European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Randomized Controlled Trial
Local vancomycin therapy to reduce surgical site infection in adult spine surgery: a randomized prospective study.
This prospective randomized controlled trial hypothesizes that intra wound vancomycin reduces postoperative infection. ⋯ Intra-wound vancomycin has no effect on SSI; in addition, it can increase the rate of gram-negative infections.
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The effect of paraspinal muscles atrophy and fat infiltration (FI) on the complications of spinal surgery has not been established. ⋯ Strong evidence was found for an association between preoperative paraspinal muscle degeneration and multiple postoperative complications after lumbar surgery. However, the findings should be interpreted with caution due to the small quantity of the available literature and high heterogeneity among studies.
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To evaluate the measurement properties of the Brazilian version of the Copenhagen Neck Functional Disability Scale (CNFDS) in patients with chronic neck pain. ⋯ The Brazilian version of the CNFDS with a one-dimensional structure and 15 items has adequate measurement properties.
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Pyogenic spondylodiscitis is a relatively rare spinal disease; non-specific spondylodiscitis (NSS) cases are increasing. This study aims to identify if changes of inflammatory markers under antibiotic therapy can be used to determine which NSS patients can benefit from surgical indication earlier than others. ⋯ The surgical treatment should be considered for patients who, after 4 weeks of conservative therapy, do not show a reduction in the ESR < 50 mm/h and of the CRP < 2.7 g/dl. The comparison between groups underwent surgically and those treated conservatively showed a reduction in the CRP at 4 weeks and better VAS for pain at 3 months in Group A.
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Multiple surgical techniques are practiced to treat sciatica caused by lumbar disk herniation. It is unknown which factors surgeons find important when offering certain surgical techniques. The objective of this study is threefold: 1) determine the relative weight surgeons place on various characteristics of sciatica treatment, 2) determine the trade-offs surgeons make between these characteristics and 3) identify preference heterogeneity for sciatica treatment. ⋯ In the context of this discrete choice experiment, it is shown that neurosurgeons consider the risk of complications as most important when a surgical technique is offered to treat sciatica, while the risk of recurrent disk herniation and effectiveness are also important factors. Neurosurgeons were prepared to trade off substantial amounts of effectiveness to achieve lower complication rates.