Spine
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A retrospective study was conducted, with clinical evaluation of hemivertebra resection using transpedicular instrumentation by a posterior approach in young children. ⋯ Posterior resection of hemivertebrae with transpedicular instrumentation is a safe and promising procedure that offers significant advantages for controlling congenital deformity: excellent correction in both the frontal and sagittal planes, short segment of fusion, high stability, no need for an anterior approach, and low neurologic risk. Surgery should be performed as early as possible to avert severe local deformities, to prevent secondary structural changes, and to avert extensive fusions.
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A retrospective review of a prospectively maintained spine database was conducted. ⋯ External beam radiation therapy was used successfully to treat patients with normal alignment or minimal subluxation. Selected patients warrant immediate stabilization. Patients with persistent pain and inability to wean from a hard collar after nonoperative therapy also should be considered for surgery. Posterior stabilization provides pain relief and neurologic preservation or recovery without the need for anterior decompression.
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A case report is presented. ⋯ Neurophysiologic monitoring using both somatosensory-evoked potentials and neurogenic mixed evoked potentials is recommended when surgery is performed to correct spine deformity. The Stagnara wake-up test, somatosensory-evoked potentials, and neurogenic mixed evoked potentials are important components of spinal cord monitoring during surgery, and should be used together for optimal protection of neurologic function.
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Randomized Controlled Trial Comparative Study Clinical Trial
Relative cost-effectiveness of extensive and light multidisciplinary treatment programs versus treatment as usual for patients with chronic low back pain on long-term sick leave: randomized controlled study.
A subgroup of 195 patients with chronic low back pain, being part of a larger study of other musculoskeletal patients, were included in a randomized controlled prospective clinical study. ⋯ The light multidisciplinary treatment model is a cost-effective treatment for men with chronic low back pain.
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Clinical Trial
Intradiscal electrothermal treatment for chronic discogenic low back pain: prospective outcome study with a minimum 2-year follow-up.
Prospective longitudinal study with a minimum 2-year follow-up. ⋯ A cohort of patients with chronic discogenic low back pain who had failed to improve with comprehensive nonoperative care demonstrated a statistically significant improvement in pain, physical function, and quality of life at 2 years after IDET.