Spine
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Retrospective cohort. ⋯ Surgeons should be cautious when performing a laminectomy adjacent to an instrumented fusion, as this increases the rate of ASD as well as revision surgery.
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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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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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A systematic review and meta-analysis. ⋯ Competency was achieved on the learning curve for endoscopic cervical foraminotomy after about 21 procedures. There is no significant difference in postoperative hospitalization time, postoperative recovery room time, intraoperative blood loss, and complication rates between the learning phase and the competency phase of the learning curve for endoscopic cervical foraminotomy, noting the relatively small sample size of this study that may underpower this finding.