The spine journal : official journal of the North American Spine Society
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Low back pain (LBP) is a prevalent and costly musculoskeletal disorder that often occurs in the working-age population. Although numerous physical activities have been implicated in its complex etiology, determining causation remains challenging and requires a methodologically rigorous approach. ⋯ There was strong evidence from six high-quality studies that there was no association between awkward postures and LBP. Similarly, there was strong evidence from three high-quality studies that there was no temporal relationship. Moreover, subgroup analyses identified only a handful of studies that demonstrated only weak associations and no evidence for other aspects of causality in certain specific subcategories. It is therefore unlikely that awkward occupational postures are independently causative of LBP in the populations of workers studied.
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Although there have been several studies in which the surgical outcomes were evaluated by pain reduction or neurological improvement, there have been few studies focused on the quality of life (QOL) of the patients after the surgery. We considered that the most important consideration in palliative surgery was to respect the wishes of patients and their families, which are likely to be influenced by the patients' QOL for their limited life span. ⋯ These results strongly suggested that palliative surgery is a valuable treatment for metastatic spinal disease. Younger patients were more likely to want active treatment and to seek any functional improvement that contributed to an improved QOL in their limited life span. Pain control and the length of patient survival were important factors for people caring for patients.
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Low back pain (LBP) is a common musculoskeletal disorder that often occurs in the working-age population. Although numerous physical activities have been implicated in its etiology, determining causation remains challenging and requires a methodologically rigorous approach. ⋯ A summary of existing studies was not able to find high-quality studies that satisfied more than three of the Bradford-Hill criteria for causation for either occupational bending or twisting and LBP. Conflicting evidence in multiple criteria was identified. This suggests that specific subcategories could contribute to LBP. However, the evidence suggests that occupational bending or twisting in general is unlikely to be independently causative of LBP.
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During the past 25 years, spinal instrumentation systems and surgical techniques used to treat idiopathic scoliosis have evolved, achieving fewer patient restrictions during arthrodesis healing, shorter constructs, and better correction. The purposes of this retrospective comparative study were to determine the survivorship of the implant/fusion without reoperation and the risk factors influencing such survival. ⋯ The most stable lower instrumented vertebra anchor configuration, bilateral pedicle screws, and the stronger transverse connector design, closed drop entry, provided the best survival of the implant/fusion without reoperation with this system and the techniques used at 9-year follow-up. We hope that this post-market study using survivorship techniques will be a guide for studies of other spinal implants.
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Even though many clinical reports about cages have been documented in patients with degenerative disorders, reports were scarce for traumatic injury cases, and those cases using metal cages were restricted to only one-level injury. ⋯ The PEEK cage and additional plate fixation is a surgical procedure that decreases donor site morbidity, obtains high fusion rate with rigid fixation, and provides satisfactory clinical outcome for traumatic cervical spine injuries, regardless of the numbers of the involved levels.