Spine
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Comparative Study
A comparison of unilateral and bilateral laminotomies for decompression of L4-L5 spinal stenosis.
A retrospective review of clinical and radiographic data was performed at a single institution. ⋯ Both unilateral and bilateral laminotomies provide sufficient decompression of spinal stenosis and excellent pain reduction. However, unilateral laminotomy can be performed with shorter operative times and less blood loss. Radiologically, the use of a unilateral laminotomy induces less translational motion increase after surgery; thus, it may reduce the risk of late instability when compared with a bilateral laminotomy.
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Comparative Study
Wound infections after surgery for neuromuscular scoliosis: risk factors and treatment outcomes.
Retrospective, case-control study. ⋯ III.
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Randomized Controlled Trial Comparative Study
Predominant leg pain is associated with better surgical outcomes in degenerative spondylolisthesis and spinal stenosis: results from the Spine Patient Outcomes Research Trial (SPORT).
As-treated analysis of the Spine Patient Outcomes Research Trial. ⋯ Among DS patients at baseline, 34% had predominant leg pain, 26% had predominant LBP, and 40% had equal pain. Similarly, 32% of SpS patients had predominant leg pain, 26% had predominant LBP, and 42% had equal pain. DS and SpS patients with predominant leg pain had baseline scores indicative of less severe symptoms. Leg pain predominant DS and SpS patients treated surgically improved significantly more than LBP predominant patients on all primary outcome measures at 1 and 2 years. Surgical outcomes for the equal pain groups were intermediate to those of the predominant leg pain and LBP groups. The differences in nonoperative outcomes were less consistent. Conclusion. Predominant leg pain patients improved significantly more with surgery than predominant LBP patients. However, predominant LBP patients still improved significantly more with surgery than with nonoperative treatment.
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Review Comparative Study
A Cochrane review of combined chiropractic interventions for low-back pain.
Cochrane systematic review of randomized controlled trials. ⋯ Combined chiropractic interventions slightly improved pain and disability in the short term and pain in the medium term for acute/subacute LBP. However, there is currently no evidence that supports or refutes that these interventions provide a clinically meaningful difference for pain or disability in people with LBP when compared to other interventions.