Spine
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Introduction of a posterior approach for internal fixation of fractures of the ankylosed cervical spine. ⋯ Patients with ankylosing spondylitis and cervical spinal fractures can be adequately treated with lateral mass plating and interspinous wiring of autologous rib graft. Adequate postoperative immobilization can be attained with a cervical collar and does not require a halo vest.
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A retrospective study of 24 sacroiliac joint computed tomographic (CT) scans of patients with persistent donor site pain. ⋯ There is a high prevalence of inner table disruption in patients with persistent sacroiliac joint pain after posterior iliac bone graft harvesting. The computed tomographic scan showed that involvement of the synovial part caused more severe degenerative changes than involvement of the ligamentous part.
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A systematic review and meta-analysis of studies on the putative mechanisms of action of lumbar supports in lifting activities. ⋯ There is evidence that lumbar supports reduce trunk motion for flexion-extension and lateral bending. More research is needed on the separate outcome measures for trunk motion before definite conclusions can be drawn about the work conditions in which lumbar supports may be most effective. Studies of trunk motion at the workplace or during specified lifting tasks would be especially useful in this regard.
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Review
Systematic review of psychosocial factors at work and private life as risk factors for back pain.
A systematic review of observational studies. ⋯ Evidence was found for an effect of low workplace social support and low job satisfaction. However, the result for workplace social support was sensitive to slight changes in the rating system, and the effect found for low job satisfaction may be a result of insufficient adjustment for psychosocial work characteristics and physical load at work. In addition, the combined evaluation of job content and job control, both aspects of decision latitude, led to strong evidence of a role for low job decision latitude. Thus, based on this review, there is evidence for an effect of work-related psychosocial factors, but the evidence for the role of specific factors has not been established yet.
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Prospective study of 34 patients with thoracolumbar spinal fractures. ⋯ A fat-suppressed T2-weighted sagittal sequence of MRI was a highly sensitive, specific, and accurate method of evaluating posterior ligament complex injury. Based on the results of this study, a fat-suppressed T2-weighted sagittal sequence of MRIs is recommended for the accurate evaluation of posterior ligament complex injury and would be helpful in the selection of treatment options.