Spine
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Randomized Controlled Trial Multicenter Study Comparative Study
Transdermal fentanyl versus sustained release oral morphine in strong-opioid naïve patients with chronic low back pain.
Open, randomized, parallel group multicenter study. ⋯ TDF and SRM provided equivalent levels of pain relief, but TDF was associated with less constipation. This study indicates that sustained-release strong opioids can safely be used in strong-opioid naïve patients.
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Prospective consecutive series. ⋯ To our knowledge, this study has been the first attempt to analyze anatomic changes in lateral spondylolisthesis using CT. It may offer further insight into the pathogenesis of adult lumbar scoliosis.
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Review Case Reports
Acute quadriparesis caused by calcification of the entire cervical ligamentum flavum in a white female--report of an unusual case and a brief review of the literature: case report.
Case report. ⋯ To our knowledge, this unusual case of complete calcification of the entire cervical LF has not previously been described. Multilevel laminectomy and fusion can improve neurologic function but may result in kyphosis.
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Intermittent pneumatic compression stockings (IPC) alone were prospectively used to avoid deep venous thrombosis (DVT) and pulmonary embolism (PE) in 100 consecutive patients undergoing single-level anterior corpectomy/fusion (ACF) and in 100 patients having multilevel ACF/posterior fusion. ⋯ IPCs were as effective for prophylaxis against DVT/PE for 100 patients undergoing single-level ACF and for 100 having circumferential procedures as existing therapies (mini-heparin and low-dose heparin), without the risk of hemorrhage. However, the 1% and 2% respective rates of PE were comparable to frequencies of PE encountered in other cranial/spinal series using mini-heparin and/or low-dose heparin regimens but avoided the 2% to 4% risk of major postoperative hemorrhage.
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Prospective study of patients with lumbar disc herniations who were operated on with a full-endoscopic uniportal transforaminal approach using an extreme lateral access. ⋯ The technique presented is an adequate and safe alternative to conventional procedures, and has the advantages of a truly minimally invasive procedure. The extreme lateral access is required for the indications described. There are clear limitations outside these indications. The possibility of selecting an access from posterolateral to extreme lateral now enables surgery of lumbar disc herniations inside and outside the spinal canal.