Randomized controlled trial of pregabalin for analgesia after surgical treatment of intervertebral disc disease in dogs

2020 ◽  
Vol 49 (5) ◽  
pp. 905-913
Author(s):  
Philipp A. Schmierer ◽  
Julia Tünsmeyer ◽  
Andrea Tipold ◽  
Sonja Hartnack‐Wilhelm ◽  
Piotr Lesczuk ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Surgical Treatment ◽  
Intervertebral Disc ◽  
Controlled Trial ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Randomized Controlled

scholarly journals RESEARCH PROTOCOL: Cervical Arthroplasty Cost Effectiveness Study (CACES) Economic Evaluation of Anterior Cervical Discectomy With Arthroplasty Versus Anterior Cervical Discectomy With Fusion in the Surgical Treatment of Cervical Degenerative Disc Disease, a Randomized Controlled Trial.

2022 ◽  
Author(s):  
Valérie N.E. Schuermans ◽  
Anouk Y.J.M. Smeets ◽  
Toon F.M. Boselie ◽  
Math M.J.J. Candel ◽  
Inez Curfs ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cost Effectiveness ◽  
Surgical Treatment ◽  
Controlled Trial ◽  
Cost Effective ◽  
Anterior Cervical Discectomy ◽  
Disc Disease ◽  
Cervical Discectomy ◽  
Randomized Controlled ◽  
Multi Level

Abstract IntroductionTo date, there is no consensus on which anterior surgical technique is more cost-effective in treating cervical degenerative disc disease (CDDD). The most commonly used surgical treatment for patients with single- or multi-level symptomatic CDDD is anterior cervical discectomy with fusion (ACDF). However, new complaints of radiculopathy and/or myelopathy commonly develop at adjacent levels, also known as clinical adjacent segment pathology (CASP). The extent to which kinematics, surgery-induced fusion, natural history and progression of disease play a role in the development of CASP remain unclear. Anterior cervical discectomy with arthroplasty (ACDA) is another treatment option that is thought to reduce the incidence of CASP by preserving motion in the operated segment. While ACDA is often discouraged, as the implant costs are higher while the clinical outcomes are similar to ACDF, preventing CASP might be a reason for ACDA to be a more cost-effective technique in the long-term.Methods and analysisIn this randomized controlled trial, patients will be randomized to receive ACDF or ACDA in a 1:1 ratio. Adult patients with single- or multi-level CDDD and symptoms of radiculopathy and/or myelopathy will be included. The primary outcome is cost-effectiveness and cost-utility of both techniques from a healthcare and societal perspective. Secondary objectives are the differences in clinical and radiological outcomes between the two techniques, as well as the qualitative process surrounding anterior decompression surgery. All outcomes will be measured at baseline, and every six months until four years post-surgery.DiscussionHigh-quality evidence regarding the cost-effectiveness of both ACDA and ACDF is lacking; to date, there are no prospective trials from a societal perspective. Considering the ageing of the population and the rising healthcare costs, there is an urgent need for a solid clinical cost-effectiveness trial addressing this question.

scholarly journals The Functional and Morphological Changes of the Cervical Intervertebral Disc after Applying Lordotic Curve Controlled Traction: A Double-Blind Randomized Controlled Study

2019 ◽  
Vol 16 (12) ◽  
pp. 2162 ◽  
Author(s):  
Chang-Hyung Lee ◽  
Sung Jin Heo ◽  
So Hyun Park ◽  
Hee Seok Jeong ◽  
Soo-Yeon Kim
Keyword(s):  
Intervertebral Disc ◽  
Treatment Outcomes ◽  
Morphological Changes ◽  
Controlled Trial ◽  
Controlled Study ◽  
Functional Score ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Randomized Controlled ◽  
Functional Scores

The newly developed cervical lordotic curve-controlled traction (C-LCCT) appears to be an ideal method to improve the treatment outcome in patients with cervical intervertebral disc disease. The purpose of this study was to investigate the treatment outcomes of C-LCCT including the functional and morphological changes of the cervical intervertebral disc compared to traditional traction (TT) with a randomized controlled trial design. A total of 40 patients with cervical intervertebral disc disease at the C5/6 level confirmed by magnetic resonance imaging were recruited and assigned to either the C-LCCT group or the TT group. The comprehensive health status changes of the patients were recorded using pain and functional scores (Visual Analogue Scale, Oswestry Disability Index) and morphological changes (cervical lordosis, cervical central canal area) before and after the traction treatment. Both groups showed a significant improvement in pain scores after traction (p < 0.05). The functional score and morphological changes improved significantly after treatment in the C-LCCT group. However, there was no significant improvement in the TT group (p < 0.05). The C-LCCT showed significant pain, functional, and morphological improvement compared to TT. C-LCCT could be effective in improving the treatment outcomes of the traction technique in patients with cervical intervertebral disc disease.

What is the Role of the Bacterium Propionibacterium acnes in Type 1 Modic Changes? A Review of the Literature

2017 ◽  
Vol 68 (4) ◽  
pp. 419-424 ◽  
Author(s):  
Mark Georgy ◽  
Mark Stern ◽  
Kieran Murphy
Keyword(s):  
Randomized Controlled Trial ◽  
Propionibacterium Acnes ◽  
Controlled Trial ◽  
Modic Changes ◽  
Low Back ◽  
Review Of The Literature ◽  
Disc Disease ◽  
Randomized Controlled

This review presents a summary of the pathology and epidemiology of Modic changes and the possible role of Propionibacterium acnes. This information is followed by a synthesis of the most recent clinical research involved in culturing the discs of patients with degenerative disc disease for the presence of bacteria. We also discuss a randomized controlled trial that investigates the effects of antibiotics on patients with chronic low back pain and type 1 Modic changes. We conclude with a brief discussion of the difficulties involved in this research and the significance of the findings.

scholarly journals Effect of a randomized controlled trial on the surgical treatment of spinal metastasis, 2000 through 2010: A population-based cohort study

Cancer ◽  
2013 ◽  
Vol 120 (6) ◽  
pp. 901-908 ◽  
Author(s):  
Michael L. Kelly ◽  
Varun R. Kshettry ◽  
Benjamin P. Rosenbaum ◽  
Andreea Seicean ◽  
Robert J. Weil
Keyword(s):  
Randomized Controlled Trial ◽  
Cohort Study ◽  
Surgical Treatment ◽  
Spinal Metastasis ◽  
Controlled Trial ◽  
Population Based ◽  
Randomized Controlled

scholarly journals Treatment of Degenerated Intervertebral Discs Using a Viable Disc Tissue Allograft for Chronic Discogenic Low Back Pain: A Randomized Controlled Trial Comparing Single-site Outcomes With Aggregate and Longer-Term Follow-Up Data

2021 ◽  
Author(s):  
Timothy Davis ◽  
Afrida Sara ◽  
Terry Nguyen ◽  
John Kenneth Burkus
Keyword(s):  
Randomized Controlled Trial ◽  
Back Pain ◽  
Controlled Trial ◽  
Single Site ◽  
Low Back ◽  
Disc Disease ◽  
Randomized Controlled ◽  
Disc Tissue ◽  
Tissue Allograft ◽  
Vas Scores

Abstract Background: Disruption of the internal structure of the nucleus pulposus commonly occurs with the development of painful degenerative lumbar disc disease. Supplementing disc tissue through autologous or allogeneic human cellular and tissue therapies has been tested in small sample clinical trials. A few investigators have reported substantial improvements in pain and function. A viable disc tissue allograft was developed to supplement tissue loss associated with intervertebral disc degeneration. Methods: We assessed results in a subgroup of patients from a large trial comparing this allograft with other treatments. A multicenter randomized controlled trial of 218 subjects with chronic low back pain secondary to degenerative disc disease was conducted. Patients were treated with the allograft, saline, or nonsurgical management and studied for 12 months. We assessed longer-term results in a single-site subgroup from this prospective trial.Results: At 12 months, subjects from the single-site subgroup who had been randomly assigned to the active allograft group (n=17) showed improvements in both mean Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) scores. There was an overall reduction of 28.69 points in the ODI and 33.06 points in the VAS. This was similar to the aggregate ODI and VAS scores of the active allograft group. At 24 months postprocedure, 9 of the 10 patients remaining in the active allograft group at the single study site had mean ODI and VAS score improvements of 28.23 and 36.13, respectively. A similar improvement in pain scores occurred in the 4 patients at 36 months with mean ODI and VAS score improvements from preoperative scores of 25.21 and 51.35, respectively.Conclusions: Clinically meaningful improvements demonstrated in this single-site analysis were comparable to the aggregate study population at 12 months. Longer-term results from this single site at 24 and 36 months suggested durability of viable disc tissue allograft supplementation for patients with discogenic back pain.Trial registration: The trial was retrospectively registered 17 October 2018 on www.clinicaltrials.gov (NCT03709901) and was approved by the Sterling Institutional Review Board, Atlanta, Georgia (IRB no. 5792).

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