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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Randomized Controlled Trial
No difference in 9-year outcome in CLBP patients randomized to lumbar fusion versus cognitive intervention and exercises.
To compare the 9-year outcome in patients with chronic low back pain treated by instrumented lumbar fusion versus cognitive intervention and exercises. ⋯ The outcome at 9 years was not different between instrumented lumbar fusion and cognitive intervention and exercises.
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A systematic search was conducted to study the efficiency of preventive educational interventions mainly focused on a biomechanical/biomedical model. ⋯ The results of the RCTs included in this review suggest that educational interventions mainly focused on a biomechanical/biomedical model are not effective in preventing LBP. However, taking into account the methodological quality level of the RCTs as well as the very short and heterogeneous interventions often proposed, additional high-quality studies with a longer education period are needed to conclude that such interventions are inefficient.
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Multicenter Study
Risk factors for major peri-operative complications in adult spinal deformity surgery: a multi-center review of 953 consecutive patients.
Major peri-operative complications for adult spinal deformity (ASD) surgery remain common. However, risk factors have not been clearly defined. Our objective was to identify patient and surgical parameters that correlate with the development of major peri-operative complications with ASD surgery. ⋯ The major peri-operative complication rate was 8.4 % for 953 surgically treated ASD patients. Significantly higher rates of complications were associated with staged and combined anterior-posterior surgeries. None of the patient factors assessed were significantly associated with the occurrence of major peri-operative complications. Improved understanding of risk profiles and procedure-related parameters may be useful for patient counseling and efforts to reduce complication rates.