Spine
-
Prospective study analyzing midterm clinical results of total lumbar disc replacement (ProDisc II) for different indications. ⋯ Present data suggest beneficial clinical results of TDR for treatment of DDD in a highly selected group of patients. Better functional outcome was obtained in younger patients under 40 years of age and patients with degenerative disc disease in association with disc herniation. Multilevel disc replacement had significantly higher complication rate and inferior outcome. Results are significantly dependent on preoperative diagnosis and patient selection, number of replaced segments, and age of the patient at the time of operation. Because of significantly varying outcomes, indications for disc replacement must be defined precisely.
-
A 20-year magnetic resonance imaging (MRI) and functional outcome follow-up study was performed on patients who had undergone anterior lumbar interbody fusion. ⋯ The prevalence of degenerative changes is similar to other studies involving normal asymptomatic subjects. Furthermore, the majority of degenerative changes seen occurred over multiple levels or at levels not adjacent to the fusion, suggesting that changes seen may be more likely related to constitutional factors as opposed to the increased stresses arising from the original fusion.
-
This is an observational study of 3482 patients undergoing lumbar spine surgery from the National Spine Network. ⋯ The negative impact of medical and psychosocial comorbidities on the change in SF-36 general health survey and condition-specific ODI scores, despite spine surgery, highlights the need for researchers and clinicians to consider these comorbidities when using these, and perhaps all, health survey instruments and interpreting these scores after surgery. Contrary to current assumptions regarding condition-specific health surveys, medical and psychosocial comorbidities similarly affect the generic SF-36 and condition-specific ODI. Further studiesare needed to determine if spine surgery outcomes can be improved by specifically addressing potentially modifiable comorbidities, which negatively impact survey scores, or whether comorbidity burden should play a role in the selection process for surgical intervention. Failure to incorporate consideration of medical and psychosocial comorbidities into preoperative discussions can be a failure to allow our patients (and ourselves) to have realistic expectations and, consequently, the best possible outcome from their treatment choice.
-
This is a prospective cohort study with a follow-up period of 6 months. ⋯ The primary treatment of complaints the of arm, neck, and/or shoulder in physiotherapy practice consists of exercise therapy and massage therapy, mostly being a combination of both. Future studies should focus on the effectiveness of exercise therapies, combined or not combined with massage, for patients with complaints of the arm, neck, and/or shoulder.
-
A prospective observational study. ⋯ Pain in the suprascapular, interscapular, or scapular regions can originate directly in the compressed root. The site of the pain is valuable for determining localization of the involved root.