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
-
The purpose of this study was to examine lumbar segmental mobility using kinetic magnetic resonance imaging (MRI) in patients with minimal lumbar spondylosis. ⋯ In the current study, we evaluated lumbar segmental mobility in patients without significant degenerative disc disease and found that translational motion was greatest in the proximal lumbar levels whereas angular motion was similar in the mid-lumbar levels but decreased at L1-L2 and L5-S1.
-
To investigate relevant change on the Neck Pain and Disability Scale (NPAD) and Neck Disability Index (NDI) and which questionnaire is the most responsive in patients with non-specific chronic neck pain (CNP). ⋯ Relevant change on both NPAD and NDI assessed with MDC and MIC resulted in different cut-offs and consequently with different amounts of certainty that the patient is improved. Responsiveness of NPAD and NDI was similar.
-
Dynamic stabilization of the spine was developed as an alternative to rigid fusion in chronic back pain to reduce the risk of adjacent segment degeneration. Dynamic neutralization system (Dynesys, Zimmer CH) is one of the most popular systems available, but some midterm studies show revision rates as high as 30 %. Some late infectious complications in our patients prompted us to review them systematically. Propionibacterium recently has been shown to cause subtle infections of prosthetic material. ⋯ The high rate of late infections with low-grade germs and the frequency of screw loosening signs made us suspect a lack of integration at the bone-screw interface. Surgeons should be suspicious if the patient presents a combination of new or increasing pain and signs of screw loosening, and aggressive revision is recommended in these cases.
-
The objective of this study was to investigate thoracic myelopathy caused by ossification of the yellow ligament (OYL) in patients with posterior instrumented lumbar fusion. ⋯ We report seven patients who suffered from thoracic myelopathy after instrumented lumbar fusion. Surgeons must be aware of the possibility of thoracic myelopathy caused by OYL at the thoracolumbar junction, especially in patients with a complaint of gait disturbance after long instrumented lumbar fusion.
-
Lumbar spine surgery in morbidly obese patients is a challenge to the operating surgeon. The aim of the study was to evaluate the surgical experience in this group of patients using the Synframe retractor system (Synthes, Paoli, PA, USA) as a tool for improved surgical access. ⋯ The surgical experience determined that the Synframe retractor system provided a stable and well-illuminated operative field. It minimized the number of personnel required for assistance and improved surgical access. As may be expected, all the above recorded parameters were greater in the morbidly obese group.