The spine journal : official journal of the North American Spine Society
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Randomized Controlled Trial Comparative Study
Lumbar microdiscectomy under epidural anesthesia: a comparison study.
Lumbar microdiscectomy is most commonly performed under general anesthesia, which can be associated with several perioperative morbidities including nausea, vomiting, atelectasis, pulmonary aspiration, and prolonged post-anesthesia recovery. It is possible that fewer complications may occur if the procedure is performed under epidural anesthesia. ⋯ Epidural anesthesia as an alternative to general anesthesia has shown less postoperative nausea and vomiting in lumbar microdiscectomy. Nevertheless, given the small number of patients, this study should be considered as preliminary, showing small differences in minor potential complications.
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Randomized Controlled Trial
Validity of the new Backache Index (BAI) in patients with low back pain.
The Backache Index (BAI) is applied to patients with low back pain (LBP) in order to help therapists, doctors, and surgeons perform physical examinations easily. It is carried out within a short space of time (<2 min) without using inclinometric instruments. ⋯ The BAI appears to be a reliable and valid assessment of overall restricted spinal movements in case of LBP and discriminates between successful and unsuccessful treatment outcome.
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To our knowledge, the presence of noncontiguous fracture-dislocation of the lumbosacral spine occurring at two levels has not been reported. The etiology, evaluation, and treatment of the unusual injury is presented. ⋯ Noncontiguous double fracture-dislocation of the lumbosacral spine is an unusual injury, which results from a very high-energy trauma. Prompt recognition of the injuries, reduction of the fracture-dislocations, and posterior stabilization is recommended for neural decompression, spinal alignment, and long-term stabilization.
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To report the middle term results of partial coccygectomy in a consecutive series of 15 patients with chronic coccygodynia. ⋯ Partial coccygectomy is a good therapeutic option for posttraumatic coccygodynia. Dynamic radiography is a useful tool to differentiate posttraumatic from idiopathic coccygodynia. MRI may be useful for further evaluation of the patients after inconclusive dynamic radiography.
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Multicenter Study
Assessment of injury to the posterior ligamentous complex in thoracolumbar spine trauma.
Posterior ligamentous complex (PLC), consisting of supraspinous ligament (SSL), interspinous ligament (ISL), ligamentum flavum (LF), and the facet joint capsules is thought to contribute significantly to the stability of thoracolumbar spine. Currently, no consensus exists on radiographic imaging parameters that may indicate injury to the posterior ligamentous complex. ⋯ Plain radiographic findings were felt to be most helpful in determining PLC injury by the members of the Spine Trauma Study Group. Physical examination findings and history of the mechanism of injury were ranked lower than imaging studies. Future analysis should focus on indicators of PLC injury when plain radiographic findings are either subtle or not present.