Spine
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
ProDisc artificial total lumbar disc replacement: introduction and early results from the United States clinical trial.
Multicenter prospective randomized study of artificial disc replacement (ProDisc) versus circumferential fusion (standard of care) for one- and two-level degenerative disc disease. This is an interim analysis on patients seen at the Spine Institute Saint John's Health Center, Santa Monica, California. ⋯ Disc replacement patients reported significantly less pain (Visual Analogue Scale) and disability (Oswestry) in the early period following surgery compared to fusion patients. This difference disappeared by 6 months. When compared to fusion, the disc replacement allowed preservation of motion at L4-L5 with a similar trend at L5-S1.
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Randomized Controlled Trial Comparative Study Clinical Trial
Clinical results with ProDisc: European experience and U.S. investigation device exemption study.
This study is based on a review of the literature related to the use of the ProDisc device and a report of the preliminary results of a prospective randomized study. ⋯ The preliminary results of this prospective randomized study found that peri-operative factors were more favorable in the disc replacement group than in the fusion group. There was a trend to greater patient satisfaction in this group. These early results suggest that total disc replacement may be a viable alternative to lumbar spinal fusion in patients with symptomatic disc disruption unresponsive to nonoperative care. Long-term follow-up is needed and is currently being collected for this study group.
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Comparative Study
Sensory stimulation-guided sacroiliac joint radiofrequency neurotomy: technique based on neuroanatomy of the dorsal sacral plexus.
A retrospective audit and examination of anatomic findings. ⋯ A sensory stimulation-guided approach toward the identification and subsequent radiofrequency thermocoagulation of symptomatic sacral lateral branch nerves appears to offer significant therapeutic advantages over existing therapies for the treatment of chronic sacroiliac joint complex pain.
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A histologic study of cerebrospinal fluid tracers in Sprague-Dawley rats undergoing lumboperitoneal shunt insertion in the excitotoxic animal model of posttraumatic syringomyelia (PTS). ⋯ Increasing caudal subarachnoid space compliance with a shunt does not affect local CSF flow into the spinal cord and syrinx. These results suggest that localized alterations in compliance, as opposed to obstruction from traumatic arachnoiditis, may act as an important factor in syrinx pathogenesis.
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Randomized Controlled Trial Comparative Study Clinical Trial
Does early intervention with a light mobilization program reduce long-term sick leave for low back pain: a 3-year follow-up study.
A randomized clinical trial. ⋯ For patients with subacute low back pain, a brief and simple early intervention with examination, information, reassurance, and encouragement to engage in physical activity as normal as possible had economic gains for the society. The effect occurred during the first year after intervention. There were no significant long-term effects of the intervention. The initial gain obtained during the first year does not lead to any increased costs or increased risks for reoccurrence of illness over the next 2 years.