The influence of obesity on the outcome of treatment of lumbar disc herniation: analysis of the Spine Patient Outcomes Research Trial (SPORT).
This publication by Rihn et al represents a retrospective analysis of data collected from the Spine Patient Outcomes Research Trial (SPORT). As has been previously published describing the SPORT trial, participants were either randomized or placed in an observational cohort. This data presented was taken from the as-treated analysis and therefore the randomization effect was […]
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 […]
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 […]
This systematic review by Singh et al (2013) provides an up to date review of the effectiveness of percutaneous lumbar laser discectomy. The acceptance of minimally invasive spine surgery continues to grow from both a demand by patients and amongst surgeons. The goals of having smaller incisions, limiting soft tissue trauma, shorter operating times and […]
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 […]