Spine
-
Comparative Study
Cross-cultural adaptation of the Roland-Morris questionnaire for German-speaking patients with low back pain.
Cross-cultural adaptation and cross-sectional psychometric testing. ⋯ Because the German version of the Roland-Morris Questionnaire seems to be reliable and valid for the assessment of the functional status in German-speaking patients with low back pain, the use of this translated instrument can be recommended in future clinical trials.
-
Clinical Trial
Hardware failure in an unconstrained lumbar pedicle screw system. A 2-year follow-up study.
A consecutive study of patients who underwent lumbar spinal arthrodesis with an unconstrained pedicle screw system. ⋯ The results of this study demonstrate an extremely high rate of hardware failure and pseudarthrosis using an unconstrained pedicle screw system. Interestingly, the initial rate of pain relief was higher and declined over time and was quite possibly associated with loosening of the hardware. Based on these data, it is difficult to recommend the use of an unconstrained fixation system in the lumbar spine.
-
Randomized Controlled Trial Clinical Trial
Intrathecal morphine. Double-blind evaluation of optimal dosage for analgesia after major lumbar spinal surgery.
A prospective, randomized, double-blind study. ⋯ For adult patients undergoing posterolateral lumbar fusion, 0.3 mg (0.004 mg/kg) is probably the optimal dose of intrathecal morphine to manage pain.
-
Biography Historical Article
The modern hippocratic tradition. Some messages for contemporary medicine.
Hippocrates (5th century B. C.), the most prominent physician of antiquity, was born in the small Greek island of Kos, which is near the coast of Asia Minor. Before his era, medicine was practiced as an empirical art and had a religious nature. ⋯ Modern medicine can derive valuable lessons from the Hippocratic tradition. For the coming 21st century, medicine more than ever senses the need to combine the concepts of humanistic values and the Hippocratic messages with the technologic "imperative" (power). This bond is necessary to the improvement of medicine in the future because, currently, the enormous biomedical technology so far has contributed little to the traditionally human fields of psychosomatic and functional disturbances, posing new dilemmas and threatening scientific problems.
-
A case report of metastatic cardiac angiosarcoma of the cervical spine. ⋯ Spinal involvement by primary cardiac angiosarcoma is very rare, and this is only the second operative case ever reported. The vascular nature of this tumor makes it behave in a manner similar to that of a high-flow arteriovenous malformation. Surgery should not be undertaken before preoperative angiography and embolization. The dismal prognosis for this rare malignancy is discussed.