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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Self-rated activity limitations in patients with non-specific chronic low back pain (cLBP) do not correlate well with performance in traditional tests of impairment (e.g. back strength, ROM, etc.). Tests using more "functional activities" have therefore been recommended as alternative "objective" outcome measures. We examined the relationship between a battery of such tests and self-reported activity limitations, before and in response to physiotherapy, and the influence of psychological factors on the relationship. ⋯ Moderately high correlations (for both absolute and change scores) were observed between the subjective and observed measures of activity limitation. This indicates that to some extent they are assessing the same underlying construct, but it also suggests that each is delivering a certain amount of unique information. Psychological factors explained some of the discrepancy between the two types of measure. Both were responsive to therapy, and their change scores reflected well the patients' global outcome ratings. The two methods of assessing activity limitations should serve to complement one another in the assessment of treatment outcome.
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Comparative Study
Spinous process morphology: the effect of ageing through adulthood on spinous process size and relationship to sagittal alignment.
Blinded radiographic analysis of CT scans reformatted for precise lumbar spinous process (LSP) measurement. ⋯ This study demonstrates that the dimensions of the LSP change with age. Increases in LSP height and even more impressive increases in LSP width occur with advancing age. There is an inverse relationship between lumbar lordosis and LSP height.
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Comparative Study
Ex vivo observation of human intervertebral disc tissue and cells isolated from degenerated intervertebral discs.
Disc degeneration, and associated low back pain, are a primary cause of disability. Disc degeneration is characterized by dysfunctional cells and loss of proteoglycans: since intervertebral tissue has a limited capacity to regenerate, this process is at present considered irreversible. Recently, cell therapy has been suggested to provide more successful treatment of IVD degeneration. To understand the potential of cells to restore IVD structure/function, tissue samples from degenerated IVD versus healthy discs have been compared. ⋯ The tissue disorganization in degenerate discs and the paucity of cells out of cluster/chondron association, make the IVD-derived cells an unreliable option for disc regeneration.
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The purpose of this study is to report clinical outcome and imaging changes of percutaneous Aperius stand-alone implant in patients with degenerative lumbar spinal stenosis and neurogenic intermittent claudication, which did not respond to conservative treatment. ⋯ Despite of the brief follow up, the preliminary results are encouraging, showing a significantly decrease of the disability parameters, a marked improvement of the function with the vanishing of the claudicatio spinalis and the following increase of the free interval during the walk. Aperius PercLID system seems to offer an alternative to the traditional decompression surgery.
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Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are effective procedures to alleviate pain caused by osteoporotic vertebral compression fractures (VCFs). New vertebral compression fracture (NVCF) has been noted as a potential late sequela of the procedures. The incidence of NVCFs and affecting risk factors were investigated. ⋯ The most important risk factors affecting NVCFs were osteoporosis and intervertebral discal cement leakage.