Spine
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Randomized Controlled Trial
Ketorolac use for postoperative pain management following lumbar decompression surgery: a prospective, randomized, double-blinded, placebo-controlled trial.
Prospective randomized double-blind placebo-controlled study. ⋯ There were no significant differences in available patient demographics, intraoperative blood loss, or postoperative Hemovac drain output between study groups. Morphine equivalent requirements were significantly less at all predetermined time points in addition to the overall hospital morphine requirement in patients randomized to receive Ketorolac. Visual Analog Pain Scores were significantly lower in patients randomized to receive Ketorolac immediately postoperative in addition to 4, 12, and 16 hours postoperative. There were no identifiable postoperative complications associated with the use of Ketorolac. CONCLUSION.: Intravenous Ketorolac seems to be a safe and effective analgesic agent following multilevel lumbar decompressive laminectomy. Patients can expect lower morphine requirements and better pain scores throughout their postoperative course.
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Randomized Controlled Trial Multicenter Study Comparative Study
Comparison of adverse events between the Bryan artificial cervical disc and anterior cervical arthrodesis.
Randomized controlled study. ⋯ Bryan cervical disc replacement and anterior cervical fusion are both safe procedures with a low incidence of significant adverse events related to the procedure. Statistically, more serious adverse events and reoperations occurred in the fusion group while a greater number of less serious surgically related events were seen in the investigational group.
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Randomized Controlled Trial Comparative Study
Single-level instrumented posterolateral fusion of lumbar spine with beta-tricalcium phosphate versus autograft: a prospective, randomized study with 3-year follow-up.
A prospective, randomized clinical study comparing beta-tricalcium phosphate (beta-TCP) with autograft bone graft with follow-up of 3 years. ⋯ Instrumented posterolateral fusion with beta-TCP combined with local autograft results in the same radiographic fusion rates and similar improvement of clinical outcomes and life quality compared with autograft alone. The authors therefore recommend the use of beta-TCP as bone graft substitute for instrumented posterolateral fusion of lumbar spine to eliminate the need of bone grafting harvesting from the ilium.
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Randomized Controlled Trial
Percutaneous lumbar zygapophysial (Facet) joint neurotomy using radiofrequency current, in the management of chronic low back pain: a randomized double-blind trial.
A randomized controlled study of percutaneous radiofrequency neurotomy was conducted in 40 patients with chronic low back pain (20 active and 20 controls). ⋯ Our study indicates that radiofrequency facet denervation is not a placebo and could be used in the treatment of carefully selected patients with chronic low back pain.