Spine
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Retrospective study. ⋯ When combined with extensive posterior releases, posterior only approach is just as effective as combined anterior and posterior surgery for adult lumbar scoliosis measuring between 40 degrees and 70 degrees .
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Using a retrograde neurotracing method with Fluoro-Gold (FG), the level at which dorsal root ganglions (DRGs) innervate the L2 and L5 vertebral bodies and the innervation pathways were investigated in rats. ⋯ Sensory nerve fibers in the L2 and L5 vertebral bodies are derived from the T11-L3 and T13-L6 DRGs, respectively. Some sensory nerves from the L2 and L5 vertebral bodies enter the paravertebral sympathetic trunks and reach the DRGs at multisegmental levels. The present findings regarding multisegmental innervation to vertebral bodies may explain the diffuse pain that originates within osteoporotic vertebral fractures in elderly patients.
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Randomized Controlled Trial Comparative Study
Effectiveness and cost-effectiveness of three types of physiotherapy used to reduce chronic low back pain disability: a pragmatic randomized trial with economic evaluation.
Pragmatic, randomized, assessor blinded, clinical trial with economic analysis. ⋯ For chronic low back pain, all three physiotherapy regimens improved disability and other relevant health outcomes, regardless of their content. Physiotherapist-led pain management classes offer a cost-effective alternative to usual outpatient physiotherapy and are associated with less healthcare use. A more widespread adoption of physiotherapist-led pain management could result in considerable cost savings for healthcare providers.
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Comparative Study
The response of the nucleus pulposus of the lumbar intervertebral discs to functionally loaded positions.
Asymptomatic volunteers underwent magnetic resonance imaging to investigate how different positions affect lumbar intervertebral discs. ⋯ These results support for the first time the validity of clinical assumptions about disc behavior in functional positions: sitting postures may increase risk of posterior derangement, and prone and supine may be therapeutic for symptoms caused by posterior disc displacement.
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Comparative Study
Comparison of segmental pedicle screw instrumentation versus anterior instrumentation in adolescent idiopathic thoracolumbar and lumbar scoliosis.
A retrospective study. ⋯ Surgical correction of both the frontal and sagittal plane deformity are comparable to anterior instrumentation. Shorter lengths of surgery and hospital stay are the potential benefits of posterior surgery. Posterior segmental pedicle screw instrumentation offer significant advantages and is a viable alternative to standard anterior instrumentation in idiopathic thoracolumbar and lumbar scoliosis.