Spine
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Meta Analysis Comparative Study
Ten Year Outcomes of Cervical Disc Arthroplasty vs. Anterior Cervical Discectomy and Fusion: A Systematic Review With Meta- Analysis.
A systematic review with meta-analysis of randomized controlled trials and comparative retrospective cohort studies. ⋯ The authors found that significantly fewer secondary surgeries and adverse events were seen after CDA than after ACDF at 10-year follow-up. CDA had statistically, but not clinically, improved neck disability index and visual analog scale scores but lower Japanese Orthopaedic Association scores in comparison to ACDF. CDA was not significantly different from ACDF in terms of a successful neurological outcome.
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Randomized Controlled Trial
A Randomized Controlled Trial Using Epidural Analgesia for Pain Relief After Lumbar Interlaminar Decompressive Spine Surgery: The RAPID trial.
Prospective, double-blind randomized controlled trial. ⋯ This randomized controlled trial shows that administrating a bolus of intraoperative epidural bupivacaine is a safe and effective method for reducing early postoperative pain following lumbar decompression surgery.
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Retrospective study. ⋯ Most patients presenting for a first diagnosis of isolated LBP went to the ED relative to urgent care. The greatest drivers of urgent care versus ED utilization for LBP were insurance type and geographic region. Utilization of advanced imaging was higher among ED patients, but rates of surgical intervention were similar between those seen in the ED and urgent care.
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Randomized double-blind controlled trial. ⋯ The addition of ketorolac to bupivacaine for wound infiltration after posterior lumbar spine decompression and fusion reduces early post-operative pain and total morphine consumption as compared to bupivacaine alone.
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Retrospective Cohort. ⋯ 3.