Spine
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Three previous reviews have reached conflicting conclusions regarding the efficacy of antidepressants for patients with back pain. ⋯ Based on a small number of studies, tricyclic and tetracyclic antidepressants appear to produce moderate symptom reductions for patients with chronic low back pain. This benefit appears to be independent of depression status. SSRIs do not appear to be beneficial for patients with chronic low back pain. There is conflicting evidence whether antidepressants improve functional status of patients with chronic low back pain.
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Case Reports Comparative Study
Minimally invasive surgery for ablation of osteoid osteoma of the spine.
Compare the effectiveness of two different techniques for the management of osteoid osteoma of the spine. ⋯ Minimally invasive surgery can successfully be applied in the treatment of osteoid osteoma of the lumbar spine. When the nidus is not adjacent to the neural elements radiofrequency thermal ablation can be an effective and safe treatment of osteoid osteoma in the spine.
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A retrospective review of the effect of suboccipital decompression and duraplasty on curve progression in 22 patients who presented with scoliosis, syringomyelia, and a Chiari 1 malformation. ⋯ Thirteen patients of the 21 study patients (62%) had curve improvement or stabilization during the follow-up period. Eight of 21 patients (38%) had curve progression. Closer analysis reveals that the age, gender, and initial size of the scoliotic curve influenced the results of suboccipital decompression on the behavior of the scoliosis. Specifically, 10 of 11 patients (91%) who were less than 10 years of age at the time of suboccipital decompression have had their curves improve or stay the same during follow-up. In contrast, 5 of 7 female patients (72%) older than 10 years old with a curve greater than 40 degrees before suboccipital decompression have either been fused or are awaiting fusion.
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Case Reports
Polymethylmethacrylate cement dislodgment following percutaneous vertebroplasty: a case report.
A case report is presented. ⋯ This complication is rare and likely to occur in treatment of osteoporotic vertebral fracture with avascular necrosis and anterior cortical defect.
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A retrospective review of patient outcomes after lumbar spinal fusion. ⋯ This retrospective review of patients who underwent lumbar fusion for degenerative instability demonstrated no adverse impact on clinical outcomes when the lumbar fusion ended adjacent to a degenerative motion segment. Although a power analysis validated these results with 98% certainty, larger prospective studies are needed to confirm that there is no benefit to include degenerated adjacent segments in a lumbar fusion for degenerative instability.