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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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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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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Comparative Study Clinical Trial
A kinematic analysis of relative stability of the lower extremities between subjects with and without chronic low back pain.
Even though a number of studies have evaluated postural adjustments based on kinematic changes in subjects with low back pain (LBP), kinematic stability has not been examined for abnormal postural responses during the one leg standing test. The purpose of this study was to evaluate the relative kinematic stability of the lower extremities and standing duration in subjects with and without chronic LBP. In total, 54 subjects enrolled in the study, including 28 subjects without LBP and 26 subjects with LBP. ⋯ There was a group interaction between side and lower extremities (F = 11.79, p = 0.001) as well as an interaction between age and dominance side (F = 7.91, p = 0.007). The relative kinematic stability had a moderate negative relationship with age (r = -0.60, p = 0.007) in subjects without LBP. Clinicians need to understand the effects of age and relative stability, which decreased significantly in the single leg holding test, in subjects with LBP in order to develop effective rehabilitation strategies.
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Comparative Study Clinical Trial
Adjacent-level degeneration after cervical disc arthroplasty versus fusion.
The principal objective of this study was to evaluate the incidence of adjacent-segment degeneration (ASD) in patients who underwent cervical disc arthroplasty (CDA) as compared with anterior cervical discectomy and fusion (ACDF). ⋯ Preservation of motion in the CDA patients was not associated with a reduction of the incidence of symptomatic adjacent-segment disease and there may be other factors that influence ASD.
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To determine whether polymorphisms (SNPs) in the genes encoding cytokines and nitric oxide synthase (NOS) might play some role in lumbar disc herniation (LDH). ⋯ Carriers of the CC genotype of the IL-1β (+3953 T/C) SNP were more frequent among LDH patients suggesting some potential role of the IL-1β SNP on LDH pathogenesis. The eNOS (-786 T/C) and iNOS (22 G/A) SNPs were more frequent among the control subjects, suggesting their possible protective role against LDH. Genotyping these SNPs could be useful to identify persons with an increased lifetime risk of disc herniation in whom measures to avoid LDH could be implemented.