European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Randomized Controlled Trial
Does continuous wound infiltration enhance baseline intravenous multimodal analgesia after posterior spinal fusion surgery? A randomized, double-blinded, placebo-controlled study.
There has been a growing interest in continuous local anaesthetic wound infiltration as a non-opioid technique for postoperative pain relief. The impact of this modality on baseline analgesia after spinal fusion surgery has however been inconclusive. We tested whether continuous wound infiltration with ropivacaine can enhance postoperative analgesia compared to a baseline intravenous multimodal analgesia protocol after spinal fusion surgery. ⋯ Our findings indicate that no additional analgesia was provided with continuous wound infiltration of ropivacaine compared to a baseline intravenous multimodal analgesia protocol after spinal fusion surgery.
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To investigate the short and medium term efficacy and patient outcomes of DIAM spinal stabilization system on back pain, disability, leg pain and quality of life. ⋯ This is the first randomized controlled trial to report equivalent efficacy and safety of herniectomy with or without DIAM spinal stabilizing device. Leg pain, back pain and the level of disability were not significantly different between groups; however, number of patients reaching the MCID for back pain was significantly higher in the investigational group at 6 through 24 months.
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Comparative Study
Postoperative changes in sacropelvic junction in short-segment angular kyphosis versus Scheuermann kyphosis.
To comparatively evaluate the biomechanical alterations those occur in the sagittal plane of sacropelvic junction in angular kyphosis (AK) and Scheuermann kyphosis (SK) patients after surgery. ⋯ The results of this study suggest that a significant sacropelvic improvement can be achieved by balanced sagittal vertical axis and T1 spinopelvic leading to a good sagittal alignment of spine in patients with AK and SK. Changes seen in morphological parameters after surgery may be closely related with baseline biomechanics and structure of the spine and pelvis. Therefore, further clinical and scientific trials are necessary both to elucidate the biomechanics, their clinical implications, and to develop new techniques and models for spine and pelvis surgery.
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To determine if the retroperitoneal oblique corridor will be affected by right lateral decubitus position. ⋯ ROC at L1/2, L2/3 and L3/4 will significantly decrease from supine to right lateral decubitus position and the reason may be due to the relaxed psoas deformation. Using MRI images in supine position for pre-operatively ROC evaluation is not accurate. Spine surgeon should also be more cautious when OLIF is performed at L4/5 where ROC is the smallest. Patients from Asia and those with strong psoas major at L1/2 and L3/4 are also associated with relatively narrow ROC.