Spine
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A cross sectional study of thoracic pedicle morphometry in the immature spine of Malaysian population using reformatted computed tomographic (CT) images. ⋯ The isthmus endosteal width in >50% of the pedicles studied were less than 3.0 mm. We conclude that transpedicular fixation in the thoracic spine using pedicle screw of >3.0 mm diameter is not feasible in children and adolescents of <18 years old in our population.
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Review Case Reports
A modified decompression surgery for thoracic myelopathy caused by ossification of posterior longitudinal ligament: a case report and literature review.
Case report and review. ⋯ The present case suggests that posterior decompression, anterior extirpation of OPLL, and interbody fusion with spinal instrumentation only via a modified posterior-lateral approach is a novel, safe, and effective procedure for surgical treatment of thoracic OPLL.
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Retrospective review of consecutive case series. ⋯ Thoracic transdiscal osteotomy with vertebral shortening is a safe and effective option for the treatment of infectious discitis/osteomyelitis with associated kyphosis. With adjuvant antibiotics, it effectively eradicates the infection through a posterior only approach, avoiding the need for anterior procedures and long anterior struts.
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Prospective cohort study. ⋯ Discectomy improved low back pain in patients suffering from lumbar disc herniation. Patients with or without Modic type 1 change showed a similar improvement of low back pain score. Low back pain in patients with disc herniation appears to mainly originate from disc or nerve root compression, and decompression surgery without fusion is an option for these patients, even those with Modic type 1 changes.
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Randomized Controlled Trial Multicenter Study
Efficacy and safety of duloxetine in patients with chronic low back pain.
This was a randomized, double-blind, placebo-controlled clinical trial. ⋯ Duloxetine significantly reduced pain and improved functioning in patients with CLBP. The safety and tolerability were similar to those reported in earlier studies.