The aim of this study was to compare the peak pull-out force
(PPF) of pedicle-lengthening screws (PLS) and traditional pedicle
screws (TPS) using instant and cyclic fatigue testing. A total of 60 lumbar vertebrae were divided into six groups:
PLS submitted to instant pull-out and fatigue-resistance testing
(groups A1 and A2, respectively), TPS submitted to instant pull-out
and fatigue-resistance testing (groups B1 and B2, respectively)
and PLS augmented with 2 ml polymethylmethacrylate, submitted to
instant pull-out and fatigue-resistance testing (groups C1 and C2,
respectively). The PPF and normalized PPF (PPFn) for bone mineral density
(BMD) were compared within and between all groups.Aims
Materials and Methods
Background. We have previously reported an injectable hydrogel (NPgel), which could deliver patients own stem cells, via small bore needles, decreasing damage to the annulus fibrosus. NPgel drives differentiation to NP cells and can inhibit the degenerate niche. However, clinical success of NPgel is dependent on the capacity to inject NPgel into naturally degenerate human discs, restore mechanical function to the IVD, prevent extrusion during loading and induce regeneration. This study assessed injectability of NPgel into human IVD, influence on mechanical properties, regeneration ability in an ex vivo culture system and retention under failure testing. Methodology. Cadaveric human discs were used to calculate disc height and to determine Youngs Modulus during simulated walking pre and post injection of NPgel, extrusion testing performed. Whole human IVDs were injected with NPgel +/− human BMPCs and maintained in culture under physiological loading regime for 4 weeks. Pre and post culture MRI imaging and in line
Objectives. Understanding lumbar facet joint involvement and
Background. Osteopathy has been shown to be effective in the management of chronic low back pain. Guidelines recommend biopsychosocial care for chronic, complex musculoskeletal conditions, including non-specific low back pain but there is a lack of evidence comparing standard osteopathic care, which has traditionally been based on dated and disputed
Background. Chronic low back pain is strongly linked to degeneration of the intervertebral disc (IVD), which currently lacks any targeted treatments. This study explores NPgel, a biomaterial combined with notochordal cells (NC), developmental precursor cells, as a potential solution. NCs, known for anti-catabolic effects on IVD cells, present a promising avenue for regenerating damaged IVD tissue. Methods. Bovine IVDs underwent enzymatic degeneration before NPgel (+/- NC) injection. Degenerated bovine IVDs were cultured under
We previously reported that osteoblasts at the curve apex in adolescent idiopathic scoliosis (AIS) exhibit a differential phenotype, compared to non-curve osteoblasts(1). However, the Hueter-Volkmann principle on vertebral body growth in spinal deformities (2) suggests this could be secondary to altered
Background. Low back pain (LBP) is a major problem across the globe and is the leading cause worldwide of years lost to disability. Self-management is considered an important component the treatment of people with non-specific LBP. However, it seems that the self-management support for people with non-specific LBP provided by physiotherapists can be improved. Moreover, the way exercise therapists (ET) address self-management in practice is unknown. Purpose. To investigate the ideas, opinions and methods used by physiotherapists and ET with regard to self-management and providing self-management support to patients with non-specific LBP. Methods. This study was a qualitative survey. An online questionnaire with open-ended questions was developed. The survey was conducted among physiotherapists and ET working in the Netherlands. Data was analysed using thematic analysis. Results. Respondents considered self-management support an important topic in physiotherapy and exercise therapy for people with non-specific LBP. In the self-management support provided by the respondents, providing information and advice were frequently mentioned. The topics included in the support given by the respondents covered a broad range of important factors. The topics frequently focused on
Purpose and background. Work-related musculoskeletal disorders, particularly back pain, are a significant issue for healthcare workers, with patient handling being the most frequently reported risk factor. Patient handling is often performed without assistive devices or equipment, which can cause healthcare staff to maintain awkward postures or experience high loads. This review aimed to comprehensively map the literature surrounding manual patient handling (without assistive devices) by healthcare practitioners to identify the current evidence-base on moving and handling of patients and explore what primary research had been conducted. Methods and results. JBI methodology for scoping reviews and an a priori registered protocol (DOI 10.17605/OSF.IO/8PR7A) was followed and AMED, CINAHL, MEDLINE, SPORTDiscus and EMBASE databases were searched. Literature published in English between 2002 and 2021 was included. Forty-nine records were included: 36 primary research studies, 1 systematic review and 12 ‘other’ including narrative and government reports. Primary research predominantly used observational cross-sectional designs (n = 21 studies). Most studies took place in hospitals (n = 13) and laboratories (n = 12). Nurses formed the largest population group (n = 13), with very little research on physiotherapists and other allied health professionals. Conclusion. This scoping review comprehensively reviewed the available literature in the area. Most of the included primary research was observational. Nurses were often investigated in hospitals and laboratories. Qualitative research investigating moving and handling and further
Objectives. Loss of motion following spine segment fusion results in increased strain in the adjacent motion segments. However, to date, studies on the
To determine the major risk factors for unplanned reoperations (UROs) following corrective surgery for adult spinal deformity (ASD) and their interactions, using machine learning-based prediction algorithms and game theory. Patients who underwent surgery for ASD, with a minimum of two-year follow-up, were retrospectively reviewed. In total, 210 patients were included and randomly allocated into training (70% of the sample size) and test (the remaining 30%) sets to develop the machine learning algorithm. Risk factors were included in the analysis, along with clinical characteristics and parameters acquired through diagnostic radiology.Aims
Methods
Symptomatic spinal stenosis is a very common problem, and decompression surgery has been shown to be superior to nonoperative treatment in selected patient groups. However, performing an instrumented fusion in addition to decompression may avoid revision and improve outcomes. The aim of the SpInOuT feasibility study was to establish whether a definitive randomized controlled trial (RCT) that accounted for the spectrum of pathology contributing to spinal stenosis, including pelvic incidence-lumbar lordosis (PI-LL) mismatch and mobile spondylolisthesis, could be conducted. As part of the SpInOuT-F study, a pilot randomized trial was carried out across five NHS hospitals. Patients were randomized to either spinal decompression alone or spinal decompression plus instrumented fusion. Patient-reported outcome measures were collected at baseline and three months. The intended sample size was 60 patients.Aims
Methods
To systematically evaluate whether bracing can effectively achieve curve regression in patients with adolescent idiopathic scoliosis (AIS), and to identify any predictors of curve regression after bracing. Two independent reviewers performed a comprehensive literature search in PubMed, Ovid, Web of Science, Scopus, and Cochrane Library to obtain all published information about the effectiveness of bracing in achieving curve regression in AIS patients. Search terms included “brace treatment” or “bracing,” “idiopathic scoliosis,” and “curve regression” or “curve reduction.” Inclusion criteria were studies recruiting patients with AIS undergoing brace treatment and one of the study outcomes must be curve regression or reduction, defined as > 5° reduction in coronal Cobb angle of a major curve upon bracing completion. Exclusion criteria were studies including non-AIS patients, studies not reporting p-value or confidence interval, animal studies, case reports, case series, and systematic reviews. The GRADE approach to assessing quality of evidence was used to evaluate each publication.Aims
Methods
The aim of this study was to reassess the rate of neurological, psoas-related, and abdominal complications associated with L4-L5 lateral lumbar interbody fusion (LLIF) undertaken using a standardized preoperative assessment and surgical technique. This was a multicentre retrospective study involving consecutively enrolled patients who underwent L4-L5 LLIF by seven surgeons at seven institutions in three countries over a five-year period. The demographic details of the patients and the details of the surgery, reoperations and complications, including femoral and non-femoral neuropraxia, thigh pain, weakness of hip flexion, and abdominal complications, were analyzed. Neurological and psoas-related complications attributed to LLIF or posterior instrumentation and persistent symptoms were recorded at one year postoperatively.Aims
Methods
Purpose and Background. The intervertebral disc is constantly subjected to forces generated by movement. But degeneration can disrupt normal
The aim of this study was to assess the ability of morphological spinal parameters to predict the outcome of bracing in patients with adolescent idiopathic scoliosis (AIS) and to establish a novel supine correction index (SCI) for guiding bracing treatment. Patients with AIS to be treated by bracing were prospectively recruited between December 2016 and 2018, and were followed until brace removal. In all, 207 patients with a mean age at recruitment of 12.8 years (SD 1.2) were enrolled. Cobb angles, supine flexibility, and the rate of in-brace correction were measured and used to predict curve progression at the end of follow-up. The SCI was defined as the ratio between correction rate and flexibility. Receiver operating characteristic (ROC) curve analysis was carried out to assess the optimal thresholds for flexibility, correction rate, and SCI in predicting a higher risk of progression, defined by a change in Cobb angle of ≥ 5° or the need for surgery.Aims
Methods
Vertebral body tethering (VBT) is a non-fusion technique to correct scoliosis. It allows correction of scoliosis through growth modulation (GM) by tethering the convex side to allow concave unrestricted growth similar to the hemiepiphysiodesis concept. The other modality is anterior scoliosis correction (ASC) where the tether is able to perform most of the correction immediately where limited growth is expected. We conducted a retrospective analysis of clinical and radiological data of 20 patients aged between 9 and 17 years old, (with a 19 female: 1 male ratio) between January 2014 to December 2016 with a mean five-year follow-up (4 to 7).Aims
Methods
Anchorage of pedicle screw rod instrumentation in the elderly spine with poor bone quality remains challenging. Our study aims to evaluate how the screw bone anchorage is affected by screw design, bone quality, loading conditions, and cementing techniques. Micro-finite element (µFE) models were created from micro-CT (μCT) scans of vertebrae implanted with two types of pedicle screws (L: Ennovate and R: S4). Simulations were conducted for a 10 mm radius region of interest (ROI) around each screw and for a full vertebra (FV) where different cementing scenarios were simulated around the screw tips. Stiffness was calculated in pull-out and anterior bending loads.Aims
Methods
Lumbar spondylolysis is a stress fracture of the pars interarticularis. We have evaluated the site of origin of the fracture clinically and
To evaluate the current
Objectives. Cement augmentation of pedicle screws could be used to improve screw stability, especially in osteoporotic vertebrae. However, little is known concerning the influence of different screw types and amount of cement applied. Therefore, the aim of this