Spine
-
A prospective assessment, performed using the Health Status Questionnaire, of the outcomes for 28 patients with cervical radiculopathy treated with one- or two-level anterior cervical discectomy and fusion. ⋯ Although this is a preliminary report involving 28 patients, it would appear, based on the results of the Health Status Questionnaire, that anterior cervical discectomy and fusion performed on appropriately selected patients is a highly reliable surgical procedure for the management of cervical radiculopathy. Additional disease-specific questions may provide more sensitivity in evaluating radiculopathy after surgical and nonsurgical intervention.
-
An observational study on the course of chronic and recurrent low back pain and its relation to disability and medication use performed on the basis of daily diary recording. ⋯ Pain intensity can affect disability, but the episodic nature of low back pain also affects the ability to function in both work and personal life. Intermittent increases in pain can markedly alter disability. Chronic low back pain should not be treated as a static phenomenon.
-
A cross-sectional study comparing the relationship of symptoms with anatomic impairment visible on lumbar magnetic resonance imaging in 408 symptomatic subjects. ⋯ The presence of disc extrusion and/or ipsilateral, severe nerve compression at one or multiple sites is strongly associated with distal leg pain. Mild to moderate nerve compression, disc degeneration or bulging, and central spinal stenosis are not significantly associated with specific pain patterns. Although segmental distributions of pain can be determined reliably from pain drawings, this finding alone is of little use in predicting lumbar impairment. The self-report of lower extremity weakness or dysesthesia is not significantly related to any specific lumbar impairments. [Key words: back pain, diagnosis, magnetic resonance imaging, nerve compression, pain drawing, pathology]
-
A descriptive case review. ⋯ Low back pain that continues or recurs after apparently solid posterolateral spinal fusion may be caused by painful disc(s) at motion segment(s) within the fusion. A solid posterolateral spinal fusion may not protect the residual disc(s) from injury. Anterior interbody fusion can provide significant improvements in pain and function and a high degree of patient satisfaction in this clinical setting.
-
An investigation of the relation between intraoperative insertional torque of pedicle screws, bone mineral density of the vertebra, and development of screw loosening in vivo. ⋯ Although a high correlation was found between the insertional torque of pedicle screws and bone mineral density in vivo, the insertional torque could not objectively predict screw loosening.