Spine
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The effects of a low, local dose of a tumor necrosis factor-alpha (TNF-alpha) inhibitor on neuropathic pain behaviors in a rat chronic constriction injury model were evaluated. ⋯ This preclinical study indicates that delivering TNF-alpha inhibitors by means of a locally administered polymeric formulation provides long-lasting analgesia in an inflammatory neuropathic pain model.
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Randomized Controlled Trial Multicenter Study
Prospective, randomized trial of metal-on-metal artificial lumbar disc replacement: initial results for treatment of discogenic pain.
This study presents data on 67 patients from 2 study sites involved in the multicenter, prospective, randomized, controlled investigational device exemption study of FlexiCore artificial disc replacement versus fusion with a 2-year follow-up. ⋯ These initial results from 2 study sites demonstrate that the FlexiCore compares very favorably to circumferential fusion for the treatment of lumbar DDD unresponsive to conservative treatment. These results are not intended to represent the overall study results.
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Randomized Controlled Trial
Effect of parecoxib on postoperative pain after lumbar spine surgery: a bicenter, randomized, double-blinded, placebo-controlled trial.
A bicenter randomized, patients, healthcare providers, and data collectors blind placebo-controlled trial in multimodal analgesia for postoperative lumbar spine surgery was conducted. ⋯ The present study demonstrates that the perioperative administration of parecoxib with patient-controlled analgesic morphine after lumber spine surgery resulted in significantly improved postoperative analgesic management as defined by reduction in opioid requirement, lower pain scores, and higher patients' subjective rating of the medication.
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Biomechanical study using human cadaver spines. ⋯ The ATB plate can significantly increase the stability of the anterior FRA at L5-S1 level. Although supplemental transpedicular instrumentation results in a more stable biomechanical environment, the resultant ROM with the addition of a plate is small, especially under physiologic preload, suggesting that the plate can sufficiently resist motion. Therefore, clinical assessment of the ATB plate as an alternative to transpedicular instrumentation to enhance ALIF cage stability is considered reasonable.
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The topical capsaicin treatment of the sciatic nerve, which was proved to destroy capsaicin-sensitive primary afferent (CSPA) fibers, was performed to determine the effect on decreases in paw withdrawal mechanical threshold (PWMT) and changes in spatial expression pattern of spinal c-Fos protein induced by the direct compression of L5 nerve root with autologous disc. ⋯ We conclude that CSPA fibers, which mainly terminated in superficial layers of dorsal horn, may play a key role in mechanical hyperalgesia in the new sciatica model.