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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Review Case Reports
Osteolysis following resorbable poly-L-lactide-co-D, L-lactide PLIF cage use: a review of cases.
Report of case series. ⋯ PLDLLA cage, which has high osteolytic nature, is considered not suitable as a fusion cage.
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Published opinions regarding the outcomes and complications in older patients have a broad spectrum and there is a disagreement whether surgery in older patients entails a higher risk. Therefore this study examines the risk of surgery for lumbar spinal stenosis relative to age in the pooled data set of the Spine Tango registry. ⋯ Our study found that age, ASA status and blood loss were significant co-varieties for the occurrence of general complications. The risk of general complications is increased in older versus younger patients. Fusion or rigid stabilization does not lead to more complications. Surgical complications as well as complication rates at follow-up showed no significant age-related variation. Physician-based outcome was good or excellent in over 80% of patients in all age groups.
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The case of a 26 year-old woman with high grade spondylolisthesis, history of diastematomyelia and tethered cord, with acute onset of back pain and bilateral sciatica after a fall. This comment will focus on three issues: indication for surgery, indication for reduction and levels to be included in fusion. Surgery is indicated in this case for intermittent urinary incontinence and saddle anesthesia, and failure of conservative treatment to control pain. ⋯ Reduction is indicated in patients with high torque through L5-S1. L5 severity index (SI) correlates with the magnitud of torque through L5-S1. Similarly, the decision to include L4 in fusion can be made based on the value of SI for L4.
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Review Meta Analysis
Trends over time in the size and quality of randomised controlled trials of interventions for chronic low-back pain.
Previous reviews of randomised controlled trials (RCTs) for low-back pain (LBP) have failed to identify any positive trend in study quality with more recent years of publication. This study aimed to identify and describe trends over time in the study design characteristics and risk of bias in chronic LBP trials performed over the past 30 years. ⋯ The continuing uncertainty regarding the efficacy of many interventions for chronic LBP again stresses the need for large RCTs with low risk of bias. Further research is needed into specific risks of bias within the RCTs for chronic LBP and the effect they have on the plausibility of the results.