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
Predictors of outcome after surgery with disc prosthesis and rehabilitation in patients with chronic low back pain and degenerative disc: 2-year follow-up.
A prospective study to evaluate whether certain baseline characteristics can predict outcome in patients treated with disc prosthesis or multidisciplinary rehabilitation. ⋯ Shorter duration of LBP, Modic type I or II changes and low FABQ-W were the best predictors of success after treatment with disc prosthesis, while high ODI, low distress and not using narcotics daily predicted better outcome of rehabilitation. Low FABQ-W and working predicted working at follow-up.
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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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Pelvic tilt is an established measure of position which has been tied to sagittal plane spinal deformity. Increased tilt is noted in the setting of the aging spine and sagittal malalignment syndromes such as flatback (compensatory mechanism). However, the femoral heads are often poorly visualized on sagittal films of scoliosis series in adults, limiting the ability to determine pelvic incidence and tilt. There is a need to establish a coronal plane (better visualization) pelvic parameter which correlates closely with pelvic tilt. ⋯ The pelvic tilt is an essential measure in the context of radiographic evaluation of spinal deformity and malalignment. Given the routinely excellent visibility of coronal films this study established the SFP as a coronal parameter which can reliably estimate pelvic tilt. The high correlation and predictive ability of the SFP angle should prompt further study and clinical application when lateral radiographs do not permit assessment of pelvic parameters.
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Review Meta Analysis
Prevalence of heterotopic ossification after cervical total disc arthroplasty: a meta-analysis.
Heterotopic ossification (HO) is a well-known complication after total hip and knee arthroplasty. But limited studies have focused on prevalence of HO following cervical total disc arthroplasty (CTDA) and the published data show controversial results. ⋯ Prognostic level III.
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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.