Spine
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Review
Cost-effectiveness of single-level anterior cervical discectomy and fusion for cervical spondylosis.
Cost-effectiveness analysis with retrospective cost analysis and literature review. ⋯ ACDF with allograft offers a benefit relative to ACDF with autograft at a cost of 496 dollars per QALY. ACDFP has a benefit relative to ACDF with allograft at an approximate cost of 32,560 dollars per QALY. CEA provides a method for comparing the benefits and risks of these three procedures. Further research needs to be performed regarding these procedures, particularly examining the postoperative recovery period.
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Randomized Controlled Trial
The role of amicar in decreasing perioperative blood loss in idiopathic scoliosis.
Four separate studies on the role of Amicar in decreasing perioperative blood loss in idiopathic scoliosis. ⋯ Amicar appears highly effective in decreasing perioperative blood loss. This results in less autologous blood donation, blood transfusion, costs, and complications. Its mechanism of action is uncertain but may be related to increased fibrinogen secretion.
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Review article. ⋯ Cervical disc replacement is an innovative technology that preserves motion at the instrumented level/s and will potentially improve load transfer to the adjacent levels compared with fusion. Clinical reports of success of cervical total disc replacement are encouraging but are also quite preliminary. As the U.S. IDE studies are completed, a clearer role for the place of cervical disc replacement in the spine surgeon's armamentarium should emerge.
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Comparative Study
Paraspinal electromyography: age-correlated normative values in asymptomatic subjects.
Cross-sectional study. ⋯ The amount of lumbar paraspinal muscle denervation does increase with age. Understanding the range of findings in asymptomatic subjects will help us interpret lumbar paraspinal needle electromyography findings in patients with spinal disorders.
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Retrospective review of current literature regarding neuroprotection and axonal regeneration therapies for acute spinal cord injury. ⋯ The initiation of human clinical trials for spinal cord-injured patients heralds great hope that effective therapies will be forthcoming, although a great deal remains to be learned. Clinicians must provide leadership in the epidemiologic design and rigor of these initial forays into human evaluation.