The spine journal : official journal of the North American Spine Society
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Randomized Controlled Trial
The spinal stenosis pedometer and nutrition lifestyle intervention (SSPANLI): development and pilot.
Owing to mobility limitations, people with lumbar spinal stenosis (LSS) are at risk for diseases of inactivity, including obesity. Therefore, weight management in LSS is critical. Body mass index is the strongest predictor of function in LSS, suggesting that weight loss may promote physical activity and provide a unique treatment option. We propose a lifestyle modification approach of physical activity and nutrition education, delivered through an e-health platform. ⋯ The spinal stenosis pedometer and nutrition lifestyle intervention was shown to be feasible, attractive to participants, and effective in this small sample. This intervention provides people with LSS the opportunity to participate in their own health management, potentially improving access to care. Efficacy is currently being assessed in a randomized trial.
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Current evidence suggests that neck pain is negatively associated with health-related quality of life (HRQoL). However, these studies are cross-sectional and do not inform the association between neck pain and future HRQoL. ⋯ We found that neck pain was negatively associated with physical but not mental HRQoL. Our analysis suggests that neck pain may be a contributor of future poor physical HRQoL in the population. Raising awareness of the possible future impact of neck pain on physical HRQoL is important for health-care providers and policy makers with respect to the management of neck pain in populations.
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Deep surgical site infections (SSIs) following spinal surgery are a significant burden to the patient, patient's family, and the health-care system. Because of increasing pressures to reduce SSIs and control costs, some spine surgeons have begun placing lyophilized vancomycin powder directly into the surgical wound at the conclusion of the procedure. However, the literature supporting this practice remains limited. ⋯ The interpretation of the available evidence supporting the use of intrasite vancomycin powder in surgical wounds is limited, and its extrapolation should be performed with caution. Despite the lack of significant high-quality evidence available in the literature, many surgeons have adopted this practice; anecdotally, it continues to provide protection from infection without apparent significant risk of side effects.
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Randomized Controlled Trial
Effects of low back pain stabilization or movement system impairment treatments on voluntary postural adjustments: a randomized controlled trial.
People with low back pain (LBP) exhibit impaired anticipatory postural adjustments (APAs). ⋯ Movement impairments in persons with LBP are not limited to tasks requiring an APA. Stabilization and movement system impairment-based treatments for LBP do not ameliorate and may exacerbate APA impairments (ie, excessive force application and increased post-movement trunk muscle activation).
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Clinical Trial
V-Y vertebral body osteotomy for the treatment of fixed sagittal plane spinal deformity.
Fixed sagittal plane imbalance (FSI) has traditionally been corrected by either opening or closing wedge osteotomies or vertebral column resections. These methods involve multiple vertebrae and have been associated with limited degrees of correction and/or neurovascular compromise. ⋯ The VYO provides a safe correction of up to 45° at a single osteotomy site in FSI patients. It involves an isolated posterior approach and is recommended for corrections below the region of the conus.