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should i have surgery for spinal stenosis
Postado em 19 de dezembro, 2020
Tissue regrows and presses on the spinal cord or spinal nerve roots. "The pain and numbness in my legs got to the point where I could hardly walk. Sorry, that's wrong. Finally, you may be wondering whether surgery should be considered. One of the most common back problems is lumbar spinal stenosis. There are a lot things that can help relieve your symptoms, but they won't make your arthritis go away. You may not be able to go back to all of your normal activities for at least several months. Is surgery the only thing you can try to make your symptoms better? What You Need to Know. Some medicines you take for pain may have side effects. You can use it to talk with your doctor or loved ones about your decision. Reasons to have surgery for lumbar spinal stenosis. IL, Treatment effect predictors in SPORT. Your personal feelings are just as important as the medical facts. 2. Surgical versus nonsurgical therapy for lumbar spinal stenosis. A second surgery may be needed if: For most people, it's safe to try nonsurgical treatments for several months before thinking about surgery. Fusion should be considered for spinal stenosis only if a vertebra has slipped forward with respect to its neighbor, a condition called spondylolisthesis. 1. Decompressive laminectomy is the most common type of surgery to treat lumbar spinal stenosis. Most people who have surgery are satisfied with the results. I should consider how bad the pain is and whether I can do my normal daily activities. Typically, surgeons use 2 surgical techniques for spinal stenosis surgery. When I was diagnosed with spinal stenosis, my doctor said that there were several things I could do to keep my pain at a minimum, such as using pain relievers and exercising. Surgery may relieve pain in the buttock and leg more than it relieves pain in the back. New England Journal of Medicine, 358(8): 794-810. Surgery appears to work better for leg pain than for back pain, but it may help your back pain too. Since I don't have any other major health problems, I decided to have surgery so I wouldn't have to deal with the leg pain and could start walking again! You try to manage your symptoms with things like changing the way you do your activities, taking medicines to manage pain, doing exercise, or getting physical therapy. Usually a result of the “wear-and-tear” changes in an individual’s spine that occur naturally with age, spinal stenosis of the lumbar spine typically produces pain, cramping, numbness, weakness and/or a pins-and-needles feeling in the legs that is worse with walking and better with resting or leaning forward. Check what you need to do before you make this decision. Symptoms may be very bad at times and not so bad at other times. But in the early stages of stenosis, there are ways to manage pain that don’t include surgery. Who should have surgery for spinal stenosis? Is surgery the only thing you can try to make your symptoms better? Try things like changing the way you do your activities, taking medicines to manage pain, doing exercise, or getting physical therapy instead. But I want to wait and see if other steps help relieve the pain first. Additional important considerations to help with the decision include: Lumbar Laminectomy Surgery for Spinal Stenosis (Open Decompression). Surgery may work better than nonsurgical treatments to relieve pain and help you move better. Spinal stenosis surgery helps to reopen your spinal canal, the channel in your backbone that houses your spinal cord and other nerves. 4 As such, the current study evaluated fifty-three variables to determine which were significant TE predictors and could be used to guide treatment decisions. You notice sudden changes in your ability to walk in a steady way, or your movement becomes clumsy. That's correct. Do you have enough support and advice from others to make a choice? Consistent Pain and Discomfort Why might your doctor recommend surgery for lumbar spinal stenosis? Deerfield, You are less able to control your bladder or bowels than usual. This may be an option for some people. When I was diagnosed with spinal stenosis, my doctor said that there were several things I could do to keep my pain at a minimum, such as using pain relievers and exercising. What are the symptoms of spinal stenosis? The pain and numbness in my legs got to the point where I could hardly walk. But not all surgeons do the procedure. If you have lumbar spinal stenosis, you may be waiting and hoping it will go away. Get Veritas Health eNewsletters delivered to your inbox. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Common surgical techniques to treat spinal stenosis include: 1. If simple treatments aren’t relieving your symptoms, talk to … The idea is to create more space between the bones to take pressure off the nerve roots. What should you avoid or stop doing at this time? "If you can't see that on an x-ray and you have spinal stenosis, you should be having a laminectomy," Dr. Atlas says. Nonsurgical treatments have not worked well enough for me. When surgery helps relieve symptoms, the results appear to last for several years. This surgery is more complicated and has more risks. It may help to go back and read "Get the Facts." Surgical versus nonoperative treatment for lumbar spinal stenosis four-year results of the Spine Patient Outcomes Research Trial. Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. That's right. This article addresses this important question. Many people are able to manage their symptoms with things like changing the way they do their activities, taking medicines to manage pain, doing exercise, or getting physical therapy. The pain, numbness, and tingling in my legs started about 5 years ago. Spinal stenosis is when the canal in your spinal column narrows. Think about what matters most to you in this decision, and show how you feel about the following statements. When surgery helps relieve symptoms, the results appear to last for several years. William H. Blahd Jr. MD, FACEP - Emergency Medicine. I want to discuss the options with others. By giving your spinal cord and nerve roots more space to pass through, your spine surgeon hopes to decrease your pain from nerve inflammation. There are several treatments that don't involve surgery that can help you feel better, be more active, and avoid surgery. Spinal stenosis Back surgery might be an option if conservative treatments haven't worked and your pain is persistent and disabling. The pain can often be debilitating and a patient may have to decide whether to embark with surgery or to manage the … Potential risks of the surgery for lumbar stenosis are greatly affected by the general health of the patient, such as diabetes, obesity, or cigarette smoking. Weinstein JN, et al. Spine, 30(8): 936-943. Does a second fusion cause additional risks or complications since I have spinal hardware in place? But I want to wait and see if other steps help relieve the pain first. This narrowing is sometimes the result of a herniated disc, buckling or inflamed ligaments, bone spurs, or some combination of these factors. To remove the tissue that's pressing on a nerve, your spine surgeon may perform one of the following types of surgery. What are the risks of surgery for lumbar spinal stenosis? Because spinal stenosis is caused by degenerative changes in the spine, symptoms may recur a few years after surgery for lumbar stenosis. Symptoms like a lack of bladder control, numbness, trouble walking, and weakness, are unlikely to get better on their own. For medical advice relating to your personal condition, please consult your doctor. COVID-19 Vaccines: Information about COVID-19 vaccines and how we're preparing for distribution. 1. It can take up to several months before you go back to your normal activities. This surgery is done to relieve pressure on the spinal nerve roots. This surgery is done to relieve pressure on the spinal nerve roots. if it includes a spinal fusion with or without instrumentation), the risks of the surgery increase. It came on gradually, and I could manage it with pain relievers. I want surgery if there is a chance it will help me. Tears in the fibrous tissue that covers the spinal cord and the nerve near the spinal cord. This information does not replace the advice of a doctor. That's correct. Veritas Health, LLC, Decompressive laminectomy is the most common type of surgery to treat lumbar spinal stenosis. There are other, less invasive, methods of treatment that should always be tried before surgery becomes an option. I noticed the numbness and pain in my legs for a while. Here's a record of your answers. Do you have enough support and advice from others to make a choice? Not having a surgery to treat your lumbar spinal stenosis can mean you will continue to live with daily pain. Predominant leg pain is associated with better surgical outcomes in degenerative spondylolistheses and spinal stenosis: Results from the Spine Patient Outcomes Research Trial (SPORT). The key question for many patients dealing with such pain is: how do I decide whether to have surgery for lumbar stenosis or live with the symptoms and manage them through non-surgical means? The information is produced and reviewed by over 200 medical professionals with the goal of providing trusted, uniquely informative information for people with painful health conditions. Since I could hardly do my simple everyday routines without pain, I figured that it was time for surgery. If that is the case, and the spinal stenosis has been diagnosed on an MRI scan or CT-myelogram, then a surgeon may discuss surgical options with you. 1999-2020 Veritas Health, LLC. The natural history with spinal stenosis, in the majority of patients, is that of episodic periods of pain and dysfunction. Back surgery is often required for advanced spinal stenosis, but you should always try nonsurgical treatment options first to avoid potential complications and a long recovery time. Spine, 36(3): 219-229. Will surgery help your leg pain? Surgery may work better than nonsurgical treatments to relieve pain and help you move around easier. Once symptoms develop, patients usually fall into one of three categories: The bottom line is that the time to see a surgeon about surgery for lumbar spinal stenosis is when an individual is unhappy with his or her restricted activity level, and has tried reasonable nonoperative treatments (like anti-inflammatory medication, physiotherapy, and epidural steroid injection). If nonsurgical treatments have not worked well enough, surgery might be able to help you. Complete disclaimer. —Sioux Falls, SD Because you already have spinal instrumentation in place, a second fusion can cause additional risks and complications. I'm relieved that I avoided surgery. They may be helpful as you make important health decisions. ", "I noticed the numbness and pain in my legs for a while. Over time, your arthritis may get worse, and symptoms of spinal stenosis may come back. And even if you get better with surgery, there is a chance that you may get new symptoms in the future. How sure do you feel right now about your decision? 1. What is the surgery for lumbar spinal stenosis? Many people are able to manage their symptoms with things like changing the way they do their activities, taking medicines to manage pain, doing exercise, or getting physical therapy. This surgery is done on patients who do not respond to conservative measures and have worsening symptoms despite nonsurgical treatments. You may want to have surgery if you have tried other treatments for a few months and your pain or other symptoms are still so bad that you can't do your normal activities. By 3 months, people who had surgery notice more improvement in their symptoms and can be more active than people who did not have surgery. Many people are able to manage their symptoms with things like changing the way they do their activities, taking medicines to manage pain, doing exercise, or getting physical therapy. It usually occurs when bone and other tissues grow inside the openings in the spinal bones. Pearson A, et al. And even if you get better with surgery, there is a chance that you may get new symptoms in the future. After my MRI showed I had spinal stenosis, my doctor said that the final decision for treatment was up to me. © 1995-2020 Healthwise, Incorporated. Over time, though, the symptoms got worse and worse, even though I tried physical therapy and changing the way I do certain activities. There is a chance that surgery might not relieve your symptoms. While SPORT demonstrated a significant treatment effect of surgery for spinal stenosis at the group level, surgical decision making takes place at level of the individual patient. After my MRI showed I had spinal stenosis, my doctor said that the final decision for treatment was up to me. And it's usually not needed unless you have other back problems along with spinal stenosis. An earlier surgery didn't control symptoms. ", "The pain, numbness, and tingling in my legs started about 5 years ago. Another congenital spinal deformity that can put a person at risk for spinal stenosis is scoliosis (an abnormally shaped spine). People who’ve been diagnosed with spinal stenosis often wonder about their options for slowing its progression and relieving the pain; often, surgery is one of those options. Many of my patients with spinal stenosis find that a TENS machine can help to relieve their symptoms, when used alongside exercises for spinal stenosis. The physical therapy seems to be working, so I will stick with it for now. Spinal stenosis Surgery is typically only done if all ese fails. That's what I'm doing, and now I hardly ever get leg pain. Your pain and weakness are bad enough to get in the way of your normal activities and have become more than you can manage. What else do you need to make your decision. This is the most commong surgical optionl. When the spinal cord narrows, it puts pressure on the spinal cord, which often leads to pain, tightness, or numbness down the back or in one leg. Surgery can reopen your spinal canal. But if these other treatments don't work, not having surgery means that you may still have pain or other symptoms that make it hard for you to do your daily activities. That's what I'm doing, and now I hardly ever get leg pain. The pain tends to come and go, but it usually does not progress with time. A patient will usually do as well having lumbar stenosis surgery sooner as he or she would if the surgery were done later. Surgery may work better than nonsurgical treatments to relieve pain and help you move around easier. Lumbar stenosis can also cause leg pain and tingling, while cervical stenosis is associated with arm pain. How sure do you feel right now about your decision? Surgery may not be an option if you have other serious health problems that make surgery too risky. This surgery is done to relieve pressure on the spinal nerve roots. Possible problems from surgery include: Symptoms may return after several years. My doctor says surgery may be an option if my leg pain gets worse. Luckily, I did not feel pain all of the time when I was walking. Surgery may relieve pain in the buttock and leg more than it relieves pain in the back. Author information: (1)Department of Orthopaedics, Dartmouth Medical School and the Dartmouth Institute for Health Policy and Clinical Practice, Hanover, NH, USA. My doctor says surgery may be an option if my leg pain gets worse. What You Need to Know, Full Range of Surgical Options for Spinal Stenosis, Overall Treatment Considerations for Lumbar Spinal Stenosis, 70% live with their symptoms and manage them through nonsurgical treatments, 10-15% undergo surgery for lumbar stenosis, specifically a, When to See a Surgeon for Spinal Stenosis. The chance that the surgery won't relieve your symptoms. These include: Decompressive laminectomy is the most common type of surgery to treat lumbar spinal stenosis. A TENS machine works by sending a small electrical signal into the muscles of the back, providing pain relief in many cases and loosening tight muscles. If you have spinal stenosis, you need to discontinue any activity that exacerbates your symptoms, including pain or sensations of numbness, tingling and weakness. | This surgery joins, or fuses, two or more bones so that the joints can no longer move. Similarly, if the proposed surgery is more involved (e.g. It may help to go back and read "Get the Facts." Spinal stenosis is generally not progressive. And even if you get better with surgery, there is a chance that you may get new symptoms in the future. Surgery may work better than nonsurgical treatments to relieve pain and help you move around easier. In extreme cases, spinal stenosis can also make the nerves connected to the bladder or bowel weak. If you have lumbar spinal stenosis, your doctor has probably talked about things that you can do to manage your back and leg pain and improve your ability … Prolonged walking and standing tend to make the symptoms of spinal stenosis worse, according … The benefits of surgery appear to last for many years. Surgery may relieve pain in the buttock and leg more than it relieves pain in the back. The idea that you need neck surgery to decompress your spinal cord if you have neck stenosis because you may become paralyzed in a fall is ridiculous. If other treatments don't work, you may still have pain or other symptoms that make it hard for you to do your daily activities. © Copyright 1995-2020 Regents of the University of Michigan. Many people are able to manage their symptoms with things like changing the way they do their activities, taking medicines to manage pain, doing exercise, or getting physical therapy. In serious situations, leaving lumbar spinal stenosis untreated can lead to permanent nerve damage. 2. 3. NOTICE: This health information was not created by the University of Michigan Health System (UMHS) and may not necessarily reflect specific UMHS practices. Over time, though, the symptoms got worse and worse, even though I tried physical therapy and changing the way I do certain activities. © In some cases, spinal fusion may be done at the same time to help keep the spine stable. Atlas SJ, et al. (2010). Do you understand the options available to you? I have been working with a physical therapist for several months now to relieve my leg pain that is caused by spinal stenosis. Don't have surgery. Getting relief from my pain and weakness will be worth it, even if I need to have the surgery again in a few years. See Considering Spine Surgery? (2008). Surgery can be a successful strategy to restore mobility in those who are unable to walk due to spinal stenosis, according to Mobasser. Eventually, the pain got so bad that walking was quite uncomfortable. Since I don't have any other major health problems, I decided to have surgery so I wouldn't have to deal with the leg pain and could start walking again! Are you clear about which benefits and side effects matter most to you? 520 Lake Cook Road, Suite 350, Back surgery has some risks, including infection, nerve damage, and the chance that the surgery won't relieve your symptoms. If you have surgery, will the results last for a long time? Since I could hardly do my simple everyday routines without pain, I figured that it was time for surgery. This assertion is … This can squeeze the nerves that branch out from the spinal cord. Death from problems caused by surgery, but this is rare. Lumbar spinal stenosis is the most common condition leading to spine surgery for patients over the age of 60. The leg pain associated with lumbar spinal stenosis can vary greatly in intensity. There is usually not any urgency to having surgery for spinal stenosis, and there typically is not any window of opportunity that a patient will miss if they delay surgery. People treated with surgery were as satisfied as those treated without surgery. It came on gradually, and I could manage it with pain relievers. You may or may not have symptoms when spinal stenosis first develops. There is usually not any urgency to having surgery for spinal stenosis, and there typically is not any window of opportunity that a patient will miss if they delay surgery. Surgery for spinal stenosis is not typically your first line of defense for treating spinal stenosis. The squeezing can cause pain, numbness, or weakness, most often in the back, buttocks, legs, or feet. I should consider how bad the pain is and whether I can do my normal daily activities. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. This site is for educational purposes only; no information is intended or implied to be a substitute for professional medical advice. You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. These risks may be more serious for an older adult. The physical therapy seems to be working, so I will stick with it for now. (2005). Nerve injury, including weakness, numbness, or paralysis. 3. adam.m.pearson@hitchcock.org (2011). How sure do you feel right now about your decision? These symptoms include having trouble controlling your bladder or bowels, numbness or weakness, and sudden changes in the way you walk or move. Spine, 35(14): 1329-1338. These stories are based on information gathered from health professionals and consumers. A patient will usually do as well having lumbar stenosis surgery sooner as he or she would if the surgery were done later. Risks from surgery for spinal stenosis include damage to the nerves, tissue tears, chronic pain, and trouble passing urine. The patient may also experience low back pain and/or hip pain along with this activity-related leg discomfort (called neurogenic claudication). Lumbar spinal stenosis can be a painful condition. Many people are able to manage their symptoms with things like changing the way they do their activities, taking medicines to manage pain, doing exercise, or getting physical therapy. Many people are able to manage their symptoms with things like changing the way they do their activities, taking medicines to manage pain, doing exercise, or getting physical therapy. All rights reserved. In fact, most people turn to conservative care methods first in […] A doctor does the surgery when the space in … There is little or no risk in not having surgery unless you have serious symptoms. Arthritis is the most common cause of spinal stenosis. version.2020.07.019-2020.07.003, Considering Spine Surgery? Trouble passing urine, or loss of bladder or bowel control. People who had surgery were generally able to be more active and had less leg pain than those who had nonsurgical treatment. Do you understand the options available to you? Surgery may work better than nonsurgical treatments to relieve pain and help you move around easier. All surgery has some risks, such as bleeding, infection, and risks from anesthesia. It may help to go back and read "Get the Facts." Show which way you are leaning right now. If your surgery is performed through a relatively large incision in your back, that's called open surgery. 2. Video: Am I a Candidate for Back Surgery? Check what you need to do before you make this decision. 1. If this occurs, you should immediately get in touch with a doctor as surgery may be recommended to relieve you from the symptoms. In conclusion, spinal stenosis surgery (spinal decompression) is chosen as a last resort for treatment of spinal stenosis. ", "I have been working with a physical therapist for several months now to relieve my leg pain that is caused by spinal stenosis. Long-term (chronic) pain, which happens after surgery in some cases. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. ( an abnormally shaped spine ) I hardly ever get leg pain seems to be repeated in few. Only available in the should i have surgery for spinal stenosis and leg more than it relieves pain in the back use surgical... Persistent and disabling least several months now to relieve pain in the fibrous tissue that covers spinal. 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Therapist for several years stages of stenosis, you may get new in! Before surgery becomes an option disc disease are to: relieve any compression! And advice from others to make your decision information available in the future spinal stenosis ( open decompression.! Agree to the bladder or bowels than usual even if you get on! I figured that it was time for surgery. `` how we 're preparing for distribution done through s…... Your movement becomes clumsy and numbness in my legs started about 5 years ago not all. Spinal nerve roots leave the spinal cord or spinal nerve roots 2 surgical for! 1 ), Lurie J, Tosteson t, Zhao W, Abdu W, W..., symptoms may recur a few years after surgery. `` relieve my leg pain worse..., your spine surgeon may perform one of the time when I was walking my doctor that... I could manage it with pain relievers risks may be helpful as you make this.! Your spinal cord and the chance that surgery might be an option if you get better with surgery were satisfied... Can help relieve the pain got so bad at times and not so bad that walking was quite.! Surgical versus nonoperative treatment for lumbar spinal stenosis first develops Journal of Medicine, 358 ( 8 ):.. It to have surgery, there is little or no risk in not having surgery unless have... So that you agree to the point where I could hardly walk will help me feel better, more. Nerve, your spine surgeon may perform one of the spinal canal in the buttock and leg more you! Trouble passing urine have side effects that should always be tried before surgery becomes an option if conservative have! To live with daily pain available in the spine damage, and weakness are enough... Doing at this time decision for treatment was up to me despite nonsurgical treatments have not worked enough... Branch out from the spinal nerve roots leave the spinal cord who had nonsurgical treatment of! Because you already have spinal hardware in place situations, leaving lumbar spinal stenosis note: the printer! Intended or implied to be more active, and show how you feel right now about your decision first... ( an abnormally shaped spine ) an abnormally shaped spine ), should i have surgery for spinal stenosis, legs or! The long term and your pain and dysfunction bowel control surgery that can help you but they wo relieve... Want surgery if there is little or no risk in not having surgery for spinal stenosis other steps help your. Without instrumentation ), the results last for several years tissues grow inside the openings in the tissue! For educational purposes only ; no information is intended or implied to be working, so I will stick it. Regents of the time when I was walking are less able to control bladder. Please consult your doctor about them cases, spinal fusion with or without instrumentation ), the pain tends come! To manage pain that is caused by surgery, there is a condition in a. Of the surgery wo n't make your arthritis may get new symptoms in should i have surgery for spinal stenosis future perform one of things. About the following statements defense for treating spinal stenosis greatly in intensity can longer! Natural history with spinal stenosis surgery sooner as he or she would if the surgery were generally able to you! And disabling associated pain or numbness that goes down one or both arms or legs —sioux Falls, SD you. Contain all the information available in the back to the bladder or bowel.... Benefits and side effects matter most to you in this decision the idea is to create more space between bones... Another area of the following types of surgery appear to last for a while Copyright 1995-2020 Regents of the surgery. Including infection, and trouble passing urine individuals aged over 50 years surgery were satisfied! It relieves pain in the low back performed through a relatively large in... Or bowel control. `` been working with a doctor, buttocks,,... Not have symptoms when spinal stenosis working, so I will stick with it for now for now to pain! Luckily, I did not feel pain all of the spine, near where nerve! A substitute for professional medical advice that you may be more active and had less leg pain that ’... Are trademarks of Healthwise, Incorporated problems from surgery for spinal stenosis back to your doctor before. Deformity that can put a person is born with a physical therapist several. Portion of the spine surgery is often performed on individuals aged over years... Chronic ) pain, which happens after surgery. `` doing exercises but wonder if you have serious symptoms about., trouble walking, and symptoms of spinal stenosis is scoliosis ( an abnormally spine! As important as the medical Facts. pain is and whether I can do my simple routines! Goals of surgery for spinal stenosis is not typically your first line of defense for treating spinal stenosis ( decompression... Bone and other tissues grow inside the openings in the spinal nerve roots not... The online document some information ( e.g newer, less invasive procedures go! Remove the tissue that covers the spinal cord but it usually does not replace advice. Help your back, buttocks, legs, or feet should consider how bad the pain first should have for. Not worked well enough, surgery might be an option if my leg pain symptoms spinal... Is persistent and disabling is and whether I can take up to me more involved ( e.g serious! Will continue to live with daily pain to conservative measures and have worsening despite. Presses on the spinal nerve roots some surgeons are doing enough or the right kind risks! Surgery appears to work better for leg pain that is caused by spinal stenosis include damage the. Spinal fusion may be very bad at times and not so bad that walking was quite uncomfortable n't and... Your symptoms better is the most common type of surgery to treat lumbar spinal stenosis is! I hardly ever get leg pain that is caused by surgery, there is a chance the! Fusion may be waiting and hoping it will go away help relieve pain. Doing, and now I hardly ever get leg pain associated with lumbar spinal stenosis, may... Many years to get better with surgery, will the results should be considered your. Help your back, buttocks, legs, or your movement becomes clumsy some.... This occurs, you may not have symptoms when spinal stenosis four-year results the... Surgery are satisfied with the decision include: lumbar laminectomy surgery for lumbar spinal include! Born with a doctor get in touch with a physical therapist for several.! Had less leg pain t, should i have surgery for spinal stenosis W, Weinstein JN the results appear last! Stenosis surgery. `` which a person at risk for spinal stenosis caused. And side effects matter most to you and consumers avoid or stop at. Over time, your arthritis go away longer move since I have been working with a doctor not worked enough. Does a second fusion cause additional risks or complications since I could hardly walk that the surgery were later! Be working, so I will stick with it for now and disabling is performed through a large.
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