Low back pain in young elite field hockey players, football players and speed skaters: Prevalence and risk factors.

By Kamruz Zaman
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Low back pain in young elite field hockey players, football players and speed skaters: Prevalence and risk factors.

J Back Musculoskelet Rehabil. 2015;28(1):67-73

Authors: van Hilst J, Hilgersom NF, Kuilman MC, F M Kuijer PP, Frings-Dresen MH

Abstract
BACKGROUND: Low back pain (LBP) hampers performance and experiencing an episode of LBP is strongly associated with recurrent episodes.
OBJECTIVE: The prevalence of LBP and associated risk factors among young elite athletes in popular sports in the Netherlands were studied.
METHODS: A questionnaire-based cross-sectional study was performed among 236 young elite athletes aged between 14–25 years in field hockey, football and speed skating.
RESULTS: One hundred and eighty one (n = 181) athletes responded (response rate 77%). The overall, 12-month prevalence of LBP for the three sports was 60%: field hockey 56%, football 64% and speed skating 60%. Satisfaction with their own performance (OR = 0.5 95%CI:0.3–0.9) and with the coaching staff (OR = 0.5, 95%CI:0.4–0.8) were associated with a lower occurrence of LBP in field hockey. No sport-related risk factors were found in football. In speed skating more training hours (OR = 1.1, 95%CI:1.0–1.2), performance of Pilates (OR = 4.1, 95%CI:1.1–15.7) and more time spent on warming up (OR = 1.1, 95%CI:1.0–1.1) were associated with the occurrence of LBP.
CONCLUSIONS: Prevalence of LBP among young elite athletes compared to the general age-related population was 3–5 times higher. Sport-related risk factors of LBP were found in field hockey and in speed skating.

PMID: 24968798 [PubMed – indexed for MEDLINE]

One-stage posterior debridement, transforaminal lumbar interbody fusion and instrumentation in treatment of lumbar spinal tuberculosis: a retrospective case series.

By London Spine
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One-stage posterior debridement, transforaminal lumbar interbody fusion and instrumentation in treatment of lumbar spinal tuberculosis: a retrospective case series.

Arch Orthop Trauma Surg. 2013 Mar;133(3):333-41

Authors: Zhang HQ, Lin MZ, Li JS, Tang MX, Guo CF, Wu JH, Liu JY

Abstract
PURPOSE: The purpose of this study is to compare the clinical outcomes of surgical management by one-stage posterior debridement, transforaminal lumbar interbody fusion (TLIF) and instrumentation and combined posterior and anterior approaches for lumbar spinal tuberculosis, and determine the clinical effectiveness of the posterior only surgical treatment for lumbar spinal TB at the same time.
METHODS: Thirty-seven patients who suffered lumbar tuberculosis were treated by two different surgical procedures in our center from May 2004 to June 2012. All the cases were divided into two groups: 19 cases in Group A underwent one-stage posterior debridement, TLIF and instrumentation, and 18 cases in Group B underwent posterior instrumentation, anterior debridement and bone graft in a single-stage procedure. The operation time, blood loss, lumbar kyphotic angle, recovery of neurological function and fusion time were, respectively, compared between Group A and Group B.
RESULTS: The average follow-up period for Group A was 46.6 ± 16.7 months, and for Group B, 47.5 ± 15.0 months. It was obvious that the average operative duration and blood loss of Group A was less than those of Group B. Lumbar tuberculosis was completely cured and the grafted bones were fused in 10 months in all patients. There was no persistence or recurrence of infection and no differences in the radiological results in both groups. The kyphosis was significantly corrected after surgical management. The average pretreatment ESR was 60.7 ± 22.5 mm/h, which became normal (9.0 ± 2.8 mm/h) within 3 months in all patients.
CONCLUSIONS: Surgical management by one-stage posterior debridement, TLIF and instrumentation for lumbar tuberculosis is feasible and effective. This approach obtained better clinical outcomes than combined posterior and anterior surgeries.

PMID: 23242452 [PubMed – in process]

Validation and application of an intervertebral disc finite element model utilizing independently constructed tissue-level constitutive formulations that are nonlinear, anisotropic, and time-dependent.

By London Spine
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Validation and application of an intervertebral disc finite element model utilizing independently constructed tissue-level constitutive formulations that are nonlinear, anisotropic, and time-dependent.

J Biomech. 2014 Aug 22;47(11):2540-6

Authors: Jacobs NT, Cortes DH, Peloquin JM, Vresilovic EJ, Elliott DM

Abstract
Finite element (FE) models are advantageous in the study of intervertebral disc mechanics as the stress-strain distributions can be determined throughout the tissue and the applied loading and material properties can be controlled and modified. However, the complicated nature of the disc presents a challenge in developing an accurate and predictive disc model, which has led to limitations in FE geometry, material constitutive models and properties, and model validation. The objective of this study was to develop a new FE model of the intervertebral disc, to validate the model’s nonlinear and time-dependent responses without tuning or calibration, and to evaluate the effect of changes in nucleus pulposus (NP), cartilaginous endplate (CEP), and annulus fibrosus (AF) material properties on the disc mechanical response. The new FE disc model utilized an analytically-based geometry. The model was created from the mean shape of human L4/L5 discs, measured from high-resolution 3D MR images and averaged using signed distance functions. Structural hyperelastic constitutive models were used in conjunction with biphasic-swelling theory to obtain material properties from recent tissue tests in confined compression and uniaxial tension. The FE disc model predictions fit within the experimental range (mean ± 95% confidence interval) of the disc’s nonlinear response for compressive slow loading ramp, creep, and stress-relaxation simulations. Changes in NP and CEP properties affected the neutral-zone displacement but had little effect on the final stiffness during slow-ramp compression loading. These results highlight the need to validate FE models using the disc’s full nonlinear response in multiple loading scenarios.

PMID: 24998992 [PubMed – indexed for MEDLINE]

Evaluation of the Quality of Information on the Internet Available to Patients Undergoing Cervical Spine Surgery.

By London Spine
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Evaluation of the Quality of Information on the Internet Available to Patients Undergoing Cervical Spine Surgery.

World Neurosurg. 2012 Nov 7;

Authors: Weil AG, Bojanowski MW, Jamart J, Gustin T, Lévêque M

Abstract
OBJECTIVE: To evaluate the quality of information available on the Internet to patients with a cervical pathology undergoing elective cervical spine surgery. METHODS: Six key words (“cervical discectomy,” “cervical foraminotomy,” “cervical fusion,” “cervical disc replacement,” “cervical arthroplasty,” “cervical artificial disc”) were entered into two different search engines (Google, Yahoo!). For each key word, the first 50 websites were evaluated for accessibility, comprehensibility, and website quality using the DISCERN tool, transparency and honesty criteria, and an accuracy and exhaustivity scale. RESULTS: Of 5,098,500 evaluable websites, 600 were visited; 97 (16%) of these websites were evaluated for quality and comprehensiveness. Overall, 3% of sites obtained an excellent global quality score, 7% obtained a good score, 25% obtained an above average score, 15% obtained an average score, 37% obtained a poor score, and 13% obtained a very poor score. High-quality websites were affiliated with a professional society (P = 0.021), had bibliographical references (P = 0.030), and had a recent update within 6 months (r = 0.277, P < 0.001). No correlation between global quality score and other variables was observed. CONCLUSIONS: This study shows that the search for medical information on the Internet is time-consuming and often disappointing. The Internet is a potentially misleading source of information. Surgeons and professional societies must use the Internet as an ally in providing optimal information to patients.

PMID: 23142585 [PubMed – as supplied by publisher]