Spine
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Comparative Study
Reduction of vertebral blood flow by segmental vessel occlusion: an intraoperative study using laser Doppler flowmetry.
During anterior spinal surgery, vertebral perfusion was assessed by laser Doppler flowmetry. Blood flow changes were assessed after unilateral ligation and contralateral compression of the segmental vessels. ⋯ Unilateral ligation of segmental vessels led only to a slight decrease of the vertebral blood flow. Future studies may show whether sparing the segmental vessels during anterior fusion enhances bone graft incorporation, thus decreasing the rate of pseudarthrosis. According to clinical data, the risk of neurologic injury through unilateral ligation is negligible. Bilateral segmental vessel occlusion markedly reduced vertebral bloodflow. Therefore, when treating patients with a higher neurologic risk or in revision cases, the surgeon should always consider sparing the segmental vessels.
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This study was designed to investigate the difference of rib length of idiopathic scoliosis using experimentally induced scoliosis by pinealectomy in chickens. ⋯ Our results indicated that rib length was not related to the experimental scoliosis examined in this study. Further study is encouraged to investigate if the asymmetric rib length plays a role in causing or promoting other types of scoliosis, especially in primate or human idiopathic scoliosis.
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Randomized Controlled Trial
A prospective, randomized, double-blind study evaluating the efficacy of postoperative continuous local anesthetic infusion at the iliac crest bone graft site after spinal arthrodesis.
Parallel design, prospective, double-blind, randomized, controlled trial composed of two independent groups treated with a continuous infusion catheter (saline vs. Marcaine) placed into the iliac crest bone graft (ICBG) site. ⋯ Continuous infusion of 0.5% Marcaine at the ICBG harvest site reduced postoperative parenteral narcotic usage by 50% and decreased overall pain scores. No complications were attributed to the infusion-catheter system. The use of continuous local anesthetic infusion at the iliac crest may help in alleviating acute graft-related pain, hastening patient recovery and improving short-term satisfaction.
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Comparative Study
In vitro stabilizing effect of a transforaminal compared with two posterior lumbar interbody fusion cages.
An in vitro biomechanical flexibility test on different lumbar interbody fusion cages using monosegmental lumbar spine specimens. ⋯ In terms of its stabilizing effect, TLIF using the MOON cage can be recommended as an alternative to PLIF using the cubic Stryker cages. Compared with the threaded BAK PLIF cages, however, the MOON TLIF cage provides a lower primary stability in lateral bending, flexion, and extension.
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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.