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
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Comparative Study Controlled Clinical Trial
Validity of pressure pain thresholds in female workers with and without recurrent low back pain.
Recurrent low back pain (LBP) is a common pain condition in elderly workers in a variety of occupations, but little is known about its origin and the mechanisms leading to an often disabling sensation of pain that may be persistent or intermittent. In the present study we evaluated the pressure pain thresholds (PPTs) in subjects suffering from recurrent LBP, as well as in healthy controls, to investigate if recurrent LBP is associated with an increased sensitivity of the muscular and ligamentous structures located on the lower back. One hundred and six female workers, aged between 45 and 62 years and working either in administrative or nursing professions were examined. ⋯ The PPT on the lower back did not significantly differ between the four groups studied, namely nurses and administrative workers with and without recurrent LBP. These results give evidence that recurrent LBP is not associated with an altered sensitivity of the muscular and myofascial tissues in the lumbar region. Furthermore, they raise questions about the value of reference point measurements in recurrent LBP.
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Randomized Controlled Trial
Randomised placebo-controlled trial on the effectiveness of nasal salmon calcitonin in the treatment of lumbar spinal stenosis.
This is a double blind randomised controlled trial to assess the effectiveness of nasal salmon calcitonin in the treatment of lumbar spinal stenosis. The trial compared the outcome of salmon calcitonin nasal spray to placebo nasal spray in patients with MRI confirmed lumbar spinal stenosis. Lumbar spinal stenosis is one of the commonest conditions encountered by spine surgeons. ⋯ There was no significant difference in walking distance between the two groups, with a mean improvement in walking distance of 21 m in the calcitonin group and 8 m in the placebo group (P = 0.78). At the end of the trial the ODI had improved by a mean of 3.7 points in the calcitonin group and 3.8 points in the placebo group (P = 0.44). This randomised placebo controlled trial has not shown any treatment effect in patients with lumbar spinal stenosis treated with nasal salmon calcitonin.
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Comparative Study Clinical Trial
Role of transarticular screw fixation in tuberculous atlanto-axial instability.
Prospective study of 27 consecutive cases of tuberculous atlanto-axial instability operated between 1998 and 2003. Early surgical stabilization of tuberculous atlanto-axial instability has gained popularity. This is largely due to success of chemotherapy in rapid control of infection. ⋯ Results in 27 consecutive patients demonstrate improved patient fusion and satisfaction rates in the TAS group. Judicious selection of patients for TAS fixation is possible with relatively few complications in tuberculosis of the atlanto-axial complex. This, however, requires a thorough understanding of the MRI pattern of involvement of the atlanto-axial complex that is difficult in non-endemic areas.
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Multicenter Study Comparative Study
Sagittal spinopelvic balance in normal children and adolescents.
The sagittal spinopelvic balance is poorly documented in normal pediatric subjects. The purpose of this study is to characterize the sagittal spinopelvic balance in the pediatric population and to evaluate the correlations between spinopelvic parameters. Seven parameters were evaluated from the lateral standing radiographs of 341 normal subjects aged 3-18 years old: thoracic kyphosis (TK), thoracic tilt (TT), lumbar lordosis (LL), lumbar tilt (LT), sacral slope (SS), pelvic tilt (PT) and pelvic incidence (PI). ⋯ Sacral orientation (SS) is correlated with the shape (LL) and orientation (LT) of the lumbar spine. Adjacent anatomical regions of the spine and pelvis are interdependent, and their relationships result in a stable and compensated posture, presumably to minimize energy expenditure. Results from this study could be used as an aid for the planning of surgery in pediatric patients with spinal deformity in order to restore a relatively normal sagittal spinopelvic balance.
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Clinical Trial
Anterior vertebral body replacement with a titanium implant of adjustable height: a prospective clinical study.
In the operative treatment of spinal injuries, the reconstruction of the anterior column of the thoracolumbar spine is still controversial. We conducted a prospective clinical study to investigate the clinical and radiological outcome of 50 patients treated with a vertebral body replacement of adjustable height (Synex). Fifty consecutive patients were evaluated during in-patient treatment and at 12 and 20 months post-operatively in clinical notes and radiographs. 38/50 patients were operated for traumatic fractures. ⋯ The loss of correction or reduction was only minimal. On the basis of our results we recommend the Synex implant as an alternative for the fixation and stabilisation of thoracolumbar fractures. However, long-term results and a clinically random control study are still required.