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Zhu C, Xiao G. Efficacy and safety of interspinous process device compared with alone decompression for lumbar spinal stenosis: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e38370. [PMID: 38847722 PMCID: PMC11155552 DOI: 10.1097/md.0000000000038370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 05/03/2024] [Indexed: 06/10/2024] Open
Abstract
STUDY DESIGN Systematic review and meta-analysis. BACKGROUND Interspinous process devices (IPD) were used as a treatment in selected patients with lumbar spinal stenosis (LSS). However, the use of IPD was still debated that it had significantly higher reoperation rates compared to traditional decompression. Therefore, the purpose of the meta-analysis was to evaluate the effectiveness and safety of IPD treatment in comparison to traditional treatment. METHODS The databases were searched of PubMed, Embase and the Cochrane, Chinese National Knowledge Infrastructure, Chongqing VIP Database and Wan Fang Database up to January 2024. Relevant studies were identified by using specific eligibility criteria and data was extracted and analyzed based on primary and secondary endpoints. RESULTS A total of 13 studies were included (5 RCTs and 8 retrospective studies). There was no significant difference of Oswestey Disability Index (ODI) score in the last follow-up (MD = -3.81, 95% CI: -8.91-1.28, P = .14). There was significant difference of Visual Analog Scale (VAS) back pain scoring in the last follow-up (MD = -1.59, 95% CI: -3.09--0.09, P = .04), but there existed no significant difference of leg pain in the last follow-up (MD = -2.35, 95% CI: -6.15-1.45, P = .23). What's more, operation time, bleeding loss, total complications and reoperation rate had no significant difference. However, IPD had higher device problems (odds ratio [OR] = 9.00, 95% CI: 2.39-33.91, P = .001) and lesser dural tears (OR = 0.32, 95% CI: 0.15-0.67, P = .002) compared to traditional decompression. CONCLUSION Although IPD had lower back pain score and lower dural tears compared with traditional decompression, current evidence indicated no superiority for patient-reported outcomes for IPD compared with alone decompression treatment. However, these findings needed to be verified in further by multicenter, double-blind and large sample RCTs.
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Affiliation(s)
- Changjiu Zhu
- Department of Orthopedics, Sichuan Provincial People’s Hospital, Chengdu, China
| | - Guiling Xiao
- Department of Orthopedics, Sichuan Provincial People’s Hospital, Chengdu, China
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Yu JE. Confirmation of the viability of a metaverse yoga class and investigation into the impact on pain, anxiety, and depression associated with low back pain after engaging in virtual yoga sessions. J Exerc Rehabil 2024; 20:24-33. [PMID: 38433855 PMCID: PMC10902692 DOI: 10.12965/jer.2346586.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/30/2023] [Accepted: 01/01/2024] [Indexed: 03/05/2024] Open
Abstract
This study aimed to explore the influence of metaverse technology (MT) factors like presence, usability, and enjoyment on patients' satisfaction, with a focus on examining potential mediating effects. In addition, it sought to assess whether the yoga practice as an intervention therapy in MT induces changes in the pain, anxiety, and depression levels of patients experiencing back pain. From the pool of 202 participants, this study chose participants who had reported enduring low back pain over 12 weeks, with a visual analogue scale (VAS) rating of 4 or higher. After completing the questionnaire, patients were randomly assigned to either the control group (COG, n=100) or the yoga exercise group (YEG, n=99). Results showed that the construct validity for questionnaires and a reasonable model fit were confirmed, and that presence showed a statistically significant effect on psychological satisfaction via the mediating path of enjoyment (β=0.592, P=0.001). Following 8 weeks of the yoga practice, the VAS increased for the COG, while it decreased significantly by ~29% for the YEG (P=0.001). YEG also exhibited a decrease in the Oswestry Disability Index by ~17%, anxiety by ~7%, and depression by ~10% (P=0.001). In conclusion, psychological satisfaction in a yoga practice using a metaverse cannot be achieved solely through the sense of presence; enjoyment is necessary for patients' satisfaction. Moreover, it was verified that virtual yoga practice is effective in ameliorating psychological factors resulting from back pain.
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Affiliation(s)
- Ji-Eun Yu
- Research Institute of Sports and Industry Science, Hanseo University, Seosan,
Korea
- Department of Physical Education, Korea University, Seoul,
Korea
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Azam F, Anand S, Dragun A, Furtado K, Nguyen M, Shukla I, Hicks WH, Hall K, Akbik OS, Bagley CA. Identifying Correlation Among Patient-Reported Outcome Measures: A Study of PROMIS-29, ODI, and VAS in Adult Spinal Deformity Patients. World Neurosurg 2024; 181:e1059-e1070. [PMID: 37967743 DOI: 10.1016/j.wneu.2023.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Adult spinal deformity (ASD) is becoming increasingly common in aging populations. Patient-reported outcome measures (PROMs) are self-reported patient surveys administered pre- and postoperatively that provide insight into patient improvement. We aim to compare 3 of the most utilized PROMs: PROMIS-29, Oswestry Disability Index (ODI), and Visual Analogue Scale (VAS), to investigate whether they provide unique and independent assessments of patient outcomes when assessed longitudinally. METHODS We retrospectively reviewed a database of ASD at UT Southwestern Medical Center between 2016 and 2021. Adult patients (>18 years old) were included if they underwent long-segment (>4 levels) thoracolumbar fusion. PROMIS-29, ODI, and VAS scores were collected preoperatively and at 3-, 6-, 12-, 18-, 24-, 30-, and 36-month follow-ups. Scores were recorded ±1 month of the time points. Pearson correlation coefficients for each PROM were then calculated in a pairwise fashion. RESULTS A total of 163 patients were included in our analysis. ODI and VAS showed significant covariance, with VAS Neck and VAS Back having Pearson coefficients of 0.95 and 0.94, respectively. ODI and PROMIS-29 also showed significant covariance, with Physical Function and ODI showing a Pearson coefficient of 0.95. PROMIS-29 and VAS demonstrated less correlation regarding Pain and Physical Function; however, they showed a significantly high Pearson coefficient when comparing VAS Back with PROMIS-29 Sleep and Pain Intensity (r = 0.97 and r = 0.96, respectively). CONCLUSIONS All 3 PROMs demonstrated significant correlation over 36 months, indicating that simultaneous administration of each during follow-up is redundant. The measure that provided the least unique information was ODI, as both VAS and PROMIS-29 demonstrated similar progression and assessed additional metrics. PROMIS-29 provided the same information as VAS and ODI, with extra facets of patient-reported outcomes, indicating that it may be a more comprehensive measure of longitudinal patient improvement.
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Affiliation(s)
- Faraaz Azam
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Soummitra Anand
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Anthony Dragun
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Kailee Furtado
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Madelina Nguyen
- Department of Neurological Surgery, University of Texas Medical Branch, Galveston, Texas, USA
| | - Ishav Shukla
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - William H Hicks
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Kristen Hall
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Omar S Akbik
- Department of Neurological Surgery, CHI Health, Omaha, Nebraska, USA
| | - Carlos A Bagley
- Department of Neurological Surgery, Saint Luke's Neurological & Spine Surgery, Kansas City, Missouri, USA.
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Moriki K, Ogihara H, Yoshikawa K, Kikuchi K, Endo R, Sato T. Effects of sleep quality on pain, cognitive factors, central sensitization, and quality of life in patients with chronic low back pain. J Back Musculoskelet Rehabil 2024; 37:119-125. [PMID: 37694349 DOI: 10.3233/bmr-220429] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
BACKGROUND Sleep quality in patients with chronic low back pain (CLBP) may affect quality of life (QoL), possibly due to worsening pain, central sensitization (CS), and cognitive factors. However, causal relationship among the factors has not been confirmed yet. OBJECTIVE The purpose of this study was to test the hypothesis that sleep quality in patients with CLBP is attributable to pain, cognitive factors, and CS, and influences QoL, by structural covariance analysis. METHODS This is a cross-sectional study. Participants were recruited from six health care facilities and 101 patients with CLBP were included. Structural covariance analysis assessed the fit of data to the model using goodness of fit index (GFI), adjusted goodness of fit index (AGFI), comparative fit index (CFI), and mean squared approximation error (RMSEA). RESULTS The structural covariance analysis showed that the goodness-of-fit indices were high (GFI = 0.993, AGFI = 0.964, CFI = 1.00, RMSEA < 0.01). Sleep quality was not directly influenced by QoL but rather by CS and cognitive factors. CONCLUSION This study suggests that sleep quality in patients with CLBP is indirectly mediated through multiple pathways, including cognitive factors and CS, which may influence QoL.
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Affiliation(s)
| | - Hirofumi Ogihara
- Division of Physical Therapy, Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, Nagano, Japan
| | - Koji Yoshikawa
- Graduate school of Health Sciences, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Kenta Kikuchi
- Department of Physical Therapy, Iwate Rehabilitation College, Iwate, Japan
| | - Ryunosuke Endo
- Graduate school of Health Sciences, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Takaaki Sato
- Division of Physical Therapy, Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, Nagano, Japan
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Li T, Yan J, Ren Q, Hu J, Wang F, Liu X. Efficacy and Safety of Lumbar Dynamic Stabilization Device Coflex for Lumbar Spinal Stenosis: A Systematic Review and Meta-analysis. World Neurosurg 2023; 170:7-20. [PMID: 36481444 DOI: 10.1016/j.wneu.2022.11.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND This systematic review and meta-analysis were performed to investigate evidence for the comparison of lumbar dynamic stabilization device Coflex (Surgalign, Deerfield, IL) with posterior lumbar fusion for lumbar spinal stenosis). METHODS Relational databases were searched to October 2022. The main outcome measures included operation time, Japanese Orthopedic Association score (JOA), visual analog scale (VAS), Oswestry disability index (ODI), total complications, and adjacent segment degeneration (ASD). Statistical analysis was performed with Review Manager 5.3 (Cochrane Collaboration). RESULTS A total of 26 studies were included. The main results of this meta-analysis showed lumbar dynamic stabilization device Coflex had shorter operation time (mean difference [MD] -50.77 min, 95% CI -57.24 to -44.30, P < 0.00001), less intraoperative blood loss (MD -122.21 mL, 95% CI -129.68 to -94.74, P < 0.00001), and shorter hospital stays (MD -3.21 days, 95% CI -4.04 to -2.37, P < 0.00001). What's more, the JOA score and ODI score were higher in the Coflex group during early follow-up. Yet, there was no significant difference between the 2 groups with the extension of follow-up time. Moreover, the Coflex group had a lower VAS score than fusion treatment (P < 0.00001). Finally, the Coflex group had lower total complications rate (P = 0.03), lower ASD rate (P = 0.001), and higher range of motion (P < 0.00001), but there was no significant difference in reoperation rate and internal fixation problems rate. CONCLUSIONS Current evidence suggests that lumbar dynamic stabilization device Coflex is superior to posterior lumbar fusion in early follow-up. However, considering that the dynamic stabilization device group also has its limitations, these findings need to be further verified by multicenter, double-blind, and large-sample randomized controlled trials.
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Affiliation(s)
- Ting Li
- Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China; Department of Postgraduate, Chengdu Medical College, Chengdu, China
| | - Jingxin Yan
- Department of Interventional Therapy, Affiliated Hospital of Qinghai University, Xining, China
| | - Qiuyu Ren
- Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China; Department of Postgraduate, Chengdu Medical College, Chengdu, China
| | - Jiang Hu
- Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Fei Wang
- Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Xilin Liu
- Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.
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Beighley A, Zhang A, Huang B, Carr C, Mathkour M, Werner C, Scullen T, Kilgore MD, Maulucci CM, Dallapiazza RF, Kalyvas J. Patient-reported outcome measures in spine surgery: A systematic review. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE 2022; 13:378-389. [PMID: 36777909 PMCID: PMC9910127 DOI: 10.4103/jcvjs.jcvjs_101_22] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/12/2022] [Indexed: 12/12/2022] Open
Abstract
Background Steadily increasing expenditure in the United States health-care system has led to a shift toward a value-based model that focuses on quality of care and cost-effectiveness. Operations involving the spine rank among some of the most common and expensive procedures performed in operating rooms nationwide. Patient-reported outcomes measures (PROMs) are a useful tool for reporting levels of outcome and analyzing patient recovery but are both under-utilized and nonstandardized in spine surgery. Methods We conducted a systematic review of the literature using the PubMed database, focusing on the most commonly utilized PROMs for spine disease as well as spinal deformity. The benefits and drawbacks of these PROMs were then summarized and compared. Results Spine-specific PROMs were based on the class of disease. The most frequently utilized PROMs were the Neck Disability Index and the modified Japanese Orthopaedic Association scale; the Oswestry Disability Index and the Roland-Morris Disability Questionnaire; and the Scoliosis Research Society 22-item questionnaire (SRS-22) for cervicothoracic spine disease, lumbar spine disease, and spinal deformity, respectively. Conclusion We found limited, though effective, use of PROMs targeting specific classes of disease within spine surgery. Therefore, we advocate for increased use of PROMs in spine surgery, in both the research and clinical settings. PROM usage can help physicians assess subjective outcomes in standard ways that can be compared across patients and institutions, more uniquely tailor treatment to individual patients, and engage patients in their own medical care.
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Affiliation(s)
- Adam Beighley
- Tulane University-Ochsner Clinic Foundation, Department of Neurosurgery, New Orleans, LA, USA
| | - Allen Zhang
- Tulane University-Ochsner Clinic Foundation, Department of Neurosurgery, New Orleans, LA, USA
| | - Brendan Huang
- Tulane University-Ochsner Clinic Foundation, Department of Neurosurgery, New Orleans, LA, USA
| | - Christopher Carr
- Tulane University-Ochsner Clinic Foundation, Department of Neurosurgery, New Orleans, LA, USA
| | - Mansour Mathkour
- Tulane University-Ochsner Clinic Foundation, Department of Neurosurgery, New Orleans, LA, USA
| | - Cassidy Werner
- Tulane University-Ochsner Clinic Foundation, Department of Neurosurgery, New Orleans, LA, USA
| | - Tyler Scullen
- Tulane University-Ochsner Clinic Foundation, Department of Neurosurgery, New Orleans, LA, USA
| | - Mitchell D. Kilgore
- Tulane University-Ochsner Clinic Foundation, Department of Neurosurgery, New Orleans, LA, USA
| | - Christopher M. Maulucci
- Tulane University-Ochsner Clinic Foundation, Department of Neurosurgery, New Orleans, LA, USA
| | - Robert F. Dallapiazza
- Tulane University-Ochsner Clinic Foundation, Department of Neurosurgery, New Orleans, LA, USA
| | - James Kalyvas
- Tulane University-Ochsner Clinic Foundation, Department of Neurosurgery, New Orleans, LA, USA
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Song Z, Zhu W, Zheng J, Wu G, Li T, Huang A, Bian J, Chen C, Li H. Comparison of short-term efficacy of MIS-TLIF and Endo-LIF in the treatment of single-segment degenerative lumbar diseases. Front Surg 2022; 9:922930. [PMID: 36211296 PMCID: PMC9545169 DOI: 10.3389/fsurg.2022.922930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/02/2022] [Indexed: 11/14/2022] Open
Abstract
Background A prospective controlled study was conducted to compare the short-term clinical results and postoperative complications of minimally invasive transforaminal lumbar decompression and fusion (minimally invasive surgery transforaminal lumbar interbody fusion, MIS-TLIF) and percutaneous endoscope-assisted transforaminal lumbar interbody fusion (endoscopic lumbar interbody fusion, Endo-LIF) in the treatment of single-segment degenerative lumbar diseases, to provide some scientific guidance for clinicians to select surgical treatment for patients with lumbar degeneration. Methods From October 2020 to October 2021, a total of 62 patients were enrolled, with 31 patients in the MIS-TLIF group and 31 patients in the Endo-LIF group. All patients were followed up for 6 months. The following information from the two groups of patients was recorded: (1) operation time, radiation exposure time, intraoperative blood loss, bed rest time, and hospital stay; (2) ODI score (The Oswestry Disability Index), low back pain VAS score (Visual Analogue Scale), and lumbar vertebra JOA score (Japanese Orthopaedic Association Scores) 1 day before the operation; 1, 3, 6 days after operation; and 1, 3 and 6 months after operation. (3) X-ray evaluations of lumbar fusion at the last follow-up. Results There were significant differences in operation time, intraoperative fluoroscopy time, and hospitalization cost between the two groups. The MIS-TLIF group was significantly better than the Endo-LIF group, and the intraoperative bleeding volume of the Endo-LIF group was significantly better than that of the MIS-TLIF group, but there was no significant difference in postoperative bed rest time and postoperative hospital stay. There was no significant difference in the scores of ODI, VAS, and JOA between the two groups before and after the operation. At the last follow-up, the fusion rate was 100% in the MIS-TLIF group and 100% in the Endo-LIF group. Conclusions There was no significant difference in short-term clinical efficacy and safety between Endo-LIF and MIS-TLIF in the treatment of single-segment degenerative lumbar diseases, but MIS-TLIF was significantly better than Endo-LIF in terms of the operation time, hospitalization cost, and fluoroscopy time, and Endo-LIF was significantly better than MIS-TLIF in terms of intraoperative blood loss.
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Affiliation(s)
- Zhiwei Song
- Department of Orthopedics, Hospital Affiliated 5 to Nantong University, Taizhou People’s Hospital, Taizhou, China
- Medical School of Nantong University, Nantong, China
| | - Weihua Zhu
- Department of Orthopedics, Hospital Affiliated 5 to Nantong University, Taizhou People’s Hospital, Taizhou, China
- Department of Orthopedics, Taizhou People’s Hospital, Nanjing Medical University, Taizhou, China
| | - Junwen Zheng
- Postgraduate Training Base of Dalian Medical University, Taizhou People’s Hospital, Jiangsu, China
| | - Gang Wu
- Postgraduate Training Base of Dalian Medical University, Taizhou People’s Hospital, Jiangsu, China
| | - Tianqi Li
- Postgraduate Training Base of Dalian Medical University, Taizhou People’s Hospital, Jiangsu, China
| | - Aibing Huang
- Department of Orthopedics, Hospital Affiliated 5 to Nantong University, Taizhou People’s Hospital, Taizhou, China
- Postgraduate Training Base of Dalian Medical University, Taizhou People’s Hospital, Jiangsu, China
| | - Jian Bian
- Department of Orthopedics, Hospital Affiliated 5 to Nantong University, Taizhou People’s Hospital, Taizhou, China
- Department of Orthopedics, Taizhou People’s Hospital, Nanjing Medical University, Taizhou, China
| | - Chunmao Chen
- Department of Orthopedics, Hospital Affiliated 5 to Nantong University, Taizhou People’s Hospital, Taizhou, China
- Department of Orthopedics, Taizhou People’s Hospital, Nanjing Medical University, Taizhou, China
| | - Haijun Li
- Department of Orthopedics, Hospital Affiliated 5 to Nantong University, Taizhou People’s Hospital, Taizhou, China
- Department of Orthopedics, Taizhou People’s Hospital, Nanjing Medical University, Taizhou, China
- Correspondence: Haijun Li
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Adhikari P, Çetin E, Çetinkaya M, Nabi V, Yüksel S, Vila Casademunt A, Obeid I, Sanchez Perez-Grueso F, Acaroğlu E. Ability of Visual Analogue Scale to predict Oswestry Disability Index improvement and surgical treatment decision in patients with adult spinal deformity. BRAIN & SPINE 2022; 2:100934. [PMID: 36605390 PMCID: PMC9808375 DOI: 10.1016/j.bas.2022.100934] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/26/2022] [Accepted: 08/24/2022] [Indexed: 01/07/2023]
Abstract
Introduction The effect of pain on HRQoL scores in ASD patients is not well studied. Disability is a major factor on decision and outcomes. On the other hand, little is known about the effect of perceived and reported pain on these parameters, especially in the elderly population. We hypothesized that baseline back and leg pain would not affect the treatment decision whereas may have a negative effect on outcomes. Research question To determine the correlation between preoperative ODI and VAS scores; and to identify the effect of baseline VAS score on treatment decision and ODI improvement following treatment. Material and methods In this retrospective study, patients with a follow-up duration of minimum 2 years were enrolled from a prospective multicentric ASD database. Pearson and Spearman correlation tests were used to evaluate the correlation between ODI and VAS scores; univariate binary logistic regression method was used to analyze the effect of VAS on treatment decision as well as the outcomes. Results 1050 patients (mean age 48.2) were analyzed. Baseline ODI and back, leg pain VAS scores were significantly correlated (P < 0.001). One unit increase in baseline back and leg pain VAS scores, increased the probability of improvement in ODI by 1.219 (P = 0.016) and 1.182 times (P = 0.029), respectively in surgically treated patients; and reduced it by 0.894 times (P = 0.012) for conservatively treated patients. For patients >70 years old, one-unit increase in baseline leg pain VAS score increased the probability of deciding on surgical treatment by 1.121 times (p = 0.016). Discussion and conclusions Preoperative back and leg pain VAS scores were found to be significantly correlated with the preoperative ODI scores. Additionally, preoperative baseline back and leg pain VAS scores were useful in predicting the improvement in disability as assessed by ODI. Another important finding was that, higher baseline leg pain (but not back pain) VAS scores increased the rate of elderly patients preferring surgical treatment.
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Affiliation(s)
- Prashant Adhikari
- Hospital for Advance Medicine and Surgery (HAMS), Dhumbarai, Mandhikatar Road, Kathmandu, Nepal,Corresponding author. Hospital for Advance Medicine and Surgery (HAMS), Dhumbarai, Mandhikatar Road, Kathmandu, Nepal.
| | - Engin Çetin
- Gaziosmanpasa Training and Research Hospital, Karayolları Mahallesi, Osmanbey Caddesi, 621, Sokak, 34255, Gaziosmanpaşa, Istanbul, Turkey
| | - Mehmet Çetinkaya
- Başakşehir Çam ve Sakura City Hospital, Başakşehir Olimpiyat Bulvarı Yolu, 34480, Başakşehir, Istanbul, Turkey
| | - Vugar Nabi
- Antalya Training and Research Hospital, Varlık Mh, Kazım Karabekir Cd, 07100, Antalya, Turkey
| | - Selcen Yüksel
- Yıldırım Beyazıt University, Department of Biostatistics, Yıldırım Beyazıt Üniversitesi Biyoistatistik Departmenı, Ankara, Turkey
| | | | - Ibrahim Obeid
- Bordeaux University Department of Orthopaedics, Bordeaux University Hospital, Department of Orthopaedics, Bordeaux, France
| | | | - Emre Acaroğlu
- Ankara Spine Center, Iran Caddesi 45/2, Kavaklidere, 06700, Ankara, Turkey
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Shen Z, Guan X, Wang R, Xue Q, Zhang D, Zong Y, Ma W, Zhuge R, Liu Z, He C, Guo L, Yin F. Effectiveness and safety of decompression alone versus decompression plus fusion for lumbar spinal stenosis with degenerative spondylolisthesis: a systematic review and meta-analysis. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:664. [PMID: 35845482 PMCID: PMC9279815 DOI: 10.21037/atm-22-2208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/08/2022] [Indexed: 11/09/2022]
Abstract
Background There have been lingering controversies reported decompression and plus fusion. And the relative safety of fusion in addition to standard decompression remains unclear. This study aimed to assess the effectiveness and safety of decompression alone or combined with fusion in lumbar spinal stenosis (LSS) with degenerative spondylolisthesis (DS). Methods In this systematic review and meta-analysis, we searched the databases of PubMed, Embase, Cochrane Library, and Web of Science for relevant literature from their inception to 28th December 2021. We identified the eligible studies based on the PICOS principles, populations (LSS with DS), interventions (decompression alone), controls (decompression combined with fusion), outcomes [overall reoperation rate, complications, Oswestry Disability Index (ODI), operative time, the amount of blood lost, length of stay (LOS), and visual analog scales (VAS)], study design (cohort studies). Quality assessment for individual study was performed with the Newcastle-Ottawa Scale (NOS). Results In all, 12 articles involving a total of 14,693 patients were finally included in the study, the majority of patients underwent decompression alone (DA group: n=11,598) and the rest underwent decompression associated with fusion (FU group: n=3,095). The quality of most of the included studies was regarded as high quality. The results indicated that the FU group had a higher rate of complication [relative risk (RR): 1.770, 95% confidence interval (CI): 1.485 to 2.110], longer operative time [weighted mean difference (WMD): 51.037, 95% CI: 13.743 to 88.330], and increased blood loss (WMD: 258.354, 95% CI: 150.468 to 366.239) than the DA group (all P<0.05), with no significant differences for overall reoperation rate (RR: 0.879, 95% CI: 0.432 to 1.786), ODI (WMD: −2.569, 95% CI: −6.548 to 1.409), LOS (WMD: 3.838, 95% CI: −2.172 to 9.848), and VAS found between the two groups (P>0.05). Conclusions In patients with LSS + DS, the effectiveness and safety of decompression alone may be superior to decompression plus fusion in terms of complication rate, operative time, and the amount of bleeding. However, more high-quality literature is needed in the future to confirm the best treatment choice for patients with LSS + DS.
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Affiliation(s)
- Zhubin Shen
- Department of Spine Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xiaojing Guan
- Department of Spine Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Rui Wang
- Department of Toxicology, School of Public Health of Jilin University, Changchun, China
| | - Qian Xue
- Department of Toxicology, School of Public Health of Jilin University, Changchun, China
| | - Ding Zhang
- Department of Spine Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Yuan Zong
- Department of Spine Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Wenxuan Ma
- Department of Toxicology, School of Public Health of Jilin University, Changchun, China
| | - Ruijian Zhuge
- Department of Toxicology, School of Public Health of Jilin University, Changchun, China
| | - Zhiming Liu
- Department of Spine Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Changhao He
- Department of Toxicology, School of Public Health of Jilin University, Changchun, China
| | - Li Guo
- Department of Toxicology, School of Public Health of Jilin University, Changchun, China
| | - Fei Yin
- Department of Spine Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
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Kim SK, Park H. The Effect of Auricular Acupressure for Chronic Low Back Pain in Elders: A Randomized Controlled Study. Holist Nurs Pract 2021; 35:182-190. [PMID: 34115736 DOI: 10.1097/hnp.0000000000000457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Chronic low back pain (CLBP) is a major problem throughout the world and getting worse because of population increase and aging. The cost of treatment increases as the population of people with CLBP increases. This study aimed to examine the effect of auricular acupressure (AA) on pain and disability in elders with chronic low back pain. The randomized, single-blinded, and placebo-controlled study was conducted on 51 elders with CLBP in South Korea from June 2019 to August 2019. The experimental group (n = 26) received AA on low back pain-related points, whereas the placebo control group (n = 25) received AA on points unrelated to low back pain. Participants received 6 weeks of AA in weekly cycles. Collected data were analyzed using IBM SPSS Statistics, version 25. Statistically significant differences between the 2 groups emerged in the visual analog scale (P < .001), pain threshold (P < .001), and Oswestry Disability Index (P < .001). This study showed that 6 weeks of AA improved CLBP and pain-related disability. Therefore, AA can be used as a noninvasive and self-managed alternative intervention for CLBP in older adults.
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Affiliation(s)
- Soo Kyoung Kim
- California Pacific Medical Center, San Francisco, California (Ms Kim); and College of Nursing, Ewha Womans University, Seoul, Republic of Korea (Ms Kim and Dr Park)
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A Randomized Controlled Trial Investigating the Effects of Equine Simulator Riding on Low Back Pain, Morphological Changes, and Trunk Musculature in Elderly Women. ACTA ACUST UNITED AC 2020; 56:medicina56110610. [PMID: 33202928 PMCID: PMC7696898 DOI: 10.3390/medicina56110610] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 01/20/2023]
Abstract
Background and objectives: Studies on the effects of an equine riding simulator (ERS) program on back pain, spinal alignment, and isokinetic moments in subjects with chronic low back pain (CLBP) remain limited. The purpose of this study was to analyze changes in elderly women with CLBP who participate in an ERS program. Materials and Methods: The 80 participants were all women aged 61–84 years who were randomly assigned to either the control group (CON) or ERS group (ERSG). ERS exercise was performed for a duration of 12 weeks (three times each week). The degree of pain was measured using the Oswestry Disability Index and the visual analog scale. Body composition and spinal alignment were measured using bioelectrical impedance and raster stereography. The isokinetic moments of trunk extensor and flexor were measured before and after the training period. Results: The ERSG showed a significant decrease in back pain compared to the CON. There was a significant decrease in levels of fat in the ERSG, although no differences were shown in terms of muscle mass. However, there was an increased basal metabolic rate (BMR) in the ERSG. Spinal alignment in the ERSG significantly improved. The peak torques of the trunk extensor in the ERSG were also significantly increased. Conclusion: It can be inferred that the ERS exercise can decrease fat and improve the trunk extensor strength through increased BMR, leading to better spinal alignment and reducing back pain in elderly women with CLBP.
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Fogarty S, McInerney C, Hay P. Pregnancy-related Pelvic Girdle Pain and Pregnancy Massage: Findings from a Subgroup Analysis of an Observational Study. Int J Ther Massage Bodywork 2020; 13:1-8. [PMID: 32523639 PMCID: PMC7260134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Pregnancy-related pelvic girdle pain (PPGP) significantly impacts women's lives both physically and psychologically. Given the severity and impact of PPGP on pregnancy, the authors anticipated that pregnant women with PPGP might respond differently to massage than pregnant women without PPGP. PURPOSE The aim of the study was to further analyze a published 2017 study to assess the response of pregnancy massage in participants with and without PPGP. SETTING Two massage clinics, one in Sydney and one in Melbourne, recruited participants from December 2016 to December 2017. PARTICIPANTS Nineteen women with PPGP and 78 without PPGP. RESEARCH DESIGN PPGP and non-PPGP women receiving at least one massage, with outcome measures assessed immediately prior to and after massage, and again one week postmassage. MAIN OUTCOME MEASURES Visual analog scales for pain, stress, range of movement, sleep, and self-reported side effects of massage. RESULTS Both groups changed significantly and similarly over time for measures of pain, stress, range of motion, and sleep (all p < .05). Post hoc analysis found significant reduction in all outcome measures immediately following massage, but returned to baseline at one week postmassage for all measures except pain, which remained reduced for the PPGP group (49.79±25.68 to 34.75±34.75, p = .03, effect size 0.593), and stress remained reduced in the non-PPGP group (33.36±21.54 to 24.90±19.18, p = .002, effect size 0.373). The PPGP group entered the study with higher baseline levels of pain (p = .01) and a greater restriction in range of motion (p = .006) than the non-PPGP group. There was no difference in the number of side effects experienced between the two groups (p = .130). CONCLUSIONS Although PPGP clients report greater pain and restriction in range of motion at baseline than non-PPGP clients, the response to pregnancy massage was similar. Results support a role of pregnancy massage in the management of PPGP. More research on massage for PPGP is needed to confirm a lasting effect of pain reduction from massage.
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Affiliation(s)
- Sarah Fogarty
- School of Medicine, Western Sydney University, Sydney NSW, Australia,Corresponding author: Sarah Fogarty, PhD, School of Medicine, Western Sydney University, PO Box 8218 Ferntree Gully, Victoria, Australia 3156,
| | | | - Phillipa Hay
- School of Medicine, Western Sydney University, Sydney NSW, Australia
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Meyblum J, Boukebous B, Diviné P, Cottin P, Flouzat Lachaniette CH, Bégué T. Influence of positioning of L4-5 disc prostheses on functional outcomes and sagittal balance: 2-year follow-up of a cohort of 38 patients. J Neurosurg Spine 2020; 32:842-849. [PMID: 32084639 DOI: 10.3171/2019.12.spine191117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 12/05/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The main objective of this study was to evaluate the influence of L4-5 total disc replacement (TDR) positioning on functional outcome at the 2-year follow-up. The secondary objective was to assess its influence on sagittal balance. METHODS Prospective data were compiled for 38 single-level L4-5 ProDisc-O TDRs. Anteroposterior placement (APP) was the distance between the center of the implant and the center of the L5 endplate divided by the total length of the L5 endplate. This ratio was expressed as a percentage (APP 0%-49%, anterior off-centering; 50%, perfect centering; and 51%-100%, posterior off-centering). The patients were divided into 3 groups depending on the APP and using quartile values: group 1, anterior placement (APP 0%-46%); group 2, central placement (APP 46.1%-52%, the 2 central quartiles); and group 3, posterior placement (APP 52.1%-100%). The sagittal balance parameters assessed were overall lordosis, segmental lordosis, and pelvic incidence. Adequate lordosis was defined for each patient according to their pelvic incidence. The Oswestry Disability Index and visual analog scale (VAS) scores for back and leg pain were assessed. RESULTS The average APP was 48% (range 40%-64%). There were 10 patients in group 1, 18 in group 2, and 10 in group 3. There was a significant difference in functional outcomes among the 3 groups. APP influenced the VAS back (p = 0.04) and VAS leg (p = 0.05) scores. Group 1 consistently showed the highest performance scores. No significant association between APP and the sagittal balance parameters was found. Patients who had preoperative sagittal imbalance or those who significantly modified their balance after the surgery had the poorest outcomes. CONCLUSIONS Disc prostheses at L4-5 seem to provide better functional outcome when they are positioned anteriorly to the center of the vertebral body.
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Affiliation(s)
- Jean Meyblum
- 1Department of Orthopaedic and Traumatological Surgery, University of Paris-Sud
| | - Baptiste Boukebous
- 2Department of Orthopaedic and Traumatological Surgery, University of Paris-Nord Val de Seine; and
| | - Pierre Diviné
- 1Department of Orthopaedic and Traumatological Surgery, University of Paris-Sud
| | - Philippe Cottin
- 1Department of Orthopaedic and Traumatological Surgery, University of Paris-Sud
| | | | - Thierry Bégué
- 1Department of Orthopaedic and Traumatological Surgery, University of Paris-Sud
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Hasenöhrl T, Windschnurer T, Dorotka R, Ambrozy C, Crevenna R. Prescription of individual therapeutic exercises via smartphone app for patients suffering from non-specific back pain : A qualitative feasibility and quantitative pilot study. Wien Klin Wochenschr 2020; 132:115-123. [PMID: 32060724 PMCID: PMC7080705 DOI: 10.1007/s00508-020-01616-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/22/2020] [Indexed: 12/19/2022]
Abstract
Background The purpose of this qualitative study was the assessment of the feasibility and acceptance of orthopedists prescribing individualized therapeutic exercises via a smartphone app to patients suffering from non-specific back pain. Methods A total of 27 patients (mean age 44.8 ± 13.2 years) diagnosed with acute non-specific back pain were prescribed individually chosen therapy exercises via a smartphone app. Before the patients started and after 4 weeks of exercising all participants went through an assessment protocol consisting of questionnaires (Oswestry Disability Index [ODI], Short Form-36 [SF-36], International Physical Activity Questionnaire [IPAQ], Work Ability Index [WAI], Visual Analogue Scale [VAS] back pain, sociodemographic parameters), assessment of functional parameters (handgrip strength, timed up and go test). With 16 randomly chosen patients semi-structured interviews were undertaken at the end of the intervention period. Interview transcripts were analyzed using thematic analysis. Power analysis and a priori sample size calculations were undertaken with the quantitative data. Results From the interviews four thematic categories emerged: prior exercise experience, evaluation of exercise intensity, communication with physician via smartphone app, and variability of exercise location. Quantitative analysis of secondary data showed significant improvements in back pain (ODI) as well as quality of life domains “physical functioning”, “bodily pain” and “vitality” (SF-36) of which “bodily pain” was sufficiently powered with the current sample size. Conclusion The prescription of therapeutic exercises via smartphone app to patients suffering from non-specific back pain is feasible and well-accepted in patients at all ages. Pilot data additionally pointed towards efficacy of the intervention.
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Affiliation(s)
- Timothy Hasenöhrl
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Thomas Windschnurer
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Ronald Dorotka
- Orthopaedic City Center-medCLINIC, Dominikanerbastei 3, 1010, Vienna, Austria
| | - Clemens Ambrozy
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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La Touche R, Pérez-Fernández M, Barrera-Marchessi I, López-de-Uralde-Villanueva I, Villafañe JH, Prieto-Aldana M, Suso-Martí L, Paris-Alemany A. Psychological and physical factors related to disability in chronic low back pain. J Back Musculoskelet Rehabil 2019; 32:603-611. [PMID: 30584119 DOI: 10.3233/bmr-181269] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Chronic low back pain (CLBP) is a public health problem that causes high levels of disability. Psychological and physical factors could play a critical role in the disability perception of patients. OBJECTIVE The objective was to identify the psychological and physical factors associated with CLBP disability in patients and assess differences between asymptomatic subjects and CLBP patients through physical tests and psychological self-reports. METHODS A cross-sectional study was performed. Total sample of 80 participants were classified into two groups: patients with CLBP (n= 49) and asymptomatic subjects (i.e. the control group) (n= 31). The physical tests included lower back range of motion (LBROM), postural stability, lower back strength (LBS), and lumbopelvic motor control tests. The psychological self-reports included low back disability (Roland Morris Disability Questionnaire), self-efficacy, pain catastrophizing, and pain-related fear. RESULTS Self-efficacy and LBS displayed moderate negative correlations with disability in patients with CLBP (R=-0.47 and -0.40, respectively). Disability was predicted by self-efficacy and LBROM (β=-0.45 and -033 respectively, p< 0.01), explaining 30% of the variance in these patients. The comparative analysis showed statistically significant differences between groups in the physical/psychological variables (p< 0.01); however, the effect-sizes were small for all these variables. CONCLUSIONS The results of this study highlight the relevance of psychological and physical factors in CLBP patient disability. Evaluation and treatment in CLBP patients should take these factors into account.
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Affiliation(s)
- Roy La Touche
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Dolor Craneofacial y Neuromusculoesquelético, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain
| | - Marcos Pérez-Fernández
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Ignacio Barrera-Marchessi
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Ibai López-de-Uralde-Villanueva
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Dolor Craneofacial y Neuromusculoesquelético, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain
| | | | - María Prieto-Aldana
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Luis Suso-Martí
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Alba Paris-Alemany
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Dolor Craneofacial y Neuromusculoesquelético, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain
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Bakirezer SD, Yaltirik CK, Kaya AH, Yilmaz SG, Ozdogan S, Billur D, Isbir T. The Evaluation of Glutathione Reductase and Malondialdehyde Levels in Patients With Lumbar Disc Degeneration Disease. In Vivo 2019; 33:811-814. [PMID: 31028201 PMCID: PMC6559890 DOI: 10.21873/invivo.11543] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 03/26/2019] [Accepted: 03/29/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND/AIM Increased oxidative stress plays a crucial role in pathogenesis of various diseases. The present study aims to investigate glutathione reductase (GR) and malondialdehyde (MDA) enzymes as markers of oxidative stress mechanisms in lumbar disc degeneration disease (LDDD). PATIENTS AND METHODS The study group consisted of 39 patients diagnosed with LDD and 37 healthy individuals in the control group. The enzyme-linked immunosorbent assay (ELISA) method was used to determine serum GR and MDA levels in the two study groups. RESULTS Serum GR levels were significantly lower (p=0.008), while MDA levels were significantly higher in the patient group compared to the controls (p=0.025). CONCLUSION Oxidative stress mechanisms play a crucial role in disc degeneration and GR deficiency could be an eligible risk factor for LDDD.
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Affiliation(s)
- Selvi Duman Bakirezer
- Department of Molecular Medicine, Institute of Health Sciences, Yeditepe University, Istanbul, Turkey
| | - Cumhur Kaan Yaltirik
- Department of Neurosurgery, Faculty of Medicine, Yeditepe University, Istanbul, Turkey
| | - Ahmet Hilmi Kaya
- Department of Neurosurgery, Faculty of Medicine, Yeditepe University, Istanbul, Turkey
| | - Seda Gulec Yilmaz
- Department of Molecular Medicine, Institute of Health Sciences, Yeditepe University, Istanbul, Turkey
| | - Selcuk Ozdogan
- Sancaktepe Sehit Prof Dr İlhan Varank Training and Research Hospital, Istanbul, Turkey
| | - Deryanaz Billur
- Department of Molecular Medicine, Institute of Health Sciences, Yeditepe University, Istanbul, Turkey
| | - Turgay Isbir
- Department of Medical Biology, Faculty of Medicine, Yeditepe University, Istanbul, Turkey
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Need for Two-Year Patient-Reported Outcomes Score for Lumbar Spine Surgery Is Procedure-Specific: Analysis From a Prospective Longitudinal Spine Registry. Spine (Phila Pa 1976) 2017; 42:1331-1338. [PMID: 28146018 DOI: 10.1097/brs.0000000000002087] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective analysis of prospectively collected data. OBJECTIVE The aim of this study was to determine whether 1-year patient-reported outcomes (PROs) can accurately assess effective care for patients undergoing surgery for degenerative lumbar spine disease. SUMMARY OF BACKGROUND DATA Prospective longitudinal PROs registries provide a means to accurately assess outcomes and determine the relative effectiveness of various spine treatments. Obtaining long-term PROs can be costly and challenging. METHODS Patients enrolled into a prospective registry who underwent lumbar spine surgery for degenerative disease were included. Baseline, 1-year, and 2-year Oswestry Disability Index (ODI) scores were captured. Previously published minimum clinically important difference (MCID) for ODI (14.9) was used. Multivariable linear regression model was created to derive model-estimated 2-year ODI scores. Absolute differences between 1-year and 2-year ODI were compared to absolute differences between 2-year and model-estimated 2-year ODI. Concordance rates in achieving MCID at 1-year and 2-year and predictive values were calculated. RESULTS A total of 868 patients were analyzed. One-year ODI scores differed from 2-year scores by an absolute difference of 9.7 ± 8.9 points and predictive model-estimated 2-year scores differed from actual 2-year scores by 8.8 ± 7.3 points. The model-estimated 2-year ODI was significantly different than actual 1-year ODI in assessing actual 2-year ODI for all procedures (P = 0.001) except for primary (P = 0.932) and revision microdiscectomy (P = 0.978) and primary laminectomy (P = 0.267). The discordance rates of achieving or not achieving MCID for ODI ranged from 8% to 27%. Concordance rate was about 90% for primary and revision microdiscectomy. The positive and negative predictive value of 1-year ODI to predict 2-year ODI was 83% and 67% for all procedures and 92% and 67% for primary and 100% and 86% for revision microdiscectomy respectively. CONCLUSION One-year disability outcomes can potentially estimate 2-year outcomes for patient populations, but cannot reliably predict 2-year outcomes for individual patients, except for patients undergoing primary and revision microdiscectomy. LEVEL OF EVIDENCE 4.
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Cezarino RS, Cardoso JR, Rodrigues KN, Magalhães YS, Souza TYD, Mota LMHD, Bonini‐Rocha AC, McVeigh J, Martins WR. Lombalgia crônica em pacientes com lúpus eritematoso sistêmico: prevalência e preditores da força muscular de extensão de tronco e sua correlação com a incapacidade. REVISTA BRASILEIRA DE REUMATOLOGIA 2017. [DOI: 10.1016/j.rbr.2017.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Cezarino RS, Cardoso JR, Rodrigues KN, Magalhães YS, Souza TYD, Mota LMHD, Bonini-Rocha AC, McVeigh J, Martins WR. Chronic low back pain in patients with systemic lupus erythematosus: prevalence and predictors of back muscle strength and its correlation with disability. REVISTA BRASILEIRA DE REUMATOLOGIA 2017; 57:438-444. [PMID: 28461080 DOI: 10.1016/j.rbre.2017.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 03/06/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To determine the prevalence of Chronic Low Back Pain and predictors of Back Muscle Strength in patients with Systemic Lupus Erythematosus. METHODS Cross-sectional study. Ninety-six ambulatory patients with lupus were selected by non-probability sampling and interviewed and tested during medical consultation. The outcomes measurements were: Point prevalence of chronic low back pain, Oswestry Disability Index, Tampa Scale of Kinesiophobia, Fatigue Severity Scale and maximal voluntary isometric contractions of handgrip and of the back muscles. Correlation coefficient and multiple linear regression were used in statistical analysis. RESULTS Of the 96 individuals interviewed, 25 had chronic low back pain, indicating a point prevalence of 26% (92% women). The correlation between the Oswestry Index and maximal voluntary isometric contraction of the back muscles was r=-0.4, 95% CI [-0.68; -0.01] and between the maximal voluntary isometric contraction of handgrip and of the back muscles was r=0.72, 95% CI [0.51; 0.88]. The regression model presented the highest value of R2 being observed when maximal voluntary isometric contraction of the back muscles was tested with five independent variables (63%). In this model handgrip strength was the only predictive variable (β=0.61, p=0.001). CONCLUSIONS The prevalence of chronic low back pain in individuals with systemic lupus erythematosus was 26%. The maximal voluntary isometric contraction of the back muscles was 63% predicted by five variables of interest, however, only the handgrip strength was a statistically significant predictive variable. The maximal voluntary isometric contraction of the back muscles presented a linear relation directly proportional to handgrip and inversely proportional to Oswestry Index i.e. stronger back muscles are associated with lower disability scores.
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Affiliation(s)
| | - Jefferson Rosa Cardoso
- Universidade Estadual de Londrina (UEL), Laboratório de Biomecânica e Epidemiologia Clínica, Londrina, PR, Brazil
| | | | | | | | | | | | - Joseph McVeigh
- Ulster University, School of Health Sciences, Centre for Health and Rehabilitation Technologies (CHaRT), Coleraine, Northern Ireland
| | - Wagner Rodrigues Martins
- Universidade de Brasília (UnB), Curso de Fisioterapia, Brasília, DF, Brazil; Universidade de Brasília (UnB), Programa de Pós-Graduação em Ciências da Reabilitação, Brasília, DF, Brazil.
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Abstract
STUDY DESIGN Systematic review of cross-cultural adaptation of the Oswestry Disability Index (ODI). OBJECTIVE The aim of this study was to evaluate the translation procedures for and measurement properties of cross-cultural adaptations of the ODI. SUMMARY OF BACKGROUND DATA The ODI is the most commonly used questionnaire to determine the outcome of low back pain, and has been translated into many other languages, such as Danish, Greek, and Korean, and adapted for use in different countries. METHODS PubMed, the Cochrane Library, Medline, and EMBASE were searched from the time they were established to January 2015. Studies related to cross-cultural adaptation of the ODI in a specific language/culture were included. Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures and Quality Criteria for Psychometric Properties of Health Status Questionnaire were used for assessment. RESULTS This study included 27 versions of ODI adaptations in 24 different languages/cultures. Only the Danish-Danish adaptation employed all six of the cross-cultural adaptation processes. Expert committee review (three of 27), back translation (eight of 27), and pretesting (nine of 27) were conducted in very few studies. The Polish-Polish (two) adaptation reported all (nine of nine) the measurement properties, whereas the Traditional Chinese-Taiwan and Hungarian-Hungarian adaptations reported six of them. Content validity (16/27), construct validity (17/27), and reliability (22/27) were determined in a relatively high number of studies, whereas agreement (three of 27), responsiveness (12/27), floor and ceiling effects (six of 27), and interpretability (one of 27) were only determined in some studies. CONCLUSION We recommend the Traditional Chinese-Taiwan, Simplified Chinese-Mandarin Chinese, Danish-Danish, German-Swiss, Hungarian-Hungarian, Italian-Italian, and Polish-Polish (two) versions for application, but Traditional Chinese-Hong Kong, French-Swiss, Japanese-Japanese (two), Polish-Polish (two), Tamil-Indian, and Thai-Thai versions may need more research. Furthermore, supplementary tests for the adaptations are necessary, especially for assessing agreement, responsiveness, and interpretability. LEVEL OF EVIDENCE 1.
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Bae HW, Davis RJ, Lauryssen C, Leary S, Maislin G, Musacchio MJ. Three-Year Follow-up of the Prospective, Randomized, Controlled Trial of Coflex Interlaminar Stabilization vs Instrumented Fusion in Patients With Lumbar Stenosis. Neurosurgery 2016; 79:169-81. [DOI: 10.1227/neu.0000000000001237] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Abstract
BACKGROUND:
Traditional surgical options for the treatment of symptomatic lumbar spinal stenosis include decompression alone vs decompression and fusion; both options have potential limitations.
OBJECTIVE:
To report the 36-month follow-up analysis of the coflex Interlaminar Stabilization (Paradigm Spine, LLC, New York, New York) after decompression, examined under a Food and Drug Administration investigational device exemption clinical trial, which is intended to provide stabilization after decompression while preserving normal segmental motion at the treated level.
METHODS:
The coflex trial was a prospective, randomized investigational device exemption study conducted at 21 clinical sites in the United States. Baseline and follow-up visits collected demographics, clinical, and radiographic status. The primary endpoint was a measure of composite clinical success 24 months postoperatively. For this current 36-month analysis, composite clinical success was calculated using analogous methods.
RESULTS:
Composite clinical success at 36 months was achieved by 62.2% among 196 coflex Interlaminar Stabilization patients and 48.9% among 94 fusion patients (difference = 13.3%, 95% confidence interval, 1.1%-25.5%, P =.03). Bayesian posterior probabilities for noninferiority (margin = −10%) and superiority of cofle Interlaminar Stabilization vs fusion were >0.999 and 0.984, respectively. Substantial and comparable improvements were observed in both groups for patient-reported outcomes, although the percentage with a clinically significant improvement (≥15) in the Oswestry Disability Index seemed larger for the coflex Interlaminar Stabilization group relative to the fusion group (P =.008). Radiographic measurements maintained index level and adjacent level range of motion in coflex Interlaminar Stabilization patients, although range of motion at the level superior to fusion was significantly increased (P =.005).
CONCLUSION:
Coflex Interlaminar Stabilization for stenosis is proven to be effective and durable at improving overall composite clinical success without altering normal spinal kinematic motion at the index level of decompression or adjacent levels.
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Affiliation(s)
- Hyun W. Bae
- The Spine Center, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
| | | | | | - Scott Leary
- Scripps Memorial Hospital, La Jolla, California
| | - Greg Maislin
- Biomedical Statistical Consulting, Wynnewood, Pennsylvania
| | - Michael J. Musacchio
- Department of Neurosurgery, NorthShore Neurological Institute, NorthShore University Health-System, Evanston, Illinois
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Asher AL, Chotai S, Devin CJ, Speroff T, Harrell FE, Nian H, Dittus RS, Mummaneni PV, Knightly JJ, Glassman SD, Bydon M, Archer KR, Foley KT, McGirt MJ. Inadequacy of 3-month Oswestry Disability Index outcome for assessing individual longer-term patient experience after lumbar spine surgery. J Neurosurg Spine 2016; 25:170-80. [PMID: 26989974 DOI: 10.3171/2015.11.spine15872] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Prospective longitudinal outcomes registries are at the center of evidence-driven health care reform. Obtaining real-world outcomes data at 12 months can be costly and challenging. In the present study, the authors analyzed whether 3-month outcome measurements sufficiently represent 12-month outcomes for patients with degenerative lumbar disease undergoing surgery. METHODS Data from 3073 patients undergoing elective spine surgery for degenerative lumbar disease were entered into a prospective multicenter registry (N(2)QOD). Baseline, 3-month, and 12-month follow-up Oswestry Disability Index (ODI) scores were recorded. The absolute differences between actual 12- and 3-month ODI scores was evaluated. Additionally, the authors analyzed the absolute difference between actual 12-month ODI scores and a model-predicted 12-month ODI score (the model used patients' baseline characteristics and actual 3-month scores). The minimal clinically important difference (MCID) for ODI of 12.8 points and the substantial clinical benefit (SCB) for ODI of 18.8 points were used based on the previously published values. The concordance rate of achieving MCID and SCB for ODI at 3-and 12-months was computed. RESULTS The 3-month ODI scores differed from 12-month scores by an absolute difference of 11.9 ± 10.8, and predictive modeling estimations of 12-month ODI scores differed from actual 12-month scores by a mean (± SD) of 10.7 ± 9.0 points (p = 0.001). Sixty-four percent of patients (n = 1982) achieved an MCID for ODI at 3 months in comparison with 67% of patients (n = 2088) by 12 months; 51% (n = 1731) and 61% (n = 1860) of patients achieved SCB for ODI at 3 months and 12 months, respectively. Almost 20% of patients had ODI scores that varied at least 20 points (the point span of an ODI functional category) between actual 3- and 12-month values. In the aggregate analysis of achieving MCID, 77% of patients were concordant and 23% were discordant in achieving or not achieving MCID at 3 and 12 months. The discordance rates of achieving or not achieving MCID for ODI were in the range of 19% to 27% for all diagnoses and treatments (decompression with and without fusion). The positive and negative predictive value of 3-months ODI to predict 12-month ODI was 86% and 60% for MCID and 82% and 67% for SCB. CONCLUSIONS Based on their findings, the authors conclude the following: 1) Predictive methods for functional outcome based on early patient experience (i.e., baseline and/or 3-month data) should be used to help evaluate the effectiveness of procedures in patient populations, rather than serving as a proxy for long-term individual patient experience. 2) Prospective longitudinal registries need to span at least 12 months to determine the effectiveness of spine care at the individual patient and practitioner level.
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Affiliation(s)
- Anthony L Asher
- Department of Neurological Surgery, Carolina Neurosurgery and Spine Associates and Neurological Institute, Carolinas Healthcare System, Charlotte, North Carolina
| | - Silky Chotai
- Department of Orthopaedic Surgery, Vanderbilt Spine Center, Vanderbilt University Medical Center
| | - Clinton J Devin
- Department of Orthopaedic Surgery, Vanderbilt Spine Center, Vanderbilt University Medical Center
| | - Theodore Speroff
- Geriatric Research Education Clinical Center, Tennessee Valley Health System, Veterans Health Administration
| | - Frank E Harrell
- Department of Biostatistics, Vanderbilt University School of Medicine
| | - Hui Nian
- Department of Biostatistics, Vanderbilt University School of Medicine
| | - Robert S Dittus
- Geriatric Research Education Clinical Center, Tennessee Valley Health System, Veterans Health Administration;,Departments of Medicine and Biostatistics, Division of General Internal Medicine and Public Health, Center for Health Services Research, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Praveen V Mummaneni
- Department of Neurological Surgery, University of California, San Francisco, California
| | - John J Knightly
- Department of Neurosurgery, Atlantic Neurosurgical Specialists, Morristown, New Jersey
| | - Steven D Glassman
- Department of Orthopedic Surgery, University of Louisville and the Norton Leatherman Spine Center, Louisville, Kentucky
| | - Mohamad Bydon
- Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota
| | - Kristin R Archer
- Department of Orthopaedic Surgery, Vanderbilt Spine Center, Vanderbilt University Medical Center;,Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville; and
| | - Kevin T Foley
- Department of Neurosurgery, University of Tennessee Health Sciences Center, Semmes-Murphey Neurologic & Spine Institute, Memphis, Tennessee
| | - Matthew J McGirt
- Department of Neurological Surgery, Carolina Neurosurgery and Spine Associates and Neurological Institute, Carolinas Healthcare System, Charlotte, North Carolina
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Sae-Jung S, Jirarattanaphochai K. Outcomes of lumbar facet syndrome treated with oral diclofenac or methylprednisolone facet injection: a randomized trial. INTERNATIONAL ORTHOPAEDICS 2016; 40:1091-8. [DOI: 10.1007/s00264-016-3154-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 03/06/2016] [Indexed: 10/22/2022]
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24
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Glassman SD, Carreon LY, Ghogawala Z, Foley KT, McGirt MJ, Asher AL. Benefit of Transforaminal Lumbar Interbody Fusion vs Posterolateral Spinal Fusion in Lumbar Spine Disorders. Neurosurgery 2015; 79:397-405. [DOI: 10.1227/neu.0000000000001118] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND:
Despite increasing use and potential benefits of transforaminal lumbar interbody fusion (TLIF) compared with posterolateral spinal fusion (PSF), previous studies have not documented improved clinical outcomes with TLIF vs PSF.
OBJECTIVE:
To compare the outcomes of TLIF with PSF in patients with spondylolisthesis, spinal stenosis, and adjacent level disease.
METHODS:
The National Neurosurgical Quality and Outcomes Database was queried for patients who had a lumbar fusion. Eighty-five percent (1722) of enrolled cases had 12-month follow-up data. There were 306 PSF patients and 1230 TLIF patients. PSF cases within each diagnostic subgroup were propensity-matched to patients who had TLIF. Sufficient propensity-matched controls were available for patients with spondylolisthesis (109), spinal stenosis (63), and adjacent segment disease (47).
RESULTS:
Operating room time, estimated blood loss, and length of stay were similar between PSF and TLIF in all 3 propensity-matched groups. In the spondylolisthesis group, there was a greater improvement in Oswestry Disability Index (ODI) with TLIF vs PSF at 3 months (19.4 vs 26.0, P =.009), 12 months (20.8 vs 29.3, P =.001), and in percentage reaching minimal clinically important difference at 12 months (80% vs 62%, P =.007). There were no differences in ODI improvement between PSF and TLIF in the stenosis or adjacent segment disease groups.
CONCLUSION:
TLIF generated more favorable ODI outcomes than PSF for patients with spondylolisthesis, but not for patients with spinal stenosis or adjacent segment disease. There was also equivalence in operating room time and estimated blood loss between TLIF and PSF, potentially altering the long-standing assumption that PSF is a simpler procedure.
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Affiliation(s)
| | | | - Zoher Ghogawala
- †Alan and Jacqueline Stuart Spine Center, Department of Neurosurgery, Lahey Hospital and Medical Center, Burlington, Massachusetts
| | - Kevin T. Foley
- §Department of Neurosurgery, University of Tennessee Health Science Center and Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee
| | - Matthew J. McGirt
- ¶Carolina Neurosurgery & Spine Associates, Charlotte, North Carolina
| | - Anthony L. Asher
- ¶Carolina Neurosurgery & Spine Associates, Charlotte, North Carolina
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25
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K-ROD internal fixation system ameliorates lumbar adjacent segment degeneration: Two-year clinical outcomes of 66 patients. Tissue Eng Regen Med 2015. [DOI: 10.1007/s13770-015-0089-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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