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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Controlled Clinical Trial
Motion characteristics of the lumbar spinous processes with degenerative disc disease and degenerative spondylolisthesis.
Recently, interspinous process devices have attracted much attention since they can be implanted between the lumbar spinous processes (LSP) of patients with degenerative disc disease (DDD) and degenerative spondylolisthesis (DLS) using a minimally invasive manner. However, the motion characters of the LSP in the DLS and DDD patients have not been reported. This study is aimed at investigating the kinematics of the lumbar spinous processes in patients with DLS and DDD. ⋯ At the involved level, the hypermobility of the LSP was seen in DDD and hypomobility of the LSP in DLS patients. The data may be instrumental for improving ISP surgeries that are aimed at reducing post-operative complications such as bony fracture and device dislocations.
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Spinal infection is a rare pathology although a concerning rising incidence has been observed in recent years. This increase might reflect a progressively more susceptible population but also the availability of increased diagnostic accuracy. Yet, even with improved diagnosis tools and procedures, the delay in diagnosis remains an important issue. This review aims to highlight the importance of a methodological attitude towards accurate and prompt diagnosis using an algorithm to aid on spinal infection management. ⋯ A methodological assessment could lead to diagnosis effectiveness of spinal infection. Towards this, we present a management algorithm based on literature findings.
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Randomized Controlled Trial
An exploration of patients' expectation of and satisfaction with surgical outcome.
The majority of studies of surgical outcome focus on measures of function and pain. Increasingly, however, the desire to include domains such as patients' satisfaction and expectations had led to the development of simple measures and their inclusion into clinical studies. The purpose of this study was to determine patients' pre-operative expectations of and post-operative satisfaction with the outcome of their spinal surgery. ⋯ Patients' pre-operative expectations of surgical outcome exceed their long-term achievement. The more importance the patient attached to a good outcome, the larger is the discrepancy between expectation and achievement. Despite this, satisfaction levels remained high. The impact of unrealistic expectations on outcome remains unclear.
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The objective of this study was to investigate the impact of the less invasive procedures of hemilaminectomy and unilateral multilevel interlaminar fenestration (UMIF) on the cervical spinal biomechanics. ⋯ The less invasive approaches of UMIF and MHL greatly preserved the flexion motion (more than 48 %) of the cervical spine compared with laminectomy, and the preserved motion mean the low-risk of postoperative spinal instability. UMIF and MHL also reduced the increased stress of annulus caused by ML, and the lesser stress will lower the risk of postoperative disc degeneration. The posterior bone elements play a slight role in spinal stability after removal of the attached ligaments.
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The purpose of this study was to analyze explanted PEEK rod spinal systems in the context of their clinical indications. We evaluated damage to the implant and histological changes in explanted periprosthetic tissues. ⋯ This study documents the surface changes and tissue reactions for retrieved PEEK rod stabilization systems. Permanent indentations by the set screws and pedicle screws were the most prevalent observations on the surface of explanted PEEK rods.