The spine journal : official journal of the North American Spine Society
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Heterotopic ossification (HO) is a well-known phenomenon occurring after joint arthroplasty. However, its incidence and clinical effects have not yet been clearly identified with cervical disc replacement. ⋯ The overall incidence of HO after cervical artificial disc replacement was relatively high. However, Grade 3 and 4 HO that limit the ROM rarely occurred. Moreover, the occurrence of HO did not affect the clinical symptoms and biomechanical dynamics. A longer follow-up with a larger group of patients should be undertaken, which may demonstrate a higher rate of HO and long-term effects on the ROM.
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Randomized Controlled Trial
One-year prognosis in sick-listed low back pain patients with and without radiculopathy. Prognostic factors influencing pain and disability.
Previous research has documented various psychosocial risk factors with influence on outcome in low back pain (LBP) patients, but the value of clinical predictors has been less well documented. ⋯ Disability and pain at 1 year were associated with baseline disability and pain, diffuse tenderness, worrying and health anxiety, compensation claim, fear avoidance, and baseline exercise habits. Only in patients with verified nerve root affection, older age, and restrained alcohol seemed to play a role. The multivariate models were insufficient in predicting disability and pain, partly because disability and pain were also strongly associated with return to work.
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Occipitocervical injuries (OCIs) are generally not common in blunt trauma victims, but autopsy studies of blunt trauma fatalities consistently report a high prevalence of these injuries. New computed tomography (CT)-based quantitative criteria have recently been developed for use in assessing the occipitocervical spine. The efficacy of these new criteria for detecting OCI would be supported if the high prevalence of OCI in blunt trauma fatalities can also be detected using these objective CT-based criteria. ⋯ Using precise CT-based measurements and reliable reference data for diagnosis of occipitocervical dissociative injuries, the prevalence of injuries in severely injured blunt trauma patients was close to the levels reported in prior autopsy studies (approximately 30%). This supports that with careful measurements, both soft- and hard-tissue OCI can be detected by CT. This study is limited by the fact that a gold standard was not available to confirm the injuries.
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Advantages of cervical artificial disc replacement (ADR) are to preserve segmental range of motion (ROM) and avoid adjacent segmental disease. To achieve successful outcome after cervical ADR, ROM maintenance is important, but few authors have investigated the factors that influence the postoperative segmental ROM. ⋯ At a minimum of 2 years after cervical ADR, clinical outcomes were satisfactory in terms of function and pain scores. Within our results, the segmental ROM was not affected by preoperative ROM but postoperative disc height increment positively and preoperative disc height negatively.
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Cervical artificial disc replacement is increasingly becoming popular among spine surgeons. Cervical disc arthroplasty aims to afford spinal stability and then balance this with flexibility. One of the fundamental benefits from performing cervical arthroplasty instead of fusion is preservation of motion in both the functional spinal unit (FSU) and the overall cervical spine. Eventually, preservation of segmental motion is believed to prevent the development of adjacent segment degeneration. But to justify its use, disc replacement prosthesis must demonstrate actual motion in vivo and preserve range of motion (ROM) after surgery as long as it allows. Without preservation of motion, disc prosthesis becomes just a functional arthrodesis equivalent. ⋯ Significant correlation was found between the postoperative overall cervical spine ROM and preoperative overall cervical spine ROM. Postoperative FSU ROM is closely correlated to both the preoperative FSU ROM and the disc insertion angle. Careful preoperative evaluation of the patient's radiographs and meticulous surgical technique during the surgical procedure could aid in achieving the goals and benefits of cervical disc arthroplasty.