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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Clinical Trial
Importance of the spinopelvic factors on the pelvic inclination from standing to sitting before total hip arthroplasty.
Dislocation after total hip arthroplasty (THA) is a major postoperative complication. Even if the cup is in the safe zone, dislocation caused by implant impingement may occur during postural changes. The aim of the present study was to investigate the spinopelvic factors that influence pelvic inclination changes from standing to sitting in patients with hip diseases who were candidates for THA. ⋯ The change in pelvic inclination from standing to sitting is strongly related to the mobility of the lumbar spine in patients with hip diseases.
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To identify predictors of both intermediate and long-term unfavorable outcomes after first time, uncomplicated lumbar disc surgery. ⋯ Identified predictors suggest that particular emphasis should put on comprehensive post-operative care at large and encouragement to adapt a physically active lifestyle in particular in rehabilitation concepts after first time uncomplicated lumbar disc surgery.
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This technical note presents, to the authors' knowledge, the first reported case of a hybrid pedicle-cortical screw system for instrumented fusion in a patient with congenital vertebral column deformity. ⋯ Cortical screw fixation may serve to be helpful in augmenting pedicle screw fixation and in circumstances in which the bone quality is suboptimal or the pedicles are compromised. Cortical screw fixation is a relatively new technology, but it may prove to be invaluable in providing an adjunct to pedicle screw constructs in anatomically distorted or osteoporotic spines.
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To determine the referral patterns, utilization and indications for postoperative physical therapy (PT) for lumbar radiculopathy. At least 50 % of patients following lumbar surgery (LS) for radiculopathy are referred for PT to address postoperative pain and disability. Very little is known regarding factors following LS that predict referral to PT, patient perceptions, satisfaction of postoperative PT and predictors of success for PT following LS for radiculopathy. ⋯ There is a need to determine if a subgroup of patients following LS exists who will respond favorably to postoperative PT.
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To provide a systematic literature review of the impact of preoperative Modic changes (MCs) on the clinical outcome following lumbar spine surgery for degenerative lumbar spine disease. ⋯ Preoperative MC showed a trend toward a negative correlation with clinical improvement in patients undergoing discectomy for LDH and a positive correlation with clinical improvement in patients undergoing TDR for degenerative disc disease. However, it is questionable whether the differences surpass the minimal clinically important difference (MCID). In patients undergoing fusion surgery, there was insufficient evidence to draw any conclusions. Future studies should include a larger patient material, focus on MCID, and include known confounding factors of the clinical outcome of spine surgery in the analysis.