Journal of spinal disorders
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Case Reports Randomized Controlled Trial Clinical Trial
The role of fusion and instrumentation in the treatment of degenerative spondylolisthesis with spinal stenosis.
Between February 1985 and March 1990 44 patients with degenerative spondylolisthesis underwent primary surgery for spinal stenosis (in all cases the decompression preserved the facets bilaterally without discectomy) and were studied prospectively. Forty-three patients have been followed for > or = 2 years and are the basis of this study. ⋯ There was significantly more spondylolisthesis progression in groups I and II than in group III (p = 0.001). A higher proportion of "spondylolisthesis unchanged subjects" reported they were helped by the surgery than those whose spondylolisthesis progressed postoperatively (p < 0.01).
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Case Reports
Salvage reconstruction in acute and late sequelae from pyogenic thoracolumbar infection.
Nine patients treated surgically for complicated pyogenic osteomyelitis of the thoracolumbar spine are reported. All patients were treated with anterior debridement and stabilization with nonvascularized autogenous fibular strut grafts. In addition, seven underwent a posterior spinal fusion with instrumentation. ⋯ Seven patients had postoperative improvement or resolution of their back pain. The use of nonvascularized autogenous fibular strut grafts for reconstruction of the spine following debridement for vertebral osteomyelitis is an effective procedure. The advantages of using the fibula for grafting are its strength and length for spanning several vertebral segments, and it can provide multiple grafts.
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Randomized Controlled Trial Comparative Study Clinical Trial
Overexertional lumbar and thoracic back pain among recruits: a prospective study of risk factors and treatment regimens.
A total of 395 male infantry recruits were evaluated in a prospective study of possible risk factors for overexertional back pain and the efficacy of drug treatment regimens for this syndrome. Recruits were classified into subgroups of lumbar or thoracic, and paraspinal or spinous process pain. Recruits were divided into three treatment groups: Ibuprofen, Paracetamol, and no drug treatment. ⋯ By multivariate analysis low body mass index was found to be a risk factor for overexertional lumbar pain (p = 0.005) and increased lumbar lordosis a risk factor for overexertional thoracic pain (p = 0.005). Of recruits with overexertional back pain, 65% were asymptomatic by the end of basic training. There was no statistically significant difference between cure rates according to treatment groups.