Spine
-
Randomized Controlled Trial Multicenter Study Comparative Study
Evaluation of spinal kinematics following lumbar total disc replacement and circumferential fusion using in vivo fluoroscopy.
In vivo fluoroscopic analysis of lumbar spinal motion with total disc replacement (TDR), fusions, and controls. ⋯ TDR produces physiologic lumbar spinal motion profiles in flexion and extension at the operative and proximal adjacent levels. Fusions, however, produced steeper motion gradients at the proximal adjacent level, while undergoing significantly greater sagittal plane translation during flexion-extension.
-
Multicenter Study
Psychosocial variables in patients with (sub)acute low back pain: an inception cohort in primary care physical therapy in The Netherlands.
A prospective cohort study of patients with episodes of acute or subacute low back pain, seeking physical therapy in primary care, with follow-up at weeks 2, 4, 8, and 12. ⋯ The study strongly revealed pain-related items to be essential factors in the development of chronicity and long-term disability in primary care physical therapy. Health status at 8 weeks seems crucial in developing chronicity.
-
Multicenter Study Comparative Study
Responsiveness of pain and disability measures for chronic whiplash.
Cohort study. ⋯ Pain bothersomeness and the Patient Specific Functional Scale provide the most responsive measures of pain and disability, respectively, in patients with chronic whiplash.
-
Comparative Study
Comparison of one-level posterior lumbar interbody fusion performed with a minimally invasive approach or a traditional open approach.
Prospective cohort study. ⋯ The present study, which was based on the authors' initial experience with the minimally invasive approach, could confirm favorable results reported by previous uncontrolled cohort studies in the aspects of less blood loss, less transfusion need, less postoperative back pain, quicker recovery, and shorter hospital stay. It also showed the similar surgical efficacy of the minimally invasive approach with that of the traditional open technique. However, the minimally invasive technique needs longer surgical time and a prudent attention to lower the risk of technical complications. Further long-term, prospective studies involving a larger study group are needed to determine the benefits of this minimally invasive percutaneous procedure.
-
Prospective observational single-cohort study. ⋯ After posterior lumbar instrumented fusion, radiographic changes suggesting disc degeneration appear homogeneously at several levels cephalad to fusion and seem to be determined by individual characteristics.