Spine
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Randomized Controlled Trial Comparative Study
Postoperative analgesia after anterior correction of thoracic scoliosis: a prospective randomized study comparing continuous double epidural catheter technique with intravenous morphine.
Prospective randomized comparative study of two techniques for postoperative analgesia. ⋯ Two epidural catheters provide better postoperative analgesia with fewer side effects and higher patient satisfaction after anterior instrumentation of thoracic scoliosis.
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Randomized Controlled Trial Comparative Study
Cost-effectiveness of two self-care interventions to reduce disability associated with back pain.
Two randomized, controlled trials. ⋯ Both the lay and psychologist interventions were associated with modest improvements in outcomes but with somewhat higher costs compared to usual care.
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Prospective, blinded validation study of an objective, quantitative measure to assess maximum canal compromise (MCC) and maximum spinal cord compression (MSCC) in individuals with acute cervical spinal cord injury (SCI). ⋯ Our results indicate that the intraobserver reliability for the MCC and MSCC was high. Although the interobserver reliability for all three radiologic parameters in the present study was below 0.75, the observed differences were small and largely accounted for by the limitations in the precision of the calibrated ruler. For cases with minimal cord compression, the measurement of canal stenosis (MCC) proved more accurate. In contrast, in cases with severe cord compression, the assessment of MSCC was more accurate. It is anticipated that the use of digital imaging technologies will further enhance the precision of these outcome measures.
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Clinical Trial
Mobility of lumbar segments instrumented with a ProDisc II prosthesis: a two-year follow-up study.
Longitudinal prospective study on a sample of 41 consecutive disc prosthesis patients, covering a postoperative time period of at least 2 years. ⋯ Disc replacement in the lumbar spine by a ProDisc II implant fails to restore normal segmental rotational motion in the sagittal plane, specifically at levels L4-L5 and L5-S1. As segmental motion of the untreated segments was lower than normal as well, though not quite as conspicuous as that of instrumented segments, adaptation of soft tissue taken place during the preoperative symptomatic time period is conjectured to cause the observed motion deficit. Postoperative physical therapy might be considered if restoration of a normal range of rotational motion is desired.
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Prospective clinical study. ⋯ TLIF is a safe and effective method to treat low-grade spondylolisthesis, which can theoretically prevent typical complications of anterior and posterior lumbar interbody fusion. The results of isthmic spondylolistheses were significantly better compared to degenerative spondylolistheses.