Spine
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This anatomic study described robotic approaches to the posterior thoracolumbar spine in a porcine model. Ergonomics, control, and approach and technical difficulties were noted. ⋯ The da Vinci could perform the major noninstrumented procedures of the posterior spine with improved ergonomics and control. Surgeon fatigue and tremor were reduced. With some modification of prototype and commercial instruments a posterior spine surgery instrument kit can be developed. Future clinical studies can better assess patient and surgeon benefits of using the da Vinci robot for posterior spine surgeries.
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Randomized Controlled Trial Multicenter Study Comparative Study
Sagittal cervical alignment after cervical disc arthroplasty and anterior cervical discectomy and fusion: results of a prospective, randomized, controlled trial.
Radiographic results of a multicenter, prospective randomized study comparing 1-level cervical total disc replacement (TDR-C) with anterior cervical discectomy and fusion (ACDF). ⋯ In both TDR-C and ACDF, lordosis increased at the device-level, cranial adjacent level, and in total cervical lordosis, while lordosis decreased at the caudal adjacent level. Although ACDF facilitated a greater increase in device level lordosis (+1.25 degrees ) and less loss of lordosis at the caudal adjacent level compared with TDR-C (-0.39 degrees ), the clinical relevance of the small differences remain unknown.
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Randomized Controlled Trial Comparative Study
Clinical study of low back pain and radicular pain pathways by using l2 spinal nerve root infiltration: a randomized, controlled, clinical trial.
Randomized control trial (RCT) for L2 spinal nerve infiltration (L2 block) in clinical cases. ⋯ The LBP and radicular pain pathways were likely interrupted by L2 block. An L2 block is useful in reducing LBP due to the disorders of L2 spinal nerve-innervated structures, such as the disc, facet joint, and sacroiliac joint. However, the therapeutic value of an L2 block may be occasionally insufficient to alleviate pain completely because of the short duration of its' effect.
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Randomized Controlled Trial
Evaluation of the effectiveness and efficacy of Iyengar yoga therapy on chronic low back pain.
The effectiveness and efficacy of Iyengar yoga for chronic low back pain (CLBP) were assessed with intention-to-treat and per-protocol analysis. Ninety subjects were randomized to a yoga (n = 43) or control group (n = 47) receiving standard medical care. Participants were followed 6 months after completion of the intervention. ⋯ Yoga improves functional disability, pain intensity, and depression in adults with CLBP. There was also a clinically important trend for the yoga group to reduce their pain medication usage compared to the control group.
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Prospective cohort study of patients registered for elective surgical lumbar discectomy (ESLD) between November 1999 and December 2003 at a major tertiary care center in Vancouver. ⋯ These results provide evidence that, contrary to conventional wisdom, compensation status was not associated with longer waits for ESLD. While patients receiving compensation have elsewhere been observed to have worse outcomes after discectomy, our results suggest this is unlikely to be due to delays imposed by queuing.