Spine
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Randomized Controlled Trial Multicenter Study
The effect of electrical stimulation on lumbar spinal fusion in older patients: a randomized, controlled, multi-center trial: part 2: fusion rates.
Randomized, controlled, multi-center trial. ⋯ Thin slice CT revealed very high nonunion rates after uninstrumented spinal fusion in older patients. DC-stimulation was not effective in increasing fusion rates in this patient population. The achievement of a solid fusion was associated with superior functional outcome.
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Randomized Controlled Trial Comparative Study
Corticosteroid injection treatment to the ischiadic spine reduced pain in women with long-lasting sacral low back pain with onset during pregnancy: a randomized, double blind, controlled trial.
Randomized double blind controlled clinical trial. ⋯ The anatomic region around the sacrospinous ligament insertion on the ischial spine is suggested to be one source of long-lasting sacral low back pain with onset during pregnancy. The pain was relieved by slow-release corticosteroid injection treatment to the ischial spine.
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Comparative Study
Facet joint orientation difference between cephalad and caudad portions: a possible cause of degenerative spondylolisthesis.
A case-control study. OBJECTIVE.: To measure the orientation of the facet joints at both cephalad and caudad portions and to compare them between patients with degenerative spondylolisthesis (DS) and patients with lumbar spinal stenosis (LSS, controls). ⋯ In this study, we confirmed that the cephalad portion of the facet joints were more sagittally oriented and that the caudad portion of the facet joints were more coronally oriented in patients with DS. These findings were observed not only at L4-L5 but also at the uninvolved L3-L4 level in patients with DS at the L4-L5 level.
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Epidemiological analysis using CTs. ⋯ The incidence of lumbar spondylolysis in the Japanese general population was 5.9% (males: 7.9%, females: 3.9%).
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Prospective observational cohort. ⋯ The presence of epidural IFNgamma-immunoreactivity corresponding to >10 pg/mL predicted significant pain relief after epidural steroid injection with >95% accuracy. These results suggest that IFNgamma may be part of a biochemical cascade triggering pain in sciatica; IFNgamma-immunoreactivity may aid as a biomarker for predicting the response to steroid therapy and/or surgical intervention, and may serve as a future therapeutic target.