Spine
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Randomized Controlled Trial Clinical Trial
Radiofrequency facet joint denervation in the treatment of low back pain: a placebo-controlled clinical trial to assess efficacy.
A prospective double-blind randomized controlled trial was performed. ⋯ Although radiofrequency facet joint denervation may provide some short-term improvement in functional disability among patients with chronic low back pain, the efficacy of this treatment has not been established.
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A prospective study was conducted to examine bone graft donor site morbidity in 106 consecutive patients undergoing posterior spinal fusion. ⋯ According to this study, it is reasonable to reassure patients that a good result from spinal surgery will not be compromised by severe symptoms or major morbidity secondary to posterior iliac crest bone graft donation. Before surgery, patients may be advised concerning the risks of donor site pain, which improves significantly by 12 months, local tenderness, and uncommonly localized sensory loss.
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Randomized Controlled Trial Clinical Trial
Lessons from a trial of acupuncture and massage for low back pain: patient expectations and treatment effects.
A subanalysis of data derived from a randomized clinical trial was performed. ⋯ The results of this study suggest that patient expectations may influence clinical outcome independently of the treatment itself. In contrast, general optimism about treatment, divorced from a specific treatment, is not strongly associated with outcome. These results may have important implications for clinical trial design and recruitment, and may help to explain the apparent success of some conventional and alternative therapies in trials that do not control for patient expectations. The findings also may be important for therapy choices made in the clinical setting.
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Comparative Study
Subtotal corpectomy versus laminoplasty for multilevel cervical spondylotic myelopathy: a long-term follow-up study over 10 years.
A retrospective study was conducted. ⋯ Subtotal corpectomy and laminoplasty showed an identical effect from a surgical treatment for multilevel cervical spondylotic myelopathy. These neurologic recoveries usually last more than 10 years. In the subtotal corpectomy group, the disadvantages were longer surgical time, more blood loss, and pseudarthrosis. In the laminoplasty group, axial pain occurred frequently, and the range of motion was reduced severely.
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Case report and literature review. ⋯ Neurologic complications of methylmethacrylate vertebroplasty necessitate active involvement of spine surgeons in patient evaluation and management.