Spine
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Randomized Controlled Trial Comparative Study
Spinal high-velocity low amplitude manipulation in acute nonspecific low back pain: a double-blinded randomized controlled trial in comparison with diclofenac and placebo.
A randomized, double-blinded, placebo-controlled, parallel trial with 3 arms. ⋯ In a subgroup of patients with acute nonspecific LBP, spinal manipulation was significantly better than nonsteroidal anti-inflammatory drug diclofenac and clinically superior to placebo.
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Multicenter Study
Posterior global malalignment after osteotomy for sagittal plane deformity: it happens and here is why.
Multicenter, retrospective analysis of 183 consecutive patients undergoing lumbar osteotomy. ⋯ A significantly lower pelvic incidence and lack of restoration of thoracic kyphosis may lead to sagittal overcorrection with a posterior alignment. Although the clinical significance of posterior malalignment is still unclear, this study showed a compensatory loss of cervical lordosis in these patients. Particular attention must be paid to preoperative planning before sagittal realignment procedures. Further study will be necessary to evaluate long-term clinical outcomes of these patients.
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Comparative Study
Reoperation rate after surgery for lumbar herniated intervertebral disc disease: nationwide cohort study.
Retrospective cohort study using national health insurance data. ⋯ The cumulative reoperation rate after 5 years was 13.4% and half of the reoperations occurred during the first postoperative year. With the exception of laminectomy, the reoperation rates of the other procedures were not different from that of open discectomy.
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Case Reports Comparative Study
Is radiation-free diagnostic monitoring of adolescent idiopathic scoliosis feasible using upright positional magnetic resonance imaging?
Prospective clinical trial. ⋯ Our results show that uMRI is capable of producing coronal and sagittal plane measurements that highly correlate with traditional plain film radiographical measurements. This, in addition to reliable vertebral rotation measurements, makes uMRI a valuable, radiation-free alternative/substitute for diagnostic evaluation in AIS.
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Clinical Trial
Serum titanium, niobium, and aluminum levels after instrumented spinal arthrodesis in children.
A prospective cohort study. ⋯ We report abnormally elevated serum titanium and niobium levels in patients with titanium-based spinal instrumentation up to 12 months. The long-term systemic consequences of debris generated by wear and corrosion of spinal instrumentation is unclear but concerning, particularly as these implants inserted into the pediatric population may remain in situ for beyond 6 decades.