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 […]
This is a classic Spine Study looking at the natural history of spondylolysis and spondylolisthesis in a population of 500 first grade students in a small community bordering New York and Pennsylvania. The initial enrollment period was 1954 to 1957. The inclusion criteria was that the first grader had parental permission and attended one of […]
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 […]
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 […]
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 […]