Spine
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A retrospective study was conducted, with clinical evaluation of hemivertebra resection using transpedicular instrumentation by a posterior approach in young children. ⋯ Posterior resection of hemivertebrae with transpedicular instrumentation is a safe and promising procedure that offers significant advantages for controlling congenital deformity: excellent correction in both the frontal and sagittal planes, short segment of fusion, high stability, no need for an anterior approach, and low neurologic risk. Surgery should be performed as early as possible to avert severe local deformities, to prevent secondary structural changes, and to avert extensive fusions.
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A case report is presented. ⋯ Neurophysiologic monitoring using both somatosensory-evoked potentials and neurogenic mixed evoked potentials is recommended when surgery is performed to correct spine deformity. The Stagnara wake-up test, somatosensory-evoked potentials, and neurogenic mixed evoked potentials are important components of spinal cord monitoring during surgery, and should be used together for optimal protection of neurologic function.
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Randomized Controlled Trial Comparative Study Clinical Trial
Relative cost-effectiveness of extensive and light multidisciplinary treatment programs versus treatment as usual for patients with chronic low back pain on long-term sick leave: randomized controlled study.
A subgroup of 195 patients with chronic low back pain, being part of a larger study of other musculoskeletal patients, were included in a randomized controlled prospective clinical study. ⋯ The light multidisciplinary treatment model is a cost-effective treatment for men with chronic low back pain.
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Historical Article
Role of "Bovie" in spinal surgery: historical and analytical perspective.
Several surgeons use electrocautery (Bovie) discreetly or avoid it completely with the fear of increasing the chances of postoperative infection and delaying wound healing. However, the experience of many other surgeons is different. The current authors have used Bovie extensively to perform a broad array of spinal surgeries. Their rate of infection in spinal surgery can be positively compared with the existing literature where Bovie has been used to variable extent. The purpose of this study is to project the authors' concept that the use of Bovie dissection in spinal surgery does not increase the chances of postoperative wound infection. ⋯ The role of Bovie for musculoskeletal surgery in general and spinal surgery in particular is not well defined. A review of the available literature indicates that Bovie delays the wound healing and increases the chances of infection. The authors' experience with the Bovie and this indirect method of analysis suggest that Bovie does not increase the chances of infection. A detailed search of the literature has been presented along with historical and analytical perspectives. More clinical and experimental studies are needed to further substantiate this claim. If future publications describe the exact surgical technique, extent of the use of Bovie, infection containment (antibiotic) method used before, during, and after surgery, length of the operative exposure, duration of the surgery, and rate of infection, then a meta-analysis of the published clinical material from different centers could be performed, which would provide more comprehensive information.
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Case report. ⋯ Brucellosis is rare in the United States and thus often overlooked in the differential diagnosis of back pain. The changing risk pattern for this disease requires a high index of suspicion, which can result in early diagnosis and predictably favorable results to treatment.