Spine
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Retrospective study. ⋯ When combined with extensive posterior releases, posterior only approach is just as effective as combined anterior and posterior surgery for adult lumbar scoliosis measuring between 40 degrees and 70 degrees .
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A retrospective review of children with neuromuscular scoliosis treated at our institution with posterior spinal fusion and instrumentation including iliac screws. ⋯ The use of screw fixation in the ilium as a means of spinopelvic anchorage is safe and effective in the treatment of neuromuscular scoliosis. The use of 2 screws in each iliac wing provides more stable fixation with fewer implant-related complications than using a single screw.
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Randomized Controlled Trial Comparative Study
Effectiveness and cost-effectiveness of three types of physiotherapy used to reduce chronic low back pain disability: a pragmatic randomized trial with economic evaluation.
Pragmatic, randomized, assessor blinded, clinical trial with economic analysis. ⋯ For chronic low back pain, all three physiotherapy regimens improved disability and other relevant health outcomes, regardless of their content. Physiotherapist-led pain management classes offer a cost-effective alternative to usual outpatient physiotherapy and are associated with less healthcare use. A more widespread adoption of physiotherapist-led pain management could result in considerable cost savings for healthcare providers.
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Cadaveric biomechanical study and retrospective chart review. ⋯ Segmental fixation of burst fractures with screws at the level of the fracture offers improved biomechanical stability. Theoretically, segmental fixation provides for additional fixation points that may aid in fracture reduction and kyphosis correction. This specific parameter is not evaluated in this study but will be an important outcome measure for a planned randomized controlled trial.
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Prospective case-control study testing a new diagnostic method. ⋯ The study demonstrates that it is feasible and safe to measure NO with a real time-sensor in or around the facet joints. The findings of higher concentrations of NO in the perifacetal region in chronic low back patients compared with healthy controls indicate that the degenerative process of the joints in these patients may cause increased NO production. The observation of higher NO concentrations in the perifacetal region in patients responding to corticosteroid/local anesthetic infiltration indirectly suggest a more pronounced inflammatory process in these patients.