This study assesses the prevalence of major and minor discordance between hip and spine T scores using Radiofrequency Echographic Multi-spectrometry (REMS). REMS is a novel technology that uses ultrasound and radiofrequency analysis to measure bone density and bone fragility at the hip and lumbar spine. The objective was to compare the results with the existing literature on Dual-Energy X-ray Absorptiometry (DEXA) the current “gold standard” for bone densitometry. REMS and DEXA have been shown to have similar diagnostic accuracy, however, REMS has less human input when carrying out the scan, therefore the rates of discordance might be expected to be lower than for DEXA. Discordance poses a risk of misclassification of patients’ bone health status, causing diagnostic ambiguity and potentially sub-optimal management decisions. Reduction of discordance rates therefore has the potential to significantly improve treatment and patient outcomes. Results from 1,855 patients who underwent REMS investigations between 2018 and 2022 were available. Minor discordance is defined as a difference of one World Health Organisation (WHO) diagnostic classification (Normal / Osteopenia or Osteopenia / Osteoporosis). Major discordance is defined as a difference of two WHO diagnostic classifications (Normal / Osteoporosis). The results were compared with reported DEXA discordance rates.Abstract
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Functional Restoration (FR) and spinal fusion are both used as treatment for patients with chronic low back pain however opinions are divided over their long term efficacy. This study examines the 18 month to 8 year outcomes of stand-alone lumbar fusion (STALIF) at L5/S1 and FR in similar groups of patients. A prospective audit was undertaken using data routinely collected from the practice of the senior author. Pain (VAS), disability (ODI) and patients' subjective appraisals were used as comparable outcome measures. SPSS was used for statistical analysis.Statement of Purposes
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