Spine
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Randomized Controlled Trial
RhBMP-2 versus iliac crest bone graft for lumbar spine fusion in patients over 60 years of age: a cost-utility study.
Randomized clinical trial. ⋯ There are more complications, increased need for additional treatment and revision surgery in patients over 60 years old receiving ICBG compared with rhBMP-2/ACS. This may account for higher costs and lower improvements in utility seen in patients receiving ICBG compared with rhBMP-2/ACS in this study population.
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A retrospective study. ⋯ Reciprocal relationship exists between lumbar lordosis and thoracic kyphosis in sagittal thoracic compensated LDK. Surgical restoration of lumbar lordosis for LDK brings about high level of statistical correlation to thoracic kyphosis improvement. At the same time, the reciprocal relationship is maintained.
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A prospective study in 19 patients after cervical laminoplasty, using magnetic resonance imaging. ⋯ The posterior shift of the spinal cord at 24 hours had a tendency to shift more posteriorly than that observed at 2 weeks after cervical laminoplasty. C5 palsy may be prevented if the expansion of dura mater, which is strongly correlated with the posterior shift, can be controlled.
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A retrospective review of 10 consecutive patients with a noninflammatory retro-odontoid pseudotumor. ⋯ Retro-odontoid pseudotumors were not always associated with radiographic atlantoaxial instability. Our data indicate that extensive OALL and ankylosis of the adjacent segments are risk factors for the formation of the pseudotumor. Retro-odontoid pseudotumors may develop as an "adjacent segment disease" after altered biomechanics of the cervical spine, especially those in the adjacent segments. Posterior fusion was effective even in cases without radiographic atlantoaxial instability.
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Prospective cohort study. ⋯ Age and concentration complaints were important independent predictors of long-lasting work disability, whereas no evidence emerged to indicate that the degree of manual labor (blue or white collar work) or educational level was involved in persistent work disability in postwhiplash syndrome. The current results suggest that work disability could benefit most from interventions related to recovery from cognitive complaints and less from physically related interventions.