Spine
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Multicenter Study Comparative Study
European comparison of costs and quality in the treatment of acute back pain.
Retrospective multicenter observational study. ⋯ There was considerable waste in treating acute back pain. The Netherlands had highest quality and lowest resource utilization in providing treatment for acute back pain.
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Comparative Study
Long-term outcomes of surgical and nonsurgical management of sciatica secondary to a lumbar disc herniation: 10 year results from the maine lumbar spine study.
A prospective cohort study. ⋯ Surgically treated patients with a herniated lumbar disc had more complete relief of leg pain and improved function and satisfaction compared with nonsurgically treated patients over 10 years. Nevertheless, improvement in the patient's predominant symptom and work and disability outcomes were similar regardless of treatment received. For patients in whom elective discectomy is a treatment option, an individualized treatment plan requires patients and their physicians to integrate clinical findings with patient preferences based on their symptoms and goals.
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Cross-sectional study of 37 patients to measure serum levels of nickel and chromium after posterior spinal arthrodesis using stainless steel implants. ⋯ Elevated levels of nickel and chromium can be measured after posterior instrumented spinal arthrodesis. The levels diminish rapidly with time from surgery but still remained above normal levels 4 years after surgery. Long-term implication of this metal ion exposure is unknown and should be studied further.
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Comparative Study
Biomechanical comparison of transarticular facet screws to lateral mass plates in two-level instrumentations of the cervical spine.
In vitro biomechanical comparison of transarticular facet screws to lateral mass plates in two level instrumentations of the cervical spine. ⋯ This study proves that transarticular facet screws and lateral mass plates are equivalent in two-level instrumentations of the cervical spine. This is the first biomechanical study to test transarticular facet screws in this context.
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Inception cohort study. ⋯ During a period of 3 months, 24% of the patients had not recovered. Psychological factors and neurological signs were strongly associated with nonrecovery at 3 months. In addition to the traditional examination of neurological symptoms and signs, psychological factors should be considered already at the initial visit of an episode of low back pain.