Spine
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Randomized Controlled Trial Comparative Study
Effectiveness of physical therapy and epidural steroid injections in lumbar spinal stenosis.
Randomized single-blind controlled trial. ⋯ Epidural steroid injections and physical therapy both seem to be effective in LSS patients up to 6 months of follow-up.
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Randomized Controlled Trial
Effect of modified techniques in Bryan cervical disc arthroplasty.
A prospective, randomized study of the clinical and radiographic outcomes in patients undergoing single- and 2-level cervical arthroplasty with Bryan cervical disc (Medtronic Sofamor Danek, Memphis, TN). ⋯ The modified techniques can improve the outcomes of the cervical arthroplasty with Bryan disc and prevent the unexpected imbalance and motion of cervical spine.
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Randomized Controlled Trial Comparative Study
Magnetic resonance imaging interpretation in patients with symptomatic lumbar spine disc herniations: comparison of clinician and radiologist readings.
Retrospective review of imaging data from a clinical trial. ⋯ Radiology reports frequently fail to provide sufficient detail to describe disc herniation morphology. Agreement between MRI readings by clinical spine specialists and radiologists was excellent when comparing herniation vertebral level and location within level, but only fair comparing herniation morphology.
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Randomized Controlled Trial Multicenter Study Comparative Study
Implant complications, fusion, loss of lordosis, and outcome after anterior cervical plating with dynamic or rigid plates: two-year results of a multi-centric, randomized, controlled study.
Prospective, controlled, randomized, multicenter study. ⋯ Dynamic cervical plate designs provide less implant complications (no patient) compared with rigid plate designs (4 patients). Speed of fusion was faster in the presence of a dynamic plate. However, loss of segmental lordosis is significantly higher if dynamic plates are used, which did not result in differences regarding clinical outcome between dynamic and constrained plates after 2 years. Thus, dynamic plates should be considered to be the preferred treatment option because of the lower risk for implant failure-related revision surgery.
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Randomized Controlled Trial Comparative Study
Cervical disc replacement in patients with and without previous adjacent level fusion surgery: a prospective study.
Prospective 6-center study. OBJECTIVE.: To evaluate outcomes of cervical disc replacement performed adjacent to a prior cervical fusion. ⋯ Although the level adjacent to a prior cervical fusion is subject to increased biomechanical forces, potentially leading to a higher risk of failure, the PCM disc was well tolerated in the short term. The early clinical results of disc replacement adjacent to a prior fusion are good and comparable to the outcomes after primary disc replacement surgery. However, in view of the small study population and short-term follow-up, continued study is mandatory.