Spine
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Comparative Study
Complications associated with lumbar laminectomy: a comparison of spinal versus general anesthesia.
A case-controlled, comparative study of 400 patients undergoing lumbar surgery, treated with either spinal or general anesthesia. An independent observer analyzed outcomes. ⋯ For patients undergoing decompressive lumbar surgery, spinal anesthesia is at least comparable to general anesthetic with respect to complications. Specific advantages to spinal anesthesia include decreased nausea and antiemetic requirements, reduced analgesic requirements, and reduced overall complication rate.
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Comparative Study
Changes in recruitment of the abdominal muscles in people with low back pain: ultrasound measurement of muscle activity.
Ultrasound and electromyographic (EMG) measures of trunk muscle activity were compared between low back pain (LBP) and control subjects in a cross-sectional study. ⋯ This study reinforces evidence for changes in automatic control of TrA in people with LBP. Furthermore, the data establish a new test of recruitment of the abdominal muscles in people with LBP. This test presents a feasible noninvasive test of automatic recruitment of the abdominal muscles.
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Comparative Study
Selective inhibition of tumor necrosis factor-alpha prevents nucleus pulposus-induced histologic changes in the dorsal root ganglion.
The possibility to prevent nucleus pulposus-induced structural changes of the dorsal root ganglion (DRG) by selective tumor necrosis factor-alpha (TNF-alpha) inhibition was assessed in an experimental model in the rat spine. ⋯ Infliximab may prevent the histologic damage induced by nucleus pulposus. When rats were given a single intraperitoneal injection of infliximab at the beginning of disc herniation, the histologic damage seemed to be reduced in comparison with the nontreated rats.
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Comparative Study
Transpedicular screw placement evaluated by axial computed tomography of the cervical pedicle.
We evaluated the trajectory of transpedicular screws in the cervical spine using axial computed tomography (CT). ⋯ Axial CT measurements should facilitate transpedicular screw fixation in the cervical spine. We believe that the screw insertion angle should be close to 50 degrees, which is the mean pedicle transverse angle from C3-C6. The entry point of the pedicle screw should be located as laterally as possible in the posterior surface of the lateral mass.
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Comparative Study
Changes in the cross-sectional area of multifidus and psoas in patients with unilateral back pain: the relationship to pain and disability.
Prospective, cross-sectional observational study. ⋯ Atrophy of multifidus has been used as one of the rationales for spine stabilization exercises. The evidence of coexisting atrophy of psoas and multifidus suggests that a future area for study should be selective exercise training of psoas, which is less commonly used in clinical practice.