Spine
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Multicenter Study Comparative Study
European comparison of costs and quality in the treatment of acute back pain.
Retrospective multicenter observational study. ⋯ There was considerable waste in treating acute back pain. The Netherlands had highest quality and lowest resource utilization in providing treatment for acute back pain.
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Cross-sectional study of 37 patients to measure serum levels of nickel and chromium after posterior spinal arthrodesis using stainless steel implants. ⋯ Elevated levels of nickel and chromium can be measured after posterior instrumented spinal arthrodesis. The levels diminish rapidly with time from surgery but still remained above normal levels 4 years after surgery. Long-term implication of this metal ion exposure is unknown and should be studied further.
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Comparative Study
Long-term outcomes of surgical and nonsurgical management of sciatica secondary to a lumbar disc herniation: 10 year results from the maine lumbar spine study.
A prospective cohort study. ⋯ Surgically treated patients with a herniated lumbar disc had more complete relief of leg pain and improved function and satisfaction compared with nonsurgically treated patients over 10 years. Nevertheless, improvement in the patient's predominant symptom and work and disability outcomes were similar regardless of treatment received. For patients in whom elective discectomy is a treatment option, an individualized treatment plan requires patients and their physicians to integrate clinical findings with patient preferences based on their symptoms and goals.
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Cross-sectional study. Women giving birth at one of two hospitals of northern Sweden from 1 January 2002 until 30 April 2002 were invited to fill in a questionnaire on their obstetric and gynecological history, actual pregnancy, and delivery. ⋯ A majority of pregnant women report LBPP. Parity, LBPP during a previous pregnancy, body mass index, a history of hypermobility, and amenorrhea are factors influencing the risk of developing LBPP during pregnancy.
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An in vitro biomechanical study on lumbar intervertebral joints. ⋯ The posterior elements of the lumbar spine are more efficient in resisting anterior and posterior shear loads. However, the anterior column will exhibit similar load-displacement characteristics if subject to greater deformations. The sum of the normalized mean shear loads of the anterior column and posterior elements sustained at maximum intact deformation is significantly different from the shear load sustained by the intact spine at the same deformation. A simple concept of load sharing between the anterior column and the posterior elements may not be valid.