Spine
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Patients completing a multidisciplinary pain treatment were contacted to obtain 13-year follow-up information on pain, mood, employment, and general health. ⋯ The data lend support to the long-term effectiveness of multidisciplinary treatment programs for chronic low back pain.
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An in vitro biomechanical study of various reconstructive techniques following decompression of the spondylotic cervical spine. OBJECTIVE.: To evaluate the biomechanical stability of anterior cervical plate fixation following three strategies of decompression for multilevel cervical spondylosis (three levels) of the cervical spine: three level discectomy, single corpectomy and discectomy, and a two-level corpectomy. ⋯ Cervical myelopathy is traditionally treated with a multilevel corpectomy and an end-construct plate fixation spanning the strut graft. A large moment arm is generated at the ends of the construct, potentially leading to plate migration or dislodgment. Often times, adequate decompression can be achieved with either a multilevel discectomy or a combined discectomy and corpectomy with segmental plate fixation. This study clearly demonstrates that segmental plate fixation affords a more biomechanically rigid method of reconstruction with regards to flexion-extension and lateral bending than end-construct plate fixation. The increased rigidity afforded by segmental fixation may significantly decrease the likelihood of plate dislodgement in the setting of anterior instrumentation alone following anterior alone, long segment reconstruction procedures.
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A retrospective review of 303 MRI scans of the lumbar spine was conducted. ⋯ Both anterior and posterior lumbar facet joint synovial cysts are rare. Posterior cysts are more common than anterior cysts. Both types of cysts are related to facet joint osteoarthritis but not to disc disease.
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Retrospective case series. ⋯ Both spine and upper thoracic transverse plane trunk deformity significantly influenced preoperative idiopathic scoliosis patients' perception of function and self-image, but not pain or mental health. However, in spite of a fairly rigorous standard of proof, P < or = 0.01, the significant r values ranged from -0.33 to -0.68, suggesting that there are factors other than spine and trunk deformity influencing the idiopathic scoliosis patients' health-related quality of life questionnaire responses. Future studies are necessary to define these factors.
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Randomized Controlled Trial Comparative Study Clinical Trial
Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective long-term study comparing fusion and pseudarthrosis.
A prospective, randomized study on patients who underwent posterior lumbar decompression with bilateral posterolateral arthrodesis. ⋯ In patients undergoing single-level decompression and posterolateral arthrodesis for spinal stenosis and concurrent spondylolisthesis, a solid fusion improves long-term clinical results. Benefits of a successful arthrodesis over pseudarthrosis were demonstrated with respect to back and lower limb symptomatology compared with prior shorter-term studies, which indicated no significant difference in clinical outcome between the two groups.