Spine
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This is a retrospective review of all patients requiring either Cotrel-Dubousset or Moss Miami rod removal. All initial spinal instrumentations were for adolescent idiopathic scoliosis from 1985 through 1994. Twenty-two patients who underwent rod removal for late-developing infection constitute the study group. ⋯ Late-appearing infection with spinal instrumentation can be treated with device removal, primary skin closure, and short-term oral antibiotics. The infections affect soft tissue, not the bone.
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Meta Analysis
The Cochrane review of surgery for lumbar disc prolapse and degenerative lumbar spondylosis.
A Cochrane review of randomized controlled trials. ⋯ There is now strong evidence on the relative effectiveness of surgical discectomy versus chemonucleolysis versus placebo. There is considerable evidence on the clinical effectiveness of discectomy for carefully selected patients with sciatica caused by lumbar disc prolapse that fails to resolve with conservative management. There is no scientific evidence on the effectiveness of any form of surgical decompression or fusion for degenerative lumbar spondylosis compared with natural history, placebo, or conservative management. The Cochrane reviews will be updated continuously as other trials become available.
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A prospective cohort study assessing the responsiveness of two disease-specific questionnaires and a generic health questionnaire for patients with low back pain and sciatica. ⋯ Responsiveness varied according to which method was used in its calculation. The responsiveness of the SF-36 questionnaire shows that it can be a useful adjunct in the assessment of patients with low back pain when combined with disease-specific questionnaires.
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Comparative Study
Variability of somatosensory-evoked potentials in different stages of scoliosis surgery.
A comparison of the latencies and amplitudes of the somatosensory-evoked potential in different stages of scoliosis surgery. ⋯ Some variability in latencies and amplitudes between different stages of scoliosis surgery is normal. These results suggest that the somatosensory-evoked potential when the spine is exposed may be used as the reference baseline to determine whether somatosensory-evoked potentials are subnormal at the subsequent stages of surgery.
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Comparative Study
Determining the lumbar vertebral segments on magnetic resonance imaging.
A study to test the ability of an additional cervicothoracic localizer scan to decrease interobserver discrepancy in the identification of vertebral segments in magnetic resonance imaging of the lumbar spine. ⋯ The addition of a cervicothoracic localizer scan in magnetic resonance imaging of the lumbosacral spine is highly recommended.