Spine
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Segmental motion and bone-implant interface stresses were analyzed at C5-C6 levels with Bryan, Prestige LP, and ProDisc-C cervical disc prostheses using an image-based finite element modeling technique. ⋯ Rigidity of the cores ("nuclei") in Prestige LP and ProDisc-C prostheses guarantee initial maintenance of disc height, but high contact stress takes place at the bone-end plate interface if they are improperly placed or undersized. Anchorage designs add an additional factor that may increase propensity of subsidence, indicated by the high contact stress occurring at the end plate flanges of Prestige LP, and at midline keel fixation on the end plate of ProDisc-C. Although Bryan disc differs in these 2 concerns, it also creates much larger displacement during motion with more variation in disc height that may theoretically increase the load sharing of facet and/or uncovertebral joints compared to more rigid artificial discs.
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Randomized Controlled Trial Comparative Study
Great expectations: really the novel predictor of outcome after spinal surgery?
Prospective study. ⋯ In this patient group, expectations of surgery were overly optimistic. Having one's expectations fulfilled was most important for a good outcome. The results emphasize the importance of assessing patient-orientated outcome in routine practice, and the factors that might influence it, such that realistic expectations can be established for patients before surgery.
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Randomized Controlled Trial
Effectiveness of the physical therapy Godelive Denys-Struyf method for nonspecific low back pain: primary care randomized control trial.
A simple blind, random controlled clinical trial. ⋯ Treatment of nonspecific LBP using the GDS method provides greater improvements in the midterm (6 months) in terms of the pain, functional ability, and quality of life perceived by patients than the conventional treatment based administered in primary care.
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An anatomic, osteologic study of spina bifida occulta (SBO). ⋯ SBO has an overall prevalence of 12.4% in a large, diverse population. SBO is more common in men and whites and decreases in prevalence with increasing age. The STA is greater in SBO when compared with controls and an increased STA predicts SBO. In SBO, the STA decreases with increasing age.
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This is a retrospective chart review of 670 clinic notes from 202 patients who underwent posterior instrumented lumbar spinal fusions (LSF) over a 9-year period by a single surgeon. ⋯ Routine radiographs seem to have limited utility in the early postoperative period after instrumented LSF and may place patients with normal H/E at an increased risk of undergoing unnecessary diagnostic studies. Patients with abnormal H/E were more likely to undergo more extensive testing leading to additional treatment being prescribed regardless of the interpretation of the radiographs.