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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Comparative Study
Outcome in adolescent idiopathic scoliosis after brace treatment and surgery assessed by means of the Scoliosis Research Society Instrument 24.
A retrospectively designed long-term follow-up study of adolescent idiopathic scoliosis (AIS) patients who had completed treatment, of at least 2 years, by means of brace, surgery, or both brace and surgery. This study is to assess the outcome after treatment for AIS by means of the Scoliosis Research Society Outcome Instrument 24 (SRS 24). One hundred and eighteen AIS patients (99 females and 19 males), treated at the Aarhus University Hospital from January 1, 1987 to December 31, 1997, were investigated with at least 2 years follow-up at the time of receiving a posted self-administered questionnaire. ⋯ All treatment groups scored "fair or better" in all domain scores of the SRS 24 questionnaire, except in post-treatment function, where all groups scored worse than "fair". Improvement of appearance by means of surgical correction increases mean scores for post-treatment self-image and post-treatment satisfaction. Double-treatment by brace and surgery does not appear to jeopardize a good final outcome.
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Image intensifier (C-arm) guided facet infiltration of a mixture of long acting local anaesthetic and corticosteroid is a safe and effective office procedure for cervical spondylosis. Visualisation of lower cervical anatomy using C-arm may not always be possible due to the shadow cast by the shoulders. We describe the successful adaptation of swimmer's view in such cases to carry out the injections.
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Comparative Study
Comparison of anterior and posterior double-rod instrumentation for thoracic idiopathic scoliosis: results of 141 patients.
Ventral derotation spondylodesis, according to Zielke, achieves good results in operative treatment of idiopathic thoracic scolioses. Corrections of scoliotic major and secondary curve as well as derotation of the spine are reliably performed. The high rate of rod fractures with subsequent correction loss as well as a proportionate kyphogenic effect represents a problem. ⋯ In case of posterior technique, however, four vertebral bodies less were integrated in spondylodesis on average. Balance of the spine did not change after anterior spondylodesis; however, it declined by using the posterior technique. Augmentation of the anterior threaded rod combined with a solid second rod significantly decreases the rate of implant breakages and reliably reduces consecutive correction losses.
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Randomized Controlled Trial Comparative Study
A randomized clinical trial and subgroup analysis to compare flexion-distraction with active exercise for chronic low back pain.
Many clinical trials on chiropractic management of low back pain have neglected to include specific forms of care. This study compared two well-defined treatment protocols. The objective was to compare the outcome of flexion-distraction (FD) procedures performed by chiropractors with an active trunk exercise protocol (ATEP) performed by physical therapists. ⋯ There were no significant differences between groups on the Roland Morris and SF-36 outcome measures. Overall, flexion-distraction provided more pain relief than active exercise; however, these results varied based on stratification of patients with and without radiculopathy and with and without recurrent symptoms. The subgroup analysis provides a possible explanation for contrasting results among randomized clinical trials of chronic low back pain treatments and these results also provide guidance for future work in the treatment of chronic low back pain.
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Comparative Study
Anterior dual rod instrumentation in idiopathic thoracic scoliosis.
For anterior correction and instrumentation of thoracic curves single rod techniques are widely used. Disadvantages of this technique include screw pullouts, rod fractures and limited control of kyphosis. This is a prospective study of 23 consecutive patients with idiopathic thoracic scoliosis treated with a new anterior dual rod system. ⋯ This new instrumentation enables an entire dual rod instrumentation over the whole thoracic fusion length. It offers primary stability without the need of postoperative bracing. Dual screw dual rod instrumentation offers the advantages of a high screw pullout resistance, an increased overall stability and satisfactory sagittal plane control.