Spine
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Clinical Trial
Interdependence between disc space height, range of motion and clinical outcome in total lumbar disc replacement.
Clinical and radiologic assessment obtained from an ongoing prospective trial following total lumbar disc replacement (TDR) with ProDisc II. ⋯ A significant interdependence was observed between the parameters DSH, ROM and the clinical outcome following TDR. Whilst the DSH is restored, TDR leads to a significant decrease in postoperative ROM, particularly at the lumbosacral junction. Higher preoperative DSH and ROM revealed a beneficial effect on the postoperative segmental mobility. The subjective outcome evaluation indicates that TDR is a viable treatment option even in advanced stages of degenerative disc disease in the absence of other contraindications, in particular facet joint arthropathies.
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Biomechanical evaluation of occipitocervical instrumentation techniques. ⋯ Occipital screw placement off-midline improves screw loads under lateral bending forces on occipitocervical constructs, though loads for FE and ROT are unchanged. As screws pullout, the loads may be redistributed, resulting in increased screw pullout forces above. Despite the improvement in screw loads for laterally based plates during lateral bending, overall ROM across the occipitocervical junction is unchanged.
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A retrospective study. ⋯ The study has shown that low-dose spine CT is a reliable method in evaluating screw placement in patients with AIS after posterior scoliosis surgery with titanium implants, using the here proposed grading system. The new grading system of screw misplacement was feasible and in line with the general agreement about the harmlessness of misplacement with minor pedicle breach. The reliability of low-dose spine CT in evaluation of lateral and medial cortical perforations was substantial. To reduce the radiation load, the postoperative assessment of titanium implants should be performed with low-dose CT.
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Retrospective study. ⋯ This is the first long-term (minimum 5 years) follow-up study focusing on patient outcomes after an anterior thoracolumbar approach for adult spinal deformity treatment. This approach appears to be associated with an appreciable high rate of postoperative pain (32.3%), bulging (43.5%), and functional disturbance (24.2%). Therefore, surgeons should use caution when recommending this approach to future adult spinal deformity patients.
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Review Meta Analysis
Spinal mechanical load as a risk factor for low back pain: a systematic review of prospective cohort studies.
Systematic review. ⋯ We found strong evidence that leisure time sport or exercises, sitting, and prolonged standing/walking are not associated with LBP. Evidence for associations in leisure time activities (e.g., do-it-yourself home repair, gardening), whole-body vibration, nursing tasks, heavy physical work, and working with ones trunk in a bent and/or twisted position and LBP was conflicting. We found no studies, thus no evidence, for an association between sleeping or sporting on a professional level and LBP.