Spine
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Comparative Study
Analysis of pedicle and translaminar facet fixation in a multisegment interbody fusion model.
This is a biomechanical study. We compared pedicle screws and translaminar screws in the setting of multisegment interbody fusions. ⋯ This study supports the omission of the middle segment screws in a 2-level interbody fusion. In addition, translaminar screws are similar to pedicle fixation in a 2-level interbody lumbar fusion.
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A prospective, case-control design. ⋯ DFV was useful for discriminating between individuals with and without LBP based on kinematic parameters. Disruptions in how the motion occurred during midrange motions were more diagnostic for LBP than range of motion variables. Cross validation of the model is required.
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Review Comparative Study
Systematic review of randomized trials comparing lumbar fusion surgery to nonoperative care for treatment of chronic back pain.
Systematic review of randomized trials comparing surgical to nonsurgical treatment of discogenic back pain. ⋯ Surgery may be more efficacious than unstructured nonsurgical care for chronic back pain but may not be more efficacious than structured cognitive-behavior therapy. Methodological limitations of the randomized trials prevent firm conclusions.
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Comparative Study
The influence of fracture mechanism and morphology on the reliability and validity of two novel thoracolumbar injury classification systems.
The Thoracolumbar Injury Severity Score (TLISS) and the Thoracolumbar Injury Classification and Severity Score (TLICS) were prospectively evaluated. ⋯ Although both schemes were noted to have substantial reproducibility and validity, our results indicate the TLISS is more reliable than the TLICS, suggesting that the mechanism of trauma may be a more valuable parameter than fracture morphology for the classification and treatment thoracolumbar injuries. Since these injury characteristics are interrelated and are critical to the maintenance of spinal stability, we think that both concepts should be considered during the assessment and management of these patients.