Spine
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Multicenter Study Comparative Study
Body appearance and quality of life in adult patients with adolescent idiopathic scoliosis treated with a brace or under observation alone during adolescence.
The Scoliosis Research Society (SRS) brace study (published in the JBJS-A, 1995) was comprised of patients with adolescent idiopathic scoliosis with moderate curve sizes (25°-35°). Forty observed and 37 braced patients (77% of the original group) attended a follow-up, a mean of 16 years after onset of maturity. ⋯ Patients who experienced less body asymmetry were more satisfied with treatment and had a better quality of life. In spite of similar curve sizes and trunk rotation in both groups, the nonbraced patients felt that their body appearance was less distorted than that of the braced patients.
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Multicenter Study
Are antifibrinolytics helpful in decreasing blood loss and transfusions during spinal fusion surgery in children with cerebral palsy scoliosis?
Therapeutic comparative study. ⋯ AFs significantly reduced intraoperative EBL associated with PSF, with no adverse effects; however, we could not demonstrate significant differences in total transfusion, except in cell salvage. TXA was more effective than EACA in decreasing the EBL and cell salvage transfusion.
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Multicenter Study
Complications and risk factors of primary adult scoliosis surgery: a multicenter study of 306 patients.
A multicentric retrospective study on primary adult scoliosis patients operated on between 2002 and 2007. A 3-step statistical analysis was performed to describe the incidence of complications, the risk factors, and the reoperation risk with survival curves for the entire cohort. ⋯ Overall complication rate was 39%, and 26% of the patients were reoperated for mechanical or neurological complications. Risk factors include number of instrumented vertebra, fusion to the sacrum, PSO, and preoperative pelvic tilt of 26° or more. There is a 44% risk of a new operation in the 6-year-period after the primary procedure.
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Randomized Controlled Trial Multicenter Study
An evaluation of a postoperative rehabilitation program after spinal surgery and its impact on outcome.
This study invited patients to evaluate the content and style of a rehabilitation program used as an intervention in a multicenter, factorial, randomized controlled trial of the postoperative management of spinal surgery patients. ⋯ Compliance with a postoperative rehabilitation program was disappointing, but the program was assessed positively and of benefit by those who attended. Issues were raised in relation to timing and location of classes.
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Randomized Controlled Trial Multicenter Study Comparative Study
A prospective randomized FDA-IDE trial comparing Cortoss with PMMA for vertebroplasty: a comparative effectiveness research study with 24-month follow-up.
Randomized, controlled, prospective (AAOS therapeutic level I) trial conducted under Food and Drug Administration Investigational Device Exemption hypothesized noninferiority of a novel bioactive composite material to polymethylmethacrylate (PMMA). ⋯ Vertebroplasty using either Cortoss or PMMA provides effective, immediate, and lasting pain relief and prevents further loss of function. Both materials performed comparably at most time points; Cortoss demonstrated better results for pain reduction at 3 months and for function at 24 months.