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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To determine the efficacy of physiotherapy approaches used in the treatment of LSS and compare their delivery characteristics. ⋯ These findings may assist clinicians in delivering effective physiotherapy interventions in LSS patients.
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To investigate the relationship between pelvic incidence (PI) and proximal junctional kyphosis (PJK) in patients treated surgically for adult spinal deformity (ASD) with fusion from thoracolumbar junction to sacrum. ⋯ When the upper-instrumented vertebra includes the thoracolumbar junction, patients with a PI > 50° are at a significantly higher risk of developing PJK compared to patients with a PI ≤ 50°.
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Foraminal stenosis is commonly investigated with radiological methods in patients with radiating pain in extremities. However, there is a lack of consensus regarding the methodology to assess compression of the nerve roots. This systematic review was performed to identify validated classification systems for foraminal stenosis in the lumbar and cervical spine based on magnetic resonance imaging (MRI). ⋯ The three classification systems demonstrated moderate to good reliability and have all been shown feasible in the clinical setting. There is however a need for further studies testing the validity of these classifications in relation to both clinical findings and to surgical outcome data.
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Review Meta Analysis
Rehabilitation to improve outcomes of lumbar fusion surgery: a systematic review with meta-analysis.
To evaluate the effectiveness of rehabilitation strategies on disability, pain, pain-related fear, and return-to-work in patients undergoing lumbar fusion surgery for degenerative conditions or adult isthmic spondylolisthesis. ⋯ There is low-quality evidence showing that both exercise therapy and multimodal rehabilitation are effective for improving outcomes up to six months after lumbar fusion, with multimodal rehabilitation providing additional benefits over exercise alone in reducing disability and pain-related fear. Additional high-quality studies are needed to demonstrate the effectiveness of rehabilitation strategies in the long term and for work-related outcomes.
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This review provides an overview of the patent literature on posteriorly placed intrapedicular bone anchors. Conventional pedicle screws are the gold standard to create a fixation in the vertebra for spinal fusion surgery but may lack fixation strength, especially in osteoporotic bone. The ageing population demands new bone anchors that have an increased fixation strength, that can be placed safely, and, if necessary, can be removed without damaging the surrounding tissue. ⋯ This review provides insights into worldwide patented intrapedicular bone anchors that aim to increase the fixation strength compared to the conventional pedicle screw. The identified anchoring methods and their working principles can be used for clinical decision-making and as a source of inspiration when designing novel bone anchors.