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
-
Low back pain (LBP) in children was considered for many years to be a rare condition revealing a serious disease, but in the last two decades, epidemiological studies have shown that the prevalence of nonspecific LBP in children is high. This study was aimed at analyzing the prevalence, severity, consequences and associated factors of LBP in children. A cross-sectional study was undertaken in two preparatory schools in the city of Monastir, Tunisia, in April 2002. ⋯ Two factors were associated with chronic LBP: dissatisfaction with school chair, OR=1.62 (95% CI, 1.46-3.32) and football playing, OR=3.07 (95% CI, 2.15-5.10). The prevalence of LBP among Tunisian schoolchildren and adolescents is high. This requires preventive measures and longitudinal studies, which are very important from the standpoint of public health.
-
Cervical disc injury due to frontal impact has been observed in both clinical and biomechanical investigations; however, there is a lack of data that elucidate the mechanisms of disc injury during these collisions. The goals of the current study were to determine the peak dynamic disc annular tissue strain and disc shear strain during simulated frontal impact of the whole human cervical spine model with muscle force replication at 4 g, 6 g, 8 g and 10 g horizontal accelerations of the T1 vertebra. These data were compared with those obtained during physiological loading, and with previously reported rear impact data. ⋯ The C5-C6 intervertebral level was at high risk for injury during both frontal and rear impacts, while during frontal impact, in addition to C5-C6, subfailure injuries were likely at superior intervertebral levels, including C2-C3. The disc injuries occurred at lower impact accelerations during rear impact as compared with frontal impact. The subfailure injuries of the cervical intervertebral disc that occur during frontal impact may lead to the chronic symptoms reported by patients, such as head and neck pain.
-
Cervical corpectomy is a frequently used technique for a wide variety of spinal disorders. The most commonly used approach is anterior, either with or without plating. The results for single-level corpectomy are better than in multilevel procedures. ⋯ Another benefit could be fewer hardware-related complications, higher fusion rate, larger range of instabilities to be treated by one implant system, less restrictive postoperative treatment and possibly better clinical outcome. From a biomechanical standpoint, in regard to primary stability the constrained systems, therefore, seem to be beneficial. Whether this leads to differences in clinical outcome has to be evaluated in clinical trials.
-
Spinal fusion in children with spina bifida: influence on ambulation level and functional abilities.
The aim of this study was to determine the influence of spinal fusion on ambulation and functional abilities in children with spina bifida for whom early mobilization was stimulated. Ten children (three males and seven females) with myelomeningocele were prospectively followed. Their mean age at operation was 9.3 years (standard deviation (SD): 2.4). ⋯ It takes about 12 months to recover to pre-surgery level, while small improvement is seen afterwards. After spinal fusion, ambulation often becomes difficult, especially in exercise walkers. These findings are important for health-care professionals, in order to inform and prepare the patients and their parents properly for a planned spinal fusion.
-
In this study we aimed to evaluate the role of closed-suction drainage on the extent of epidural fibrosis (EF) after lumbar disc surgery and to define a new grading system of epidural fibrosis in these patients, based on magnetic resonance imaging. Seventy-nine patients (34 women, 45 men) with a unilateral, single-level lumbar disc herniation were included in this study. ⋯ Pain intensity was evaluated by visual analog scale (VAS), and the patients' function and working ability were measured according to the Prolo functional-economic scale. We conclude that, in patients operated on for unilateral, single-level lumbar disc hernias, implantation of closed-suction drainage into the operation site results in less formation of EF radiologically and yields better clinical outcome.