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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Multicenter Study Comparative Study
Bacteria: back pain, leg pain and Modic sign-a surgical multicentre comparative study.
To compare bacterial findings in pain-generating degenerated discs in adults operated on for lumbar disc herniation (LDH), and mostly also suffering from low back pain (LBP), with findings in adolescent patients with non-degenerated non-pain-generating discs operated on for scoliosis, and to evaluate associations with Modic signs on magnetic resonance imaging (MRI). Cutibacterium acnes (Propionibacterium acnes) has been found in painful degenerated discs, why it has been suggested treating patients with LDH/LBP with antibiotics. As multidrug-resistant bacteria are a worldwide concern, new indications for using antibiotics should be based on solid scientific evidence. ⋯ Cutibacterium acnes found in discs and vertebrae during surgery for disc herniation in adults with degenerated discs may be caused by contamination, as findings in this group were similar to findings in a control group of young patients with scoliosis and non-degenerated discs. Furthermore, such findings were almost always combined with bacterial findings on the skin and/or in the wound. There was no association between preoperative Modic changes and bacterial findings. Antibiotic treatment of lumbar disc herniation with sciatica and/or low back pain, without signs of clinical discitis/spondylitis, should be seriously questioned. These slides can be retrieved under Electronic Supplementary Material.
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To automatically measure the Cobb angle and diagnose scoliosis on chest X-rays, a computer-aided method was proposed and the reliability and accuracy were evaluated. ⋯ The computer-aided method has potential for automatic Cobb angle measurement and scoliosis diagnosis on chest X-rays. These slides can be retrieved under Electronic Supplementary Material.
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Measurement of vertebral axial rotation (VAR) is relevant for the assessment of scoliosis. Stokes method allows estimating VAR in frontal X-rays from the relative position of the pedicles and the vertebral body. This method requires identifying these landmarks for each vertebral level, which is time-consuming. In this work, a quasi-automated method for pedicle detection and VAR estimation was proposed. ⋯ The proposed method allowed calculating VAR values in frontal radiographs with minimal user intervention and robust quasi-automated pedicle localization. These slides can be retrieved under Electronic Supplementary Material.
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This study examined for factors contributing to postoperative pain in adolescent idiopathic scoliosis (AIS), including those of sagittal alignment and lumbar disc degeneration. ⋯ While preoperative lumbar disc degeneration was not associated with pre- or postoperative pain in AIS, higher preoperative pain and higher postoperative T5-12 kyphotic angle had significant associations with augmented postoperative pain. Higher preoperative pain was related to increased Risser grade and lower mental health score. These slides can be retrieved under Electronic Supplementary Material.
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To define the longitudinal rotation axis around which individual vertebrae rotate, and to establish the various extra- and intravertebral rotation patterns in thoracic adolescent idiopathic scoliosis (AIS) patients, for better understanding of the 3D development of the rotational deformity. ⋯ In AIS, the vertebrae rotate away around an axis that is localized posterior to the spine. The distance between this axis and the spine is minimal at the apex and increases gradually to the neutral zones. The vertebral axial rotation is accompanied by smaller amounts of intravertebral rotation and local mechanical torsion, which increases toward the apical region. The altered morphology and alignment are important for a better understanding of the 3D pathoanatomical development of AIS and better therapeutic planning for bracing and surgical intervention. These slides can be retrieved under Electronic Supplementary Material.