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 determine the extent to which the clinical manifestations of a cohort of people undergoing surgery for lumbosacral nerve root compression satisfy those described in The National Institute for Health and Care Excellence (NICE) guidance. ⋯ In this small sample, from two units, NICE's description of the clinical manifestations of lumbar nerve root compression did not describe 99% of people having surgery for it. Using NICE's definition to triage people with low back pain could result in prolonged symptoms and delayed treatment. Diagnosing lumbar nerve root compression is complex. NICE's guidance requires examination.
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Evaluation of the psychometric properties of a cross-culturally adapted questionnaire, the Core Outcome Measurement Index for neck pain (COMI-neck). ⋯ This study provides evidence that the Italian version of the COMI-neck is a valid and responsive questionnaire in the population of patients examined. Its use is recommended for clinical and research purposes.
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Clinical Trial
Patient involvement in surgical treatment decisions and satisfaction with the treatment results after lumbar intervertebral discectomy.
To evaluate involvement of patients in surgical treatment decision making (STDM) in relations to satisfaction with the results of lumbar discectomy. ⋯ A significant proportion of patients with LDH prefer to be actively involved in treatment decisions and experience an STDM process that matches their preferences for participation. However, individual differences in preferences for involvement in STDM are common and global satisfaction with the treatment results is not significantly related to the activity of involvement in STDM.
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Dural tears in primary decompressive lumbar surgery. Is primary repair necessary for a good outcome?
Case control series with prospective data collection. ⋯ Our study demonstrates that incidental durotomy in primary lumbar decompressive surgery can be successfully managed without primary suture repair with no adverse effect on surgical outcome in the longer term.
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Comparative Study
The effect of design parameters of interspinous implants on kinematics and load bearing: an in vitro study.
A number of concepts with controversy approaches are currently discussed for interspinous stabilization (IPS). However, comparative biomechanical studies among the different systems are rare. Nevertheless, it remains unclear which biomechanical characteristics are influenced by different design features of these implants, such as implant stiffness or an additional tension band. Therefore, the aim of the present study was to compare different interspinous implants to investigate the biomechanical impact of IPS implant design on intersegmental kinematics, such as range of motion, neutral zone, center of rotation (COR), as well as load transfer like intradiscal pressure (IDP), to gain additional experience for clinical indications and limitations. ⋯ For the IPS, we found a correlation between compression stiffness and stabilization in extension. Here, the system with the lowest stiffness, DIA, displayed nearly no stabilization of the treated segment, whereas the system with the highest stiffness, WAL and COF, was most pronounced. This applies also for the correlation between device stiffness and IDP. In flexion only the degree of stabilization is in correlation with the tensile stiffness, whereas the IDP stays constant and is not affected by the different tensile stiffness. IPS is not able to stabilize in the frontal and transversal plane. Furthermore IPS does not substantially alter the location of the COR.