Spine
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Clinical Trial
Duration of antituberculosis chemotherapy in conjunction with radical surgery in the management of spinal tuberculosis.
The effectiveness of duration of antituberculous chemotherapy in conjunction with radical surgery for tuberculosis of the spine is reported. One hundred fourteen patients were followed prospectively for a mean period of 14.6 years after radical resection of the tuberculous lesion and reconstruction of the resultant gap with bone graft. ⋯ The authors' findings show that a 6-month chemotherapeutic regimen combined with surgical excision and bone grafting is adequate for management of tuberculosis of the spine, as it produced clinical and radiologic results comparable with the 18-month chemotherapeutic regimen.
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Case Reports Clinical Trial
The use of implantable direct current stimulation in multilevel spinal fusion without instrumentation. A prospective clinical and radiographic evaluation with long-term follow-up.
A prospective study with long-term follow-up of 143 patients who underwent spinal fusion with direct current stimulation and no instrumentation. ⋯ Multilevel fusion in this series with long-term follow-up evaluation of direct current stimulated patients without instrumentation showed clinical and radiographic success higher than in recent studies without instrumentation and comparable with recent studies using instrumentation.
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Twenty-nine patients with primary bone tumors and solitary metastases of the thoracolumbar spine treated with en bloc resection are reviewed retrospectively. ⋯ En bloc resection can be performed in selected tumors of the spine; the indication to such major surgery must be based on the oncologic stage, and the procedure must be carefully planned. For this purpose, the Weinstein-Boriani-Biagini system could be a helpful tool. Long-term results must be weighed before a definitive statement of the indications can be made.
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A prospective clinical trial was conducted. ⋯ Lifting of postoperative restrictions after limited discectomy allowed shortened sick leave without increased complications. Postoperative precautions in these patients may not be necessary.
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Cervical spine manipulation and mobilization were reviewed in an analysis of the literature from 1966 to the present. ⋯ Cervical spine manipulation and mobilization probably provide at least short-term benefits for some patients with neck pain and headaches. Although the complication rate of manipulation is small, the potential for adverse outcomes must be considered because of the possibility of permanent impairment or death.