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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Randomized Controlled Trial
Rehabilitation following lumbar fusion surgery (REFS) a randomised controlled feasibility study.
Following lumbar fusion surgery (LFS), 40% of patients are unsure/dissatisfied with their outcome. A prospective, single-centre, randomised, controlled trial was conducted to evaluate the feasibility (including clinical and economic impact) of a theoretically informed rehabilitation programme following LFS (REFS). ⋯ Results suggest that REFS is feasible and potentially affordable for delivery in the National Health Service. It is associated with a clinically meaningful impact. A multicentre randomised controlled study to further elucidate these results is warranted. These slides can be retrieved under Electronic Supplementary Material.
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Review Meta Analysis
Pain and disability after first-time spinal fusion for lumbar degenerative disorders: a systematic review and meta-analysis.
Lumbar spinal fusion (LSF) is frequently and increasingly used in lumbar degenerative disorders despite conflicting results and recommendations. A thorough understanding of patient outcomes after LSF is required to inform decisions regarding surgery and to improve post-surgery management. The current study aims to evaluate the course of pain and disability in patients with degenerative disorders of the lumbar spine after first-time LSF. ⋯ There is a substantial improvement in pain and disability after first-time LSF for degenerative disorders. However, long-term outcomes indicate that leg pain might be more reduced and for a longer period of time than axial back pain and disability. Registration PROSPERO CRD42015026922. These slides can be retrieved under Electronic Supplementary Material.
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Controlled Clinical Trial
Radiologic parameters of ankylosing spondylitis patients treated with anti-TNF-α versus nonsteroidal anti-inflammatory drugs and sulfasalazine.
Limited data are available on the relationship between treatment agents and sagittal balance in ankylosing spondylitis (AS). We investigated radiological features related to treatment agents and compared sagittal balance between patients treated with anti-tumor necrosis factor-α (anti-TNF-α) and those treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and sulfasalazine (SSZ). ⋯ This study demonstrated a clear association between treatment agents and radiologic parameters in AS. Anti-TNF-α treatment improved LL with improvement in clinical outcomes. Lumbar lordosis was a significant predictor of clinical outcome in AS patients treated with anti-TNF-α. These slides can be retrieved under Electronic Supplementary Material.
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The aim of this study was to develop and internally validate a multivariable model for accurate prediction of surgical site infection (SSI) after instrumented spine surgery using a large cohort of a Western European academic center. ⋯ We developed and internally validated a prediction model for SSI after instrumented thoracolumbar spine surgery using predictor variables of standard clinical practice that showed reasonable discriminative ability and calibration. Identification of patients at risk for SSI allows for individualized patient risk assessment with better patient-specific counseling and may accelerate the implementation of multi-disciplinary strategies for reduction of SSI. These slides can be retrieved under Electronic Supplementary Material.
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In total joint replacement, culturing of the sonication fluid of removed implants has proven to be more sensitive than conventional periprosthetic tissue culture for the microbiological diagnosis of prosthetic joint infection. However, its role in postoperative spinal implant infection (PSII) is not well investigated. Therefore, the aim of this study was to determine the validity of sonication in detecting infection following instrumented spine surgery. ⋯ Culture of samples obtained by spinal implant sonication was more sensitive than conventional peri-implant tissue culture for the microbiological diagnosis of PSII. Therefore, sonication should be used as a routine tool in the diagnostic workup of PSII. These slides can be retrieved under Electronic Supplementary Material.