European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Lifting restrictions postoperatively are quite common, but there appears to be little scientific basis for them. Lifting restrictions are inhibitory in terms of return to work and may be a factor in chronicity. The mean functional spinal motion unit stiffness changes with in vitro or computer-simulated discectomies, facetectomies and laminectomies were reviewed from the literature. ⋯ The adjusted NIOSH guidelines provide a reasonable way to estimate weight restrictions and accommodations such as lifting aids. Such restrictions should be as liberal as possible so as to facilitate, not prevent, return to work. Patients need more advice regarding lifting activities and clinicians should be more knowledgeable about the working conditions and constraints of a given workplace to effectively match the solution to the patient's condition.
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Tuberculosis of the spine is probably one of the earliest diseases to have affected the human race. Over the past few decades, the epidemiology, pathology, natural history and diagnostic methodology have been well studied. ⋯ Although it appears from this study that conservative treatment is as effective as surgical intervention for earlier and milder diseases, there are still reservations on the effect of such treatment at much longer follow-ups and for more severe diseases. Further developments in diagnosis using molecular genetic techniques, more effective antibiotics and more aggressive surgical protocols in the next millennium may help in solving the problems of late severe deformity and paraplegia in the debilitated immunocompromised patients.
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Clinical Trial Controlled Clinical Trial
Sitting and low back pain: the positive effect of rotary dynamic stimuli during prolonged sitting.
In this study the effect of dynamic stimuli on low back pain during prolonged sitting was investigated. The pain experience of two groups of 60 subjects with a specific low back pain was recorded. ⋯ Two different frequencies of rotation were applied in subgroups. The authors concluded that such stimuli, especially of the lower frequency, reduced pain in prolonged sitting.
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Comparative Study Clinical Trial
Treatment of idiopathic scoliosis with side-shift therapy: an initial comparison with a brace treatment historical cohort.
A group of 44 patients with idiopathic scoliosis (mean age 13.6 years) with an initial Cobb angle between 20 degrees and 32 degrees received side-shift therapy (mean treatment duration 2.2 years). A group of 120 brace patients (mean age 13.6 years) with an initial Cobb angle in the same range (mean brace treatment 3.0 years) was the historical reference group. ⋯ The difference in the mean progression of the Cobb angle for the respective groups is small (for efficiency: 3 degrees vs -2 degrees, for efficacy: 2 degrees vs -1 degrees ). Side-shift therapy appears to be a promising additional treatment for idiopathic scoliosis in adolescents with an initial Cobb angle between 20 degrees and 32 degrees.