Spine
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A retrospective study of postoperative pain management with intrathecal morphine. ⋯ Intrathecal morphine in the moderate dose range of 9 to 19 microg/kg (mean 14 microg/kg), provides safe and effective postoperative analgesia in the immediate postoperative period for patients with idiopathic scoliosis undergoing PSF and SSI. Higher doses did not result in significantly better analgesia and had a greater frequency of respiratory depression requiring PICU admission.
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A radiographic study was conducted to investigate sacral morphology in a children and adolescent population with developmental L5-S1 spondylolisthesis. ⋯ The sagittal sacral morphology is a constant anatomic variable specific to each individual and unaffected by the position of the patient in space. The anatomy of the sacrum in children and adolescents with L5-S1 spondylolisthesis is particular and different from a control group. This study suggests that sacral anatomy may have a direct influence on the progression of spondylolisthesis; a lower STA and higher sacral kyphosis may be 2 factors predisposing to vertebral slip in developmental spondylolisthesis.
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Randomized Controlled Trial
Physical therapy treatment of back complaints on children and adolescents.
A randomized controlled trial was performed. ⋯ An individual assessment by a knowledgeable physiotherapist and an active treatment model improve how children and adolescents experience their back problems with respect to health and physical function, pain, strength, and mobility, regardless of whether treatment consists of a home exercise program with follow-up or home exercise combined with exercise and treatment supervised by a physiotherapist.
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Comparative Study Clinical Trial
Bone morphogenetic protein (RhBMP-2) as a substitute for iliac crest bone graft in multilevel adult spinal deformity surgery: minimum two-year evaluation of fusion.
Prospective, single center, nonblinded radiographic analysis of anterior and posterior adult spinal deformity fusions performed with bone morphogenetic protein (rhBMP-2). ⋯ In multilevel ASF, BMP (10 mg/level) generates fusion without autogenous bone. In multilevel PSF, BMP (20 mg/level) with LBG and TCP-HA produced fusion. BMP (40 mg/level) and TCP-HA without LBG achieved fusion. In multilevel spinal fusion, rhBMP-2 eliminated the necessity for iliac crest bone graft and yielded an excellent fusion rate.
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Multicenter Study Comparative Study
Age-gender matched comparison of SRS instrument scores between adult deformity and normal adults: are all SRS domains disease specific?
Prospective, observational study. ⋯ Our findings confirm the SRS instrument has excellent discriminate validity in the adult population. It appears to be disease-specific in the domains of pain, appearance and activity in adult spinal deformity patients who have not had prior surgery.