Spine
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A systematic review of randomized controlled trials. ⋯ When fusion of the motion segment is considered to be the working mechanism for pain relief and functional improvement, iliac crest autograft appears to be the golden standard. When ignoring fusion rates and looking at complication rates, a cage as a golden standard has a weak evidence base over iliac crest autograft, but not over discectomy.
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Comparative Study
Maximal pulmonary recovery after spinal fusion for adolescent idiopathic scoliosis: how do anterior approaches compare?
Retrospective analysis of prospectively collected data. ⋯ Compared to ASF or PSF, VATS procedures showed an initial decline in pulmonary function, which resolved fully by 6- to 12-months follow-up. Modest declines in maximal pulmonary function with VATS-I were seen when comparing all curve types together but not when comparing Lenke 1 curves alone. VATS procedures for thoracic scoliosis and open approaches for thoracolumbar curve types were associated with minimal to no permanent deficits.
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Clinical study correlating preoperative pulmonary function tests (PFTs) to radiographic measures of thoracic deformity severity in adolescent idiopathic scoliosis (AIS) patients. ⋯ Preoperative PFTs are clinically impaired in 19% of AIS patients, and correlate significantly with the MT and sagittal plane deformity severity, and with PT curve severity to a lesser degree. PFTs do not correlate with degree of axial deformity. From a purely pulmonary standpoint, attention directed to coronal and sagittal plane deformity correction appears warranted, to address the specific deformities which are associated with PFT impairment.
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A prevalence and reliability study of Modic changes (MCs) in the cervical spine. ⋯ A high prevalence of MCs was observed with type 2 predominating. The C5/6 and C6/7 levels are most effected. Patients with MC are more likely to have a DH at the same level. MC type 2 predominates. The classification is reliable.
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Review Meta Analysis
Spinal manipulative therapy for chronic low-back pain: an update of a Cochrane review.
Systematic review of interventions. ⋯ High-quality evidence suggests that there is no clinically relevant difference between SMT and other interventions for reducing pain and improving function in patients with chronic low-back pain. Determining cost-effectiveness of care has high priority.