The spine journal : official journal of the North American Spine Society
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Factors associated with variability in length of sick leave because of acute low back pain in Chile.
Acute low back pain (LBP) is a frequent cause of physician visits and sick leave. Patients with longer sick leave account for most costs associated with LBP. Most research on risk factors for prolonged sick leave because of LBP has been done in Anglo-Saxon or Northern European populations with occupational LBP. Few studies have been conducted in less affluent Latin countries. ⋯ Physicians who treat patients with LBP should be aware of these variables associated with longer sick leave because of acute LBP, which represents a significant burden to any society and is an important epidemiologic problem.
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Comparative Study
Effects of scoliosis on respiratory muscle strength in patients with neuromuscular disorders.
Neuromuscular disorders (NMD) are characterized by loss of lung volume and respiratory muscle weakness, but the effects of scoliosis on lung function are unclear. ⋯ Both inspiratory and expiratory muscle strength were diminished in patients with NMD compared with healthy controls. Significant differences were also noted in pulmonary function in patients with NMD with or without scoliosis. This suggests that NMD may impact respiratory function independently of the effects of scoliosis. Clinicians treating patients with NMD should be aware of the possibility of compromised respiratory function in these patients to address possible complications.
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Anterior corpectomy and reconstruction with bone graft and a rigid screw-plate construct is an established procedure for treatment of cervical neural compression. Despite its reliability in relieving symptoms, there is a high rate of construct failure, especially in multilevel cases. ⋯ This study suggests that screw divergence from the end plates not only increases load transmission to the graft but also predisposes the screws to higher shear forces after corpectomy reconstruction. In particular, the inferior screw demonstrated larger stress than the upper-level screws. In the proposed hybrid fusion model, lower stresses on the bone graft, end plates, and bone-screw interface were recorded, inferring lower construct failure (end-plate fractures and screw pullout) potential at the inferior construct end.