The spine journal : official journal of the North American Spine Society
-
Previous research has failed to identify strong consistent risk factors for low back pain (LBP). A plausible solution is to conduct hypothesis-generating studies, such as twin case-control surveys. ⋯ Twins attributed the differences in LBP history to risk factors related to physical workload. Future studies investigating the risk factors for LBP should include valid and comprehensive assessments of these factors.
-
Some, smaller studies have investigated the effect of preoperative depression on postoperative improvement in quality of life (QOL). However, they have not used the Patient Health Questionnaire 9 (PHQ-9) in self-reported depression. ⋯ Increased preoperative pain and depression were shown to be associated with significantly reduced improvement in postoperative QOL, as measured by the EQ-5D.
-
Atlantoaxial anterior transarticular screw fixation: a case series and reappraisal of the technique.
Atlantoaxial instability is commonly treated with C1-C2 fixation performed via posterior approaches. Although anterior transarticular screw (ATS) fixation, performed with a classic retropharyngeal approach, was described more than 10 years ago, the published literature still lacks a comprehensive analysis of the procedure and a real case series. ⋯ Although the procedure is still not widely known, ATS allows the effective and safe treatment of C1-C2 instability even in patients with systemic comorbidities. It offers several advantages over posterior approaches.
-
Fusionless scoliosis surgery is frequently performed in children. Many studies have analyzed the effects of spinal growth modulation by tethering the anterior and anterolateral aspects of the spine in animal models. However, few studies have reported the disc health and spinal motion in spines with posterior unilateral elastic tethering. ⋯ Unilateral elastic tethering resulted in vertebral wedging and scoliosis. Although changes in collagen and MMP-3 distribution, proteoglycan synthesis, end-plate epiphysis, and disc thickness were observed, the tethered discs and end plates did not demonstrate gross morphologic signs of degeneration.
-
Randomized Controlled Trial
The clinical efficacy of short-term steroid treatment in multilevel anterior cervical arthrodesis.
Dysphagia is the most common complication of anterior cervical discectomy and fusion (ACDF), and it is closely related to prevertebral soft-tissue swelling (PSTS). A few studies have found that local or systemic methylprednisolone is effective against laryngopharyngeal edema and airway obstruction. ⋯ The short-term use of systemic methylprednisolone after ACDF appears to be effective in relieving dysphagia and decreasing the PSTS. Furthermore, the short-term use of methylprednisolone was not associated with any adverse effects of short-term IV steroid usage, such as peptic ulcer disease or postoperative infection. The clinical use of methylprednisolone in relieving dysphagia and decreasing PSTS deserves consideration during the early postoperative period.