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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Observational Study
Outcomes and their predictors in lumbar spinal stenosis: a 12-year follow-up.
The aim of this prospective observational cohort study was to evaluate long-term outcomes in patients with mild-to-moderate lumbar spinal stenosis (LSS) and to analyse the predictors of clinical outcomes. ⋯ Satisfactory objective and subjective clinical outcomes were disclosed in about half of the patients with mild-to-moderate LSS in a 12-year follow-up. The number of comorbid diseases had an unfavourable effect on subjective evaluation of clinical outcome. The lowest transverse diameter of spinal canal proved to be the only independent predictor of deterioration of clinical status in LSS patients.
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Case Reports
Bilateral reconstructive costoplasty for razorback deformity correction in adolescent idiopathic scoliosis.
Correcting the chest wall deformity is an important goal of scoliosis surgery. A prominent rib hump deformity may not be adequately addressed by scoliosis correction alone. It has been shown that costoplasty in conjugation with scoliosis correction and instrumented spinal fusion is superior to spinal fusion alone in addressing the chest wall deformity. In cases of severe rib hump deformity unilateral convex side costoplasty alone might not adequately restore thoracic cage symmetry necessitating for additional concave side rib cage reconstruction. ⋯ Bilateral costoplasty in conjugation with scoliosis correction may provide a safe and effective method for the treatment of severe rib cage deformities associated with thoracic scoliosis. It should be considered in the presence of prominent rib hump deformity, where scoliosis correction alone or with unilateral costoplasty is unlikely to provide adequate correction.
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Comparative Study
Comparison between walking test and treadmill test for intermittent claudication associated with lumbar spinal canal stenosis.
To clarify the priorities of the walking test and the treadmill test for intermittent claudication of lumbar canal stenosis. ⋯ The walking test detected significantly more symptoms that were not detected at rest than the treadmill test.
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There is no comparative study regarding surgical outcomes between microsurgical extraforaminal decompression (MeFD) and posterior lumbar interbody fusion (PLIF) for the treatment of lumbar foraminal stenosis (LFS). Therefore, the purpose of this study was to compare the surgical outcomes of LFS using two different techniques: MeFD alone or PLIF. ⋯ This study demonstrated that MeFD alone and PLIF have equivalent outcomes regarding improvement in disability at 1 year after surgery. However, the higher rate of revision surgery in the MeFD group should emphasize the technically optimal amount of decompression.
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While a considerable body of research has explored the relationship between patient expectations and clinical outcomes, few studies investigate the extent to which patient expectations change over time. Further, the temporal relationship between expectations and symptoms is not well researched. ⋯ The expectations of most people presenting to primary care with low back pain do not change over the first 3 months of their condition. People with very positive, stable expectations generally experience a good outcome. While we attempted to identify a causal influence of expectations on symptom severity, or vice versa, we were unable to demonstrate either conclusively.