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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Patient-rated measures are considered the gold standard for assessing the outcome of spine surgery, but there is no consensus on the appropriate timing of follow-up. Journals often demand a minimum 2-year follow-up, but the indiscriminate application of this principle may not be warranted. We examined the course of change in patient outcomes up to 5 years after surgery for degenerative spinal disorders. ⋯ Stable group mean COMI scores were observed for all patients from 12 months postoperatively onwards. The early postoperative results appeared to herald the longer term outcome. As such, a 'wait and see policy' in patients with a poor initial outcome at 3 months is not advocated. The insistence on a 2-year follow-up could result in a failure to intervene early to achieve better long-term outcomes.
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To evaluate the radiographic, functional outcomes, complications and surgical specificities of L5 pedicle subtraction osteotomy for fixed sagittal and coronal malalignment. ⋯ PSO of L5 can be a safe and effective technique to treat and correct fixed sagittal imbalance and provide biomechanical stability. The high complication rate mandates a careful assessment of the risk/benefit ratio of such a major surgery. Most patients are satisfied, particularly when sagittal balance is achieved.
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Low bone mass and a female gender increase susceptibility to the development of degenerative lumbar scoliosis (DLS), which suggests the potential involvement of an osteoporosis-related gene in the pathogenesis of DLS. In the present study, the authors studied the relations between polymorphisms of interleukin 6 (IL-6) gene and DLS in a patient cohort. ⋯ The results of this study suggest that the IL6-572 G/C polymorphism influences LSBMD in Korean DLS patients and the prevalence of the disease.
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This study reports the results of a registry data collection project within a secondary care spinal osteopathy service. ⋯ The secondary care spinal osteopathy service demonstrated high satisfaction, few therapeutic complications and positive outcomes on all PROMs. Registry participation has facilitated robust clinical governance and the data support the use of osteopaths to deliver a conservative spinal service in this setting. Registry data collection is a significant administrative and clinical task which should be structured to minimise burden on patients and resources. These slides can be retrieved under Electronic Supplementary Material.
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Fresh frozen intervertebral disc allograft transplantation has been reported to be a viable treatment option for advanced degenerative disc diseases, but rapid degeneration of the postoperative allograft was found. Loss of nutrient supply is believed to be the most likely inducer because the disc allografts have to endure in an ischaemic environment until the nutrient pathway is re-established. The aim of this study was to focus on the revascularisation of the disc allograft after transplantation in goats. ⋯ Revascularisation of the postoperative disc allograft has been determined, but its pattern was different from that in adult normal discs, suggesting that the typical nutrient diffusion pattern may be affected after transplantation.