The spine journal : official journal of the North American Spine Society
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The Short Form 36 (SF-36) health survey has been shown to be a valid instrument when used to measure the self-reported physical and mental health of patients. The impact of lumbar spinal disorders can be assessed as the difference between the SF-36 scale scores and age- and gender-specific population norms. ⋯ All four lumbar spine disorders have a significant negative impact on all eight of the SF-36 scales. The greatest negative impact was seen in those scales that measure physical health (role limitations due to physical symptoms [RP], physical functioning [PF], and bodily pain [BP]). The HNP diagnostic group experienced a significantly greater impact upon these three scales. This diagnostic group had the youngest patients, whose baseline physical functional status would be expected to be the most optimal. When we stratified by age in all the diagnostic groups, the greatest negative impact scores for physical health were seen in the <40 years and 40-60 years age groups. These patients were also more likely to perceive their health as poor, experience decreased energy, and have more social impairment when compared with their age/gender norms.
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Selective lumbar nerve blocks (SLNBs) are a popular, minimally invasive treatment and diagnostic tool for lumbar radiculopathy. It is therefore relevant to determine the complication rate for SLNBs, as well as examine the association between needle-tip position and complication rates in order to improve safety. ⋯ Our results suggest that SLNBs performed with fluoroscopic guidance have a low incidence of complications. All of our complications were minor. The specific needle-tip position within or adjacent to the lumbar neural foramen does not appear to be associated with the incidence of complications.
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Postoperative delirium is a great concern in the treatment of hip fracture. However, there have been no reports regarding the postoperative delirium in spine surgery. ⋯ Low concentrations of hemoglobin and hematocrit 1 day after surgery were risk factors for postoperative delirium. As delirium is thought to represent not only brain dysfunction, but also impaired general physical condition, careful observation is necessary for the management of patients with postoperative delirium.
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Although thoracic disc herniations are rare, misdiagnosis is an undesirable situation, as it results not only in unnecessary diagnostic studies and surgical procedures, but also in progressive myelopathy and paralysis. Therefore, it is important to be aware of patients with thoracic disc herniations presenting with unusual or atypical symptoms mimicking other non-spinal disorders. ⋯ Thoracic disc herniation should be considered in the differential diagnosis of patients with pain likely caused by nonspinal disorders, especially if basic diagnostic studies do not reveal the cause.
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A pedicle subtraction osteotomy can be considered as part of the surgical treatment of a symptomatic sagittal imbalance. The literature on the use of this technique is limited and thus far not applied to a rigid thoracolumbar hyperkyphosis. ⋯ A pedicle subtraction osteotomy is a technically demanding but well tolerated operative procedure for the correction of a kyphotic deformity. This technique can also be considered as an adjunctive tool in the surgical treatment of a rigid thoracolumbar (Scheuermann's) kyphosis.