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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Although analysis of scoliotic deformity is still studied extensively by means of conventional roentgenograms, computer-assisted digital analysis may allow a faster, more accurate and more complete evaluation of the scoliotic spine. In this study, a new computer-assisted measurement method was evaluated. This method uses digital reconstruction images for quantitative analysis of the scoliotic spine. ⋯ The interobserver bias was negligible. It can be concluded that the reliability of our new method for quantifying geometrical variables on digital reconstruction images is better than measurements on conventional roentgenograms in previously published reports. The presented method is therefore considered to be more accurate for research of spinal deformities and more adequate for clinical management of scoliosis.
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Clinical Trial
Pain and function after intradiscal electrothermal treatment (IDET) for symptomatic lumbar disc degeneration.
The goal of this study was to evaluate the short-term effects of intradiscal electrothermal treatment (IDET) for chronic discogenic low back pain. Twenty consecutive patients with symptomatic degenerative discs were treated with IDET and evaluated preoperatively, and 3 and 6 months postoperatively. Pain was measured with a 100-mm visual analog scale (VAS) and function was evaluated with the Oswestry score and SF-36 questionnaire. ⋯ The Oswestry scores did not improve significantly. The SF-36 showed improvement, but only for the subscales vitality (P=0.023) and bodily pain (P=0.047). Based on these results, we conclude that IDET is not effective in reducing pain and improving functional performance in a sample of 20 patients treated for chronic discogenic low back pain after 6 months follow-up.
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Using two nonlinear finite element models of the lumbar spine, the concept of optimal posture is explored by minimizing the segmental sagittal moments required for the equilibrium of the passive lumbar spine under a total of 2800 N axial compression while varying the pelvic tilt and lumbar lordosis. The redundant active-passive system is subsequently solved for this posture using a novel kinematics-based muscle calculation algorithm along with minimization approach. Some flattening in the lumbar spine substantially reduces the required moments and internal passive shear forces under 2800 N axial compression force. ⋯ Without such changes in posture, the required moments probably exceed the moment-generating capability of local lumbar muscles. Consideration of such active-passive synergy and lack of its restriction may prove crucial in many activities. Moreover, a kinematics-based algorithm is proposed for the solution of spinal redundancy that fully accounts for the existing passive-active synergy while simultaneously satisfying all kinematics and equilibrium conditions along the length of the spine.
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The aim of this prospective study was to evaluate radiographic findings, patient satisfaction and clinical outcome, and to report complications and instrumentation failure after operative treatment of Scheuermann's disease using a combined anterior and posterior spondylodesis. The loss of sagittal plane correction after removal of the posterior instrumentation was analysed. The indication for surgery was a thoracic kyphosis greater than 60 degrees in adolescents and adults with persistent back pain, which failed to respond to conservative treatment. ⋯ There was no significant correlation between the radiographic outcome and the SRSI score (P>0.05). Our series showed relatively fair outcome after operative treatment in Scheuermann's disease. Therefore, the indication for surgery in patients with Scheuermann's disease can be questioned.