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 Clinical Trial
Pain-drawing does not predict the outcome of fusion surgery for chronic low-back pain: a report from the Swedish Lumbar Spine Study.
Despite a widespread use of pain drawing in the selection of patients for surgical and non-surgical treatment, its value as a predictor of outcome is still not well documented. In a prospective multicentre randomised controlled trial of surgical and non-surgical treatment for chronic low-back pain (CLBP), two hypotheses were tested: (1). Pain drawing predicts outcome of treatment for CLBP, (2). ⋯ The pain drawing was associated with pre-treatment back pain intensity and depressive symptoms. No predictive value of the pain drawing regarding the outcome of treatment of CLPB was demonstrated. The concept of "organic/non-organic" pain in conjunction with chronic low-back pain is not supported by the results of the present study.
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Randomized Controlled Trial Clinical Trial
Day-case conventional discectomy: a randomised controlled trial.
A prospective randomised trial compared the results of conventional lumbar discectomy performed as day cases with those performed on an in-patient basis. The aim of the study was to investigate whether conventional discectomy can be performed safely on a day-case basis. ⋯ The rate of complications was unchanged. It is concluded that conventional discectomy can be undertaken safely as day-case surgery and may indeed speed up the recovery process.
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Randomized Controlled Trial Clinical Trial
The effect of transpedicular intracorporeal grafting in the treatment of thoracolumbar burst fractures on canal remodeling.
Short-segment posterior instrumentation for the treatment of thoracolumbar burst fractures has been reported with a high rate of failure. Transpedicular intracorporeal grafting in combination with short-segment instrumentation has been offered as an alternative to prevent failure. However, concern still remains about the potential complication of further canal narrowing or failure of remodeling with this technique. ⋯ Spinal canal narrowing was 38.5+/-18.2% at presentation, 22.1+/-19.8% postoperatively, and it further improved to -2.5+/-16.7% at follow-up, similar for both groups. Our results demonstrate that transpedicular intracorporeal grafting in the treatment of burst fractures does not have a detectable effect on the rate of reconstruction of the canal area or on remodeling. Spinal canal remodeling was observed to occur in all patients regardless of grafting.
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Randomized Controlled Trial Comparative Study Clinical Trial
The use of plate fixation in anterior surgery of the degenerative cervical spine: a comparative prospective clinical study.
The method of anterior mono- or bisegmental cervical spine fusion is a well-established procedure for degenerative conditions of the cervical spine. While the early reports promote fusion with bone graft alone, recent studies report superior results with the addition of anterior plating. The objective of this study was to evaluate the influence of using plates in anterior cervical spine fusion in a prospective study. ⋯ There was no significant difference between the groups for fusion rating, but graft quality (graft height) was significantly better in the plated group. We conclude that the overall data do not suggest better results with plating in mono- or bisegmental anterior spine fusions. Indications for additional internal fixation are restricted to special conditions with increased instability, insufficient bone quality or inappropriate graft placing.
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Randomized Controlled Trial Clinical Trial
The General Function Score: a useful tool for measurement of physical disability. Validity and reliability.
The General Function Score (GFS) is a disease-specific instrument consisting of nine items focusing on strict physical activities of daily living. It is intended as an alternative to the more complex scores of disability (such as the Oswestry Disability Index), serving as a complement to the quality of life instruments in the study of low back pain (LBP). It was developed from an original 17-item questionnaire, of which 11 of the items were tested for criterion validity in an observer-supervised performance test. ⋯ The GFS showed a high responsiveness to difference and change. The effect size was 0.82-0.96 in surgically treated disc herniation and 0.55-0.85 in spondylolisthesis. The GFS is a highly valid and reliable instrument with good responsiveness and feasibility, useful for evaluation of physical disability.