Spine
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This is a clinic-based cross-sectional study involving 2 health-related quality-of-life (HRQL) questionnaires. ⋯ In a spinal deformity population 8 to 18 years of age, the score distribution and reliability, internal consistency, and reproducibility of the SRS-22r were at least as good as the CHQ-CF87. The SRS-22r function, pain, and mental health domains were concurrently valid in comparison to relevant CHQ-CF87 domains, but the SRS-22r self-image and satisfaction/dissatisfaction domains were not, thereby providing health-related quality-of-life information not provided for by the CHQ-CF87.
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An updated Cochrane Review. ⋯ Surgical discectomy for carefully selected patients with sciatica due to lumbar disc prolapse provides faster relief from the acute attack than conservative management, although any positive or negative effects on the lifetime natural history of the underlying disc disease are still unclear. The evidence for other minimally invasive techniques remains unclear except for chemonucleolysis using chymopapain, which is no longer widely available.
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Meta Analysis
Statistical significance versus clinical importance: trials on exercise therapy for chronic low back pain as example.
Critical appraisal of the literature. ⋯ It seems that many conclusions of studies of exercise therapy for chronic low back pain have been based on statistical significance of results rather than on clinical importance and, consequently, may have been too positive. Authors of trials should report not only statistical significance of results but also clinical importance.
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Meta Analysis
The surgical management of degenerative lumbar spondylolisthesis: a systematic review.
Systematic review. ⋯ Spinal fusion may lead to a better clinical outcome than decompression alone. No conclusion about the clinical benefit of instrumenting a spinal fusion could be made. However, there is moderate evidence that the use of instrumentation improves the chance of achieving solid fusion.
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Prospective cross-sectional measurement study. ⋯ Even though ceiling effects (>20%) were not common, scores clustered near the top of the SQLI scale. The SQLI score distribution may impair the questionnaire's sensitivity to change and discriminative ability, particularly in younger subjects with lesser low or moderate curve severity, under observation or after surgery. The clinical utility of some SQLI items within each domain may be limited by high ceiling effects.