Spine
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This is a cohort investigation of 2 categories of patients with adult lumbar scoliosis. ⋯ Categorization of patients into 2 groups, 1 with primarily stenosis symptoms and 1 with primarily deformity symptoms, may be effective for surgical decision making. These 2 categories of patients may be expected to enjoy similar clinical improvements after surgical treatment.
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Randomized Controlled Trial Comparative Study
Accuracy of robot-assisted placement of lumbar and sacral pedicle screws: a prospective randomized comparison to conventional freehand screw implantation.
Single-center prospective randomized controlled study. ⋯ In this study, the accuracy of the conventional FH technique was superior to the RO technique. Most malpositioned screws of the RO group showed a lateral deviation. Attachment of the robot to the spine seems a vulnerable aspect potentially leading to screw malposition as well as slipping of the implantation cannula at the screw entrance point.
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Randomized Controlled Trial
Oxiplex reduces leg pain, back pain, and associated symptoms after lumbar discectomy.
Prospective, randomized, blinded clinical trial. ⋯ These data demonstrate improvements in clinical outcomes resulting from the use of Oxiplex gel in discectomy procedures for treatment of lumbar disc herniation.
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Multicenter Study
Complications and risk factors of primary adult scoliosis surgery: a multicenter study of 306 patients.
A multicentric retrospective study on primary adult scoliosis patients operated on between 2002 and 2007. A 3-step statistical analysis was performed to describe the incidence of complications, the risk factors, and the reoperation risk with survival curves for the entire cohort. ⋯ Overall complication rate was 39%, and 26% of the patients were reoperated for mechanical or neurological complications. Risk factors include number of instrumented vertebra, fusion to the sacrum, PSO, and preoperative pelvic tilt of 26° or more. There is a 44% risk of a new operation in the 6-year-period after the primary procedure.
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Randomized Controlled Trial
Implementation of a guideline for low back pain management in primary care: a cost-effectiveness analysis.
Cost-effectiveness analysis alongside a cluster randomized controlled trial. ⋯ Trends in cost-effectiveness are visible but need to be confirmed in future studies. Researchers performing cost-evaluation studies should test for baseline imbalances of health care utilization data instead of judging on the randomization success by reviewing non-cost parameters like clinical data alone.