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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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
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.
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This experimental study in pigs was aimed at evaluating spinal growth disorders after partial arrest of the vertebral epiphyseal plates (EP) and neurocentral cartilages (NCC). Unilateral and multisegmental single or combined lesions of the physeal structures were performed by electrocoagulation throughout a video-assisted thoracoscopical approach. ⋯ In summary, unilateral direct lesion of the EP by hemicircumferential thoracoscopic electrocoagulation modifies vertebral growth, but is not able to induce true scoliostic curves in pigs. Only animals with damaged NCC developed mild scoliotic curves of lordotic type. This work rediscovers and emphasizes the decisive role of the neurocentral cartilage in the ethiopatogeny of idiopathic scoliosis.
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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.