Spine
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Randomized Controlled Trial Comparative Study
Urgent surgical decompression compared to methylprednisolone for the treatment of acute spinal cord injury: a randomized prospective study in beagle dogs.
Experimental dog model of acute spinal cord injury. ⋯ In the setting of acute and persistent spinal cord compression in beagle dogs, surgical decompression 6 hours after injury, with or without methylprednisolone, is more effective for improving neurologic recovery than methylprednisolone alone.
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Randomized Controlled Trial
Physical therapy treatment of back complaints on children and adolescents.
A randomized controlled trial was performed. ⋯ An individual assessment by a knowledgeable physiotherapist and an active treatment model improve how children and adolescents experience their back problems with respect to health and physical function, pain, strength, and mobility, regardless of whether treatment consists of a home exercise program with follow-up or home exercise combined with exercise and treatment supervised by a physiotherapist.
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Randomized Controlled Trial Comparative Study
The cost effectiveness of surgical versus nonoperative treatment for lumbar disc herniation over two years: evidence from the Spine Patient Outcomes Research Trial (SPORT).
Spine Patient Outcomes Research Trial observational and randomized cohort participants with a confirmed diagnosis of intervertebral disc herniation (IDH) who received either usual nonoperative care and/or standard open discectomy were followed from baseline at 6 weeks, 3, 6, 12, and 24 months at 13 spine clinics in 11 US states. ⋯ Surgery for IDH was moderately cost-effective when evaluated over 2 years. The estimated economic value of surgery varied considerably according to the method used for assigning surgical costs.
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Randomized Controlled Trial
Epidural steroid following discectomy for herniated lumbar disc reduces neurological impairment and enhances recovery: a randomized study with two-year follow-up.
We randomized 200 patients after lumbar discectomy to receive epidural steroid or none with a 2-year follow-up. ⋯ Epidural methylprednisolone enhances recovery after discectomy for herniated disc disease without apparent side effects.
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Randomized Controlled Trial Comparative Study
Greater peripheral blood flow but less bleeding with propofol versus sevoflurane during spine surgery: a possible physiologic model?
Prospective, randomized, single blind. ⋯ Despite the greater blood flow when it is used, propofol causes less bleeding than sevoflurane during spine surgery and could be more indicated to produce hypotension during anesthesia. Moreover, it is possible to explain our findings hypothesizing a selective vasodilation of propofol (postcapillary, venous vasodilation), different from that of sevoflurane (precapillary, arteriolar vasodilation).