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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Randomized Controlled Trial
Centralization in patients with sciatica: are pain responses to repeated movement and positioning associated with outcome or types of disc lesions?
To determine the frequency of different patterns of centralization and their association with outcomes and MRI findings in patients experiencing sciatica. ⋯ In patients with sciatica, centralization was common and associated with improvement in activity limitation and leg pain. Centralization was very common in ruptured disc therefore the study does not support the theory, that centralization only occurs if the intra-discal hydrostatic mechanism is functional.
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The conventional open pedicle screw fusion (PSF) requires an extensive detachment of the paraspinal muscle from the posterior aspect of the lumbar spine, which can cause muscle injury and subsequently lead to "approach-related morbidity". The spinous process-splitting (SPS) approach for decompression, unilateral laminotomy for bilateral decompression, and the Wiltse approach for pedicle screw insertion are considered to be less invasive to the paraspinal musculature. We investigated whether SPS open PSF combined with the abovementioned techniques attenuates the paraspinal muscle damage and yields favorable clinical results, including alleviation in the low back discomfort, in comparison to the conventional open PSF. ⋯ In conclusion, SPS open PSF was less damaging to the paraspinal muscle than the conventional open PSF and had a significant clinical effect, reducing low back discomfort over 1 year after the surgery.
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Pedicle-screw-based dynamic implants are intended to preserve intervertebral mobility while releasing certain spinal structures. The aim of the study was to determine the as yet unknown optimal stiffness value of the longitudinal rods that fulfils best these opposing tasks. ⋯ The optimal axial stiffness of a pedicle-screw-based motion preservation implant for the lumbar spine is approximately 50 N/mm.
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Leg length inequalities (LLI) are a common finding. Rasterstereography offers a non-invasive, contact-free and reliable method to detect the effects of LLIs on spinal posture and pelvic position. ⋯ Our study showed that there was a correlation between an artificial leg length inequality up to 15 mm and pelvic tilt or torsion, but only minor changes in the spinal posture were measured. Further studies should investigate the effects of greater leg length inequalities on spine and pelvis.
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Not much is known about musculoskeletal disorders (MSD) in peacekeeping missions and to what extent such conditions are disabling. The objective of this study was to assess the occurrence and severity of MSD in Swedish military personnel on 6 months duty in Afghanistan. ⋯ Musculoskeletal pain was common during peacekeeping mission and gradual onset was dominating. Most often, it did not affect the daily activities. Nevertheless, it may be of important to consider broadening the medical disciplines onsite to provide preventive measures and treatment at an early stage, and thereby reducing the risk of chronicity.