The spine journal : official journal of the North American Spine Society
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Pain is commonly associated with symptoms of depression or anxiety, although this relationship is considered bidirectional. There is limited knowledge regarding causal relationships. ⋯ The relationship between chronic LBP and the future development of depression or anxiety symptoms is not causal. The relationship is likely to be explained by confounding from shared familial factors, given the non-statistically significant associations in the co-twin case-control analyses.
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The relationship between sedentary lifestyle and low back pain (LBP) remains unclear and previous research has not accounted for genetic and early environmental factors. ⋯ Sedentary behavior is associated with concurrent LBP. However, this association is weak; it only appears in females and decreases when accounting for genetics. Future studies using a twin design with larger samples should be conducted to further test these findings.
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Spinal epidural lipomatosis (SEL) refers to an excessive accumulation of fat within the epidural space. It can be idiopathic or secondary, resulting in significant morbidity. The prevalence of SEL, including idiopathic and secondary SEL, and its respective risk factors are poorly defined. ⋯ We found that about 1 in 40 patients undergoing a spine MRI had SEL; 23% of whom with no symptoms, 72% with spine-related symptoms, and 5% with symptoms specific for SEL. Our data help identify patients who might warrant an increased index of suspicion for SEL.
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Transcranial motor evoked potential (MEP) monitoring has been widely adopted in spine surgery, but so far the useful monitoring data for patients with preoperative spinal deficits (PPSDs) are limited. Originally we thought that they seemed technically more difficult and less reliable in performing the MEP monitoring to PPSDs. ⋯ Intraoperative MEP monitoring is feasible for most of the PPSDs. The rapid MEP loss during high-risk diagnoses and complicated surgical procedures may indicate new spinal deficits.
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Knowledge of sagittal radiographic parameters in adolescent idiopathic scoliosis (AIS) patients has not yet caught up with our understanding of their roles in patients with adult spinal deformity. It is likely that more emphasis will be placed in restoring sagittal parameters for AIS patients in the future. Therefore, we need to understand how these parameters may vary in AIS to facilitate management plans. ⋯ Most radiographic sagittal spinal parameters in AIS patients are generally reproducible with some variations up to a maximum of 4°. This natural variation should be taken into account when interpreting these radiographic sagittal parameters so as to achieve the most accurate results in surgical planning.