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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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.
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Clinical Trial
The position of the aorta relative to the spine before and after anterior instrumentation in right thoracic scoliosis.
Preoperative magnetic resonance images (MRI) and postoperative axial computed tomography (CT) scans in 25 consecutive patients with idiopathic right thoracic adolescent scoliosis (AIS) and anterior correction and fusion with a dual rod system were analyzed in a prospective study. ⋯ This MRI and CT based study of 25 patients with thoracic AIS treated by standard open dual rod and dual screw instrumentation demonstrates a migration of the aorta by 31 degrees from a more posterolateral position before surgery to a more anteromedial position after surgery at the curve apex. Scoliosis surgeons should be aware of these changes; any excessive contralateral screw penetration must be avoided at any level.