European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
-
Randomized Controlled Trial
Can povidone-iodine solution be used safely in a spinal surgery?
Intra-operative incidental contamination of surgical wounds is not rare. Povidone-iodine solution can be used to disinfect surgical wounds. Although povidone-iodine is a good broad-spectrum disinfecting agent, it has occasionally been reported to have a negative effect on wound healing and bone union. Therefore, its safety in a spinal surgery is unclear. A prospective, single-blinded, randomized study was accordingly conducted to evaluate the safety of povidone-iodine solution in spinal surgeries. Ascertained herein was the effect of wound irrigation with diluted povidone-iodine solution on wound healing, infection rate, fusion status and clinical outcome of spinal surgeries. ⋯ Diluted povidone-iodine solution can be used safely in spinal surgeries, and it will not influence wound healing, bone union and clinical outcome.
-
Comparative Study
Predictors for work ability and disability in men and women with low-back or neck problems.
In many countries back and neck problems are the most common reason for work incapacity. Numerous studies have looked for reliable predictors of return to work (RTW) or not return to work (NRTW) for those incapacitated, but with few exceptions their predictive and detective ability has been limited. We aimed to perform a comparative study of various commonly used health measures ability to predict RTW or NRTW in a cohort of men and women sick-listed for more than 28 days due to low-back pain (LBP) or neck pain (NP). ⋯ There was an improvement from day 28 up until 2 years, reflected by the different scales, more pronounced for LBP than for NP patients and for men with LBP compared with women with LBP. For all separately tested scales EuroQol (EQ-5D) had the highest overall ability to predict RTW or NRTW irrespective of gender, diagnoses or duration of the problems. When RTW or NRTW were predicted in a cohort of sick-listed low-back or neck patients, EQ-5D had outstanding properties in this respect irrespective of gender, diagnosis or elapsed time during this 2-year study.
-
Comparative Study
Validity and interobserver agreement of a new radiographic grading system for intervertebral disc degeneration: Part I. Lumbar spine.
Many different radiographic grading systems for disc degeneration are described in literature. However, only a few of them are tested for interobserver agreement and none for validity. Furthermore, most of them are based on a subjective terminology. ⋯ However, the inexperienced observer tended to assign slightly lower degrees of degeneration than the experienced one. In conclusion, we believe that the new radiographic grading system is an almost objective, valid and reliable tool to quantify the degree of degeneration of individual lumbar intervertebral discs. However, the user should always remember that the "real" degree of degeneration tends to be underestimated and that slight differences between the ratings of observers with different levels of experience have to be expected.
-
Direct comparison of the correction of scoliosis achieved by different surgical methods is usually limited by the heterogeneity of the patients analyzed (their age, curve pattern, curve magnitude, etc.). The hypothesis is that an analysis of comparable scoliotic curves treated by different implant systems could detect subtle differences in outcome. The objective of this study was therefore: (1) to measure the 3D radiological parameters of scoliotic deformity and to quantify their postoperative changes, and (2) to compare the radiographic results achieved with one anterior and one posterior instrumentation methods applied to similar curves but representing different mechanisms of correction. ⋯ Anterior instrumentation provided better correction of the vertebral axial rotation and of the rib hump. CD instrumentation was more powerful in translation and more specifically addressed the sagittal plane: the postoperative thoracic kyphosis angle increased in the hypokyphotic curves and slightly decreased in the normokyphotic curves.
-
We report preliminary results for unstable sacral fractures treated with a modified posterior triangular osteosynthesis. Seven patients were admitted to our trauma center with an unstable sacral fracture. The average age was 31 years (22-41). ⋯ The preliminary results are promising. The fixation is sufficiently stable to allow an immediate progressive weight-bearing, and safe nursing care in polytrauma cases. The only problem seems to be related to prominent heads of the distal screws.