Spine
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Randomized Controlled Trial
Ketorolac use for postoperative pain management following lumbar decompression surgery: a prospective, randomized, double-blinded, placebo-controlled trial.
Prospective randomized double-blind placebo-controlled study. ⋯ There were no significant differences in available patient demographics, intraoperative blood loss, or postoperative Hemovac drain output between study groups. Morphine equivalent requirements were significantly less at all predetermined time points in addition to the overall hospital morphine requirement in patients randomized to receive Ketorolac. Visual Analog Pain Scores were significantly lower in patients randomized to receive Ketorolac immediately postoperative in addition to 4, 12, and 16 hours postoperative. There were no identifiable postoperative complications associated with the use of Ketorolac. CONCLUSION.: Intravenous Ketorolac seems to be a safe and effective analgesic agent following multilevel lumbar decompressive laminectomy. Patients can expect lower morphine requirements and better pain scores throughout their postoperative course.
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Our clinical study design was prospective, concurrently enrolled and single-center trial of the new functional intervertebral cervical disc prosthesis (Medtronic Sofamor Danek, Memphis, TN) in the treatment of patients with single-level and multiple-level degenerative disc disease of the cervical spine. ⋯ Arthroplasty using the Bryan disc seemed to be safe and provided encouraging clinical and radiologic outcome in our study. Although early and intermediate results are promising, this is also a relatively new approach, long-term follow up studies are required to prove its efficacy and its ability to prevent adjacent segment disease.
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Comparative Study
Cross-cultural adaptation and validation of the Argentinean version of the Roland-Morris Disability Questionnaire.
Psychometric testing of a translated, culturally adapted questionnaire. ⋯ The results of the study show that the Argentinean version of the RMDQ is reliable and valid as a lumbar disability measurement tool. The authors recommend this tool for future clinical studies.
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Randomized Controlled Trial
Percutaneous lumbar zygapophysial (Facet) joint neurotomy using radiofrequency current, in the management of chronic low back pain: a randomized double-blind trial.
A randomized controlled study of percutaneous radiofrequency neurotomy was conducted in 40 patients with chronic low back pain (20 active and 20 controls). ⋯ Our study indicates that radiofrequency facet denervation is not a placebo and could be used in the treatment of carefully selected patients with chronic low back pain.
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Comparative Study
Differences in low back pain behavior are reflected in the cerebral response to tactile stimulation of the lower back.
Two groups of patients with chronic low back pain (cLBP) were scanned with functional magnetic resonance imaging during stimulation of the lower back; those showing 4 or 5 positive Waddell signs (WS-H) and those showing 1 or none (WS-L) as an index of pain-related illness behavior. ⋯ Successful adjustment to cLBP is associated with a patient's ability to effectively engage a sensory modulation system. In patients in whom such activation does not occur, subjective lack of control maypredispose to altered affective and behavioral responses with poor adjustment to pain. Pain experience may be furthermodified by reorganization of somatosensory cortex, contributing to maintenance of the chronic pain state.