Spine
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Randomized Controlled Trial Comparative Study Clinical Trial
Two-year follow-up of a randomized clinical trial of spinal manipulation and two types of exercise for patients with chronic neck pain.
Randomized clinical trial. ⋯ The results of this study demonstrate an advantage of spinal manipulation combined with low-tech rehabilitative exercise and MedX rehabilitative exercise versus spinal manipulation alone over two years and are similar in magnitude to those observed after one-year follow-up. These results suggest that treatments including supervised rehabilitative exercise should be considered for chronic neck pain sufferers. Further studies are needed to examine the cost effectiveness of these therapies and how spinal manipulation compares to no treatment or minimal intervention.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effects of side-posture positioning and spinal adjusting on the lumbar Z joints: a randomized controlled trial with sixty-four subjects.
A blinded, randomized controlled trial was conducted. ⋯ Spinal adjusting produced increased separation (gapping) of the Z joints. Side-posture positioning also produced gapping, but less than that seen with lumbar side-posture adjusting. This study helps to increase understanding about the mechanism of action for spinal manipulation.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Clinical and radiographic outcomes of anterior lumbar interbody fusion using recombinant human bone morphogenetic protein-2.
A prospective, nonblinded, multicenter study of outcomes in patients undergoing single-level anterior lumbar discectomy and interbody fusion with InFUSE Bone Graft. ⋯ The use of InFUSE Bone Graft is a promising method of facilitating anterior intervertebral spinal fusion, decreasing pain, and improving clinical outcomes in patients who have undergone anterior lumbar fusion surgery with structural threaded cortical allograft bone dowels.
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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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Harvesting of autologous bone graft from the posterior iliac crest for lumbar spinal fusions is a frequently performed procedure in orthopedic surgery. The most common complication associated with this procedure is an alteration in sensation over the donor site manifested as chronic pain, hyperesthesia, dysesthesia, or diminished sensitivity resulting from superior cluneal nerve (SCN) injury. ⋯ The authors suggest that conventional treatments be limited to a 2-month period, and that alcohol neurolysis be applied as soon as possible to prevent lengthy pain experiences.