Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
-
Locking plates are an internal fixation material useful in the treatment of bone fractures, which provides effective stabilization between the plate and locking head screws (LHSs) via the locking mechanism. However, difficulty in removing LHSs is relatively common, and such cases can require long surgical procedures or use of special removal equipment. The purpose of this study was to report the incidence and risk factors for difficult removal of LHSs. ⋯ This study suggests that (1) the use of LHSs with a 3.5 mm diameter is a necessary condition for difficulty in screw removal, and that (2) longer time from internal fixation to removal, and (3) younger age, are risk factors for it. When removing LHSs with a 3.5 mm diameter, appropriate instruments and sufficient training are necessary.
-
An epidemiological survey conducted in Japan in fiscal year 2010 revealed a high prevalence of chronic musculoskeletal pain, low patient satisfaction with treatment, a high incidence of protracted treatment lasting a year or more, and reduced quality of life. To improve the current system for treating chronic musculoskeletal pain, it is important to identify risk factors, including patient characteristics, for developing chronic pain. Thus, we sought to determine the incidence of new chronic pain in the Japanese population, as well as the persistence rate, associated factors, and current state of treatment of chronic pain, by repeating a postal survey in a nationwide representative sample group first surveyed in 2010. ⋯ We identified risk factors related to the development of new chronic pain and the persistence of chronic pain. Countermeasures to prevent chronic pain could be especially important for the high-risk populations for understanding the pathology of chronic pain.
-
The anti-seizure drug pregabalin is currently used for peripheral neuropathic pain, including degenerative lumbar disease with a neuropathic component. Although there are many reports associated with pregabalin, treatment outcome in low back pain (LBP) patients with depression remains uncertain. This study investigated the outcomes of pregabalin in LBP patients with depression. ⋯ This investigation indicated that pregabalin is safe and effective for reducing both LBP and mood disturbance in patients with depression.
-
Diabetes mellitus (DM) is reported to be a risk factor for surgical site infection (SSI), which is a serious complication after spinal surgery. The effect of DM on SSI after instrumented spinal surgery remains to be clarified. The aim was to elucidate perioperative risk factors for infection at the surgical site after posterior thoracic and lumbar spinal arthrodesis with instrumentation in patients with DM. ⋯ DM patients whose blood glucose levels were poorly controlled before surgery were at high risk for SSI. To prevent SSI in DM patients, we recommend lowering the HbA1c to <7.0 % before performing surgery.
-
Clumsiness and numbness of the upper extremity is one of the most common complaints of patients with cervical myelopathy. However, most previous evaluations after cervical laminoplasty have only been based on physicians' points of view. We used Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) self-report questionnaire, which was designed to measure physical function and symptoms in people with upper-limb disorders to evaluate functional outcomes after laminoplasty. ⋯ QuickDASH was useful in evaluating upper-extremity functional outcomes after cervical laminoplasty.