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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Anterior (ALIF) and transforaminal (TLIF) lumbar interbody fusion have shown similar clinical outcomes at short- and medium-term follow-ups. Possible advantages of ALIF in the long run could be better disc height and lumbar lordosis and reduced risk of adjacent segment disease. We aimed to study if ALIF could be associated with superior clinical outcomes than TLIF at long-term follow-up. ⋯ Diagnostic: individual cross-sectional studies with the consistently applied reference standard and blinding.
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To evaluate the neuronal metrics/microstructure of the spinal cord around apical region in patients with hyperkyphosis using diffusion tensor imaging (DTI). ⋯ In patients with hyperkyphosis, the FA of spinal cord at apical level was associated with the neuronal metrics/microstructure of the spinal cord. Furthermore, the DTI parameter of FA at apical level was associated with GK and sagittal DAR.
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Lumbar spinal stenosis (LSS) is associated with increased levels of psychological distress, including depression; however, the prognostic value of depression remains unclear. The purpose of this systematic review was to synthesize the evidence on the prognostic value of depression for a range of outcomes in patients with LSS. ⋯ Depression appears to have small to moderate prognostic value for LSS outcomes, with the strongest evidence for postoperative disability and symptom severity. The prognostic value of depression for LSS outcomes should be further explored using standardized measures in additional cohorts, including patients managing their condition conservatively, who have been neglected in related research.
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Vertebral dimensions may constitute a potential risk factor for degenerative changes in the spine. Previous studies have found a positive association between vertebral height and both type 2 Modic changes and intervertebral disc height loss. Also, vertebral endplate size has been associated with disc degeneration. However, only a few studies have investigated the association between vertebral dimensions and lumbar disc displacement (LDD). This study aimed to investigate the association between vertebral cross-sectional area (CSA) and LDD among the general middle-aged Finnish population. We hypothesized that larger vertebral CSA is associated with LDD. ⋯ Larger L4 vertebral CSA was associated with LDD in our study sample. Even though smaller vertebral size exposes our vertebrae to osteoporotic fractures, it simultaneously seems to protect us from LDD.
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Randomized Controlled Trial
A comparison of the effects of thoracolumbar interfascial plane (TLIP) block and erector spinae plane (ESP) block in postoperative acute pain in spinal surgery.
Spinal surgeries are a very painful procedure. New regional techniques for postoperative pain management are being considered. The present study aimed to evaluate the hypothesis that the ultrasound-guided erector spinae plane (ESP) block would lead to lower opioid consumption compared to the thoracolumbar interfascial plane (TLIP) block after lumbar disk surgery. The study's primary objective was to compare postoperative total opioid consumption, and the secondary objective was to assess postoperative pain scores. ⋯ This study demonstrated the analgesic efficacy of both techniques, revealing that the ESP block provides more effective analgesia in patients undergoing lumbar disk surgery.