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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Both endoscopic lumbar spinal surgery and the non-standardized and unstable retractor systems for the lumbar spine presently on the market have disadvantages and limitations in relation to the minimally invasive surgical concept, which have been gradually recognized in the last few years. In an attempt to resolve some of these issues, we have developed a highly versatile retractor system, which allows access to and surgery at the lumbar, thoracic and even cervical spine. This retractor system - Synframe - is based on a ring concept allowing 360 degrees access to a surgical opening in anterior as well as posterior surgery. ⋯ This ring also functions as a carrier for fiberoptic illumination devices and different sizes of endoscopes, used to transmit the surgical procedure out of the depth of the surgical exposure for both teaching purposes and for the surgical team when it has no longer direct visual access to the procedure. The ring is stable, being fixed onto the operating table, allowing precise minimally open approaches and surgical procedures under direct vision with optimal illumination. This ring system also opens perspectives for an integrated minimally open surgical concept, where the ring may be used as a reference platform in computer-navigated surgery.
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This study was designed as a cross-sectional questionnaire-based survey of low back pain (LBP) in 13- to 16-year-old Danish school children. The cohort consisted of 671 boys and 718 girls in eighth and ninth grade in 46 municipal schools in three counties of Sealand. All the pupils filled in a questionnaire with LBP as the main topic and were at the same time examined by the school doctors. ⋯ This was positively correlated to female gender, BMI more than 25 kg/m(2), competitive sport for boys, poor physical fitness, daily smoking, heavy jobs in leisure time, increased use of the health system and reduced life quality. Stepwise logistic regression analysis indicates that female gender, daily smoking and heavy jobs are important associated factors for severe LBP in adolescents, with an observed probability of 46% if all factors are present. We don't know yet whether these factors are of any causal importance in the development of severe LBP.
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CT measurement methods have good reliability for idiopathic scoliosis transverse plane deformity evaluation. However, because of application difficulties and variations in how these methods are applied, more sensitive methods are needed. This paper presents a new method for measurement of vertebral rotation from tomographic scans. ⋯ Intraobserver and inter-observer analysis showed that this method was reliable. An experimental study was then conducted to show the confidence limits of our new method, which were found to be +/-1.6 degrees, and there was no significant difference between the mean rotation value obtained from CT scans using our new method and that obtained using the mechanical method. These results suggest that our new method is a simple, practical and reliable method for measurement of vertebral rotation from CT scans.