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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From a clinical point of view, knowledge of customary standing positions among healthy young adolescents is of primary importance. The purpose of this study was to document the correlations between sagittal standing posture parameters in a pre-peak height velocity (pre-PHV) cohort. ⋯ Although the correlation schemes do not imply a causal relationship, the proposed postural model allows conjecture about standing posture to be organized slightly differently in pre-PHV boys and girls. Whereas the standing posture in pre-PHV boys might be organized predominantly according to an ascending mode, bottom-up and top-down organizations appear to coexist in pre-PHV girls.
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'Low back pain' (LBP) is a prevalent condition with a majority showing no specific organic pathology. Distinguishing 'secondary gain motives (SGM)' from organic causes is imperative in clinical practice. We describe here, three new tests-resistive straight leg raise test (rSLRT), resistive forward bend test (rFBT) and heel compression test (HCT) to help differentiate patients with 'SGM' from those without. We conducted a prospective study to validate the above tests in predicting non-organic causes as a reason for LBP. ⋯ rSLRT, rFBT and HCT (NK triad) are highly practical tests which strongly predict SGM status in patients.
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Long spinal deformity fusions in elderly patients continue to be controversial. However, there is a growing population of elderly patients with spinal deformities that may be optimally treated by reconstructive surgery requiring a long fusion to the sacrum. This study evaluated clinical outcomes in elderly (>65) adult deformity patients who underwent posterior instrumented reconstruction consisting of fusion from the thoracic spine to the sacrum with iliac fixation. ⋯ Properly selected patients 65 years of age and older who have substantial sagittal imbalance, a considerable disease burden, and a lesser degree of mental distress can obtain as much clinical benefit as their younger counterparts (≤55 years of age) 2 years following spinal deformity surgery that requires fusion from the thoracic spine to the sacrum with segmental instrumentation and iliac fixation.
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Little is known about when and how progressive spondylolisthesis occurs. In this report segmental motion related to age and disc degeneration at L4/5 disc was investigated. ⋯ Our results with radiography and MRI indicate that grade 3 disc degeneration is a critical stage for the progression of lumbar spondylolisthesis at L4/5 segment.
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To investigate whether the presence of Modic changes type I (MC I) found on preoperative MRI scans represent a risk factor for persistent back pain 12 months after surgery amongst patients operated for lumbar disc herniation. ⋯ Patients with preoperative MC I can expect less but still significant improvement of back pain 1 year after microdiscectomy, but not if they smoke cigarettes.