Spine
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Comparative Study
Biomechanical comparison of three methods of sacral fracture fixation in osteoporotic bone.
Biomechanical cadaveric bench study. ⋯ All 3 fixation methods resulted acutely in motion similar to that of the intact pelvis. Although motion increased as a function of cyclical loading, no significant differences were found between fixation methods. All 3 repair methods reduced fracture site motion, but clinical studies are needed to determine if each method relieves pain and provides sufficient fixation for fracture healing.
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Surgeon survey. ⋯ The catastrophic morbidity of a symptomatic postoperative epidural hematoma remains a substantial disincentive to start chemoprophylaxis after spinal surgery. The rarity of this complication makes study of its risk factors difficult. Although many surgeons perceive the risk to be higher, the reported incidences of clinically relevant postoperative epidural hematoma are lower, ranging from 0% to 1%. Despite this finding, there is insufficient published data available to precisely define the safety of postoperative chemoprophylaxis. Though not pertaining to prophylaxis, the available evidence does suggest that use of therapeutic doses of heparin in postoperative spinal patients who sustain a PE may have a higher incidence of bleeding complications.
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Randomized Controlled Trial Comparative Study
Is a behavioral graded activity program more effective than manual therapy in patients with subacute neck pain? Results of a randomized clinical trial.
A randomized clinical trial. ⋯ Based on this trial it can be concluded that there are only marginal, but not clinically relevant, differences between a BGA program and MT.
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Retrospective study. ⋯ Hemilaminectomy or laminectomy remains one of the mainstay surgical treatments for symptomatic intraspinal synovial cysts. Our experience shows that the majority of patients undergoing decompression/excision of synovial cysts will have immediate improvement in back and leg pain. However, within 2 years, patients receiving hemilaminectomy or laminectomy alone have an increased incidence of back pain and cyst recurrence. Decompression with instrumented fusion appears to be associated with the lowest incidences of cyst recurrence or back pain.
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An in vivo clinical trial, and an in vitro cadaveric biomechanical and micromorphologic analysis. ⋯ Vertebroplasty using viscoplastic bone cement is clinically feasible and can effectively improve the vertebral strength and reduce the cement infiltration depth. The risk of cement leakage can also be decreased by using viscoplastic bone cement.