Spine
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Randomized Controlled Trial Multicenter Study Comparative Study
Acupuncture for chronic low back pain: a multicenter, randomized, patient-assessor blind, sham-controlled clinical trial.
Multicenter, randomized, patient-assessor blind, sham-controlled clinical trial. ⋯ This randomized sham-controlled trial suggests that acupuncture treatment shows better effect on the reduction of the bothersomeness and pain intensity than sham control in participants with cLBP.
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Subgroup analysis of a prospective, randomized database. ⋯ Lumbar fusion and instrumentation were not associated with increased rate of reoperation at index or adjacent levels compared with nonfusion techniques. The only specific risk factor for reoperation after treatment of spinal stenosis was duration of pretreatment symptoms more than 12 months. The overall incidence of reoperations for spinal stenosis surgery was 13%, and reoperations were equally distributed between index and adjacent lumbar levels. Reoperation may be related to the natural history of spinal degenerative disease.
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Retrospective cohort study using the Pediatric Health Information System database. ⋯ Broad-spectrum antimicrobial prophylaxis varied across hospitals and was often associated with known risk factors for SSI. These results highlight the need for future studies comparing the effectiveness of various prophylaxis strategies, particularly in high-risk subgroups. This research can inform the development of best practice for SSI prevention in spinal fusion procedures.
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A case report and review of the literature. ⋯ Epidural pneumorrhachis may cause dural sac compression, thus worsening a patient's previous symptoms and possibly eliciting new problems such as CES. Conservative treatment should be the first-line approach, but surgery is often necessary when the problem remains unsolved. Percutaneous computed tomography-guided translaminar trephination may be an alternative to surgical decompression of the epidural space in selected patients.
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Case Reports
Bacteroides fragilis vertebral osteomyelitis complicated by percutaneous epidural adhesiolysis.
A case report of anaerobic vertebral osteomyelitis after percutaneous epidural adhesiolysis. ⋯ This is the first report to be issued regarding BFS secondary to percutaneous epidural adhesiolysis. In our case, the pathogenesis may have been direct inoculation of Bacteroides fragilis into the epidural space and disc during percutaneous epidural adhesiolysis because the procedural approach used was adjacent to the anus.