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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Wound infection after spine surgery is a debilitating complication. Local placement of vancomycin powder into the surgical wounds prior to closing of the fascia has been introduced as a method to reduce deep infection rates. ⋯ In conclusion, the use of vancomycin reduces the rate of deep wound infections and irrigation and debridement procedures after spine surgery in a referral center among surgeons with a high surgical volume.
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Facet joint dislocation is a traumatic injury, which frequently results in devastating clinical outcomes. In Western Australia (WA), Royal Perth Hospital (RPH) provides a statewide Spinal Trauma Service and accepts all referrals from the entirety of the state. The economies of distance in WA mean that there is often a considerable delay between initial presentation at the peripheral hospital and enlocation of the dislocation in Perth. This study aims to identify any prejudicial clinical outcomes as a consequence of this delay. ⋯ This study confirms the challenges of management of these injuries in a large geographical area, with a centralised spinal trauma service. Generally, facet joint dislocations that had delayed reductions had a poorer outcome. We hope that the proposed protocol would deliver better management of these injuries.
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Evidence supporting the use of therapeutic intra-articular facet joint injections for patients with suspected facet joint pain is sparse. A systematic review including a narrative synthesis was carried out to determine if intra-articular facet joint injections with active drug are more effective in reducing back pain and back pain-related disability than a sham procedure or a placebo/inactive injection. Secondly, to determine if intra-articular facet joint injections with active drug or placebo/inactive injection are more effective in reducing back pain and back pain-related disability than conservative treatment. ⋯ The studies found here were clinically diverse and precluded any meta-analysis. A number of methodological issues were identified. The positive results, whilst interpreted with caution, do suggest that there is a need for further high-quality work in this area.
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To investigate the prevalence of low back pain (LBP) and its absence rate among female university student athletes in different types of sports. ⋯ While most of the existing literatures regarding female athletes' LBP have focused on particular sports with specific low back demands (such as skiing and rowing), many other sports have not been studied very well in this regard. Investigating LBP prevalence and related factors in other types of sports, such as combat sports, badminton and shooting, can help us better understand the prevalence of low back pain and provide us with necessary insight to take effective steps towards its prevention in athletes.
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Observational Study
The added prognostic value of MRI findings for recovery in patients with low back pain in primary care: a 1-year follow-up cohort study.
Information on the prognostic value of MRI findings in low back pain patients in primary care is lacking. The objective of this study is to investigate the added prognostic value of baseline MRI findings over known prognostic factors for recovery at 12-month follow-up in patients with low back pain referred to MRI by their general practitioner. ⋯ At 12-months follow-up, only 53% of these patients with low back pain referred for MRI in general practice reported recovery. Five clinic baseline characteristics were associated with recovery at 12-months follow-up; adding the MRI findings did not result in a stronger prediction of recovery.