Spine
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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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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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In this multicenter, prospective, 2-year study, 146 male patients underwent a single-level anterior lumbar interbody fusion with a tapered threaded titanium fusion device. All the patients were advised before surgery of the risk for retrograde ejaculation. After surgery, any case of retrograde ejaculation was recorded as an adverse event, and the patient was observed up for the remainder of the study. ⋯ A transperitoneal approach to the lumbar spine at L4-L5 and L5-S1 has a 10 times greater chance of causing retrograde ejaculation in men than a retroperitoneal approach.
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A population-based, incidence cohort study was conducted. ⋯ Low back pain is a common traffic injury with a prolonged recovery. Its incidence and prognosis are affected by multiple factors, including the type of compensation system. Our study suggests that biopsychosocial factors are important in determining prognosis.
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The effect of cement augmentation on an osteoporotic lumbar functional spinal unit was investigated using finite-element analysis. ⋯ Cement augmentation restores the strength of treated vertebrae, but leads to increased endplate bulge and an altered load transfer in adjacent vertebrae. This supports the hypothesis that rigid cement augmentation may facilitate the subsequent collapse of adjacent vertebrae. Further study is required to determine the optimal reinforcement material and filling volume to minimize this effect.