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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The natural course of lumbar spinal stenosis (LSS) fluctuates and is not necessarily progressive. The aim of this study was to explore the predictors of clinical outcome in patients with LSS that might eventually help to optimise the therapeutic choices. ⋯ Satisfactory outcomes were disclosed in about 61 % of the patients with mild-to-moderate LSS in a 7-year follow-up. Electrophysiological abnormalities, namely the presence of pluriradicular involvement and abnormalities of the soleus H-reflex, were predictive of deterioration of clinical status in these patients.
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To investigate the effect of an anti-TNF-α agent (etanercept) on recovery processes in a partial spinal cord injury (SCI) model using clinical and electrophysiological tests. ⋯ These results show that blocking TNF-α mediated inflammation pathway by an anti-TNF-α agent enhances clinical and electrophysiological recovery processes in partial SCI model.
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We evaluated the consequences of cobalt-chromium alloy (CoCr) wear debris challenge in the peri-spine region to determine the inflammation and toxicity associated with submicron particulates of CoCr-alloy and nickel on the peri-spine. ⋯ Subtle peri-spine inflammation associated with CoCr-alloy implant particles was dose dependent and persistent. Neuropathy can be induced by highly reactive Ni particles. This suggests peri-spine challenge with CoCr-alloy implant debris (e.g., TDA) is consistent with past reports using titanium alloy particles, i.e., mild persistent inflammation.
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Everyday activities such as walking may elicit spinal shrinkage in an order of magnitude that has been related to lower back pain. The present study aims to compare the effects of unloaded treadmill walking with walking carrying loads representing everyday shopping tasks. ⋯ Results suggest that the body adopts less anterior lean with an immediate load-bearing demand, to decrease the necessary extension moment generated by the spinal extensors for spinal stability. Further postural alteration in the same direction is observed with prolonged loading. In combination with lumbar spinal shrinkage, such postural changes are likely to increase the loading on the facet joints and subsequently unload the discs which may be beneficial for those with low back pain.