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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The Oswestry Disability Index (ODI) plays a significant role in lumbar spinal stenosis research and is used to assess patient's walking limitations. The World Health Organisation describes the constructs of walking capacity and performance and recommend measuring both to fully describe patient's walking ability. Objective methods to assess walking capacity and performance is being investigated and used alongside the traditional use of PROs. This review of the literature was made to provide an overview of relations between the ODI and outcome measures of walking capacity and performance in spinal stenosis research, and to provide a strategy for improving such measures in future research. ⋯ The ODI should not stand alone when evaluating walking limitations in patients with lumbar spinal stenosis. To enable a comprehensive assessment of walking ability, a walking test should be used to assess walking capacity and accelerometers should be investigated and standardized in measuring walking performance. These slides can be retrieved under Electronic Supplementary Material.
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Quality registers give unique possibilities to achieve information from large groups of patients, but outcome must be interpreted carefully due to less stringent data collection and lower follow-up rates than in research projects. We tried to quantify any outcome differences between a national spine quality register and a prospective observational study. ⋯ Higher response rates than seen in Swespine are not needed to achieve reasonably representative data on patient-reported outcome for large cohorts. Two-year data do not seem to add additional information. These slides can be retrieved under Electronic Supplementary Material.
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Chance fracture of the high thoracic spine is rare, and its impact on the adjacent cervical spine can be important. ⋯ Literature is sparse on the treatment of high thoracic chance fractures. The current case shows that early surgical management should prevent a secondary kyphotic deformity that may need a more aggressive treatment at a later stage.
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The presence of prominent OALL (ossification of anterior longitudinal ligament) in the anterior cervical spine has been implicated as a cause of dysphagia. Surgical resection of the OALL is considered effective for the management of diffuse idiopathic skeletal hyperostosis (DISH)-related dysphagia. Although many reports have been published on DISH-related dysphagia, no cases of postoperative cervical instability have been reported thus far. We present a case in which the patient developed myelopathy associated with instability consequent to resection of OALL in DISH. ⋯ Surgical resection of DISH-related dysphagia typically yields excellent outcomes, but our experience in this case highlights the possibility of OALL regrowth and subsequent cervical instability after resection of OALL.
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The aim of this report was to describe a case using combined USG and fluoroscopy for cervical VP via a percutaneous route under sedoanalgesia. ⋯ We consider that the combined use of C-arm fluoroscopy and USG should improve success rates and prevent vascular and neural injuries and dura perforation.