Spine
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A retrospective follow-up study of low-grade (slip < or = 50%) isthmic spondylolisthesis after posterior or posterolateral fusion in young patients. ⋯ Long-term clinical and radiographic outcomes after posterolateral fusion of low-grade spondylolisthesis were satisfactory. Cosmetic aspects of this deformity should be included as one of the outcome measurements, since cosmetic questions on the Scoliosis Research Society questionnaire showed inverse correlations between the amount of slip at final follow-up observation. The Scoliosis Research Society questionnaire could be used as a primary patient-oriented outcome tool after back surgery in young patients.
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The Load Sharing Classification of spinal fractures was evaluated by 5 observers on 2 occasions. ⋯ Kappa statistics showed high levels of agreement when the Load Sharing Classification was used to assess thoracolumbar burst fractures. This system can be applied with excellent reliability.
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A report of five cases of thoracolumbar osteoid osteoma treated with combined computer-assisted and gamma probe-guided high-speed drill excision. ⋯ The combination of both computer-assisted surgery and gamma probe-guided high-speed drill excision for osteoid osteoma of the spine helps to localize and excise the nidus of the osteoid osteoma with minimal bone resection of the posterior spinal structures.
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Comparative Study
Reliability of retrospective clinical data to evaluate the effectiveness of lumbar fusion in chronic low back pain.
Patients in whom a posterior spinal fusion instrumentation had been performed to treat low back pain were asked to recall their preoperative clinical status by retrospectively filling out the same 3 self-evaluation scales they had completed before surgery in a prospective fashion. ⋯ Relying on a patient's recall of preoperative clinical status is not an accurate method to evaluate surgical outcome after posterior spinal fusion instrumentation. Cross-sectional studies may overestimate the effectiveness of surgery.
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Retrospective study on a consecutive series of patients. ⋯ The results of the present study indicate that both back and leg pain are, on average, still moderately high 2 years after instrumentation with the Dynesys system. Only half of the patients declared that the operation had helped and had improved their overall quality of life; less than half reported improvements in functional capacity. The reoperation rate after Dynesys was relatively high. The results provide no support for the notion that semirigid fixation of the lumbar spine results in better patient-oriented outcomes than those typical of fusion.