Spine
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Comparative Study
Relationship between early opioid prescribing for acute occupational low back pain and disability duration, medical costs, subsequent surgery and late opioid use.
Retrospective cohort study of workers' compensation (WC) claims with acute disabling low back pain (LBP). ⋯ Given the negative association between receipt of early opioids for acute LBP and outcomes, it is suggested that the use of opioids for the management of acute LBP may be counterproductive to recovery.
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Comparative Study
Are lumbar spine reoperation rates falling with greater use of fusion surgery and new surgical technology?
A retrospective analysis of population-based hospital discharge registry from all nonfederal acute care hospitals in Washington State. ⋯ A higher proportion of fusion procedures and the introduction of new spinal implants between 1993 and 1997 did not reduce reoperation rates. Patients who had lumbar surgery for degenerative disease in the late 1990s were more likely to undergo a repeat operation within 4 years than patients who had surgery in the early 1990s.
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Comparative Study
Vertebral augmentation with a novel Vessel-X bone void filling container system and bioactive bone cement.
Evaluation of a novel, leakage-free vertebroplastic instrumentation by fresh cadaveric studies. ⋯ Vessel-X was comparable to kyphoplasty in restoring the mechanical properties and height of the fractured vertebrae. Interestingly, Vessel-X instrumentation showed considerably less cement leakage and better cement placement in the vertebral body. Therefore, it could be a leakage controllable technique in percutaneous vertebral augmentation.
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Case report. ⋯ Although this case is extremely rare, clinicians should be keep in mind that cervical dystonia may carry a risk of atlantoaxial subluxation, potentially progressing to myelopathy. Neurosurgery combined with globus pallidus internus-deep-brain stimulation and atlantoaxial fixation is one treatment option for cervical dystonia with atlantoaxial rotatory subluxation.
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Prospective cohort study with 10-year follow-up. ⋯ Radiologic results, patient satisfaction, and mean scores for quality of life and back function were excellent after CD instrumentation for AIS, but a considerable number of patients had treatment for back problems.