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Sethi G, Aljawadi A, Choudhry MN, Fischer B, Divecha HM, Leach J, Arnall F, Verma R, Yasin N, Mohammad S, Siddique I. Concomitant back pain as a predictor of outcome after single level lumbar micro-decompressive surgery - A study of 995 patients. J Orthop 2019; 16:478-482. [PMID: 31680735 DOI: 10.1016/j.jor.2019.08.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 08/11/2019] [Indexed: 11/29/2022] Open
Abstract
Objective To determine if preoperative leg pain and low back pain severity affected postoperative outcome. Method Prospectively collected Spine-Tango data was analysed for 995 consecutive patients who underwent a primary, single level, lumbar micro-decompression/microdiscectomy at a single tertiary spinal centre. Result At 3 months, 72% of patients were satisfied with the outcome of surgery. Pre-operative low back pain was a significant predictor of poor outcome (P < 0.01). Conclusion Our study has shown that patients with a low back pain VAS of 6 or more have a significantly greater chance of a poor outcome following primary lumbar microdecompressive/microdiscectomy surgery.
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Affiliation(s)
- G Sethi
- Trauma and Orthopaedics- Spinal, University of Salford, Salford, Manchester, UK.,School of Health Sciences Allerton Building, University of Salford, Fredrick Road Campus, M6 6PU, UK
| | - A Aljawadi
- Trauma and Orthopaedics, University of Salford, Salford, Fredrick Road Campus, M6 6PU, UK
| | - M N Choudhry
- Spinal Registrar, Department of Spinal Surgery, Salford Royal NHS Trust, Stott Lane, Salford, M6 8HD, UK
| | | | - H M Divecha
- StR Trauma & Orthopaedics, North Western Deanery, UK
| | - J Leach
- Consultant Neurosurgeon, Department of Neutosurgery, Salford Royal NHS Trust, Stott Lane, Salford, M6 8HD, UK
| | - F Arnall
- Consultant Physiotherapist. Lecturer Fellow Higher Education Academy, MSc Trauma & Orthopaedics Academic Module Lead, School of Health Sciences Allerton Building C711, University of Salford, Fredrick Road Campus, M6 6PU, UK
| | - R Verma
- Consultant Spinal Surgeon, Department of Spinal Surgery, Salford Royal NHS Trust, Stott Lane, Salford, M6 8HD, UK
| | - N Yasin
- Consultant Spinal Surgeon, Department of Spinal Surgery, Salford Royal NHS Trust, Stott Lane, Salford, M6 8HD, UK
| | - S Mohammad
- Consultant Spinal Surgeon, Department of Spinal Surgery, Salford Royal NHS Trust, Stott Lane, Salford, M6 8HD, UK
| | - I Siddique
- Consultant Spinal Surgeon, Department of Spinal Surgery, Salford Royal NHS Trust, Stott Lane, Salford, M6 8HD, UK
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Abstract
Anal fistulae management is a balance of effective healing and the risk of incontinence from sphincter division. This review examines the heterogeneity in the literature of treatment options and the difficulties this presents for surgical training and decision making.
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Affiliation(s)
- J Phillips
- Surgical Registrar (ST7) in the Department of General Surgery, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust, Cottingham, East Riding of Yorkshire HU16 5JQ
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Koumantakis GA, Arnall F, Cooper RG, Oldham JA. Paraspinal muscle EMG fatigue testing with two methods in healthy volunteers. Reliability in the context of clinical applications. Clin Biomech (Bristol, Avon) 2001; 16:263-6. [PMID: 11240063 DOI: 10.1016/s0268-0033(00)00113-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Comparison of the accuracy of surface electromyogram for back muscle endurance assessment with two different tests. DESIGN Test-retest measurements in 16 healthy volunteers on two separate occasions for each test under controlled conditions. BACKGROUND Back muscle endurance is considered important in low back pain rehabilitation. Reliability of paraspinal muscle endurance assessment is a pre-requisite for accurate and meaningful clinical applications of the technique. METHODS All participants performed each test twice. A direct comparison was made between two popular fatigue testing methods, the modified Biering-Sørensen and a 60% maximum voluntary isometric contraction in the upright position during which time fatigue was assessed from the electromyogram spectral and amplitude analysis. RESULTS Reproducibility of initial median frequency was excellent for both tests. Normalised median frequency slope values were more reliable with the 60% maximum voluntary contraction upright test. The clinical applicability of these measures in detecting significant differences after patient rehabilitation is recommended. Root mean square had very large between-day error for both tests.
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Affiliation(s)
- G A Koumantakis
- Centre for Rehabilitation Science, Central Manchester Healthcare Trust, University of Manchester, Oxford Road, Manchester M13 9WL, UK.
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