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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Global sagittal alignment is considered as an important aspect in the management of spinal disorders, but the evidence establishing its clinical impact in lumbosacral spondylolisthesis is still poor. This study evaluated the impact of global sagittal alignment on the health-related quality of life (HRQOL) of patients with spondylolisthesis. ⋯ In high-grade spondylolisthesis, an increasing positive sagittal alignment was related to a poorer SRS-22 total score, especially when the C7P is in front of the hip axis. Global sagittal alignment should particularly be assessed in patients with high-grade spondylolisthesis.
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Intraobserver and interobserver reliabilities of the several different methods to measure lumbar lordosis have been reported. However, it has not been studied sofar in patients with ankylosing spondylitis (AS). ⋯ These results are the first to provide a reliability analysis of different global lumbar lordosis measurement methods in AS. The findings in this study demonstrated that the Cobb L1-L5 method is reliable for measuring the global lumbar lordosis in AS.
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Randomized Controlled Trial Multicenter Study
Limaprost alfadex and nonsteroidal anti-inflammatory drugs for sciatica due to lumbar spinal stenosis.
Limaprost, a prostaglandin E1 analog, has vasodilatory properties and increases blood flow of the nerve root. However, it has not been clarified whether limaprost affects pain sensation associated with radiculopathy due to lumbar spinal stenosis (LSS). The aim of this study was to compare the efficacy of oral limaprost with nonsteroidal anti-inflammatory drugs (NSAIDs) for radiculopathy. ⋯ These obtained findings suggest that the effects of limaprost seem to be limited to radicular pain, not for LBP. Overall, a combination treatment might be more effective in the management of radiculopathy induced by LSS than monotherapy with either agent.
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Comparative Study
Prospective study on serum metal levels in patients with metal-on-metal lumbar disc arthroplasty.
Metal-on-metal total disc replacement is a recent alternative treatment for degenerative disc disease. Wear and corrosion of these implants can lead to local and systemic transport of metal debris. This prospective longitudinal study examined the serum chromium and cobalt levels in 24 patients with cobalt-chromium alloy metal-on-metal lumbar disc replacements. ⋯ In general, these results indicated that serum Co and Cr levels are elevated at all postoperative time points and are of the same order of magnitude as those observed in well-functioning metal-on-metal surface replacements of the hip and in metal-on-metal total hip replacements at similar postoperative time points.
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Comparative Study
HIZ's relation to axial load and low back pain: investigated with axial loaded MRI and pressure controlled discography.
The aims were to investigate if the detection of high-intensity zones (HIZ) is affected by axial load, and to study the correlation between HIZ and discogenic pain provoked with pressure controlled discography (PCD). ⋯ The detection of HIZ was not influenced by axial load. With strict PCD, discogenic pain can neither be confirmed when having HIZ (PPV 39 %) nor ruled out in discs without HIZ (NPV 76 %). Larger PCD studies including quantification of HIZ at conventional and alMRI are needed, before any dynamic component affected by axial load can be ruled out completely.