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https://www.readbyqxmd.com/read/28730987/evaluation-of-an-advanced-practice-physiotherapist-in-triaging-patients-with-lumbar-spine-pain-surgeon-physiotherapist-level-of-agreement-and-patient-satisfaction
#1
Susan Robarts, Paul Stratford, Deborah Kennedy, Barry Malcolm, Joel Finkelstein
BACKGROUND: Surgery for lumbar spine pain is indicated for specific etiologies. Given the majority of individuals referred to spine surgeons are not surgical candidates, care delivery is inefficient, with consultations being of limited value for most. Using specially trained physiotherapists in triage is a human resource strategy that may optimize surgeons' time and the patient experience. METHODS: An advanced-practice physiotherapist (APP) and a surgeon assessed consecutive patients with lumbar spine pain presenting at an academic health centre's spine surgery clinic...
August 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28728587/minimally-invasive-unilateral-pedicle-screws-and-a-translaminar-facet-screw-fixation-and-interbody-fusion-for-treatment-of-single-segment-lower-lumbar-vertebral-disease-surgical-technique-and-preliminary-clinical-results
#2
Peng Huang, Yiguo Wang, Jiao Xu, Bo Xiao, Jianheng Liu, Luyang Che, Keya Mao
BACKGROUND: Conventional open transforaminal lumbar interbody fusion (TLIF) using unilateral pedicle screws and a translaminar facet screw has been performed for many years with good results. The outcomes of minimally invasive TLIF (MIS TLIF) are similar to the good outcomes of open TLIF, with the additional benefits of reducing iatrogenic injury, shortening hospital stays, and reducing the recovery duration. Instead of using small cuts on both sides, we performed MIS TLIF through a single cut using unilateral pedicle screws and a translaminar facet screw...
July 20, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28728580/lumbar-microdiscectomy-and-post-operative-activity-restrictions-a-protocol-for-a-single-blinded-randomised-controlled-trial
#3
Chris D Daly, Kai Zheong Lim, Jennifer Lewis, Kelly Saber, Mohammed Molla, Naor Bar-Zeev, Tony Goldschlager
BACKGROUND: Lumbar microdiscectomy is the most commonly performed spinal surgery procedure, with over 300,000 cases performed annually in the United States alone. Traditionally, patients were advised to restrict post-operative activity as this was believed to reduce the risk of disc reherniation and progressive instability. However, this practice would often delay patients return to work. In contemporary practice many surgeons do not restrict patient post-operative activity due to the perception this practice is unnecessary...
July 20, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28727718/quantity-of-disc-removal-and-radiological-outcomes-of-percutaneous-endoscopic-lumbar-discectomy
#4
Ji Han Heo, Chi Heon Kim, Chun Kee Chung, Yunhee Choi, Young-Geun Seo, Dong Hoi Kim, Sung Bae Park, Jung Hyeon Moon, Won Heo, Jong-Myung Jung
BACKGROUND: Herniated intervertebral disc disease (HIVD) is a common cause of lower back and leg pain. Percutaneous endoscopic lumbar discectomy (PELD) is indicated when non-surgical treatments such as medication and interventions are intractable. Ruptured discs and loose fragments inside discs are removed during PELD. Nerve root decompression is usually assessed by visualizing the free movement of the traversing nerve root or epidural fat, the free passage of a probe into the epidural space, the depression of the annulus, and the removal of the expected ruptured discs and loose fragments based on preoperative magnetic resonance images (MRI)...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28727709/transforaminal-percutaneous-endoscopic-discectomy-and-foraminoplasty-after-lumbar-spinal-fusion-surgery
#5
Jian-Jun Wu, Hui-Zhen Chen, Changkun Zheng
BACKGROUND: The most common causes of pain following lumbar spinal fusions are residual herniation, or foraminal fibrosis and foraminal stenosis that is ignored, untreated, or undertreated. The original surgeon may advise his patient that nothing more can be done in his opinion that the nerve was visually decompressed by the original surgery. Post-operative imaging or electrophysiological assessment may be inadequate to explain all the reasons for residual or recurrent symptoms. Treatment of failed lumbar spinal fusions by repeat traditional open revision surgery usually incorporates more extensive decompression causing increased instability and back pain...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28723772/anatomic-investigation-of-lumbar-transforaminal-fenestration-approach-and-its-clinical-application-in-far-lateral-disc-herniation
#6
Baoshan Xu, Haiwei Xu, Jean Destandau, Xinlong Ma, Jian He, Qun Xia, Ning Ji, Qiang Yang, Yue Liu, Hongfeng Jiang
Treating lumbar disease at the intervertebal foramina is controversial because we lack an approach providing sufficient exposure and preserving spinal stability. The primary objective of this study was to investigate the feasibility of the transforaminal fenestration (TFF) approach for treating lumbar disease involving the intervertebal foramina.In the anatomic study of 30 adult cadaveric lumbar spine specimens, the TFF approach was used from L1 to S1. The scope of resection was measured manually and on 3D CT images...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28720991/transforaminal-epidural-etanercept-for-the-treatment-of-prolapsed-lumbar-intervertebral-disc-induced-sciatica
#7
Ashish Dagar, Ramesh Kumar, Abhishek Kashyap, Vinay Prabhat, Hitesh Lal, Lalit Kumar
STUDY DESIGN: Hospital based prospective study. OBJECTIVE: To study clinical response of transforaminal epidural Etanercept for lumbar prolapsed intervertebral disc induced sciatica. METHOD: Patients presenting to O.P.D and Emergency services of our hospital were screened for inclusion and exclusion criteria & suitable candidates were enrolled in study. Patients received 2 transforaminal epidural injections of Etanercept 2 mg, 2 weeks apart, and were assessed for efficacy at 2 week, 1 month and 3 months after the second injection...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28720984/spinal-cord-injury-the-role-of-surgical-treatment-for-neurological-improvement
#8
REVIEW
N Rath, B Balain
Acute spinal cord injury (ASCI) is common and no consensuses have been reached regarding timing of surgical decompression. This article highlights the main issues regarding surgical management of ASCI patients. The importance of timing of surgery along with physiological stability of the cord, and indications for surgery has been discussed to facilitate better understanding of the condition. The importance of the type of injury to the spinal column, besides the cord injury, is also discussed. A brief review of relevant literature has been done to try and answer the question whether early or late surgical treatment for ASCI is better than conservative management, reflecting the ethos of treatment for these problems in Robert Jones And Agnes Hunt Orthopaedic Hospital in Oswestry...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28720144/identifying-predictors-for-postoperative-clinical-outcome-in-lumbar-spinal-stenosis-patients-using-smart-shoe-technology
#9
Sunghoon I Lee, Andrew Campion, Alex Huang, Eunjeong Park, Jordan H Garst, Nima Jahanforouz, Marie Espinal, Tiffany Siero, Sophie Pollack, Marwa Afridi, Meelod Daneshvar, Saif Ghias, Majid Sarrafzadeh, Daniel C Lu
BACKGROUND: Approximately 33% of the patients with lumbar spinal stenosis (LSS) who undergo surgery are not satisfied with their postoperative clinical outcomes. Therefore, identifying predictors for postoperative outcome and groups of patients who will benefit from the surgical intervention is of significant clinical benefit. However, many of the studied predictors to date suffer from subjective recall bias, lack fine digital measures, and yield poor correlation to outcomes. METHODS: This study utilized smart-shoes to capture gait parameters extracted preoperatively during a 10 m self-paced walking test, which was hypothesized to provide objective, digital measurements regarding the level of gait impairment caused by LSS symptoms, with the goal of predicting postoperative outcomes in a cohort of LSS patients who received lumbar decompression and/or fusion surgery...
July 18, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/28716365/functional-disability-in-patients-with-low-back-pain-the-mediator-role-of-suffering-and-beliefs-about-pain-control-in-patients-receiving-physical-and-chiropractic-treatment
#10
M Graça Pereira, Edite Roios, Marta Pereira
BACKGROUND: Low back pain is the leading cause of disability worldwide. There is evidence that depression, anxiety, and external locus of control are negative predictors of functional disability in low back patients. METHODS: This study focused on the mediator role of suffering and beliefs about pain control in the relationship between psychological morbidity and functional disability in patients receiving physical therapy and chiropractic treatment for chronic low back pain...
July 3, 2017: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/28710050/transforaminal-endoscopic-lumbar-discectomy-for-lumbar-disc-herniation-causing-bilateral-symptoms
#11
Chunpeng Ren, Yin Li, Rujie Qin, Penghao Sun, Peng Wang
BACKGROUND: Transforaminal endoscopic lumbar discectomy (TELD), a minimally invasive spinal technique, has advantages over open discectomy. Unilateral TELD for disc herniation causing bilateral symptoms is challenging. In this study, we describe a percutaneous endoscopic herniotomy technique by using a unilateral approach for lumbar disc herniation with bilateral obvious symptoms. METHODS: From June 2014 to October 2015, 26 patients who had back as well as bilateral leg pain and/or weakness due to lumbar disc herniation were treated by transforaminal endoscopic lumbar discectomy (TELD) with a unilateral approach...
July 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28710043/minimally-invasive-computer-navigation-assisted-endoscopic-transforaminal-interbody-fusion-with-bilateral-decompression-via-a-unilateral-approach-initial-clinical-experience-at-one-year-follow-up
#12
Yaqing Zhang, Chuang Xu, Yue Zhou, Bo Huang
OBJECTIVE: The purpose of this study was to assess the feasibility of minimally invasive transforaminal lumbar interbody fusion (TLIF) and bilateral decompression via a unilateral approach that was performed with a novel working retractor with an endoscopic system for degenerative lumbar spondylolisthesis associated with spinal stenosis, to minimize surgical trauma without compromising the quality of the treatment outcome. METHODS: In this case series, the procedure was performed in 17 patients...
July 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28705257/single-stage-transforaminal-decompression-debridement-interbody-fusion-and-posterior-instrumentation-for-lumbosacral-brucellosis
#13
Yakefu Abulizi, Wei-Dong Liang, Aikeremujiang Muheremu, Maierdan Maimaiti, Wei-Bin Sheng
BACKGROUND: Spinal brucellosis is a less commonly reported infectious spinal pathology. There are few reports regarding the surgical treatment of spinal brucellosis in existing literature. This retrospective study was conducted to determine the effectiveness of single-stage transforaminal decompression, debridement, interbody fusion, and posterior instrumentation for lumbosacral spinal brucellosis. METHODS: From February 2012 to April 2015, 32 consecutive patients (19 males and 13 females, mean age 53...
July 14, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28704626/the-effectiveness-of-neural-mobilization-for-neuro-musculoskeletal-conditions-a-systematic-review-and-meta-analysis
#14
Annalie Basson, Benita Olivier, Richard Ellis, Michel Coppieters, Aimee Stewart, Witness Mudzi
Study Design Systematic review with meta-analysis. Background Neural mobilization (NM) or neurodynamics is a movement-based intervention aimed at restoring the homeostasis in and around the nervous system. The current level of evidence for NM is largely unknown. Objectives To determine the efficacy of NM for musculoskeletal conditions with a neuropathic component. Methods Databases were searched for randomised trials investigating the effect of NM for neuro-musculoskeletal conditions. Standard methods for article identification, selection and quality appraisal were used...
July 13, 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28704333/the-impact-of-depression-on-patient-reported-outcome-measures-after-lumbar-spine-decompression
#15
Robert K Merrill, Lukas P Zebala, Colleen Peters, Sheeraz A Qureshi, Steven J McAnany
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To investigate the effect depression has on the improvement of patient reported outcome measures (PROMs) following lumbar decompression. SUMMARY OF BACKGROUND DATA: Decompression without fusion is a viable treatment option for lumbar spine stenosis. Depression reportedly has a negative impact on PROMs after certain types of spine surgery, though verification of this with new, more precise outcome measures is needed...
July 12, 2017: Spine
https://www.readbyqxmd.com/read/28702785/changes-in-dural-sac-caliber-with-standing-mri-improve-correlation-with-symptoms-of-lumbar-spinal-stenosis
#16
Yvonne Yan On Lau, Ryan Ka Lok Lee, James Francis Griffith, Carol Lai Yee Chan, Sheung Wai Law, Kin On Kwok
PURPOSE: Weight bearing does alter the dimension of lumbar spinal canal, but no study has analyzed its clinical correlation. This study aims to evaluate whether the changes in dural sac cross-sectional area (DSCA) and sagittal anteroposterior (AP) diameter on standing magnetic resonance imaging (MRI) correlate better with clinical symptoms of lumbar spinal stenosis. METHODS: Seventy consecutive patients with neurogenic claudication were prospectively recruited to undergo a 0...
July 12, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28699719/which-functional-outcome-parameters-correlate-better-with-elderly-patients-satisfaction-after-non-fusion-lumbar-spine-surgery
#17
Triantafyllos Bouras, Fahed Zairi, Maria Loufardaki, Michel Triffaux, George Stranjalis
BACKGROUND: Elderly patients are increasingly operated for spinal degenerative diseases. The treatment objective is quality of life, which, in this population, is difficult to assess. Hence, patient satisfaction, although less objective, is of high importance. In this study, we have examined the relation of various functional parameters after non-fusion spinal surgery, with patient satisfaction. PATIENTS AND METHODS: A 5-year follow-up after non-fusion lumbar spine surgery on 185 elderly patients was performed...
July 10, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28699301/prospective-evaluation-of-patient-usage-of-above-and-below-threshold-waveforms-with-traditional-spinal-cord-stimulation-devices
#18
Stephanie Owusu, Alexander Huynh, Eric Gruenthal, Julia Prusik, Stephane Owusu-Sarpong, Rasan Cherala, Sophia Peng, Julie G Pilitsis, Sarah E McCallum
OBJECTIVES: Spinal cord stimulation (SCS) is an efficacious therapy used to treat chronic pain. The type of SCS programming is important in improving patients' quality of life and overall satisfaction. In this study, 19 patients who underwent SCS with traditional devices were given between 4 and 6 programs including programs with stimulation below sensory threshold and above sensory threshold. Usage patterns and preferences were assessed. METHODS: SCS patients were given 4-6 programs, some above sensory threshold and some below threshold immediately postoperatively after permanent implantation...
July 11, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28698876/standard-versus-minimally-invasive-transforaminal-lumbar-interbody-fusion-a-prospective-randomized-study
#19
Daniel Serban, Niki Calina, Gabriel Tender
Symptomatic spondylolisthesis patients may benefit from surgical decompression and stabilization. The standard (S) technique is a transforaminal lumbar interbody fusion (TLIF). Newer, minimally invasive (MI) techniques seem to provide similar results with less morbidity. We enrolled patients with at least 6 months of symptoms and image-confirmed low-grade spondylolisthesis, at a single academic institution, between 2011 and 2015. The patients were randomized to either S or MI TLIF. The primary outcome measure was the Oswestry Disability Index (ODI) improvement at 1 year...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28694678/placebo-disclosure-does-not-result-in-negative-changes-in-mood-or-attitudes-towards-health-care-or-the-provider
#20
Joel E Bialosky, Michael E Robinson
Objectives: The purposes of this study were to (1) determine whether disclosure of having received a placebo treatment following participation in a randomized manual therapy trial resulted in changes in negative mood or attitudes towards health care and the provider and (2) examine the association between changes in mood or attitude and changes in clinical outcomes over the two-week study period. Methods: Participants with low back pain (N = 110) were randomly assigned to receive a spinal manipulative therapy (SMT), a standard placebo SMT in which participants were aware of a chance of receiving a placebo, an enhanced placebo SMT in which participants were instructed 'the manual therapy technique you will receive has been shown to significantly reduce low back pain in some people,' or no treatment...
July 2017: Journal of Manual & Manipulative Therapy
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