Journal of spinal disorders & techniques
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J Spinal Disord Tech · Oct 2006
Randomized Controlled Trial Multicenter StudyMeasurement of lumbar lordosis: inter-rater reliability, minimum detectable change and longitudinal variation.
Repeated measures design to examine reliability and longitudinal variation of lumbar lordosis measurement. ⋯ This study demonstrates that the 4-line Cobb method can be a highly reliable and precise method for measuring lumbar lordosis if standardized procedures are used. The Cobb method has an MDC that is appropriate for clinical use. Also, there is minimal longitudinal variation in lordosis measurements over a 2-year period.
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J Spinal Disord Tech · Oct 2006
Wedge osteotomy for treating post-traumatic kyphosis at thoracolumbar and lumbar levels.
Local post-traumatic kyphosis may impair spinal sagittal balance and result in severe disability. The goal of this study is to evaluate posterior closing wedge osteotomy at the level of injury, by comparing thoracolumbar (T12-L1) and lumbar (L2-4) spinal levels. Thirteen consecutive patients had surgery in an average 13 months after the initial injury. ⋯ The ERD was significantly different initially (P=0.014) and after surgery (P=0.06). The anatomical result was complete in the thoracolumbar group, because the correction of the deformity at this level does not require more than correction of the vertebral body kyphosis. On the contrary, due to adjacent disc damage, the technique did not fully restore the physiological regional lordosis at lower levels.
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J Spinal Disord Tech · Oct 2006
Video-assisted ALIF with cage and anterior plate fixation for L5-S1 spondylolisthesis.
Spondylolysis and spondylolisthesis grade 0, 1, and 2 are mainly asymptomatic but with aging process and different factors some back pain can occur and lead to chronic low back pain. The conservative treatment with physiotherapy and steroid injection is the gold standard but in some cases is not efficient enough and a surgical treatment is proposed. ⋯ The results of this technique compare favorably with posterior stabilization and fusion (posterior lumbar interbody fusion and postero-lateral fusion) reported in the literature. Unlike posterior lumbar interbody fusion, however, it seems that the complication rate due to the approach is much lower, the fusion rate is similar. Grade 2 SPL is the limitation of the technique. The main advantage of the technique is to avoid posterior muscle damage and a quick recovery with no blood loss. Preservation of adjacent level disease can be assessed only after long-term follow-up.
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J Spinal Disord Tech · Oct 2006
Early clinical and radiologic outcomes of cervical arthroplasty with Bryan Cervical Disc prosthesis.
Among 61 patients underwent disc replacement with the Bryan prosthesis, 47 patients were followed more than 3 months and their clinical and radiologic data were retrospectively analyzed to clarify very early clinical and radiologic outcomes and complications of disc arthroplasty with the Bryan Cervical Disc prosthesis during the learning period. Mean follow-up period was 6 months. Mean age was 45.6 years. ⋯ Cervical arthroplasty with the Bryan Cervical Disc prosthesis failed to restore segmental lordotic angle. A concern arises because it is well known that the fusion in kyphotic curvature causes more frequent problems on adjacent levels in anterior cervical discectomy and fusion. For the present, it seems preferable to exclude the patient who already has significant segmental kyphosis from disc arthroplasty with Bryan Cervical Disc prosthesis.
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J Spinal Disord Tech · Oct 2006
Multicenter StudyAgreement between orthopedic surgeons and neurosurgeons regarding a new algorithm for the treatment of thoracolumbar injuries: a multicenter reliability study.
Considerable variability exists in the management of thoracolumbar (TL) spine injuries. Although there are many influences, one significant factor may be the treating surgeon's specialty and training (ie, orthopedic surgery vs. neurosurgery). Our objective was to assess the agreement between spinal orthopedic and neurologic surgeons in rating the severity of TL spine injuries with a new treatment algorithm. This information could be important in establishing consensus-based protocols for managing these challenging injuries. ⋯ The TLISS demonstrated good reliability in terms of intraobserver and interobserver agreement on the algorithmic treatment recommendations. The recommendation for operation seems to be consistent between fellowship-trained orthopedic and neurosurgical spine surgeons. This type of classification system may reduce the existing variability and initial management decision for treatment of TL injuries.