Clinical Practice Guideline No. Rockville, MD; FDA; July 14, 2004. Fischgrund, Rhyne, and Vajkoczy) had a consulting relationship with the study's device manufacturer. Thats 3.7 million people. The main drawback of this study was its retrospective nature and the inadvertent biases that this study design may have introduced. In the first 6 months, the frequency of AEs did not differ between groups (p = 0.664). Outcomes of interest assessing the 2 techniques included demographic and clinical baseline characteristics, peri-operative variables, complications, recurrent herniation rate and post-operative functional outcomes. Boult M, Fraser RD, Jones N, et al. The findings of this small study are promising. Implantation of an ACD in patients with small annular defects could not be justified clinically given the inherently low risk of symptom recurrence in these individuals. N Engl J Med. Patient outcome measures after treatment of symptomatic disk herniation and neuro-foraminal stenosis were evaluated. Patients were carefully selected based on pedicle integrity and a spread calculation to quantify VB fragment displacement. Percutaneous cryodenervation of lumbar facet joints: A prospective clinical trial. Subjects were asked about their NRS scores, ODI scores, and progression to secondary treatment. Mean ABH was also significantly increased from 1.5 cm to 1.9 cm following treatment with the SpineJack system; but was reduced to 1.8 cm at 12 months post-procedure. Implantation is done by simply placing the device into the interlaminar space between the superior and inferior spinous processes after bilateral segmental laminectomy. The time from initial painful fracture to treatment was 3.0 weeks 1.3. BDSM 07/07/17: OZone 02 : Open Arms (4.44) Family reunion Dhorne style. Among children and youth ages 6 to 11, more than 1 in 5 (20.3%) have obesity. Bursitis occurs when the bursae become inflamed. Minimally invasive transforaminal lumbar interbody fusion with expandable versus static interbody devices: radiographic assessment of sagittal segmental and pelvic parameters. Washington State Health Care Authority, Sacroiliac joint fusion. In multi-level ACDF patients, there was a higher rate of revision surgery (SA 3.8 % versus SC 7.3 %, odds ratio [OR] = 1.982, p < 0.001) in the SC group, and a higher rate of dysphagia in the SA group (SA 15.9 % versus SC 12.9 %). The Lumbar Spinal Stenosis Consensus Group convened to evaluate the peer-reviewed literature as the basis for making minimally invasive spine treatment (MIST) recommendations. All fusion constructs significantly reduced the range of motion compared to intact in flexion-extension, lateral bending, and axial rotation (P<0.05). Minimally invasive, lumbar decompression and dynamic stabilisation using an interlaminar device, with no rigid fixation to the vertebral pedicles, of one or two lumbar motion. However, with the difficulty in accurate diagnosis and evidence for the efficacy of SIJ fusion itself lacking, serious consideration of the cause of pain and alternative treatments should be given before performing the operation. The outcome measure was short-term pain relief of at least 6 months or long-term pain relief of more than 6 months. UpToDate [online serial]. Outcome predictors for sacroiliac joint (lateral branch) radiofrequency denervation. Spine (Phila Pa 1976). The authors concluded that both allograft and PEEK spacers were acceptable options for ACDF surgery. These researchers compared clinical outcomes of TED to micro-discectomy (Micro). Lonne G. Treatment of lumbar spinal stenosis; comparison of two different surgical methods; Mini-invasive decompression to X-stop (LSSS). Further comparative studies of ILS stabilization to decompression alone, especially performed using a minimally invasive technique, are interesting . Success rate, comprised of no second intervention and an ODI improvement of greater than or equal to 15 points, was 57.6% of ILS and 46.7% of fusion patients (p = 0.095). The short form-36 questionnaire and Majeed's scoring system were used for pre- and post-operative functional evaluation. The authors stated that considering the short-term follow-up, the results and function of the SJ system need to be studied in a larger series, and future studies should focus on long-term clinical and radiological outcomes. Among these, 2 were directly supported by industry funding, which increased the risk of publication bias. Gibson JN, Cowie JG, Iprenburg M. Transforaminal endoscopic spinal surgery: The future 'gold standard' for discectomy? Overall, it is considered that while the procedures are safe, there is only modest evidence for effectiveness. Therapeutic sustainability and durability of coflex interlaminar stabilization after decompression for lumbar spinal stenosis: A four year assessment. Some simple lifestyle changes may help reduce hip pain at night: People can relieve and control hip pain in several different ways: During pregnancy, it is quite common for individuals to experience changes in their body and hormone levels. At the 3-month follow-up, there was significant improvement in VAS and ODI (p < 0.05); at long-term follow-up VAS showed additional significant improvement (p < 0.05) and ODI remained stable. Low back disorders. Pain. Diffuse painful lesions and long bone diaphysis should not be good indications. In addition, NASS has concluded that lateral interbody fusion (XLIF orDLIF) should not be considered experimental or investigational (Baker, 2010). Effective methods for diagnosing and treating sacroiliac joint pain in patients without spondyloarthropathy remain controversial. These researchers stated that the medical device reports that were submitted to the FDA and posted on the MAUDE database were submitted by healthcare professionals and patients. Moreover, the Specialist Advisors believed the effectiveness of this procedure to be unproven; and they also noted a number of potential complications including nerve injury and infection. Clin Neurol Neurosurg. Adjacent segment degeneration at L3/L4 and L5/S1 was assessed by Pfirrmann classification. The treatment mechanism of an interspinous process implant for lumbar neurogenic intermittent claudication. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. Chiang CJ, et al. 1995;20(1):31-37. Some secondary outcomes favored methylprednisolone, such as use of analgesic medication within the previous 24 hours (22 % versus 43 %, 95 % CI for difference of 20 %: 0 % to 40 %) and functional disability (19 % versus 49 %, 95 % CI for difference of 29 %: 9 % to 49 %). Orthop Traumatol Surg Res. 2017;106:413-421. Causes of lower back pain when standing or walking. Choy DSJ, Ascher PW, Saddekni S, et al. The patient population consisted of 20 patients undergoing SIJ arthrodesis between December 1994 and December 2001. It can occur in an elbow, wrist, finger, thigh, or elsewhere. Comparative outcomes of cooled versus traditional radiofrequency ablation of the lateral branches for sacroiliac joint pain. 2009;34(10):1066-1077. While the CCS was statistically superior for ILS, it is unclear whether these findings are also clinically significant. Moreover, these researchers stated that because there is currently very little peer-reviewed evidence, continued research is needed to confirm the safety and effectiveness of the procedure. In contrast to discectomy, sequestrectomy was associated with significantly less operative time (p < 0.001), lower VAS for LBP (p < 0.05), less post-operative analgesic usage (p < 0.05) and better patients' satisfaction (p < 0.05). Epstein NE. Waltham, MA: UpToDate; reviewed September 2019. Ruetten S, Meyer O, Godolias G. Endoscopic surgery of the lumbar epidural space (epiduroscopy): Results of therapeutic intervention in 93 patients. But stress can cause pain to travel farther down the back because of the inflammatory response it sets off. This study followed the Cochrane's guidelines for systematic reviews of interventions. Only 4.5% (n = 3) had less than 80% resolution of pre-operative symptoms. Minimally invasive transforaminal lumbar interbody fusion with reduction of spondylolisthesis: Technique and outcomes after a minimum of 2 years' follow-up. An additional drawback was the high cross-over rate after 6 months. This finding may have a profound effect on the health economics and societal costs of treating the increasing number of patients suffering from spinal stenosis. London, UK: BMJ Publishing Group; April 2006. Periarticular steroid injection does not require radiographic guidance. This region has 12 spinal disks, several vertebrae, and many muscles and ligaments. Epiduroscopy and spinaloscopy: Endoscopic studies of lumbar spinal spaces. Jacobson (2020) presented a case of short-term symptomatic failure with continued vertebral collapse after a T12 kyphoplasty for an acute fracture in a severely osteoporotic elderly patient. We avoid using tertiary references. Clinical outcomes were more heterogenetic for patient's treated with steroid injections. Treatment of neck pain. Overall, Food and Drug Administration success criteria required that a patient meet 4 criteria: According to the manufacturer, BacFast HD (Hyper-Demineralized) is a demineralization technology used to expose the collagen surface. Patient selection was based on the history, physical examination and positive medial branch blocks. J Pain Res. Radiographic parameters were assessed at a minimum of 1-year post-op on all patients. Artificial intervertebral disc arthroplasty for treatment of degenerative disc disease of the cervical spine. These were infected hematoma (2), L5 nerve root irritation (1), and L5-S1 discitis (1). Computerized tomography-guided kryorhizotomy in 76 patients with lumbar facet joint syndrome. Jackson RP. Furthermore, whereas analyses of opioid sparing effects and outcomes followed the pre-specified outcomes and analyses of the trial protocol statistical analysis plan, this sub-analysis was not pre-planned and was executed after database lock and unblinding, potentially introducing bias. 2014;1(5):5. On 6 month postop CT scan, 18/19 patients had radiographic evidence of bone ingrowth and bone into or across the SI joint was evident in 8/19 patients. 2018;11:113-121. The efficacy of a percutaneous expandable titanium device in anatomical reduction of vertebral compression fractures of the thoracolumbar spine. 2002;27(7):722-731. Last medically reviewed on December 8, 2022, Causes of upper back pain include herniated discs, muscle overuse, osteoarthritis, and a pinched nerve. Proceedings of the NASS 24th Annual Meeting. Chicago, IL: BCBSA; December 2004;19(13). One, 3, and 6 months after the procedure, 11 (79%), 9 (64%), and 8 (57%) RF-treated patients experienced pain relief of 50% or greater and significant functional improvement. Neurosurgery. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): A randomised controlled trial. These were of interest as the procedure used did not directly decorticate the joint and did not involve placement of bone graft. Please note: the Acadia is not US Food and Drug Administration (FDA) approved; it is currently in an ongoing clinical trial. The efficacy of the synthetic interbody cage and Grafton for anterior cervical fusion. The authors described a less invasive anterior retropleural surgical approach to address central thoracic disk herniations that is less extensive than a thoracotomy and allows better anterior access than posterior or postero-lateral approaches. A total of 142 consecutive adult patients with symptomatic cervical disc disease underwent Deuk Laser Disc Repair during a 4-year period. Joint Bone Spine. The authors concluded that the findings of this study suggested that treatment with the SpineJack system could provide significantly better VB height restoration and KA correction than VP for at least 1 year following the procedure. These researchers reported clinical outcomes in a case series of patients treated with C-RFA for lumbar facet syndrome. Yet another reason tokick the habit: Smoking damages the spine, according to a Swedish study published in The Spine Journal. In this network meta-analysis, node-splitting analysis and loop inconsistency analysis showed no significant inconsistencies. Member has experienced severe pain limiting activities of daily living for at least 6 months; Member has had no prior spinal fusion surgery at the level to be treated; Neuroradiologic studies are negative or fail to confirm disc herniation; Member has no significant narrowing of the vertebral canal or spinal instability requiring surgery; Member has tried and failed sixor more weeks of conservative treatments such as bed rest, back supports, physiotherapy, correction of postural abnormality, as well as pharmacotherapies (e.g., anti-inflammatory agents, analgesics, and muscle relaxants); Use with allograft or autogenous bone graft in members who meet criteriaforlumbar spinal fusion as outlined in, Synthetic spine cages/spacers for cervical fusion for members who meet criteria in. However, whether IPD was superior to bony decompression (DP) was still debated. Interspinous distraction procedures for spinal stenosis causing neurogenic claudication in the lumbar spine. The authors concluded that TESSYS had clinical advantages over FD and entailed less trauma and quicker post-operative recovery, suggesting that TESSYS was well-tolerated by patients and was a better approach than FD in surgical treatment of LDH. Reg Anesth Pain Med. 1993;18(15):2212-2217. In a prospective, multi-center, randomized, controlled, IDE non-inferiority trial, these researchers determined the 2-year outcomes in patients with intermittent neurogenic claudication secondary to moderate LSS who were treated with the Superion interspinous process spacer. 1997;42(6):367-379. Onik G, Helms CA. Anterior cervical discectomy with or without fusion with ray titanium cage: A prospective randomized clinical study. Epidural steroid injections may result in some improvement in radicular lumbosacral pain when determined between 2 and 6 weeks following the injection, compared to control treatment (Level C, Class I to III evidence). 2013;38:1436-1442. One patient was lost to follow-up. The authors concluded that these registry findings supported the clinical adoption of minimally invasive IPD in patients with NC associated with LSS. In a retrospective study, Sachs and Capobianco (2013) reported on the safety and effectiveness of MIS SIJ arthrodesis using a series of triangular, porous plasma coated implants in patients who were refractory to conservative care. While surprising on the surface, this was common in studies of populations with chronic pain. Spine. It is being investigated as a method of soft tissue re-approximation of the anulus fibrosus after a lumbar discectomy procedure. If you wear soft-sole shoes, you might feel like youre absorbing some of the impact, but if theyre too soft, youre introducing instability, he says. Ottawa, ON: Canadian Agency for Drugs and Technologies in Health (CADTH); August 18, 2006. Moojen WA, Arts MP, Jacobs WC, et al; Leiden-The Hague Spine Intervention Prognostic Study Group. Data from the Superion FDA clinical trial, a prospective spinal registry, and the literature were used to populate the model. Adding a foam topper, which can be purchased online, may make a difference. NCHS Health E-Stats, Centers for Disease Control and Prevention. There is Level I evidence for percutaneous image-guided lumbar decompression as superior to lumbar epidural steroid injection, and 1 RCT supported spacer use in a non-inferiority study comparing 2 spacer products currently available. Approximately 10 million U.S. adults over 50 have osteoporosis. The double-segment-fixed patients underwent interbody fusion. London, UK: BMJ Publishing Group; April 2006. 2011;153(5):1011-1019. Chou R. Subacute and chronic low back pain: Surgical treatment. Between February 2001 and March 2004, CT-guided kryorhizotomy of facet joints was carried out in 76 patients with LFJS. Chicago, IL: BCBSA; April 2014;28(14). The study cohort of 45 cases (69% women) achieved post-operative survey follow-up at 9.9 and 32.3 months; SF-12 physical component summary statistically improved while all other scores were equivalent. A subgroup of patients who did not benefit from cryoneurolysis had elevated depression scores. Jancuska and colleagues (2015) stated that LSTV are increasingly recognized as a common anatomical variant associated with altered patterns of degenerative spine changes. 2004;29:1681-1688. That puts unequal stress or strain on one side of the body versus the other. The solution may be as simple as adding a lift into the shoe on the shorter side, but physical therapy can help, he notes. Pain Physician. Comparison of adverse outcomes following placement of Superion interspinous spacer device versus laminectomy and laminotomy. The treatment of foraminal stenosis could lead to improved short-term clinical outcome but was associated with a high re-operation rate at 1 year post-op. Statistically significant signals were found with each of the 3 interspinous spacer devices (Coflex, Vertiflex, and X-Stop) and each of the following AEs: fracture, migration, and pain/worsening symptoms. Mobbs RJ, Phan K, Malham G, et al. Am Fam Physician. All patients underwent a minimally invasive, para-median tubular-based approach for resection of the LSTV; 3 (43%) of 7 patients reported complete resolution of LBP, 2 (29%) of 7 patients had reduced LBP, and 2 patients (29%) experienced initial relief but return of LBP at 1 and 4 years post-operatively; 3 (50%) of the 6 patients with radicular pain had complete relief of this symptom. Racz GB, Heavner JE. Similar results in terms of clinical effectiveness and safety were obtained for the Xclose system. Turns out, even sensible shoes can change your gait and lead to back pain if the soles are uneven, which happens when youve worn them too long. Pichon Riviere A, Augustovski F, Ferrante D, et al. 2019;44:499506. Chronic stress can provide the on switch for the release of inflammation-causing molecules throughout the body. About 1 in 16 children and adolescents ages 2 to 19 (6.1%) have severe obesity. Supplements for heart health: Which ones are beneficial and which ones are not? Staats PS, Chafin TB, Golovac S, et al, MiDAS ENCORE Investigators. Clinical Practice Guideline No. It avoids unnecessary violation of the disc space and much of the bony stabilizers of the cervical spine. 5. Primary outcome was ZCQ in this intention-to-treat (ITT) analysis. High blood pressure. A total of 17 patients with chronic, greater than 6 months, LBP unresponsive to at least 3 months of conservative care were enrolled; 16 patients were treated successfully following screening using MRI finding of Modic type I or II changes and positive confirmatory discography to determine the affected levels. Rev Rhum Engl Ed. As with the arthroscopic microdiscectomy/PED, APLD does not allow direct visualization of the disc or surrounding tissues. A history of thoracolumbar instrumentation (16/45) did not significantly affect outcomes; 3 complications described by screw malposition with neurologic deficit (6.7%) were treated with screw re-positioning (1 case) and removal of a single superior implant (2 cases) with time to revision of 2.2 months. Osteoporosis can cause a decrease in bone mineral density and bone mass. The mean follow-up was for 17 months (9 to 39). In light of the superior results shown with SIJ surgery, the authors felt that there was no clinical equipoise to suggest that additional randomized controlled trials (RCTs) would be acceptable. The ACS-NSQIP dataset was more extensive in documenting patient co-morbidities and complication rates in comparison to the SISS device data, which were provided by the instrumentation company, except for ACS-NSQIP data only tracking post-operative complications and re-operations for 30 days. In a prospective, open-label RCT, these investigators reported the results of the full randomized trial, including the 3-month and 6-month between-arm comparisons, 12-month treatment arm results, and 6-month outcomes of BVN ablation in the former SC arm. In a retrospective review, Tram et al (2020) examined the literature on the efficacy and complications associated with decompression and interspinous devices (ISDs) used in surgeries for LSS. A 3rd assessment was based on a telephone interview (by an independent assessor) at least 4 months after the procedure. 2009;34(13):1349-1354. tumor, infection), acute fracture or inflammatory arthropathy that would not be properly addressed by SIJ fusion; Plain X-rays of the pelvis including the ipsilateral hip to evaluate potential concomitant hip pathology; Cross-sectional imaging (e.g. Apaucity of significant long-term data exists in the literature regarding outcomes of XLIF (Bahtia et al, 2009). Bone. Updated February 8, 2021. Putzier M, Schneider SV, Funk JF, et al. Perhaps the most important and defendable response is the failure to confirm the discus is symptomatic by not meeting this strict criteria. Zhang and colleagues (2018) examined the curative effect of dynamic fixation Coflex treatment for patients with degenerative lumbar spinal stenosis. In a retrospective study, Jasper et al (2013a) evaluated the benefit of transforaminal endoscopic discectomy and foraminotomy in geriatric patients with single level and multi-level lumbar disc herniation and lumbar radiculopathy. Spine. The average ODI was (60.50 +/- 4.40)% pre-operatively, (17.80 +/- 2.10)% post-operatively and (16.20 + 2.40)% at the last follow-up. A greater than or equal to 50 % NRS reduction was observed in 52 % (95 % confidence interval [CI]: 31 % to 74 %) and 44 % (95 % CI: 22 % to 69 %) of subjects in the C-RFA and T-RFA groups, respectively (p = 0.75). Gibson JNA, Waddell G. Surgical interventions for lumbar disc prolapse. 2013;6:77-84. 2013 S2:006. doi:10.4172/2165-7939.S2-006. Aust N Z J Surg. NASS explained that "if one were to consider[lateral interbody fusion]as experimental or investigational, than one would need to conclude that there is only one correct method of performing an anterior lumbar interbody fusion, that all surgeons access the spine through the exact same tissue planes, and that the disc and vertebral bodies are all accessed in the exact same orientation. Two interbody grafts were placed with bilateral pedicle screws using Medtronic instrumentation in the MITLIF group. Results were compared with those of mini-open transforaminal lumbar interbody fixation (oTLIF) using a muscle splitting (Wiltse) approach. Trigger point injections: Diagnosis and management. Neurology. Retrospective review of patient self-reported improvement and post-procedure findings for mild (minimally invasive lumbar decompression). If the initial injection did not produce a positive response, a second diagnostic injection is considered not medically necessary. 2005;30(9):1019-1029; discussion 1030. Opioid use was stratified into 3 groups by 2 blinded external reviewers. Oncotarget. 2015;40(9):E525-E530. The use of CT guidance guaranteed an exact needle-tip position control and documentation for repeated procedures. 2008;25(2):E10. If the injury affects the spinal cord, it can lead to tingling, numbness, and incontinence. Health state utility values were calculated using the EQ-5D and SF-36 at baseline and 6 and 12 months after SIJ fusion surgery in subjects participating in a prospective, multi-center clinical trial (n=172). This study provided short-term follow-up data (24 months). Kienzler et al (2019) noted that a larger defect in the annulus fibrosus following lumbar discectomy is a well-known risk factor for re-herniation. Seventeen patients (85%) had solid fusion. The TriNetX Research Network was retrospectively queried. Rockville, MD: FDA; updated September 3, 2004. Complications analyzed included rates of wound infection, pulmonary embolism (PE), deep venous thrombosis (DVT), urinary tract infection (UTI), sepsis, septic shock, cardiac arrest, death, as well as re-operation within 30 days of index surgery. 2015;10(3):e0121816. All PEEK cages were filled with local autografts. Med Sci Monit. Comparison of discectomy versus sequestrectomy in lumbar disc herniation: A meta-analysis of comparative studies. Pyramidal syndrome. Pan et al (2016) compared the safety and efficacy of percutaneous transforaminal endoscopic spine system (TESSYS) and traditional fenestration discectomy (FD) in treatment of lumbar disc herniation (LDH). Percutaneous epidural neuroplasty: Prospective one-year follow-up. Alberta Heritage Foundation for Medical Research (AHFMR). Muramatsu K, Hachiya Y, Morita C. Postoperative magnetic resonance imaging of lumbar disc herniation: Comparison of microendoscopic discectomy and Love's method. It is intended for attachment to the spinous processes for the purpose of achieving stabilization to promote fusion in patients suffering from DDD, with or without attendant grade I spondylolisthesis. J Clin Neurosci. Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: A prospective randomized double-blind sham-controlled multi-center study. In the cervical group, it remained stable, while in the lumbar group, VAS decreased even more during 36 months (p = 0.012), and 1 ingle patient had spinal surgery. An interventional guidance on laser lumbar discectomy issued by the National Institute for Health and Clinical Excellence (NICE, 2003) stated that "Current evidence on the safety and efficacy of laser lumbar discectomy does not appear adequate to support the use of this procedure without special arrangements for consent and for audit or research". Ruetten S, Meyer O, Godolias G. Epiduroscopic diagnosis and treatment of epidural adhesions in chronic back pain syndrome of patients with previous surgical treatment: First results of 31 interventions. The randomized treatment groups included those treated with VP (88 patients), BKP (124 patients), the SpineJack system (60 patients), an intravertebral expandable pillar (IVEP) (46 patients) and vesselplasty (36 patients). Pain relief (VAS scores) and functional capacity (ODI scores) were obtained via telephonic interviews with the patients or their families, were significantly improved within each group but not between the treatment groups. Spine. At 24 and 48 hours post-operatively, CRP level was remarkably higher in the FD group compared to the TESSYS group (p < 0.001). Technology Assessment Program. Pain assessment was determined using a VAS at the 1st visit before (baseline) and after the procedure at 1, 3, and 6 months. Markman JD, Rhyne AL, Sasso RC, et al. Are You and Your Partner Sleep Compatible? This can improve support and distribute weight more evenly to minimize pressure on hips. N Engl J Med. The main drawbacks of this study were: In a retrospective study with long-term (up to 6 years) follow-up, Vanaclocha and colleagues (2018) determined responses to conservative management (CM), SIJ denervation, and SIJF in patients with SIJ pain unresponsive to CM. Strengthen the hip, thigh, pelvis, and gluteal muscles with exercises that involve moving these areas from side to side. Serious systemic or local complications and neurologic deterioration were not reported. Recurrent herniation rate, re-operation rate, intra-operative blood loss, hospitalization duration and VAS for sciatica were without significant difference. The authors concluded that the 6-month follow-up from this level 1 study showed that minimally invasive SI joint fusion using triangular titanium implants was more effective than non-surgical management in relieving pain, improving function and improving quality of life in patients with SI joint dysfunction due to degenerative sacroiliitis or SI joint disruptions. m, after preparation and marking of the L3 to L4, L4 to L5, and L5 to S1 foramina. Sayhan et al (2018) stated that radiopaque gelified ethanol (RGE; DiscoGel, Gelscom SAS, France) is used as a chemo-nucleolysis substance in treating intradiscal herniation, showing good results without complications. Jarvik JG, Kallmes DF, Deyo RA. The authors stated that challenges for this technique include the complex nature of LBP, with numerous potential contributing etiologies; thus, it is important to ensure appropriate patient selection. Clinical outcome after the use of a new craniocaudal expandable implant for vertebral compression fracture treatment: One year results from a prospective multicentric study. Physical therapy was short term (twice a week for "up to" 8 weeks), and a full quarter of subjects had 15 or fewer physical therapy sessions. Efficacy of treatment of trochanteric bursitis: A systematic review. The authors stated that short-term results of this technique are quite encouraging; longer-term analysis can help in outlining the true benefits of this technique. Lee JS, Yoon KB, Kim IK, Yoon DM. This study provided mid-term (4 years) follow-up; long-term follow-up is needed to determine the durability of the Coflex inter-spinous device. Cochrane Database Syst Rev. 2014;2(5):1041. Patricks sign is also referred to as the Fabere test. In all, 82% of subjects were very satisfied with the procedure at 3 years. 1991;8(73-A):1179-1183. Fifteen patients (75%) completed pre-operative and post-operative SF-36 forms. The authors concluded that the addition of a bone-anchored ACD following lumbar discectomy in patients with large post-surgical annular defects reduced the risk of re-operation and provided better long-term pain and disability relief over 4 years compared to lumbar discectomy only. Spine. One of the most common treatment for spinal trauma or degenerative diseases/disorders is arthrodesis (spinal fusion)of one or more vertebral segments. 2019;33(2):183198. Lindsey DP, Swanson KE, Fuchs P, et al. Chopra P, Smith HS, Deer TR, Bowman RC. Decrease in health care resource utilization with mild. Spinal endoscopic adhesiolysis in the management of chronic low back pain: A preliminary report of a randomized, double-blind trial. Surgical technique consisted of a lateral position followed by retro-pleural exposure through tubular retractor system without the need of intra-operative lung collapse. 2018a;11:2943-2948. Villavicencio et al (2006) retrospectively compared outcomes in 167 consecutive patients with DDD treated with MITLIF (n = 73), open TLIF (n = 51), or APLIF (n = 43). In a controlled laboratory study, these investigators determined the accuracy of US-guided SIJ injections using a cadaveric model. No placebo-controlled trial was found. Qualities of the articles included were assessed using Scottish Intercollegiate Guidelines Network (SIGN). 14. Sortland O, Kleppe H, Aandahl M, Blikra G. Percutaneous lumbar discectomy. Interspinous process devices(IPD) alone versus decompression surgery for lumbar spinal stenosis(LSS): A systematic review and meta-analysis of randomized controlled trials. 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