Spine
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Survey. ⋯ Routine sedation does not seem to be required for patients receiving spinal injections, but more-anxious patients benefit from sedation before an injection. Benzodiazepams are effective in controlling anxiety for the majority of patients.
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Randomized Controlled Trial
A prospective, randomized, double-blind study of the efficacy of postoperative continuous local anesthetic infusion at the iliac crest bone graft site after posterior spinal arthrodesis: a minimum of 4-year follow-up.
Parallel design, prospective, double-blinded, randomized, controlled trial composed of 2 independent groups treated with a continuous infusion catheter (saline vs. Marcain) placed into the iliac crest bone graft site (ICBG). ⋯ Continuous infusion of 0.5% Marcain at the ICBG harvest site significantly reduced chronic dysesthesias. Overall satisfaction with the procedure, number of painful days per month, and VAS scores were significantly better in the treatment group at 4 years. No long-term complications were attributed to either the ICBG site or the catheter-infusion system. The use of continuous local anesthetic infusion at the iliac crest may help in alleviating graft-related pain beyond the perioperative phase.
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Review Case Reports
Three-column ligamentous extension injury of the thoracic spine: a case report and review of the literature.
This is a report of a patient with a rare unstable 3-column ligamentous injury of the thoracic spine. ⋯ A high index of suspicion is necessary to identify such extremely unstable injury despite its relative benign clinical and radiologic presentation.
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Systematic Review. ⋯ Pain has a central role to play as a prognostic factor for the development of LWS. Other physical factors commonly used in the clinical setting showed inconclusive evidence for their influence on prognosis. There is a need for improved quality of studies with consistent use of validated measures of all categories of prognostic factors and outcome. This may then provide a clearer understanding of prognosis of Whiplash Associated Disorders and therefore facilitate effective management of this costly problem.
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Multicenter Study
COL6A1 polymorphisms associated with ossification of the ligamentum flavum and ossification of the posterior longitudinal ligament.
A case-control association study was conducted to investigate the genetic etiology for ossification of the ligamentum flavum (OLF) and ossification of the posterior longitudinal ligament of the spine (OPLL). ⋯ This is the first report on SNPs of COL6A1 in OLF that suggests polymorphisms may be a risk factor for OLF. Our findings indicate that COL6A1 may be a common susceptibility gene for OLF and OPLL in Chinese Han population.