Spine
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Randomized Controlled Trial Pragmatic Clinical Trial
Costs and cost-effectiveness of epidural steroids for acute lumbosacral radicular syndrome in general practice: an economic evaluation alongside a pragmatic randomized control trial.
A pragmatic, randomized, controlled, single-blinded trial in Dutch general practice. ⋯ The effect on pain and disability of epidural steroids in lumbosacral radicular syndrome is small but significant, and at lower costs with no reported complications or adverse effects. Segmental epidural steroid injections could be considered by policy makers as an additional treatment option.
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Simulate the progression of human disc degeneration. ⋯ Poor nutritional supply has a long-term effect on disc degeneration.
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Prospective cohort study. ⋯ Patients undergoing elective lumbar arthrodesis reported relatively limited functional deficit due to stiffness at 2-year follow-up. Paradoxically, patients undergoing 1-level arthrodesis actually reported significantly less limitation due to stiffness postoperatively. Although the effects of stiffness did trend toward greater impacts among patients undergoing longer fusions, 91% of patients were satisfied with trade-offs of function and pain relief in exchange for perceived increases in lumbar stiffness.
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Retrospective study of 146 patients with the diagnosis of occipitalization, atlantoaxial dislocation (AAD) and basilar invagination, using a novel surgical treatment strategy. ⋯ Although technically demanding, the C1 lateral mass placement in occipitalization is very useful in the rescue situation where more conventional stabilization alternatives are not technically possible, or as routine occipitocervical stabilization. It provides firm stabilization offering an optimum situation for bony fusion, and meanwhile the effective reduction of fixed AAD and basilar invagination. An extremely high fusion rate can be expected with minimal complications and minimal postoperative immobilization with this technique.
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A descriptive study of the association between diffuse idiopathic skeletal hyperostosis (DISH) and kyphosis. ⋯ DISH is associated with greater Cobb angle of kyphosis, especially when present in the thoracic spine alone. The association of DISH with Cobb angle is stronger within the African American population.