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
Influence of gender on patient-oriented outcomes in spine surgery.
Few studies have examined gender differences in patient-oriented health-related quality of life before and after spine surgery. This study examined the influence of gender on baseline status and 1-year postoperative outcomes in a large series of patients undergoing surgery for different degenerative spinal disorders. ⋯ This results show that women do not differ significantly from men regarding their postoperative outcome, even though they present with a worse preoperative status. The management of a patient's condition should not differ depending on their gender, since both men and women are able to improve to a similar extent.
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The STarT Back Screening Tool (SBST) is a 9-item questionnaire designed for screening low back pain (LBP) patients into three prognostic groups for stratified care. The stratified care approach has proven to be clinically more beneficial and cost-effective than the current best physiotherapy practice. The objective of this study was to translate, culturally adapt and study psychometric properties of the SBST among Finnish LBP patients. ⋯ The Finnish translation of the SBST is linguistically accurate and has been adapted to the Finnish-speaking population. It showed to be a valid and reliable instrument and comparable with the original English version. Therefore, it may be used in clinical work with Finnish LBP patients.
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Subarachnoid pleural fistula (SPF) is a type of cerebrospinal fluid (CSF) fistula that can arise as a complication following transthoracic resection of intervertebral disc herniation in the thoracic spine. It is an abnormal communication between the subarachnoid and pleural space. Negative intrapleural pressure promotes CSF leak due to a suction effect into the pleural cavity, with little chance of spontaneous closure. ⋯ We report a case of a 72-year-old woman who underwent anterior thoracic surgery to treat thoracic myelopathy caused by an ossified intradural disc herniation. The postoperative period was complicated by a subarachnoidal pleural fistula. We describe our successful treatment of this using noninvasive positive pressure ventilation and lumbar CSF drainage and review other methods reported in the literature.
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The aim of this study was to describe the associations among pain, disability and psychosocial factors preoperatively as well as 3 and 24 months later for patients who undergo first time discectomy and to analyse the predictive value of psychosocial factors on the outcome 24 months after surgery. ⋯ Having high expectations on the return to work after surgery was the strongest predictor for a favourable outcome. Therefore, low preoperative expectations on return to work convey an important prognostic signal.
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The purpose of this study was to validate the Oswestry Spinal Risk Index (OSRI) in an external population. The OSRI predicts survival in patients with metastatic spinal cord compression (MSCC). ⋯ Our study has found that the OSRI is a significant predictor of survival at levels similar to those of the original authors and is a useful and simple tool in aiding complex decision making in patients presenting with MSCC.