Spine
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Prospective longitudinal cohort. ⋯ Patients with good preoperative MCS and poor preoperative ODI scores who are not on workers' compensation are more likely to improve after lumbar fusion. Threshold values for MCS, PCS, and ODI predictive of a patient achieving minimum clinically important difference for PCS and ODI could not be determined.
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Randomized Controlled Trial Multicenter Study Comparative Study
Implant complications, fusion, loss of lordosis, and outcome after anterior cervical plating with dynamic or rigid plates: two-year results of a multi-centric, randomized, controlled study.
Prospective, controlled, randomized, multicenter study. ⋯ Dynamic cervical plate designs provide less implant complications (no patient) compared with rigid plate designs (4 patients). Speed of fusion was faster in the presence of a dynamic plate. However, loss of segmental lordosis is significantly higher if dynamic plates are used, which did not result in differences regarding clinical outcome between dynamic and constrained plates after 2 years. Thus, dynamic plates should be considered to be the preferred treatment option because of the lower risk for implant failure-related revision surgery.
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A comprehensive literature review. ⋯ The literature reveals a number of rare, potentially catastrophic neurologic sequelae including brain and spinal cord infarction. Most of these are thought to be due to intravascular uptake of particulate steroids. The true overall incidence remains obscure due to the lack of blinded controlled studies. Injectionists, referring physicians, and patients should be aware of the nature and potential consequences of these complications. Additionally, it is imperative for injectionists to standardize techniques to minimize complications, especially by using a test dose of local anesthetic before injection of preferably nonparticulate corticosteroid.
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Comparative Study
In vivo analysis of atlantoaxial motion in individuals immobilized with the halo thoracic vest or Philadelphia collar.
In vivo biomechanical comparison of the halo thoracic vest (HTV) and the Philadelphia collar (PC). ⋯ Under the extremes of flexion and extension bendings, the current study demonstrated that there was no significant difference in restriction of sagittal motion at C1-C2 when using the PC instead of the HTV in a group of 20 young normal adults. In light of the current biomechanical data and a selected review of literature, it is concluded that the use of a PC is sufficient for the treatment of stable odontoid fractures.
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Prospective clinical study. ⋯ In this study, we evaluated the utility of RSA in evaluating segmental motion after ACDF and demonstrated a significant difference between segments that demonstrated radiographic evidence of fusion when compared with segments that demonstrated evidence of pseudarthrosis. RSA appears to be a quantitative technique capable of assisting in the evaluation of fusion.