Spine
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Multicenter Study
Distal junctional kyphosis of adolescent idiopathic thoracic curves following anterior or posterior instrumented fusion: incidence, risk factors, and prevention.
This is a retrospective multicenter analysis of a subset of 375 patients with thoracic adolescent idiopathic scoliosis (AIS) treated with either anterior (238) or posterior (137) fusion with preoperative or postoperative distal junctional kyphosis (DJK) >or=10 degrees . ⋯ It appears that both posterior and anterior instrumentation for thoracic curves must include the junctional level to prevent postoperative DJK when postoperative DJK is present. The presence of increased kyphosis after surgery in the T10-L2 region seen in both anterior and posterior groups that had postoperative DJK develop constitutes a "risk factor" for the development of DJK.
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Validation of a translated, culturally adapted questionnaire. ⋯ The Spanish version of the FABQ has good comprehensibility, internal consistency, and reliability. It cannot be analyzed parametrically, but only nonparametrically. The total FABQ is at least as valid as its subscales and simpler to score, making it more suitable for routine clinical use.
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Randomized Controlled Trial Multicenter Study Comparative Study
The treatment of disc herniation-induced sciatica with infliximab: results of a randomized, controlled, 3-month follow-up study.
A randomized controlled trial. ⋯ The results of this randomized trial do not support the use of infliximab for lumbar radicular pain in patients with disc herniation-induced sciatica.
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Randomized Controlled Trial Multicenter Study Comparative Study
Comparison of OP-1 Putty (rhBMP-7) to iliac crest autograft for posterolateral lumbar arthrodesis: a minimum 2-year follow-up pilot study.
A prospective, randomized, controlled, multicenter clinical study. ⋯ This study represents the first clinical trial to demonstrate the safety and similarity of OP-1 Putty as a replacement for autogenous bone graft in the posterolateral fusion environment with a minimum of 2-year follow-up. OP-1 Putty was able to achieve osteoinduction leading to a radiographically solid fusion in the absence of autogenous iliac crest bone graft in 55% of the patients at 24 and 36 months. These results compare favorably to the historical fusion rates reported for uninstrumented arthrodesis in this challenging clinical scenario.
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Randomized Controlled Trial Multicenter Study Comparative Study
Transdermal fentanyl versus sustained release oral morphine in strong-opioid naïve patients with chronic low back pain.
Open, randomized, parallel group multicenter study. ⋯ TDF and SRM provided equivalent levels of pain relief, but TDF was associated with less constipation. This study indicates that sustained-release strong opioids can safely be used in strong-opioid naïve patients.