Spine
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Systematic Review. ⋯ ACDA is a surgical procedure that may replace cervical fusion in selected patients suffering from cervical degenerative disc disease. Within 2 years of follow-up, the effectiveness of ACDA appears similar to that of cervical fusion. Weak evidence exists that ACDA may be superior to fusion for treating neck and arm pain. Future studies should report change scores and change score variance in accordance with RCT guidelines, in order to strengthen credibility of conclusions and to facilitate meta-analyses of studies.
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Review article. ⋯ The nature of the relationship between compensation-related factors and health is unclear. Current approaches to testing the compensation hypothesis are prone to several important sources of bias, which compromise the validity of their results. Methods that explicitly test the hypothesis and establish whether or not a causal relationship exists between compensation factors and prolonged whiplash symptoms are needed in future studies.
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Literature review. ⋯ Current evidence from structural MRI based studies demonstrates the widespread presence of fatty infiltrates in neck muscles of patients with chronic whiplash. Such findings have not shown to feature in patients with chronic insidious onset neck pain, suggesting traumatic factors play a role in their development. Recent studies have revealed that muscle fatty infiltrates manifest soon after whiplash but only in those with higher pain and disability and symptoms of post-traumatic stress disorder. The possibility that such muscle changes are associated with a more severe injury including poor functional recovery remains the focus of current research efforts.
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This is a prospective cohort study with serial imaging. ⋯ Nearly one-fourth of patients undergoing lumbar discectomy demonstrated radiographic evidence of recurrent disc herniation at the level of prior surgery, the majority of which were asymptomatic. Asymptomatic disc herniation was not associated with clinical consequences by 2 years. Clinically silent recurrent disc herniation is common after lumbar discectomy. When obtaining MRI evaluation within the first 2 years of discectomy, providers should expect that radiographic evidence of reherniation may be encountered and that treatment should be considered only when correlating radicular symptoms exist.
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A cross-sectional population-based study of paraspinal muscle asymmetry. ⋯ Paraspinal muscle asymmetry greater than 10% was commonly found in men without a history of LBP. This suggests caution in using level- and side-specific paraspinal muscle asymmetry to identify subjects with LBP and spinal pathology.