Spine
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Prospective study. ⋯ The midline anterior retroperitoneal approach from the right side is a safe alternative compared with the classical approach from the left side. The low rate of venous injury is explained by the sidewall thickness of the vena cava compared with the left iliac vein sidewall. Contrary to what happens by left-sided approach, the vascular retraction required for access to L4-L5 and above does not lead to arterial occlusion and therefore diminishes the risk in atheromatous patients. The absence of retrograde ejaculation confirms previous studies conducted on the left anastomosis of the superior hypogastric plexus, suggesting that its approach and mobilization by the left side are delicate.
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Prospective cohort study. ⋯ Awkward postures were associated with chronic LBP in the general population. Exposure to awkward postures at 2 measurements with 5 years in between did increase the risk for incident chronic LBP, but not for persistence of chronic LBP.
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Multicenter Study Comparative Study
Body appearance and quality of life in adult patients with adolescent idiopathic scoliosis treated with a brace or under observation alone during adolescence.
The Scoliosis Research Society (SRS) brace study (published in the JBJS-A, 1995) was comprised of patients with adolescent idiopathic scoliosis with moderate curve sizes (25°-35°). Forty observed and 37 braced patients (77% of the original group) attended a follow-up, a mean of 16 years after onset of maturity. ⋯ Patients who experienced less body asymmetry were more satisfied with treatment and had a better quality of life. In spite of similar curve sizes and trunk rotation in both groups, the nonbraced patients felt that their body appearance was less distorted than that of the braced patients.
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Comparative Study
Ultrasound-guided lumbar transforaminal injections: feasibility and validation study.
Preclinical feasibility study. ⋯ Ultrasound-guided lumbar transforaminal injections are accurate and feasible in the preclinical setting.
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Cost effectiveness analysis for single-level instrumented fusion during a 5-year postoperative interval. ⋯ In the future, surgeons will need to demonstrate cost-effectiveness as well as clinical efficacy in order to justify payment for medical and surgical interventions, including lumbar spine fusion. This study indicates that at 5-year follow-up, single-level instrumented posterolateral spine fusion is both effective and durable, resulting in a favorable cost/QALY gain compared to other widely accepted healthcare interventions.