Spine
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Prospective study with patient and physician questionnaires, clinical records, and imaging. ⋯ Despite clear average improvement, surgeons tended to give overly optimistic predictions that were not correlated with patient outcome. For patients receiving a treatment not meeting explicit criteria of appropriateness, more optimistic physician expectation was associated with better improvement of psychological dimensions. Besides prognostic ability, the influence of physician expectation on patient outcome is discussed and the concept of "curabo effect" (differentiated from "placebo effect") proposed.
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Retrospective radiographic and chart review. ⋯ The radiographic ROM at 8.6-year follow-up was positively correlated with several outcomes measures. Patients with motion > 5 degrees had clinically modest but statistically better outcomes in ODQ and modifiedStauffer-Coventry scores. Longer follow-ups will be necessary to measure fully the impact of TDR ROM on outcome.
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Descriptive. ⋯ This is an unusual presentation of an expanding intra-abdominal mass originating from the lumbar spine during pregnancy. It most likely represents rapid growth of a previous unrecognized recurrence of a GCT. Close observation and follow-up CT scanning are imperative to identify and treat GCTs of the spine before rapid growth occurs.
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Comparative Study Controlled Clinical Trial
Spinal cord stimulation for axial low back pain: a prospective, controlled trial comparing dual with single percutaneous electrodes.
A prospective, controlled, clinical trial comparing single and dual percutaneous electrodes in the treatment of axial low back pain from failed back surgery syndrome. ⋯ While we observed disadvantages for dual electrodes in treating axial low back pain, we achieved technical success with single or dual electrodes in most patients and maintained this success clinically with dual electrodes in 53%.
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Comparative Study
Pedicle screw placement in the thoracic spine: a comparison of image-guided and manual techniques in cadavers.
A cadaveric study comparing image guidance technology to fluoroscopic guidance as a means of pedicle screw placement in the thoracic spine, using a unique starting point for screw placement. ⋯ Our study showed no significant differences in the overall exit rates between the two techniques. Image guidance may increase confidence of surgeons with limited experience in thoracic pedicle screw placement. Successful placement of screws within the pedicle varies with the anatomic diameter of the pedicle itself. Concerns regarding accuracy of screw placement should be greatest in the middle thoracic vertebrae (T4-T7), where pedicle diameters are smallest and proximity of the great vessels is nearest.