Spine
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A new surgical technique for en bloc resection of posterior mediastinum tumors invading the spine is described. ⋯ Even though a learning curve is necessary to achieve this extreme type of surgery, selective preoperative screening of patients is mandatory. Interesting results today confirm the feasibility of possible treatment of tumors still considered unresectable.
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Comparative Study
Comparison of bone grafts for posterior spinal fusion in adolescent idiopathic scoliosis.
A retrospective comparison of three different types of bone grafts for posterior spinal fusion in adolescent idiopathic scoliosis. ⋯ Fusion rates were comparable for GroupA (ICBG) and Group C (composite graft of autologous bone marrow and demineralized bone matrix). The composite graft is our preferred graft for fusions in adolescent idiopathic scoliosis.
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A reliability study was performed. ⋯ The ODI was highly reliable. The questions about work, back satisfaction, and pain medication showed good agreement. The GFS, pain intensity, fear-avoidance beliefs, and life satisfaction appeared to lack sufficient reliability to be recommended in postal questionnaires.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prospective randomized clinical trial comparing patient-controlled intravenous analgesia with patient-controlled epidural analgesia after lumbar spinal fusion.
A prospective, randomized, double-blind clinical trial was conducted. ⋯ Both postoperative analgesic regimens provided good overall patient satisfaction. The only clinical advantage of PCEA over PCA for spine fusion patients was the lower amount of opioid consumed, although the PCEA group experienced significantly more side effects than the PCA group. There were no other significant differences. Therefore, patient or physician preference could select either postoperative pain management delivery system.
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Clinical Trial Controlled Clinical Trial
Lumbar paraspinal muscle function, perception of lumbar position, and postural control in disc herniation-related back pain.
A follow-up study evaluating postural control, lumbar movement perception, and paraspinal muscle reflexes in disc herniation-related chronic low back pain (LBP) before and after discectomy. ⋯ The results demonstrate impaired lumbar proprioception and postural control in sciatica patients. During short-term follow-up after operative treatment, postural control does not seem to change, but impaired lumbar proprioception and feed-forward control of paraspinal muscles seem to recover.