The spine journal : official journal of the North American Spine Society
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Patients with comorbid disease may experience suboptimal quality of life (QOL) improvement following decompression spinal surgery. Prior studies have suggested the deleterious effect of diabetes upon postoperative QOL; however, these studies have not used minimal clinically important differences (MCIDs) or multivariable statistical techniques. ⋯ The burden of comorbidities may impact the QOL benefit of decompression spine surgery. In the present study, diabetes was found to independently predict diminished improvement in QOL after lumbar decompression.
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Comparative Study
Interspinous Process Devices versus Standard Conventional Surgical Decompression for Lumbar Spinal Stenosis: Cost Utility Analysis.
In the 1980s, a new implant was developed to treat patients with intermittent neurogenic claudication caused by lumbar spinal stenosis (LSS). This implant is now widely used. ⋯ Implantation of IPD as indirect decompressing device is highly unlikely to be cost effective compared with bony decompression for patients with intermittent neurogenic claudication caused by LSS.
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Comparative Study
Where should a laminoplasty start? The effect of the proximal level on post-laminoplasty loss of lordosis.
Open-door laminoplasty is a useful operation in the surgical management of cervical myelopathy with favorable outcomes and relatively low complications. One potential undesirable outcome is a decrease in cervical lordosis postoperatively. It is unknown whether the most proximal level undergoing laminoplasty affects the magnitude of loss of lordosis. ⋯ Starting the laminoplasty at C4 led to significantly less loss of lordosis than starting at C3. When the pattern of spinal cord compression does not require laminoplasty at C3, consideration should be given to making C4 the most cephalad laminoplasty level rather than C3 to better preserve lordosis.
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Retraction Of Publication
WITHDRAWN: Characteristics of patients with herniated discs at the cervicothoracic junction.
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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Review
Quality assessment of systematic reviews for surgical treatment of low back pain: an overview.
Low back pain is one of the most frequent reasons for medical appointments. Surgical treatment is widely controversial, and new surgical techniques and treatment modalities have been developed within the last decade. Treatment for low back pain should be evidence-based through systematic reviews and meta-analysis. Thus, the quality of these reviews is sometimes put into question as methodological mistakes are frequently seen. ⋯ In conclusion, most systematic reviews for low back pain do not reach very good or excellent quality, and only 27.5% of them have evidence-based conclusions. Including a meta-analysis is a significant factor to improve quality and evidence for systematic reviews.