Spine
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Comparative Study Clinical Trial
Surgical and nonsurgical management of lumbar spinal stenosis: four-year outcomes from the maine lumbar spine study.
A prospective cohort study of patients with lumbar spinal stenosis recruited from the practices of orthopedic surgeons and neurosurgeons throughout Maine. ⋯ For the patients with severe lumbar spinal stenosis, surgical treatment was associated with greater improvement in patient-reported outcomes than nonsurgical treatment at 4-year evaluation, even after adjustment for differences in baseline characteristics among treatment groups. The relative benefit of surgery declined over time but remained superior to nonsurgical treatment. Outcomes for the nonsurgically treated patients improved modestly and remained stable over 4 years. Determining whether outcomes continue to converge will require longer-term evaluation.
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A study of the relation between the development of mechanical allodynia and the reorganization of primary afferent terminals in the sensory lamina of the rat spinal cord dorsal horn after partial dorsal root ganglion injury in rats. ⋯ Morphologic change in spinal cord dorsal horn lamina II occurs after partial dorsal root ganglion injury. This change may have significance in the pathogenesis of chronic mechanical allodynia after partial dorsal root ganglion injury.
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An examination of the accuracy of percutaneous pedicle screw placement in the lumbar spine. Using computed tomography scan analysis after implant removal, the screw tracts could be analyzed regarding the degree and direction of screw dislocation. ⋯ This study has shown that percutaneous insertion of pedicle screws in the lumbar spine is a safe and reliable technique. Despite the low misplacement rate of only 6.6%, it should be kept in mind that the surgical procedure is technically demanding and should be performed only by experienced spine surgeons.
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A retrospective review of 244 adult spine instrumentation and fusion surgery cases (1994-1995) from one institution. ⋯ The need for transfusion is associated with multiple factors, suggesting that a multifaceted, integrated approach may be necessary to reduce this risk.
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Comparative Study
Comparative results between conventional and computer-assisted pedicle screw installation in the thoracic, lumbar, and sacral spine.
A comparative study on the position of pedicle screws in patients treated surgically with and without computer assistance. ⋯ Computer assistance can decrease the incidence of incorrectly positioned pedicle screws.