Spine
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Randomized Controlled Trial Multicenter Study
Who should have surgery for spinal stenosis? Treatment effect predictors in SPORT.
Combined prospective randomized controlled trial and observational cohort study of spinal stenosis (SpS) with an as-treated analysis. ⋯ With the exception of smokers, patients who met strict inclusion criteria improved more with surgery than with nonoperative treatment, regardless of other specific characteristics. However, TE varied significantly across certain subgroups, and these data can be used to individualize shared decision making discussions about likely outcomes. Smoking cessation should be considered before surgery for SpS.
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Randomized Controlled Trial Multicenter Study
The effect of early initiation of rehabilitation after lumbar spinal fusion: a randomized clinical study.
A multicenter randomized clinical trial including 82 patients. ⋯ Early start of rehabilitation (6 wk vs. 12 wk) after lumbar spinal fusion resulted in inferior outcomes. The improvements in the 12-week group were 4 times better than that in the 6-week group, indicating that the start-up time of rehabilitation is an important contributing factor for the overall outcome.
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Review Case Reports
Diagnosis and treatment of benign notochordal cell tumors of the spine: report of 3 cases and literature review.
Clinical case series. ⋯ Benign notochordal cell tumors represent a clinical entity derived from notochordal tissue, with characteristics distinct but closely related to the classic chordoma. Some radiological features may suggest the presence of chordoma precursors. Because its true potential for aggressiveness is still undetermined, a careful decision making must weigh the morbidity of en bloc procedures in the spine with uncertain natural history.
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Review
Whole-body vibration: is there a causal relationship to specific imaging findings of the spine?
Systematic review. ⋯ Based on our results from this systematic review, no causality can be shown between WBV and abnormal spinal imaging findings. With the conflicting data available in the literature, WBV has not been established as a cause for objective spinal pathological changes on a scientific basis.
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Comparative Study
Seeing double: a comparison of microstructure, biomechanical function, and adjacent disc health between double- and single-layer vertebral endplates.
Experimental and computational assessment of thickness, porosity, biomechanical behavior, and adjacent disc glycosaminoglycan content in double- and single-layer bony endplate samples harvested from human cadaver spines. ⋯ Compared with single-layer endplates, double-layer endplates seem to permit a more optimal balance between endplate biomechanical and nutritional functions, and may therefore offer a significant protective factor against disc degeneration.