Spine
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Prospective observational study. ⋯ Interspinous process spacer surgery appears associated with a higher rate of early postoperative spinous process fracture than previously reported. In all cases, in this series, plain radiographs were inadequate to identify fractures because all fractures were initially minimal or nondisplaced, many patients were osteopenic, and the metallic wings of the devices often obscured fractures. Moreover, in most patients, fractures were associated with mild or no acute localized pain. This study suggests that unrecognized spinous process fracture may be responsible for a significant number of patients who experience unsatisfactory outcome after IPS surgery. CT imaging is required to identify the vast majority of such fractures.
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Cross-sectional surveys of health-related quality of life (QOL) in subjects with low back pain and knee pain using a population-based cohort. ⋯ This study revealed that low back pain has a larger impact than knee pain on QOL. Furthermore, low back pain with VFx is strongly associated with physical QOL loss.
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Ligamentum flavum (LF) thickness was measured by using lumbar magnetic resonance imaging in patients with low back or leg pain. ⋯ Thickening of the LF is correlated with disc degeneration, aging, BMI, LSS, spinal level, and disc herniation. The authors concluded that thickening of the LF is due to buckling of the LF into the spinal canal secondary to disc degeneration more than to LF hypertrophy. Sex and the degree of pain were not correlated with the thickness of the LF.
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Retrospective magnetic resonance imaging (MRI)-based study. ⋯ In the absence of any significant clinical correlation between patient demographics and the entry site in Wiltse's approach, the spine surgeon may use distances described in this paper to apply to a broad base of spine patients regardless of BMI, sex, or age.
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We conducted a cross-sectional, genotyping study in patients with lumbar spinal stenosis (LSS) and controls. ⋯ Although no SNPs in COL9A2 were associated with LSS, a COL9A2 haplotype (HAP2) was significantly associated with LSS in the Korean population, whereas another haplotype (HAP4) may play a protective role against LSS development. However, the genetic functions of COL9A2 haplotypes in LSS remain to be determined.