients with two disorders commonly treated with surgery. ⋯ A positive depression screener response is strongly associated with poorer functional status and health-related quality of life, as measured by the Short-Form 36-Item Health Survey, among patients with lumbar disc herniation or spinal stenosis, and higher symptom intensity.
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Randomized Controlled Trial Comparative Study Clinical Trial
Characteristics of patients with chronic low back pain selected for surgery: a comparison with the general population reported from the Swedish lumbar spine study.
A group of surgical candidates with chronic low back pain was compared with a random sample of the general population. ⋯ The surgical candidates in the current study resembled the average Swedish citizen with back pain. Although selected for treatment because of symptom severity, they did not otherwise differ substantially from the general population with back pain. On the contrary they unexpectedly were affected only a little by depressive symptoms, distinguishing them from patients with chronic low back pain in pain clinics and rehabilitation centers. Therefore, the results of the this outcome study are not generally applicable to every patient with chronic low back pain.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Chronic low back pain and fusion: a comparison of three surgical techniques: a prospective multicenter randomized study from the Swedish lumbar spine study group.
A multicenter randomized study with a 2-year follow-up period and an independent observer was conducted. ⋯ All the fusion techniques used in the study could reduce pain and improve function in this selected group of patients with severe chronic low back pain. There was no obvious disadvantage in using the least demanding surgical technique of posterolateral fusion without internal fixation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effectiveness of four conservative treatments for subacute low back pain: a randomized clinical trial.
A randomized, assessor-blinded clinical trial was conducted. ⋯ For subacute low back pain, combined joint manipulation and myofascial therapy was as effective as joint manipulation or myofascial therapy alone. Additionally, back school was as effective as three manual treatments.