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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Observational Study
Classification of endplate lesions in the lumbar spine and association with risk factors, biochemistry, and genetics.
To detect the associations between the degree of the endplate (EP) lesions with the presence of risk factors, biochemical and genetic markers previously observed in low back pain (LBP) patients with EP defects in comparison with hernia/discopathy patients and healthy controls. ⋯ The markers previously identified as associated with the presence of EP lesions have been confirmed as related to their severity and could be used to follow the pathology progression.
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To analyze the clinical and radiographic characteristics of thoracic disk disease associated with myelopathy (TDM). ⋯ The onset of TDM was generally insidious but may be triggered acutely by apparently trivial events. With a low prevalence, TDM varied clinical symptoms. Different types of TDM had various clinical features, which might indicate different pathological mechanisms.
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Surgical treatment of herniated lumbar intervertebral disks is a common procedure worldwide. However, recurrent herniated nucleus pulposus (re-HNP) may develop, complicating outcomes and patient management. The purpose of this study was to utilize machine-learning (ML) analytics to predict lumbar re-HNP, whereby a personalized risk prediction can be developed as a clinical tool. ⋯ Our predictive modeling via an ML approach of our large-scale cohort is the first study, to our knowledge, that has identified significant risk factors for the development of re-HNP after initial lumbar decompression. We developed the re-herniation after decompression (RAD) profile index that has been translated into an online screening tool to identify low-high risk patients for re-HNP. Additional validation is needed for potential global implementation.
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While telemedicine usage has increased due to the COVID-19 pandemic, there remains little consensus about how spine surgeons perceive virtual care. The purpose of this study was to explore international perspectives of spine providers on the challenges and benefits of telemedicine. ⋯ Spine surgeons are supportive of the benefits of telemedicine, and only a small minority experienced technical issues. The decreased ability to perform the physical examination was the top challenge and remains a major obstacle to virtual care for spine surgeons around the world, although interestingly, 61.4% of providers did not acknowledge this to be a major challenge. Significant groundwork in optimizing remote physical examination maneuvers and achieving legal and reimbursement clarity is necessary for widespread implementation.
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The authors describe a percutaneous technique to treat advanced degenerative disk disease in elderly patients. ⋯ Percutaneous discoplasty can result as an alternative minimal invasive strategy for the treatment of advanced degenerative disk disease.