Spine
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Biography Historical Article
The case of James A. Garfield: a historical perspective.
In 1881, President James A. Garfield was shot in the back and died 79 days later. During this time, many controversies arose that had repercussions for years to come. ⋯ Many have felt that the choice of treatment may have proved to be worse than the injury itself. What did the autopsy show? Even this was controversial, with different observers claiming different results. This historical perspective reviews the case as well the controversies that surrounded it.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Reduction of radiculopathy and pain with Oxiplex/SP gel after laminectomy, laminotomy, and discectomy: a pilot clinical study.
Safety using Oxiplex/SP Gel during single-level discectomy for reduction of symptoms associated with unilateral herniation of the lumbar disc was investigated by self-assessment questionnaire and magnetic resonance imaging. ⋯ Oxiplex/SP Gel was easy to use and safe for patients undergoing unilateral discectomy. Greater benefit in clinical outcome measures was seen in gel-treated patients, especially those with severe leg pain and weakness at baseline.
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Workers' compensation back injury claimants completed baseline and follow-up telephone interviews in a prospective population-based cohort study. ⋯ The RDQ is a valid measure of physical disability among workers with back injuries. Its greater responsiveness to change suggests its superiority to the Short-Form 12 and Short-Form 36 as an outcome measure in this population.
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A longitudinal cohort study involving 1749 patients with chronically disabling spine disorder (CDSD) who underwent tertiary rehabilitation investigated the relation between the Million Visual Analog Scale (MVAS) score and treatment outcome. ⋯ The current study represents the first large-scale examination of the relation between MVAS ratings and treatment outcomes in a CDSD population. These results demonstrate the effectiveness of a simple disability rating scale, such as the MVAS, for systematic disability assessment in potentially predicting treatment outcomes in patients with CDSD. Despite the popularity of other questionnaires, the MVAS is the first disability inventory with demonstrated effectiveness for this purpose in a large CDSD population.
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A retrospective clinical study investigated patients undergoing surgery for destructive pyogenic and tuberculous spondylodiscitis. ⋯ In single-level spondylodiscitis with no major substance loss, anterior debridement and bone grafting alone seem to be adequate, especially in the lumbar spine. Additional posterior instrumentation is indicated in multiple-level spondylodiscitis, extensive kyphotic deformity, or both.