Spine
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Case Reports Clinical Trial
The use of implantable direct current stimulation in multilevel spinal fusion without instrumentation. A prospective clinical and radiographic evaluation with long-term follow-up.
A prospective study with long-term follow-up of 143 patients who underwent spinal fusion with direct current stimulation and no instrumentation. ⋯ Multilevel fusion in this series with long-term follow-up evaluation of direct current stimulated patients without instrumentation showed clinical and radiographic success higher than in recent studies without instrumentation and comparable with recent studies using instrumentation.
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Twenty-nine patients with primary bone tumors and solitary metastases of the thoracolumbar spine treated with en bloc resection are reviewed retrospectively. ⋯ En bloc resection can be performed in selected tumors of the spine; the indication to such major surgery must be based on the oncologic stage, and the procedure must be carefully planned. For this purpose, the Weinstein-Boriani-Biagini system could be a helpful tool. Long-term results must be weighed before a definitive statement of the indications can be made.
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A prospective clinical trial was conducted. ⋯ Lifting of postoperative restrictions after limited discectomy allowed shortened sick leave without increased complications. Postoperative precautions in these patients may not be necessary.
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Clinical Trial
The outcome of posterolateral fusion in highly selected patients with discogenic low back pain.
A prospective analysis of the clinical outcome of a consecutive series of patients treated with posterior lumbar arthrodesis. Preoperative data were collected retrospectively by chart review. ⋯ Posterolateral intertransverse fusion can be used to successfully manage chronic discogenic back pain. However, patient selection remains a challenge, and successful outcome appears to be limited in the subset of patients receiving worker's compensation and those chronically disabled. Prospective and randomized study with objective pain criteria, independent review, and patient-oriented outcome is recommended.
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Clinical Trial
Results of sacroiliac joint double block and value of sacroiliac pain provocation tests in 54 patients with low back pain.
This prospective study consisted of the evaluation of a double sacroiliac block in patients with low back pain. ⋯ The present study suggests the sacroiliac joint is an uncommon but real source of low back pain. The accuracy of some of the presumed "sacroiliac pain provocations tests" is questioned.