Spine
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Prospective cohort study. ⋯ This study found that being older, having lower fitness scores, wearing armor longer, and wearing heavier loads increased the risk of LBP in deployed soldiers. Units more likely to wear loads such as the Infantry and Cavalry and tasks commonly involving wearing loads such as patrolling all increased the risk of LBP as well.
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A retrospective review of a consecutive population of patients treated with radiofrequency-targeted vertebral augmentation (RF-TVA) for malignant vertebral compression fractures (VCFs). ⋯ We report optimum safety and efficacy results in the treatment of malignant VCFs with a novel RF-TVA technique in which controlled delivery of an ultrahigh viscosity PMMA is used for fracture stabilization. The deposition of PMMA with RF-TVA is predictable and uniform, and can be performed without the PMMA handling constraints that may be encountered with vertebroplasty and balloon kyphoplasty. The safety and efficacy we report with RF-TVA achieved equivalency with other methods of treatment for VCF stabilization.
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Retrospective institutional database review. ⋯ Preoperative in-room time prior to the start of surgical incision is an independent risk factor for SSI. All possible steps should be taken prior to entry into the operating theater to reduce in-room time and opening of surgical sterile instrumentation be delayed until the surgery is ready to proceed.
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Randomized Controlled Trial Multicenter Study Comparative Study
A prospective, randomized, controlled clinical investigation comparing PCM cervical disc arthroplasty with anterior cervical discectomy and fusion. 2-year results from the US FDA IDE clinical trial.
Prospective, multicenter, randomized Food and Drug Administration approved investigational device exemption clinical trial. ⋯ The treatment of symptomatic single-level cervical spondylosis with PCM achieves clinical outcomes that are at least equivalent to ACDF while maintaining motion. At 2 years, patients with PCM had lower NDI scores, statistically lower rate of prolonged dysphagia, greater patient satisfaction, and superior overall success.
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Randomized Controlled Trial
Effects of continuous epidural anesthesia and postoperative epidural analgesia on pain management and stress response in patients undergoing major spinal surgery.
A prospective, randomized study was used to compare 2 anesthesia/analgesia methods for reconstructive spine surgery. ⋯ Combined epidural/general anesthesia and postoperative epidural analgesia produced better pain control, less bleeding, and a lower surgical stress response than general anesthesia with postoperative systemically administered narcotic analgesia. This technique deserves further study in the setting of major spinal surgery.