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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To describe normal variations in sagittal spinal radiographic parameters over an interval period and establish physiological norms and guidelines for which these images should be interpreted. ⋯ Radiographic sagittal parameters vary between serial images and reflect dynamism in spinal balancing. SVA and PT are predisposed to the widest variation. SVA has the largest variation between individuals of low pelvic tilt. Therefore, interpretation of these parameters should be patient specific and relies on trends rather than a one-time assessment.
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Randomized Controlled Trial
Lumbar total disc replacement: predictors for long-term outcome.
We aimed to identify patient characteristics associated with favourable long-term outcomes after lumbar total disc replacement (TDR). ⋯ Patients with Modic changes prior to the TDR surgery were more likely to report a clinically important functional improvement at long-term follow-up. Comorbidity, low level of education, long-term sick leave and high ODI score at baseline were associated with unemployment at long-term follow-up.
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Wei et al. evaluated the global research in spine using scientometric methods based on a sample of 13,115 papers published in 5 spine journals from 2004 to 2013. This study builds on this pioneering study and provides up-to-date and thorough information on spine based on a sample of 166,962 papers for the stakeholders. ⋯ The optimal design of research sample made it possible to obtain nearly 13 times the size of the sample in Wei et al. as a true representation of the research in spine through the use of an optimal keyword set for the titles of both papers and 10 spine journals. However, despite the inefficient design of the incentive structures for the relevant stakeholders, the research in spine had expanded 6.8 times since 1980.
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Patient-rated measures are considered the gold standard for assessing the outcome of spine surgery, but there is no consensus on the appropriate timing of follow-up. Journals often demand a minimum 2-year follow-up, but the indiscriminate application of this principle may not be warranted. We examined the course of change in patient outcomes up to 5 years after surgery for degenerative spinal disorders. ⋯ Stable group mean COMI scores were observed for all patients from 12 months postoperatively onwards. The early postoperative results appeared to herald the longer term outcome. As such, a 'wait and see policy' in patients with a poor initial outcome at 3 months is not advocated. The insistence on a 2-year follow-up could result in a failure to intervene early to achieve better long-term outcomes.