Spine
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Clinical Trial Controlled Clinical Trial
Proximal neuromuscular impairment in lumbar disc herniation: a prospective controlled study.
A prospective and controlled study investigated the relation of muscle dysfunction to residual pain and disability in patients with lumbar disc herniation. ⋯ Neuromuscular dysfunction frequently is present in patients with lumbar disc herniation. Sciatica resolves quickly after surgery, whereas disability improves gradually up to 4 months and muscular performance improves throughout the first year. Proximal muscular dysfunction in lumbar disc herniation has a prognostic value concerning residual pain and disability.
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A retrospective investigation of the L5-S1 motion segment after an isolated L4-L5 posterior lumbar fusion. ⋯ There appears to be no need to routinely include the L5-S1 segment when performing a posterior lumbar fusion for patients with instability or stenosis at L4-L5 if no symptoms are attributed to the lumbosacral level. At an average of 7.3 years, there was neither increased symptomatic disc degeneration nor symptoms necessitating the need for an L5-S1 fusion.
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This retrospective study analyzed the effects of cervical alignment on surgical results of expansive laminoplasty (ELAP) for cervical spondylotic myelopathy (CSM). ⋯ The influence of cervical malalignment on neurologic recovery after ELAP for CSM was shown. When patients have local kyphosis exceeding 13 degrees, anterior decompression or posterior correction of kyphosis as well as ELAP should be considered. Expansive laminoplasty for CSM is best indicated for patients with local kyphosis less than 13 degrees.
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A case report of low back pain associated with a diagnosis of melorheostosis of the lumbosacral spine. ⋯ Melorheostosis rarely causes severe low back pain that can respond favorably to fusion surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
A prospective, randomized, controlled cervical fusion study using recombinant human bone morphogenetic protein-2 with the CORNERSTONE-SR allograft ring and the ATLANTIS anterior cervical plate.
A prospective, randomized, pilot clinical trial compared recombinant human bone morphogenetic protein-2 (rhBMP-2) with iliac crest autograft bone for the treatment of human cervical disc disease. ⋯ This pilot study demonstrates the feasibility of using rhBMP-2 safely and effectively in the cervical spine.