Category: Degenerative
The Norwegian Cervical Arthroplasty Trial (NORCAT): 2-year clinical outcome after single-level cervical arthroplasty versus fusion-a prospective, single-blinded, randomized, controlled multicenter study.
This investigation by Sundseth et al presents a prospective randomized study comparing cervical anterior discectomy and fusion (using interbody cage) versus cervical disc arthroplasty in a Norwegian population. Outcomes were determined at 2 years, which is a relatively short time period. Outcome measures included the Neck Disability Index (NDI), SF36, and EuroQol-5D-3L. Overall, this multicenter […]
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Decompression and Coflex interlaminar stabilization compared with decompression and instrumented spinal fusion for spinal stenosis and low-grade degenerative spondylolisthesis: two-year results from the prospective, randomized, multicenter, Food and Drug Administration Investigational Device Exemption trial.
By most definitions, this is a good example of a randomized control trial (RCT). The study populations were well matched and the outcomes were standardly measured. The follow-up rate was greater than 80%. The inclusion criteria included the presence of back pain (VAS of 5/10 or more), along with spinal stenosis and up to grade […]
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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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Surgery for spinal stenosis: long-term reoperation rates, health care cost, and impact of instrumentation.
There has been a significant increase in the rates of spinal fusion in the past 15 years in the United States. This study attempted to identify the efficacy and costs associated with this trend. This study by Lad et al provided a retrospective cohort analysis of a population that underwent spinal stenosis surgery between 2002 […]
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What level of pain are patients happy to live with after surgery for lumbar degenerative disorders?
This study by Fekete et al, which has been approved for publication in The Spine Journal, provided an alternative approach to evaluating clinical outcomes in patients with degenerative lumbar disorders. The study population was derived from a spine surgery outcomes database and EUROSPINE Spine Tango Registry. Over 6900 patients in the database met the inclusion […]
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ISSLS Prize winner: The anatomy of failure in lumbar disc herniation: an in vivo, multimodal, prospective study of 181 subjects.
Conventional wisdom states that the mode of failure and cause of disc herniation is secondary to a rupture of nucleus material through the annulus fibrosis. In this paper, the senior author prospectively defined the nature of intraoperatively identified disc herniations in 181 consecutive patients qualified for inclusion. Inclusion criteria included requiring a single level lumbar […]
