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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Low back pain (LBP) is the most disabling condition worldwide. Although LBP relates to different spinal pathologies, vertebral bone marrow lesions visualized as Modic changes on MRI have a high specificity for discogenic LBP. This review summarizes the pathobiology of Modic changes and suggests a disease model. ⋯ Modic changes are likely to be more than just a coincidental imaging finding in LBP patients and rather represent an underlying pathology that should be a target for therapy.
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Sarcopenia-related falls and fractures among women with osteoporosis are becoming an emerging problem because of rapid aging worldwide. We aimed to investigate the association between sarcopenia, given by the muscle mass of the arms and legs, and osteoporotic vertebral fracture (OVF) among female patients. ⋯ We found higher prevalence of sarcopenia and lower leg muscle mass among patients with acute OVF compared with patients who did not have an OVF. These results suggest that sarcopenia may be a risk factor for OVF.
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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.
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Randomized Controlled Trial
A prospective randomized controlled study comparing the pain relief in patients with osteoporotic vertebral compression fractures with the use of vertebroplasty or facet blocking.
To compare the clinical and radiological outcomes of patients undergoing percutaneous vertebroplasty (PVP) versus those undergoing facet blocking (FB) for severe pain due to osteoporotic vertebral compression fractures (OVCFs). ⋯ PVP produced better pain relief than FB in the short term (≤1 week). However, the difference in pain-relief between these two techniques was insignificant in the long term (follow-up between 1 month and 12 months).
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To determine whether depression in postmenopausal women with osteoporosis is associated with an increased risk of thoracolumbar fragility fracture. ⋯ Depression is associated with a higher risk of thoracolumbar fracture, with more fracture pain and with lower quality of life in the 2 months following fracture.