Spine
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Case report of multifocal necrotizing fasciitis with lumbar involvement. ⋯ Necrotizing infections rarely involve the spine. Heightened awareness of this potential focus of infection may facilitate its detection. As with other sites, aggressive surgical debridement of this potentially fatal condition is imperative.
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Randomized Controlled Trial Multicenter Study Comparative Study
Revisability of the CHARITE artificial disc replacement: analysis of 688 patients enrolled in the U.S. IDE study of the CHARITE Artificial Disc.
A prospective, randomized, multicenter, FDA-regulated Investigational Device Exemption clinical trial. ⋯ Lumbar TDR with the CHARITE Artificial Disc did not preclude any further procedures at the index level during primary insertion, with nearly one third being revisable to a new motion-preserving prosthesis and just over two thirds being successfully converted to ALIF and/ or posterior pedicle screw arthrodesis, the original alternative procedure.
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A systematic search of three electronic databases was done to identify randomized controlled trials on the effect of written or audiovisual information in low back pain. ⋯ Information based on a biopsychosocial model is recommended in primary care to shift patient beliefs on low back pain. Nevertheless, information delivery alone is not sufficient to prevent absenteeism and reduce healthcare costs.
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Multicenter Study Comparative Study
Can condition-specific health surveys be specific to spine disease? An analysis of the effect of comorbidities on baseline condition-specific and general health survey scores.
This is an observational cross-sectional study of 26,290 patients seen and evaluated in the 25 centers of the National Spine Network. ⋯ Traditional medical comorbidities correlate with both SF-36 (e.g., PCS) general health survey scores as well as disease-specific ODI scores. However, psychosocial comorbidities such as poor self-rated health (SF-1), an active compensation case, and low education level have a higher association than traditional medical comorbidities on these health status measures. The results show that the type of survey (disease-specific e.g., ODI, vs. generic e.g., SF-36) used may be less important than the need to assess and control for psychosocial and medical comorbidities when any patient-reported health survey is used in the spine population.
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Multicenter Study
Reliability of a novel classification system for thoracolumbar injuries: the Thoracolumbar Injury Severity Score.
Prospective study of 5 spine surgeons rating 71 clinical cases of thoracolumbar spinal injuries using the Thoracolumbar Injury Severity Score (TLISS) and then re-rating the cases in a different order 1 month later. ⋯ The TLISS has good reliability and compares favorably to other contemporary thoracolumbar fracture classification systems.