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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The treatment of low back pain associated to Disc Degenerative Disease (DDD) is still controversial. Segmental Fusion is the gold standard, but many studies have reported that motion-preserving devices bring substantial clinical benefits to patients. Concerns on the associated complications and on the long-term clinical effectiveness of such instrumentations are still present and have led recently to a decrease of the number of Lumbar Total Disk Replacements (TDR). The objective of this prospective study is to present the clinical and radiographic outcomes of the Maverick Lumbar disk prostheses (Medtronic, TE, Memphis, USA) at long-term follow-up. ⋯ A significant, clinically relevant, and lasting reduction of back pain has been achieved in patients who underwent a total disk arthroplasty or a Hybrid construct with Maverik prosthesis. TDR is a safe and effective technique to decrease pain in patients with one or two levels of DDD.
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Observational Study
Outcome of surgery for degenerative lumbar scoliosis: an observational study using the Swedish Spine register.
The outcome of surgery for degenerative lumbar scoliosis was studied in the Swedish Spine register. ⋯ Surgery for degenerative lumbar scoliosis improves quality of life with medium to large effect sizes, but carries a high risk of additional surgery.