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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Sagittal plane alignment is crucial for treating spinal malalignment and low back pain. Pelvic incidence-lumbar lordosis (PI-LL) mismatch is commonly used to evaluate clinical outcomes in patients with sagittal malalignment. The association between PI-LL mismatch and changes surrounding the intervertebral disc is very important to understand the compensatory mechanisms involved. This study aimed to examine the association between PI-LL mismatch and magnetic resonance imaging (MRI) changes surrounding the intervertebral disc in a large population-based cohort. ⋯ MC and DD were significantly associated with PI-LL mismatch. Therefore, profiling MC may be helpful in improving the targeted treatment of LBP associated with the adult spinal deformity.
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Chronic back pain (CBP) carries a significant burden. Understanding how and why CBP prevalence varies spatially, as well as the potential impact of policies to decrease CBP would prove valuable for public health planning. This study aims to simulate and map the prevalence of CBP at ward-level across England, identify associations which may explain spatial variation, and explore 'what-if' scenarios for the impact of policies to increase physical activity (PA) on CBP. ⋯ CBP prevalence varies at ward-level across England. At ward-level, physical inactivity is strongly positively correlated with CBP. This relationship is largely explained by geographic variation in confounders (the proportion of residents that are: over 60, in low-skilled jobs, female, pregnant, obese, smokers, white or black, disabled). Policies to increase PA by 30 min weekly MVPA will likely result in a significant reduction in CBP prevalence. To maximise their impact, policies could be tailored to areas of high prevalence, which are identified by this study.
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Review Meta Analysis
Full-endoscopic discectomy for thoracic disc herniations: a single-arm meta-analysis of safety and efficacy outcomes.
Surgical intervention is the treatment of choice in patients with thoracic disc herniation with refractory symptoms and progressive myelopathy. Due to high occurrence of complications from open surgery, minimally invasive approaches are desirable. Nowadays, endoscopic techniques have become increasingly popular and full-endoscopic surgery can be performed in the thoracic spine with low complication rates. ⋯ Full-endoscopic discectomy has a low incidence of adverse outcomes in patients with thoracic disc herniations. Controlled studies, ideally randomized, are warranted to establish the comparative efficacy and safety of the endoscopic approach relative to open surgery.
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Multicenter Study
Pediatric cervical spine injuries-results of the German multicenter CHILDSPINE study.
The aim of this study was to provide epidemiological data of pediatric patients suffering from cervical spinal trauma in Germany, in order to integrate these data in future decision-making processes concerning diagnosis and therapy. ⋯ The upper cervical spine was more frequently affected in young children. Older children more often suffered from subaxial pathologies. The majority of cervical spinal column injuries were treated conservatively. Nevertheless, 15% of the hospitalized children had to be treated surgically.
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Review
Defining "successful" treatment outcomes in adolescent idiopathic scoliosis: a scoping review.
Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis that affects children aged 10-18 years old, manifesting in a three-dimensional spinal deformity. This study aimed to explore outcome measures used in defining AIS treatment success. Particularly, analyzing the extent of qualitative and quantitative (radiographic and quality of life domains) measures to evaluate AIS and whether AIS treatment approaches (surgical, bracing and physiotherapy) influences outcomes used as proxies of treatment success. ⋯ This study identified that no articles employed qualitative measures of describing the psychosocial implications of AIS in defining treatment success. Although quantitative measures have merit in clinical diagnoses and management, there is increasing value in using qualitative methods such as thematic analysis in guiding clinicians to develop a biopsychosocial approach for patient care.