Spine
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Multicenter Study Comparative Study
European comparison of costs and quality in the treatment of acute back pain.
Retrospective multicenter observational study. ⋯ There was considerable waste in treating acute back pain. The Netherlands had highest quality and lowest resource utilization in providing treatment for acute back pain.
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To assess the effects of acupuncture and dry-needling for the treatment of nonspecific low back pain. ⋯ The data do not allow firm conclusions regarding the effectiveness of acupuncture for acute low back pain. For chronic low back pain, acupuncture is more effective for pain relief and functional improvement than no treatment or sham treatment immediately after treatment and in the short-term only. Acupuncture is not more effective than other conventional and "alternative" treatments. The data suggest that acupuncture and dry-needling may be useful adjuncts to other therapies for chronic low back pain. Because most of the studies were of lower methodologic quality, there is a clear need for higher quality trials in this area.
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Comparative Study
Long-term outcomes of surgical and nonsurgical management of lumbar spinal stenosis: 8 to 10 year results from the maine lumbar spine study.
A prospective observational cohort study. ⋯ Among patients with lumbar spinal stenosis completing 8- to 10-year follow-up, low back pain relief, predominant symptom improvement, and satisfaction with the current state were similar in patients initially treated surgically or nonsurgically. However, leg pain relief and greater back-related functional status continued to favor those initially receiving surgical treatment. These results support a shared decision-making approach among physicians and patients when considering treatment options for lumbar spinal stenosis.
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Randomized Controlled Trial
The efficacy of corticosteroids in periradicular infiltration for chronic radicular pain: a randomized, double-blind, controlled trial.
A randomized, double-blind controlled trial. ⋯ Clinical improvement occurred in both groups of patients. Corticosteroids did not provide additional benefit.
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Comparative Study
Biomechanical comparison of transarticular facet screws to lateral mass plates in two-level instrumentations of the cervical spine.
In vitro biomechanical comparison of transarticular facet screws to lateral mass plates in two level instrumentations of the cervical spine. ⋯ This study proves that transarticular facet screws and lateral mass plates are equivalent in two-level instrumentations of the cervical spine. This is the first biomechanical study to test transarticular facet screws in this context.