Spine
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Randomized Controlled Trial Clinical Trial
Stopping nicotine exposure before surgery. The effect on spinal fusion in a rabbit model.
A double-blind, prospective, randomized study using a validated rabbit model of intertransverse process fusion. ⋯ Chronic nicotine exposure was shown to decrease spinal fusion rates. Discontinuing nicotine before surgery improved fusion rates.
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A consecutive case retrospective chart and radiographic review. ⋯ Spinal deformities in patients with neurofibromatosis 1 should be regarded as deformities in evolution. One should resist assigning these evolving deformities to either the dystrophic or nondystrophic end of the spectrum without considering the possibility of modulation across the spectrum. A spinal deformity that develops before 7 years of age should be followed closely for evolving dystrophic features (i.e., modulation). When a curve acquires either three penciled ribs or a combination of three dystrophic features, clinical progression is almost a certainty.
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Comparative Study
Comparison of push-prone and lateral-bending radiographs for predicting postoperative coronal alignment in thoracolumbar and lumbar scoliotic curves.
A comparative evaluation of supine right and left lateral-bending radiographs and push-prone radiographs in patients with thoracolumbar and lumbar scoliosis to determine postoperative correction of the curve. ⋯ The push-prone and lateral-bending radiographs are similar in predicting less correction of the Cobb angle after anterior spinal surgery. The push-prone radiograph helps in determining the effects that correction of the primary curve has on the curves above and below the level of fusion by better predicting the translational correction of the lowest instrumented vertebra and the rotation of the lowest instrumented vertebra.
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A retrospective evaluation of the occurrence of the crankshaft phenomenon in skeletally immature patients with idiopathic scoliosis. ⋯ These findings suggest that scoliotic deformity progression can be prevented in skeletally immature patients with idiopathic scoliosis as young as 10 years of age with the use of stiff segmental posterior instrumentation, without the necessity of concomitant anterior arthrodesis.
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A 22-month prospective cohort study. ⋯ Once established, chronic low back pain is persistent. Most patients with chronic low back pain seek little care, and a majority are employed. Future research should emphasize maintenance of employment and function.