Spine
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Randomized Controlled Trial Clinical Trial
Effectiveness and cost-effectiveness analysis of neuroreflexotherapy for subacute and chronic low back pain in routine general practice: a cluster randomized, controlled trial.
A cluster randomized, controlled trial was performed. ⋯ Referral to neuroreflexotherapy intervention improves the effectiveness and cost-effectiveness of the management of nonspecific low back pain.
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Comparative Study
Simplifying outcome measurement: evaluation of instruments for measuring outcome after fusion surgery for chronic low back pain.
A comparative evaluation of outcome instruments and global assessment was performed. ⋯ Patient global assessment is a valid and responsive descriptor of overall effect in randomized controlled trials of treatment for chronic low back pain.
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Comparative Study
Corpectomy versus laminoplasty for multilevel cervical myelopathy: an independent matched-cohort analysis.
Matched patient cohorts using retrospective chart and radiographic review with independent clinical and radiographic follow-up were reviewed. ⋯ Both multilevel corpectomy and laminoplasty reliably arrest myelopathic progression in multilevel cervical myelopathy and can lead to significant neurologic recovery and pain reduction in a majority of patients. Surprisingly, the laminoplasty cohort tended to require less pain medication at final follow-up than did the multilevel corpectomy cohort. Given this and the higher prevalence of complications among multilevel corpectomy patients, it is believed that laminoplasty may be the preferred method of treatment for multilevel cervical myelopathy in the absence of preoperative kyphosis.
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A retrospective chart analysis of pediatric trauma patients with suspected cervical spine injury was performed. ⋯ In obtunded and intubated pediatric trauma patients with suspected cervical spine injury, the clearance protocol using cervical spine MRI was effective and cost-efficient.
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A case was reported in which paradoxical air embolism arose from the patent foramen ovale in scoliosis surgery. ⋯ It is critical to detect a patent foramen ovale before surgery and cerebral embolization intraoperatively. This might permit ascertainment of the etiologic diagnosis in case of a complication in surgery for scoliosis.