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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The Swiss Federal Office of Public Health demanded a nationwide HTA registry for lumbar total disc arthroplasty (TDA), to decide about its reimbursement. The goal of the SWISS spine registry is to generate evidence about the safety and efficiency of lumbar TDA. ⋯ Lumbar TDA appeared as efficient in long-term pain alleviation, consequent reduction of pain medication consumption and improvement of quality of life. The procedure also appeared sufficiently safe, but surgeons have to be aware of a list of potential adverse events. The outcome is stable over the 5-year postoperative period. The vast majority of treated segments remained mobile after 5 years, although almost half of patients showed osteophytes.
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Comparative Study
Heavy domestic, but not recreational, physical activity is associated with low back pain: Australian Twin low BACK pain (AUTBACK) study.
To evaluate the association between domestic and recreational physical activity (PA) and low back pain (LBP) after adjusting for genetic and environmental influences. ⋯ We found evidence that heavy domestic PA is associated with an increased probability of LBP, and the combination of heavy domestic and recreational PA might increase the probability of LBP more so than heavy domestic or recreational PA alone. Associations being greater when using the co-twin case-control analysis indicate that genetic and environmental factors influence the relationship between PA and LBP, and demonstrate the value of a twin design.
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Comparative Study
Comparison between pain at discography and morphological disc changes at axial loaded MRI in patients with low back pain.
Discogenic pain is induced by axial load, but there are no studies evaluating the influence of dynamic MRI in relation to provoked pain at discography. The aim of this study was to investigate the relationship between discography-induced pain and morphological disc changes, occurring during axial loaded MRI (alMRI). A secondary aim was to compare and register the frequency of provoked concordant pain at alMRI and discography. ⋯ In the majority of patients with low back pain, discography as well as alMRI provoked concordant pain. Loading of the spine, alMRI, revealed however no clinically useful morphological characteristics in the discs with concordant discograms. Alternative or more sensitive diagnostic methods are needed to understand load-induced discogenic pain.
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Clinical Trial
Volumetric change in interbody bone graft after posterior lumbar interbody fusion (PLIF): a prospective study.
The purpose of this study is to quantify the change in the volume of the interbody bone graft after the PLIF and monitor the change over time for subsequent analysis. ⋯ The post-PLIF volumes of interbody bone grafts exhibited increases particularly from the second to fifth years after the procedure. Even the elderly and those with poor bone qualities can expect to have volumetric increases over time. Sufficient interbody space should be secured for accommodating bone grafts by intraoperative reduction, wherever possible.
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The aim of the study is to use an algorithm previously published to decide whether to perform open surgery or percutaneous surgery with short fixation in patients with thoraco-lumbar junction and lumbar spine fractures, and to compare retrospectively surgical and conservative options of treatment. ⋯ We can conclude that the percutaneous procedure seems to give better results in terms of satisfaction and return to normal activities, although both procedures guarantee excellent fusion rates.