Radiographic evaluation of indirect decompression of mini-open anterior retroperitoneal lumbar interbody fusion: oblique lateral interbody fusion for degenerated lumbar spondylolisthesis.

By London Spine
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Radiographic evaluation of indirect decompression of mini-open anterior retroperitoneal lumbar interbody fusion: oblique lateral interbody fusion for degenerated lumbar spondylolisthesis.

Eur Spine J. 2015 Aug 6;

Authors: Sato J, Ohtori S, Orita S, Yamauchi K, Eguchi Y, Ochiai N, Kuniyoshi K, Aoki Y, Nakamura J, Miyagi M, Suzuki M, Kubota G, Inage K, Sainoh T, Fujimoto K, Shiga Y, Abe K, Kanamoto H, Inoue G, Takahashi K

Abstract
PURPOSE: Extreme lateral interbody fusion provides minimally invasive treatment of spinal deformity, but complications including nerve and psoas muscle injury have been noted. To avoid nerve injury, mini-open anterior retroperitoneal lumbar interbody fusion methods using an approach between the aorta and psoas, such as oblique lumbar interbody fusion (OLIF) have been applied. OLIF with percutaneous pedicle screws without posterior decompression can indirectly decompress the spinal canal in lumbar degenerated spondylolisthesis. In the current study, we examined the radiographic and clinical efficacy of OLIF for lumbar degenerated spondylolisthesis.
METHODS: We assessed 20 patients with lumbar degenerated spondylolisthesis who underwent OLIF and percutaneous pedicle screw fixation without posterior laminectomy. MR and CT images and clinical symptoms were evaluated before and 6 months after surgery. Cross sections of the spinal canal were evaluated with MRI, and disk height, cross-sectional areas of intervertebral foramina, and degree of upper vertebral slip were evaluated with CT. Clinical symptoms including low back pain, leg pain, and lower extremity numbness were evaluated using a visual analog scale and the Oswestry Disability Index before and 6 months after surgery.
RESULTS: After surgery, significant increases in axial and sagittal spinal canal diameter (12 and 32 %), spinal canal area (19 %), disk height (61 %), and intervertebral foramen areas (21 % on the right side, 39 % on the left), and significant decrease of upper vertebral slip (-9 %) were found (P < 0.05). Low back pain, leg pain, and lower extremity numbness were significantly reduced compared with before surgery (P < 0.05).
CONCLUSIONS: Significant improvements in disk height and spinal canal area were found after surgery. Bulging of disks was reduced through correction, and stretching the yellow ligament may have decompressed the spinal canal. Lumbar anterolateral fusion without laminectomy may be useful for lumbar spondylolisthesis with back and leg symptoms.

PMID: 26245906 [PubMed – as supplied by publisher]

Surgical treatment for idiopathic intervertebral disc calcification in a child: case report and review of the literature.

By London Spine
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Surgical treatment for idiopathic intervertebral disc calcification in a child: case report and review of the literature.

Childs Nerv Syst. 2014 Sep 6;

Authors: Chu J, Wang T, Pei S, Yin Z

Abstract
PURPOSE: Intervertebral disc calcification (IDC) is rare in children. Conservative treatment has been recommended for the majority of cases. We describe surgical treatment of a case of IDC with progressive neurological impairment and review the literature relevant to this rare entity and its management.
METHODS: A 16-year-old boy presented with sudden onset of severe neck pain, radiating into his left shoulder. Three months later, he developed neurological symptoms and signs with a progressive motor and sensory loss of his left upper limb.
RESULTS: Anterior cervical corpectomy with fusion and instrumentation was performed. Neurologic deficits completely resolved within 1 week. After 1-year follow-up, radiological images showed solid fusion and no further compression.
CONCLUSION: Surgical decompression should be recommended for cases with acutely progressive and severe neurological impairments in IDC and a good result can be obtained. When surgery is needed, anterior decompression is usually used in cervical lesion, while in thoracic and lumbar area, posterior approach is suggested.

PMID: 25192983 [PubMed – as supplied by publisher]

Widespread pain – do pain intensity and care-seeking influence sickness absence? – A population-based cohort study.

By Kamruz Zaman
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Widespread pain – do pain intensity and care-seeking influence sickness absence? – A population-based cohort study.

BMC Musculoskelet Disord. 2016 May 04;17:197

Authors: Mose S, Christiansen DH, Jensen JC, Andersen JH

Abstract
BACKGROUND: Both musculoskeletal pain-intensity in relation to a specific location (e.g. lower back or shoulder) and pain in multiple body regions have been shown to be associated with impaired function and sickness absence, but the impact of pain intensity on the association between widespread pain and sickness absence has not been studied. Additionally it is unknown whether care-seeking in general practice due to musculoskeletal disorders has a positive or negative impact on future absenteeism. The purpose of this study was to examine the influence of pain intensity on the association between number of musculoskeletal pain sites and sickness absence, and to analyze the impact on absenteeism from care-seeking in general practice due to musculoskeletal disorders.
METHODS: 3745 Danish adults registered with eight General Practitioners (GPs) in one primary medical center reported location and intensity of experienced musculoskeletal pain in seven different body regions in February 2008. Outcome was duration of sickness absence based on register data divided into long-term (>52 weeks during follow-up) and sickness absence of shorter duration (12-52 weeks during follow-up) over a period of 4 years. Data on pain-intensity were analyzed at three different cut-off levels for each body region: i) > 1 (any pain), ii) > 2 (bothersome pain), iii) > 3 (very bothersome pain). Analyses were stratified and compared between participants without GP contact and participants with GP contact due to musculoskeletal disorders.
RESULTS: Musculoskeletal pain in more than two body regions was strongly associated with long-term sickness absence in an exposure-response pattern. Different cut-off levels of pain intensity and adjustment for age, sex, educational level and work environmental factors did not alter the results. Similar findings were observed for sickness absence of shorter duration, although the association was weaker. Care-seeking in general practice due to musculoskeletal disorders did not overall alter the odds of later sickness absence.
CONCLUSION: Pain intensity and care-seeking due to musculoskeletal disorders did not seem to influence the association between the number of pain sites and later sickness absence. The number of musculoskeletal pain sites seems to be a strong risk factor for later sickness absence.

PMID: 27142067 [PubMed – indexed for MEDLINE]

Adenovirus-mediated sphingomyelin synthase 2 increases atherosclerotic lesions in ApoE KO mice.

By London Spine

Adenovirus-mediated sphingomyelin synthase 2 increases atherosclerotic lesions in ApoE KO mice.

Lipids Health Dis. 2011;10:7

Authors: Wang X, Dong J, Zhao Y, Li Y, Wu M

Sphingomyelin synthase 2 (SMS2) contributes to de novo sphingomyelin (SM) biosynthesis. Its activity is related to SM levels in the plasma and the cell membrane. In this study, we investigated the possibility of a direct relationship between SMS and atherosclerosis.

PMID: 21235823 [PubMed – indexed for MEDLINE]

Metric Properties of the SPARCC Score of the Sacroiliac Joints – Data from Baseline, 3-month, and 12-month Followup in the SPACE Cohort.

By London Spine
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Metric Properties of the SPARCC Score of the Sacroiliac Joints – Data from Baseline, 3-month, and 12-month Followup in the SPACE Cohort.

J Rheumatol. 2015 May 1;

Authors: van den Berg R, de Hooge M, Bakker PA, van Gaalen F, Navarro-Compán V, Fagerli KM, Landewé R, van Oosterhout M, Ramonda R, Reijnierse M, van der Heijde D

Abstract
OBJECTIVE: To evaluate metric properties of the SpondyloArthritis Research Consortium of Canada (SPARCC) score of the sacroiliac (SI) joints.
METHODS: Patients with back pain (≥ 3 months, ≤ 2 years, onset < 45 years) were included in the SPACE cohort (SpondyloArthritis Caught Early). Patients with (possible) axial spondyloarthritis had followup visits after 3 and 12 months and were treated according to clinical practice. Magnetic resonance imaging (MRI) of the SI joints (MRI-SI) was scored in 2 independent campaigns (campaign 1: at baseline and 3 months; campaign 2: at baseline, 3 months, and 12 months) by 2 different blinded reader pairs, applying the Assessment of Spondyloarthritis International Society (ASAS) definition (MRI-SI+ vs MRI-SI-; discordant cases were adjudicated by a third reader) and SPARCC score (mean of 2 agreeing readers). Calculations were made for agreement between SPARCC score cutoff values and a consensus judgment of MRI-SI+ (ASAS definition) as external standard, change in SPARCC score, and smallest detectable changes (SDC) over 3 and 12 months.
RESULTS: SPARCC score ≥ 2 showed best agreement with MRI-SI+ in both campaigns. Regarding observed changes in relation to SDC, SPARCC score changed in 70/151 patients; 26/70 patients changed > SDC (3.4), of whom 20 patients received stable treatment over 3 months in campaign 1. Over 3 months, 20/68 patients showed changes in SPARCC score; 11/20 > SDC (2.1), of whom 8 patients received stable treatment. Over 1 year, 23/74 patients changed their SPARCC score; 14/23 changed > SDC (2.4), of whom 7 received stable treatment in campaign 2.
CONCLUSION: SPARCC score ≥ 2 can be used as surrogate for a consensus judgment of MRI-SI+ (ASAS definition) in clinical trials. The SDC ranged from 2.1-3.4 dependent on reader pair and were close to the proposed minimum important change of 2.5.

PMID: 25934824 [PubMed – as supplied by publisher]