The spine journal : official journal of the North American Spine Society
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The impact of preoperative facet degeneration (FD) on surgical outcomes following laminoplasty has not been established. ⋯ Preoperative FD severity did not influence the 2-year surgical outcomes of laminoplasty, in terms of improvement in myelopathy, patient-oriented score of quality of life, physical and mental status, as well as neck pain. Furthermore, preoperative FD severity correlated with neither preoperative cervical imbalance nor balance deterioration after laminoplasty. These results may encourage physicians to consider laminoplasty for patients with cervical spondylotic myelopathy, regardless of the severity of FD.
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Observational Study
The Spine Functional Index: development and clinimetric validation of a new whole-spine functional outcome measure.
Most spine patient-reported outcome measures are divided into neck and back subregions. This prevents their use in the assessment of the whole spine. By contrast, whole-spine patient-reported outcome measures assess the spine from cervical to lumbar as a single kinetic chain. However, existing whole-spine patient-reported outcomes have been critiqued for clinimetric limitations, including concerns with practicality. ⋯ The SFI demonstrated sound clinimetric properties with lower response errors, efficient completion and scoring, and improved responsiveness and overall clinimetric performance compared with the FRI. These results indicated that the SFI was suitable for functional outcome measurement of the whole spine in both the research and clinical settings.
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Randomized Controlled Trial
Platelet-rich plasma enhances bone union in posterolateral lumbar fusion: A prospective randomized controlled trial.
Platelet-rich plasma (PRP) accelerates bone union in vivo in a rodent model of spinal fusion surgery. However, PRP's effect on bone union after spinal surgery remains unclear. ⋯ Patients treated with PRP showed a higher fusion rate, greater fusion mass, and more rapid bone union after spinal fusion surgery than patients not treated with PRP.
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It is widely recognized that sagittal spinal alignment changes with age. However, there are presently no clear benchmarks for such values or those for the cervical spine in the general population. Quality epidemiological studies are needed to establish standards for spinal alignment deviation. ⋯ This first resident cohort of Japanese individuals determined average spinal alignment parameters by age and gender. Spinal balance generally shifts forward as age increases. A forward shift in the upper cervical spine occurs first in men, whereas lumbopelvic alignment shift occurs first in women.
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Protein biomarkers associated with lumbar disc disease have been studied as diagnostic indicators and therapeutic targets. Recently, a cartilage degradation product, the fibronectin-aggrecan complex (FAC) identified in the epidural space, has been shown to predict response to lumbar epidural steroid injection in patients with radiculopathy from herniated nucleus pulposus (HNP). ⋯ Patients who are "FAC+" are more likely to demonstrate clinical improvement following microdiscectomy. The data suggest that the inflammatory milieu plays a significant role regarding improvement in patients undergoing discectomy for radiculopathy in lumbar HNP, even in those with preoperative weakness. The FAC represents a potential target for treatment in HNP.