Spine
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Randomized Controlled Trial Multicenter Study Comparative Study
Adjacent level degeneration and facet arthropathy after disc prosthesis surgery or rehabilitation in patients with chronic low back pain and degenerative disc: second report of a randomized study.
Randomized clinical trial with 2-year follow-up. ⋯ In this first study that compared the courses of degeneration after treatment with disc prosthesis surgery or rehabilitation, ALD was observed at similar frequencies at the 2-year follow-up. However, the surgery group had increased FA at the implant level.
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Multicenter Study
Radiographical risk factors for major intraoperative blood loss during laminoplasty in patients with ossification of the posterior longitudinal ligament.
A retrospective multi-institutional study. ⋯ Laminoplasty for OPLL is associated with a risk of major intraoperative blood loss, which can potentially give rise to devastating postoperative complications. An occupying ratio of 60% or greater is a risk factor for major blood loss during laminoplasty in patients with OPLL.
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An international, multicenter, prospective, postmarketing clinical registry to record the accuracy of pedicle screw placement, using the O-arm Complete Multidimensional Surgical Imaging System with StealthStation Navigation. ⋯ The use of the O-arm in combination with a navigation system increases the accuracy of pedicle screw placement. The accuracy of the surgeon's perception and the need to limit the radiation dose for the patient justify an additional CT scan only after careful assessment of the potential additional value.
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A retrospective cohort. ⋯ Early physical therapy following a new primary care consultation was associated with reduced risk of subsequent health care compared with delayed physical therapy. Further research is needed to clarify exactly which patients with LBP should be referred to physical therapy; however, if referral is to be made, delaying the initiation of physical therapy may increase risk for additional health care consumption and costs.
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A prospective, observational study. ⋯ A single ESI in postmenopausal women adversely affects BMD of the hip. This is in conjunction with a rise in bone remodeling activity, as evidenced by an increase in bone-specific alkaline phosphatase and CTX. In addition, when compared with an age-matched control population, our study population exhibited a greater decline in BMD. Our findings show that epidural administration of corticosteroids has a deleterious effect on bone, which should be considered when contemplating treatment options for radiculopathy. The resulting decrease in BMD, while slight, suggests that ESIs should be used with caution in those at a risk for fracture.