Spine
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A prospective longitudinal study was conducted to evaluate dysphagia after anterior cervical spine surgery. ⋯ Dysphagia after anterior cervical spine surgery is a common early finding. However, it decreases significantly by 6 months. The minority of patients experience moderate or severe symptoms by 6 months after the procedure. Female gender and multiple surgical levels could be identified as risk factors for the development of postoperative dysphagia.
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Retrospective literature review. ⋯ The studies published so far suggest that the pain resulting from lumbar disc disease may be diminished by intradiscal electrothermal annuloplasty. All these studies project a positive therapeutic effect. However, all the studies suffer from the same methodologic flaws. A prospective cohort design or a nonrandomized prospective design is used with a biased control. The scientific validity of various study designs is discussed, and a randomized prospective study is recommended. Additionally, more investigation into the basic science of the action of intradiscal electrothermal annuloplasty is required.
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A literature review was conducted. ⋯ Current BT-CBT helps many patients with chronic pain. Continuing clinical research should improve the matching of treatments with patient characteristics and refine the focus of treatments on behavior changes most associated with positive outcome. Further study of fear, attention, readiness to adopt self-management strategies, acceptance of pain, and new combinations of interdisciplinary treatments may lead to improved interventions.
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A randomized comparison of conventional and image-guided technology techniques for pedicle screw placement was performed. ⋯ Accuracy of pedicle screw placement in the thoracolumbosacral spine is improved with the use of image-guided methods, particularly guidance by computed tomography. This is especially relevant clinically when the anatomy is obscured or altered as a result of inflammatory spondyloarthropathy (e.g., ankylosing spondylitis in which spontaneous fusions obscure surgical landmarks for pedicle access), or when used postsurgically in the setting of a posterolateral fusion.
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Comparative Study Clinical Trial
Intraoperative neurophysiologic detection of iatrogenic C5 nerve root injury during laminectomy for cervical compression myelopathy.
A retrospective and prospective study was conducted to investigate intraoperative neurophysiologic monitoring during cervical laminectomy to detect iatrogenic C5 nerve root palsy. ⋯ In an effort to reduce postoperative C5 nerve root palsy, the clinician should consider intraoperative deltoid and biceps transcranial electrical motor-evoked potential and spontaneous electromyography monitoring whenever there is potential for iatrogenic C5 nerve root injury.