Journal of neurosurgery. Spine
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Randomized Controlled Trial
Split-spinous process laminotomy and discectomy for degenerative lumbar spinal stenosis: a preliminary report.
The authors evaluated a new minimally invasive spinal surgery technique to correct degenerative lumbar spinal stenosis involving a split-spinous process laminotomy and discectomy (also known as the "Marmot operation"). ⋯ A Marmot operation may provide effective spinal decompression. Although this method requires more operative time than a conventional method, it may involve only minimal muscular trauma, spinal stability maintenance, and early mobilization; shorten the duration of hospital stay; reduce postoperative back pain; and provide satisfactory neurological and functional outcomes.
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Randomized Controlled Trial Multicenter Study Comparative Study
Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial.
The authors report the results of a prospective randomized multicenter study in which the results of cervical disc arthroplasty were compared with anterior cervical discectomy and fusion (ACDF) in patients treated for symptomatic single-level cervical degenerative disc disease (DDD). ⋯ The PRESTIGE ST Cervical Disc System maintained physiological segmental motion at 24 months after implantation and was associated with improved neurological success, improved clinical outcomes, and a reduced rate of secondary surgeries compared with ACDF.
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Randomized Controlled Trial
Serum creatine phosphokinase activity and histological changes in the multifidus muscle: a prospective randomized controlled comparative study of discectomy with or without retraction.
The aim of this study was to determine the extent of muscle injury caused by continuous or intermittent muscle retraction during macro- and microdiscectomy in lumbar disc surgery. Pain scores, serum creatine phosphokinase (CPK) levels, and histological findings obtained in muscle specimens were compared. ⋯ In this prospective randomized clinical trial, the authors determined that muscle injury during lumbar disc surgery was closely related to muscle retraction and relaxation times whereas the size of the paravertebral skin incision had no effect on postoperative back pain and disability. There was no significant difference among the groups in terms of back pain during the long-term follow-up period (18-19 months).
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Randomized Controlled Trial Multicenter Study Comparative Study
Quality of life of lumbar stenosis-treated patients in whom the X STOP interspinous device was implanted.
This study was conducted to compare the quality of life (QOL) in patients with neurogenic intermittent claudication (NIC) secondary to lumbar spinal stenosis (LSS). Using the 36-Item Short Form (SF-36) questionnaire, the authors compared the results obtained in patients treated with the X STOP Interspinous Process Decompression (IPD) System with those obtained in patients who underwent nonoperative therapies. ⋯ The results of this study demonstrate that the X STOP device is significantly more effective than nonoperative therapy in improving the QOL in patients with LSS. The results are comparable with those reported in other studies involving traditional decompressive techniques for LSS and suggest that the X STOP implant can provide an effective treatment compared with nonoperative and conventional surgical therapies.
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Randomized Controlled Trial Multicenter Study
Treatment of neurogenic claudication by interspinous decompression: application of the X STOP device in patients with lumbar degenerative spondylolisthesis.
Interspinous process decompression (IPD) theoretically relieves narrowing of the spinal canal and neural foramen in extension and thus reduces the symptoms of neurogenic intermittent claudication (NIC). The purpose of this study was to compare the efficacy of IPD with nonoperative treatment in patients with NIC secondary to degenerative spondylolisthesis. ⋯ The X STOP device was more effective than nonoperative treatment in the management of NIC secondary to degenerative lumbar spondylolisthesis.