Spine
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Review Meta Analysis Comparative Study
Examining heterogeneity in meta-analysis: comparing results of randomized trials and nonrandomized studies of interventions for low back pain.
Literature review. ⋯ Comparisons between RCTs and NRSs may be influenced by various factors, including study design. However, other factors were more powerful explanatory variables than study design. These factors included pain duration, involvement of workers' compensation, presence of spondylolisthesis, previous surgery, and levels fused.
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Randomized Controlled Trial Comparative Study
Self-report measures best explain changes in disability compared with physical measures after exercise rehabilitation for chronic low back pain.
Sixteen-week intervention for chronic patients with low back pain (LBP) with 9-month follow-up. Primary randomization at 4 weeks into either supervised Swiss ball exercise or an exercise advice group. ⋯ Supervised exercise is a more successful subsequent to manual treatment compared with exercise advice. The improvements associated with this type of program were primarily manifested in the psychologic self-report measures rather than physical measurements.
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Prospective clinical study. ⋯ The reported biomechanical principles of Dynesys do not reflect advantages in outcome compared with none or others stabilization systems after microsurgical radicular decompression reported in the literature.
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A case report of late-onset paraplegia from an epidural abscess in a patient years after her instrumentation and fusion for scoliosis. ⋯ This case reports a delayed spinal epidural abscess years after removal of her implants for infection. This demonstrates that our patients remain at risk for reactivation of spinal infections even though they may be healthy hosts and may have had all foreign bodies removed as part of their treatment for deep postoperative infections. This case suggests that extensive unilateral decompression and debridement through a fusion mass is a viable treatment method in patients with fused spine.
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Retrospective review. ⋯ Although pharmacologic thromboprophylaxis probably does not have a role after posterior spinal surgery, the data in this study suggest that it does lower the incidence of PE after anterior spinal surgery.