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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
Abnormal magnetic-resonance scans of the cervical spine in asymptomatic subjects. A prospective investigation.
This classic paper published by Boden et al (1990) is a parallel study to the one investigating abnormal magnetic resonance imaging scans of the lumbar spine in asymptomatic subjects that was published the same year. This study included 63 asymptomatic volunteers who were screened and underwent an MRI scan of the cervical spine. The MRI […]
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 […]
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 […]