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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Comparative Study Clinical Trial
Validity of the 10-s step test: prospective study comparing it with the 10-s grip and release test and the 30-m walking test.
Cervical compressive myelopathy (CCM) is one of the common neurological disorders seen in the geriatric population. The 10-s Grip and Release ("G and R") Test and the 30-m Walking ("Walking") Test are widely known as quantifiable physical assessments for the severity of cervical myelopathy. We developed the 10-s Step ("Step") Test as another easily performable quantifiable measure for this. ⋯ Linear regression analyses showed that the results of the Step Test correlated with JOA scores to the same degree as the Walking Test results did, and to a greater degree than the G and R Test results did. Moreover, the results of the Step Test showed a significant degree of correlation with JOACMEQ-L. In view of these findings, our conclusion was that the easily performed Step Test is an useful test for assessing the severity of cervical myelopathy, especially for the lower limb dysfunction secondary to CCM.
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Clinical Trial
Impact of magnetic resonance imaging on decision making for thoracolumbar traumatic fracture diagnosis and treatment.
The role of magnetic resonance imaging (MRI) has recently been enhanced in the diagnosis of thoracolumbar fractures due to its ability to examine soft tissue injury. ⋯ MRI seems to be a useful tool in the evaluation of thoracolumbar acute fractures, as it allows a better visualization of the posterior complex integrity and of the levels involved, offering additional information compared to traditional diagnostic tools.
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Patients with low back pain (LBP) suffer chronic disability. In 40% of LBP patients degenerative disc disease (DDD) seems to be the cause. This prospective case series assessed the efficacy of the interspinous device for intervertebral assisted motion (DIAM™) in patients with LBP resulting from DDD. ⋯ At 48 months, 67.3% of patients reached the minimum clinically important difference (MCID; ≥1.5-unit improvement) in VAS score and 78.9% of patients reached the MCID (≥30% improvement) in RMDQ score. No complications were associated with surgery. In conclusion, patients with LBP treated with the interspinous DIAM™ system showed significant and clinically meaningful improvements in pain and disability for up to 4 years.
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Single-stage posterior corpectomy for the management of spinal tumors has been well described. Anterior column reconstruction has been accomplished using polymethylmethacrylate (PMMA) or expandable cages (EC). The aim of this retrospective study was to compare PMMA versus ECs in anterior vertebral column reconstruction after posterior corpectomy for tumors in the lumbar and thoracolumbar spine. ⋯ Seven patients had complications that led to reoperation (5 infections). PMMA or ECs are viable options for reconstruction of the anterior vertebral column following tumor resection and corpectomy. Both approaches allow for correction of the kyphotic deformity, and stabilization of the anterior vertebral column with similar functional and performance status outcomes in the lumbar and thoracolumbar area.
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Comparative Study Clinical Trial
Intimate relationship between instability and degenerative signs at L4/5 segment examined by flexion-extension radiography.
Relationship between lumbar disc degeneration and segmental instability has remained controversial. Using instability factors that found close relations with symptoms in flexion-extension radiographic study, their relationship with degenerative findings was examined. More than (≥) 3 mm slip in neutral position (SN), ≥3 mm translation (ST), and ≥10° angulation (SA) at L4/5 segment were defined as instability factors and were applied on 447 patients who had low back and/or leg pain and satisfied inclusion criteria for accurate measurements. ⋯ Disc height was the most important in the examined parameters and showed an intimate relationship with age and instability factors. Although the etiology is still unknown, clinical common knowledge, that a diminution of disc height with progressive degeneration had a close relation with anterior vertebral slippage, was firstly confirmed. This study allows comprehensive understanding of segmental instability and is useful for considering surgical indications.