Archives: Articles

Minimum 25-year outcome and functional assessment of lumbar discectomy.

This paper is a retrospective review on 348 consecutive patients who had lumbar discectomy surgery between 1973 and 1979 by the orthopedic department of Federico II Hospital in Naples, Italy.   Seven different surgeons participated in the surgical treatments.   Two Hundred One (201)  patients agreed to participate in follow-up,  either by mail or by an in […]

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The Neck Disability Index: a study of reliability and validity.

The Neck Disability Index (NDI) was developed by Vernon and Mior in the late 1980’s and published in 1991. It remains the most widely used outcome instrument for the assessment of patients with neck related disorders. The NDI was developed to provide an objective measure to assess activities of daily living (ADL) in patients with […]

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Long-term outcomes of surgical and nonsurgical management of sciatica secondary to a lumbar disc herniation: 10 year results from the maine lumbar spine study.

The debate of surgical management vs. nonsurgical care for the treatment of sciatica resulting from a lumbar disc herniation remains ongoing. This study by Atlas et al (2005) represents a long term prospective investigation looking at the outcomes of surgery vs. conservative treatment up to ten years for patients with sciatica due to a disc […]

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Frequency and clinical predictors of adverse reactions to chiropractic care in the UCLA neck pain study.

This study by Hurwitz et al from 2005 looked at the type and frequency of adverse events associated with chiropractic treatments for neck pain. Study participants were included if they had neck pain without progressive neurologic deficit or presence of disc herniations. Additionally they were excluded if they had evidence of myelopathy, spondyloarthropathy or were […]

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1997 Volvo Award winner in clinical studies. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation.

This prominent historical study by Fischgrund et al published in 1997, was a well-controlled randomized trial looking at both clinical and radiographic outcomes of lumbar laminectomy with arthrodesis surgery in patients with degenerative spondylolisthesis and spinal stenosis. Patients in this study (N=68) were randomly assigned to two treatment groups; Lumbar laminectomy with posterolateral intertransverse process […]

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Surgery for lumbar spinal stenosis. Attempted meta-analysis of the literature.

This paper published by Turner et al in 1992 represented an attempted meta-analysis  of the literature covering a 24 year period (1996-1990).  Based on the methods described by the authors, 74 studies met the inclusion criteria. One of the major issues in trying to include or exclude studies was a lack of a standardized outcome […]

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The prediction of curve progression in untreated idiopathic scoliosis during growth.

The natural history of adolescent idiopathic scoliosis is still not entirely understood despite decades of research. This study by Lonstein and Carlson is truly one of the classic papers published on the subject of idiopathic scoliosis, looking at the prognostic factors related to curve progression.  The study population was drawn from a database of juvenile and adolescent […]

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Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis.

This study by Hilibrand et al remains one of the most widely cited studies in regarding adjacent segment disease following anterior cervical discectomy and fusion.   The study population of 374 consecutive patients (409 fusions) were followed prospectively for the development of adjacent segment disease, as defined by symptomatic radiculopathy or myelopathy, at an adjacent segment […]

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2001 Volvo Award Winner in Clinical Studies: Lumbar fusion versus nonsurgical treatment for chronic low back pain: a multicenter randomized controlled trial from the Swedish Lumbar Spine Study Group.

This multicenter, randomized control trial out of Sweden was the 2001 Volvo Award Winner in Clinical Studies.   Fritzell et al randomized 294 patients into a surgical treatment group (n=222) versus a non-surgical group (N=72).  Patients were randomly assigned treatment and multiple validated outcome measures were utilized.  The overall goal of the study was to define “if lumbar fusion […]

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Accelerated degeneration of the segment adjacent to a lumbar fusion.

The study published by Lee in 1988 was intended to descriptively define conditions and pathomechanics at adjacent segments following a lumbar fusion.  This was at a time period where the effectiveness of lumbar fusion for low back pain was one of the foremost questions to be answered and potential complications of the procedure were largely […]

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