Spine
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Randomized Controlled Trial Multicenter Study Comparative Study
A comparison between two physical therapy treatment programs for patients with lumbar spinal stenosis: a randomized clinical trial.
Multicenter randomized, controlled trial. ⋯ Patients with lumbar spinal stenosis can benefit from physical therapy. Additional gains may be realized with the inclusion of manual physical therapy interventions, exercise, and a progressive body-weight supported treadmill walking program.
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Randomized Controlled Trial Comparative Study
A prospective randomized double-blind trial of the use of intrathecal fentanyl in patients undergoing lumbar spinal surgery.
A randomized, double-blind controlled study. ⋯ Intrathecal fentanyl is effective at reducing pain and morphine PCA use after lumbar spinal surgery with minimal respiratory depression.
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Randomized Controlled Trial Comparative Study
Clinical outcomes and fusion success at 2 years of single-level instrumented posterolateral fusions with recombinant human bone morphogenetic protein-2/compression resistant matrix versus iliac crest bone graft.
This is a prospective, randomized study comparing iliac crest bone graft to bone morphogenetic protein (BMP)/compression resistant matrix in instrumented posterolateral fusions for single-level lumbar degenerative disease. A higher recombinant human bone morphogenetic protein (rhBMP)-2 dose and a carrier specific for posterior spine applications were used. ⋯ There was significant improvement of Short Form 36 (physical component score and pain), Oswestry Low Back Pain Disability Index, and leg and back pain scores in both groups over all time intervals. Surgical time and blood loss were significantly less in the BMP/compression resistant matrix group. The fusion rate in the BMP/compression resistant matrix group was significantly higher than the iliac crest bone graft group.
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Randomized Controlled Trial Multicenter Study Comparative Study
Effect of high-dose intravenous dexamethasone on postlumbar discectomy pain.
A prospective, randomized triple-blind clinical trial. ⋯ Intraoperative IV injection of 40 mg dexamethasone could effectively reduce postoperative radicular leg pain and narcotics usage in patients with single-level herniated lumbar disc.
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Randomized Controlled Trial Comparative Study
Effectiveness of microdiscectomy for lumbar disc herniation: a randomized controlled trial with 2 years of follow-up.
Prospective randomized controlled trial. ⋯ Lumbar microdiscectomy offered only modest short-term benefits in patients with sciatica due to disc extrusion or sequester. Spinal level of the herniation may be an important factor modifying effectiveness of surgery, but this hypothesis needs verification.