The spine journal : official journal of the North American Spine Society
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Despite an increase in the clinical use of no-profile anchored interbody cages (AIC) for anterior cervical discectomy and fusion (ACDF) procedures, there is little published biomechanical data describing its stabilizing effect relative to the traditional anterior plating technique over two contiguous levels. ⋯ The anchored cage fusion construct conferred similar acute biomechanical stability in lateral bending and axial rotation ROMs relative to rigid anterior plating. We identified a statistically significant reduction (Δ=3.4°, combined over two levels) in sagittal plane ROM conferred by the ALP relative to the AIC construct. Our biomechanical findings may support the clinical use of no-profile integrated interbody devices over two contiguous levels in ACDF.
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Although the high cost of spine surgery is generally recognized, there is little information on the extent to which payments vary across hospitals. ⋯ Medicare payments for episodes of spine surgery vary widely across hospitals. As they respond to the new financial incentives inherent in health care reform, high cost hospitals should focus on the use of spinal fusion and postacute care.
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Review Meta Analysis
Association of rs11190870 near LBX1 with adolescent idiopathic scoliosis in East Asians: a systematic review and meta-analysis.
The rs11190870 single nucleotide polymorphism in the 3'-flanking region of the LBX1 gene has been implicated in the etiology of adolescent idiopathic scoliosis (AIS). A thorough appraisal of the evidence supporting this association has not been previously attempted. ⋯ Based on a comprehensive analysis of the currently available evidence, rs11190870 is likely a susceptibility variant for AIS in East Asians. Further investigation of this association is necessary in other populations.
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The role of preoperative (preop) narcotic use and its influence on outcomes after spinal deformity surgery are unknown. It is important to determine which patient factors and comorbidities can affect the success of spinal deformity surgery, a challenging surgery with high rates of complications at baseline. ⋯ In adults with degenerative scoliosis taking narcotics a significant decrease in pain medication use was noted after surgery. All outcome scores significantly improved postop in both groups. However, the Narc group had significantly greater improvements in SRS pain scores versus the NoNarc group.
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Randomized Controlled Trial
Outcomes are not different for patient-matched versus nonmatched treatment in subjects with chronic recurrent low back pain: a randomized clinical trial.
Classification schemas for low back pain (LBP), such as the Treatment-Based Classification and the Movement System Impairment, use common clinical features to subgroup patients with LBP and are purported to improve treatment outcomes. ⋯ Providing a matched treatment based on either the Treatment-Based Classification or the Movement System Impairment classification schema did not improve treatment outcomes compared with an unmatched treatment for patients with chronic LBP, except on one secondary disability measure.