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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It has not been determined which factors were related to multilevel lumbar disc degeneration (MLDD). The objective of this study was to determine the prevalence of MLDD among symptomatic patients using the magnetic resonance imaging method. The study also aimed to clarify the associations between MLDD and suspected risk factors through a multivariate model. ⋯ Despite the young age of this cohort, MLDD is common among patients with low back pain. A significant independent association exists between age, HT, anemia and multilevel disc degeneration in the lumbar region.
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Proprioceptive deficits are common in low back pain. The multifidus muscle undergoes substantial structural change after back injury, but whether muscle spindles are affected is unclear. This study investigated whether muscle spindles of the multifidus muscle are changed by intervertebral disc (IVD) degeneration in a large animal model. ⋯ Changes to the connective tissue and collagen expression of the muscle spindle capsule are likely to impact their mechanical properties. Changes in capsule stiffness may impact the transmission of length change to muscle spindles and thus transduction of sensory information. This change in muscle spindle structure may explain some of the proprioceptive deficits identified with low back pain.
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Posterior and transforaminal lumbar interbody fusion (PLIF, TLIF) are among the most popular surgical options for lumbar interbody fusion. If non-union occurs with consequent pain and reduced quality of life, revision surgery should correct any previous technical errors, avoiding further complications. The aim of this study was to analyze technical advantages, radiological and clinical outcomes of anterior approaches (ALIF) in case of failed PLIF or TLIF. ⋯ Salvage ALIF is a safe option that can significantly ameliorate residual pain achieving primary interbody stability with an ideal segmental lordosis according to pelvic parameters. The advantages of a naive anterior approach fulfils the main objectives of a revision surgery in order to significantly increase the chances of definitive fusion.
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This study exploits a novel musculoskeletal finite element (MS-FE) spine model to evaluate the post-fusion (L4-L5) alterations in adjacent segment kinetics. ⋯ Alterations in segmental rotations mainly affected adjacent disc shear forces, facet/ligament forces, and annulus/collagen fibers stresses/strains. An altered lumbopelvic rhythm (increased pelvis rotation) tends to mitigate some of these surgically induced changes.
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To assess whether saphenous somatosensory-evoked potentials (saphSSEP) monitoring may provide predictive information of femoral nerve health during prone lateral interbody fusion (LIF) procedures. ⋯ Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.