Spine
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Randomized Controlled Trial Comparative Study
Effect of facet joint injection versus systemic steroids in low back pain: a randomized controlled trial.
Randomized clinical trial. ⋯ Both treatments were effective, with a slight superiority of the intra-articular injection of steroids over intramuscular injection.
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Reliability and agreement study, retrospective case series. ⋯ The AOSpine TL injury classification system is clinically relevant according to the consensus agreement of our international team of spine trauma experts. Final evaluation data showed reasonable reliability and accuracy, but further clinical validation of the proposed system requires prospective observational data collection documenting use of the classification system, therapeutic decision making, and clinical follow-up evaluation by a large number of surgeons from different countries.
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Multicenter Study
Deep wound infections after spinal fusion in children with cerebral palsy: a prospective cohort study.
Prospective cohort. ⋯ Deep wound infection occurred in 6.4% of children with CP after spinal fusion. The presence of a gastrostomy/gastrojejunostomy tube was a significant predictor of infection. Gram-negative organisms were the most common causative agents. Surgeons should be cognizant of these factors when treating children with CP and may consider Gram-negative antibiotic prophylaxis.
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Eight cases of fibrous dysplasia (FD) of the mobile spine treated surgically at the same center were retrospectively reviewed. ⋯ The radiological features of spinal FD may be atypical. The rate of correct preoperative pathological diagnosis by computed tomography-guided biopsy was low for patients with suspected spinal FD. Vertebroplasty is probably a valuable therapeutic option for spinal FD with pathological fractures. Limited decompression and stability with vertebroplasty might be recommended for patients with neurological deficits.
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Randomized Controlled Trial Comparative Study
Early versus late initiation of rehabilitation after lumbar spinal fusion: economic evaluation alongside a randomized controlled trial.
Economic evaluation conducted alongside a randomized controlled trial with 1-year follow-up. ⋯ Initiating rehabilitation at 6 weeks as opposed to 12 weeks after surgery is on average more costly and less effective. The uncertainty of this result did not seem to be sensitive to methodological issues, and clinical managements who have already adapted fast-track rehabilitation strategies have reason to reconsider their choice. .