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 Comparative Study
Comparing the process of creeping substitution between allograft bone and local bone grafting in lumbar interbody fusion.
A self-control study was designed to compare the process of creeping substitution between allograft bone and local bone grafting in lumbar interbody fusion. ⋯ The results of our study showed a superiority of local bone grafting over allograft bone.
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Randomized Controlled Trial
A multidisciplinary rehabilitation programme improves disability, kinesiophobia and walking ability in subjects with chronic low back pain: results of a randomised controlled pilot study.
To evaluate the effect of a multidisciplinary rehabilitation programme on disability, kinesiophobia, catastrophizing, pain, quality of life and gait disturbances in patients with chronic low back pain (CLBP). ⋯ The multidisciplinary rehabilitation programme including cognitive-behavioural therapy was superior to the exercise programme in reducing disability, kinesiophobia, catastrophizing, and enhancing the quality of life and gait cadence of patients with CLBP.
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Compared to titanium cage, polyetheretherketone (PEEK) cage with pedicle screw fixation has been increasingly used in transforaminal lumbar interbody fusion (TLIF). However, there is insufficient evidence supporting the superiority of PEEK cages over titanium cages as optimal TLIF spacers. The aim of this study was to compare the clinical and radiographic outcomes of patients at a 2-year follow-up after undergoing instrumented TLIF in which either a PEEK cage or a titanium cage was implanted. ⋯ The superiority of PEEK cages over titanium cages for bony fusion was not demonstrated. Additionally, we found unfavorable radiographic findings in the cases with a PEEK cage, which may lead to nonunion. Improvement in biocompatibility of a PEEK cage will be needed to increase the fusion rate.
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This study aimed at determining the variables that may prove useful in predicting clinical outcomes following lumbar disc arthroplasty. ⋯ Several variables may prove effective at optimizing clinical outcomes including a preoperative disc height <8 mm, Modic type 2 changes adjacent to the target disc, a low amount of lordosis present at the treatment level, low levels of fatty replacement of the paraspinal musculature, a prominent amount of facet joint or disc degeneration, and the presence of flat or convex vertebral endplates. There were also post-operative findings associated with better patient outcomes including a larger percent of the endplate covered with the implant, larger implant heights, greater increases in disc space heights, and a larger increase in index level lumbar lordosis. These variables could be explored in other clinical studies to facilitate meta-analyses that could identify effective strategies to optimize clinical outcomes with lumbar disc arthroplasty.
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Comparative Study Clinical Trial
Prospective comparative study between straight and curved probe for pedicle screw insertion.
To evaluate difference in accuracy of pedicle screw insertion in thoracic and lumbosacral spine using a straight pedicle probe vis-à-vis a curved one. ⋯ No significant difference in outcome of pedicle screw insertion with either a straight or a curved pedicle probe.