Archives: Articles

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 […]

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2009 ISSLS Prize Winner: Does discography cause accelerated progression of degeneration changes in the lumbar disc: a ten-year matched cohort study.

The 2009 ISSLS Prize Winner for the best paper was awarded to Carragee et al for the Paper Titled Does Discography Cause accelerated progression of degenerative changes in the lumbar Spine: In this paper, Dr. Carragee followed a group of asymptomatic volunteers who had discography from L3-S1 performed in 1997,  and compared the results of […]

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Predictors of the efficacy of epidural steroid injections for structural lumbar degenerative pathology.

This study which has been accepted  and is currently pending publication in The Spine Journal presents an interesting predictive model for lumbar epidural steroid injection efficacy for those who have specific defined degenerative pathology. Treatment success for this study was defined by achieving at least a 7.1% improvement on the Oswestry Disability Index (ODI). Using […]

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The natural history of spondylolysis and spondylolisthesis.

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 […]

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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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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 […]

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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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