Spine
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Randomized Controlled Trial Comparative Study
Hemostatic and electrolyte effects of hydroxyethyl starches in patients undergoing posterior lumbar interbody fusion using pedicle screws and cages.
Prospective, randomized, double blind, clinical study. ⋯ If coagulopathy is a concern during PLIF, then, a HES with low MW/DS in a saline-based medium (Voluven) may be a better alternative than a HES with high MW/DS in a balanced salt medium (Hextend).
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STUDY DESIGN.: Retrospective cohort study. OBJECTIVE.: To identify predictors of early mortality following traumatic spinal cord injury (TSCI). SUMMARY OF BACKGROUND DATA.: Limited information is available on factors associated with early mortality following TSCI. ⋯ Timely recognition of these factors is crucial for improving survival in the acute care setting. Severe systemic injuries, medical comorbidities, and TBI continue to be the main limiting factors affecting the outcome. These findings also suggest the need to allocate resources for trauma prevention, and promote research towards improving the care of acutely injured patients.
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A structured literature review. ⋯ Wide variation in the number and type of eligibility criteria from randomized clinical trials of well defined back pain syndromes was identified. These results support the need for developing and disseminating international classification criteria for these clinical conditions.
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A retrospective study of postoperative pain management. ⋯ A low frequency of adverse events and a mean postoperative VAS pain score of 5 or less demonstrate that a continuous postoperative morphine infusion is a safe and effective method of pain management in patients with IS following PSF and SSI.
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Consecutive case series. ⋯ In a large series of rhBMP-2 augmented multilevel fusions, the pseudarthrosis rate was 10.2% at 6 months following surgery. Since the risk of pseudarthrosis increases with the number of fusion levels, a long fusion lever arm may biomechanically overwhelm the biologic advantage of rhBMP-2. While rhBMP-2 is known to enhance fusion rates, it does not guarantee fusion in all situations.