Neurosurg Focus
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Randomized Controlled Trial Multicenter Study
Clinical outcomes of the Dynesys dynamic neutralization system: 1-year preliminary results.
In this study the authors present the preliminary clinical outcomes of dynamic stabilization with the Dynesys spinal system as part of a multicenter randomized prospective Food and Drug Administration (FDA) investigational device exemption (IDE) clinical trial. ⋯ The early clinical outcomes of treatment with Dynesys are promising, with lessening of pain and disability found at follow-up review. Dynesys may be preferable to fusion for surgical treatment of degenerative spondylolisthesis and stenosis because it decreases back and leg pain while avoiding the relatively greater tissue destruction and the morbidity of donor site problems encountered in fusion. However, long-term follow-up care is still recommended.
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Previous investigations of health outcome after spinal surgery for tethered cord syndrome (TCS) have been single-institution studies. The aim of this study was to report inpatient complications and outcomes on a nationwide level. ⋯ This study provides a national perspective on inpatient complications and outcomes after spinal surgery for TCS in the United States. The authors have demonstrated the impact of age, complications, and medical comorbidities on the outcome of surgery for patients with this common disorder.
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Multicenter Study Controlled Clinical Trial
Dynamic intraspinous spacer technology for posterior stabilization: case-control study on the safety, sagittal angulation, and pain outcome at 1-year follow-up evaluation.
To assess the safety and efficacy of the DIAM implant, the authors compared the mean 12-month outcomes in patients who underwent lumbar surgery with DIAM placement and in those who underwent lumbar surgery only. ⋯ After simple lumbar surgery, the placement of a DIAM interspinous process spacer did not alter disc height or sagittal alignment at the mean 12-month follow-up interval. No adverse local or systemic reaction to the DIAM was noted. No difference in VAS or MacNab outcome scores was noted between the groups treated with or without the DIAM implants, particularly when the DIAM was used to alleviate low-back pain.
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Review Historical Article
Cervical spine surgery in the ancient and medieval worlds.
The early historical literature on cervical spine surgery lacks printed material for review, and we can rely only on pathological material from the prehistoric period that has survived as a result of anthropological investigations. After the introduction of Egyptian and early Hellenic medicine, some written material became available. This paper reviews these materials, from both books and manuscripts, in an effort to understand the development of cervical spine surgery from the perspectives of the personalities involved and the early surgical practices used. The review thus considers the following five eras of medicine: 1) prehistoric; 2) Egyptian and Babylonian; 3) Greek and early Byzantine; 4) Middle Eastern; and 5) medieval.
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Review Historical Article
Hippocrates' influence on the origins of neurosurgery.
Hippocrates is widely considered the father of medicine. His contributions revolutionized the practice of medicine and laid the foundation for modern-day neurosurgery. He inspired several generations to follow his vision, by pioneering the rigorous clinical evaluation of cranial and spinal disorders and combining this approach with a humanistic and ethical perspective focused on the individuality of the patient. His legacy has forever shaped the field of medicine and his cumulative works on head injuries and spinal deformities led to the basic understanding of many of the fundamental neurosurgical principles in use today.