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Day: July 18, 2017

Quality of Life Comparison between Vertebroplasty and Kyphoplasty in Patients with Osteoporotic Vertebral Fractures.

By London Spine

Quality of Life Comparison between Vertebroplasty and Kyphoplasty in Patients with Osteoporotic Vertebral Fractures.

Asian Spine J. 2014 Dec;8(6):799-803

Authors: Lee SK, Lee SH, Yoon SP, Lee YT, Jang G, Lim SY, Lee HM, Moon SH, Song KS

Abstract
STUDY DESIGN: Retrospective evaluation.
PURPOSE: To compare quality of life in postmenopausal women with osteoporotic vertebral fractures (OVFs) who underwent vertebroplasty (VP) or kyphoplasty (KP).
OVERVIEW OF LITERATURE: Patient with OVFs who do not respond to conservative treatment can be treated with VP or ballon KP for faster pain relief. There are controversies on which procedure is more effective.
METHODS: Five hundred twenty-eight postmenopausal women in nationwide hospitals with age of 50 years or older who underwent VP of KP for OVFs were enrolled in this study. Health related quality of life was measured using the European Quality of Life 5 Domains (EQ-5D) and visual analogue scale (VAS).
RESULTS: In the VP group, average EQ-5D dimension was 1.95 in mobility, 1.86 in self care, 2.02 in usual activity, 2.19 in pain, 1.69 in anxiety or depression. In the KP group, average EQ-5D dimension was 1.83 in mobility, 1.78 in self care, 1.98 in usual activity, 2.03 in pain, 1.55 in anxiety or depression. Quality of life of KP group was significantly better than that of the VP group in mobility (p=0.016), pain (p=0.001), and anxiety or depression (p=0.008). Average EQ-5D index of the VP and the KP group was 0.353 (±0.472) and 0.485 (±0.357), respectively. The EQ-5D index of the KP group was significantly (p<0.001) higher than that of the KP group. The difference of VAS between VP and KP group was not statistically significant (p=0.580).
CONCLUSIONS: Quality of life in patient with OVFs who underwent KP was significantly better than that of patients who underwent VP.

PMID: 25558323 [PubMed]

The Impact of Preoperative Depression on Quality of Life Outcomes Following Lumbar Surgery.

By London Spine
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The Impact of Preoperative Depression on Quality of Life Outcomes Following Lumbar Surgery.

Spine J. 2014 Jul 4;

Authors: Miller J, Derakhshan A, Lubelski D, Alvin MD, McGirt MJ, Benzel EC, Mroz TE

Abstract
BACKGROUND CONTEXT: Other, smaller studies have investigated the effect of preoperative depression upon postoperative improvement in QOL. However, they have not utilized the PHQ-9 questionnaire in self-reported depression.
PURPOSE: To assess the effect of preoperative depression as measured by the PHQ-9 questionnaire upon postoperative improvement in quality of life (QOL).
STUDY DESIGN/SETTING: Retrospective review at a single tertiary-care referral center.
PATIENT SAMPLE: Patients that underwent lumbar decompression or fusion between 2008 and 2012.
OUTCOMES MEASURES: Self-Reported EuroQol 5-Dimensions (EQ-5D) Quality-Adjusted Life-Years Index METHODS: QOL data was collected using the institutional prospectively-collected database of patient-reported health status measures. The EQ-5D, PDQ, and PHQ-9 questionnaires were utilized. Linear and logistic regression analyses were performed to assess the impact of preoperative depression upon QOL improvement. No funding sources nor conflicts of interest were present.
RESULTS: Elevated preoperative pain (PDQ, β = -0.0017, p = 0.0009) and worsened depression (PHQ-9, β = -0.0044, p = 0.0359) were significantly associated with a diminished postoperative improvement in QOL, as measured by the EQ-5D. Furthermore, greater depression (PHQ-9, OR 0.93, p < 0.0001) and pain (PDQ, OR 0.99, p = 0.02) were associated with a significantly diminished postoperative improvement exceeding the minimum clinically important difference (MCID).
CONCLUSIONS: Increased preoperative pain and depression were shown to be associated with a significantly reduced improvement in postoperative QOL, as measured by the EQ-5D.

PMID: 25007757 [PubMed – as supplied by publisher]

Is the presence of modic changes associated with the outcomes of different treatments? A systematic critical review.

By London Spine

Related Articles Is the presence of modic changes associated with the outcomes of different treatments? A systematic critical review. BMC Musculoskelet Disord. 2011;12:183 Authors: Jensen RK, Leboeuf-Yde C Abstract BACKGROUND: Modic changes (MCs) have been identified as a diagnostic subgroup associated with low back pain (LBP). The aetiology of MCs is still unknown and there…

Lumbar Decompression Surgery for Large Disc Prolapse

By London Spine

I suffered a prolapse on a lower disc.  We tried an epidural cortisone injection but the progress was not good enough. I had surgery about 4-5 weeks ago. My experience of all treatments was positive, and although I didn’t feel comfortable, the professionalism of Mr Akmal and his team put me at ease. I wish there was a…