Sense of coherence and outcome of anterior low-back fusion A 5- to 13-year follow-up of 85 patients

1996 ◽  
Vol 115 (5) ◽  
pp. 280-285 ◽  
Author(s):  
N. Santavirta ◽  
H. Bj�rvell ◽  
Y. T. Konttinen ◽  
S. Solovieva ◽  
M. Poussa ◽  
...  
Keyword(s):  
Sense Of Coherence ◽  
Low Back

Sense of coherence and outcome of low-back surgery: 5-year follow-up of 80 patients

1996 ◽  
Vol 5 (4) ◽  
pp. 229-235 ◽  
Author(s):  
N. Santavirta ◽  
H. Bj�rvell ◽  
Y. T. Konttinen ◽  
S. Solovieva ◽  
M. Poussa ◽  
...  
Keyword(s):  
Sense Of Coherence ◽  
Low Back ◽  
Back Surgery

PERCUTANEOUS EPIDURAL NEUROPLASTY (PEN) USING COMBINATION OF HYALURONIDASE AND HYPERTONIC SALINE (NaCl 3%) IN TREATING FAILED BACK SURGERY SYNDROME

2018 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Wawan Mulyawan ◽  
Yudi Yuwono Wiwoho ◽  
Syaiful Ichwan
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Hypertonic Saline ◽  
Failed Back Surgery Syndrome ◽  
Favourable Outcome ◽  
Lumbar Spine Surgery ◽  
Low Back ◽  
Failed Back Surgery ◽  
Scale Scores

Background: Following surgical treatments for low back pain, lower extremity pain or neurologic symptoms would last or recur, this is defined as failed sack surgery syndrome (FBSS). FBSS usually occurs in 5-40% of these surgical patients. The most common cause is an epidural scar adhesion. Percutaneous epidural neuroplasty is the non-mechanical treatment for this condition. Previously, the use of hyaluronidase and hypertonic saline separately is commonly used for epidurolysis but the combination of hyaluronidase and hypertonic saline 3% has not been explored.Objective: To investigate the two-year outcomes of percutaneous epidural neuroplasty using a combination of hyaluronidase and hypertonic saline 3% in patients with FBSS.Methods: Twelve patients who experience low back pain, with or without radiculopathy, who have underwent lumbar spine surgery previously were assigned to the study. Parameters, such as the visual analogue scale scores for the back (VAS-B) and legs (VAS-L), and the Oswestry disability index (ODI), were recorded and compared between pretreatment, 1 week, 1 month, 3 months, 1 year and 2 years follow-up.Results: For all 12 patients, the postoperative VAS-B, VAS-L, and ODI were significantly different from the preoperative values in all follow-up periods: 1 month, 3 months, 1 year, and 2 years.Conclusion: Based off this study group, percutaneous epidural neuroplasty using a combination of hyaluronidase and hypertonic saline 3% has a favourable outcome in the 2 years follow-up

scholarly journals 325 - Relationship quality in dementia: Preliminary longitudinal analyses of the EU-JPND Actifcare cohort study

2020 ◽  
Vol 32 (S1) ◽  
pp. 83-83
Author(s):  
Maria J. Marques ◽  
Bob Woods ◽  
Eva Y.L. Tan ◽  
Marjolein de Vugt ◽  
Frans Verhey ◽  
...  
Keyword(s):  
Social Support ◽  
Cohort Study ◽  
Relationship Quality ◽  
Sense Of Coherence ◽  
Unmet Needs ◽  
Neuropsychiatric Symptoms ◽  
Longitudinal Analyses ◽  
Family Carers ◽  
Over Time

INTRODUCTIONRelationship quality (RQ) in dyads of persons with dementia and their family carers is important both as a clinical outcome and as a determinant of health and quality of life. In previous work we studied RQ using baseline data of a large-scale European longitudinal study on timely access to and use of community formal services in dementia (EU-JPND Acticare). We concluded that neuropsychiatric symptoms and carer stress contributed to discrepancies in RQ ratings within the dyad, which were less favourable when reported by family carers. This and other associations (e.g. between carer-rated RQ and sense of coherence) were cautiously interpreted, in the context of a cross-sectional analysis.OBJECTIVESTo analyse how carer-reported RQ varies over time and to examine its most important influencing factors.METHODSWe present preliminary longitudinal analyses from the Actifcare cohort study of 451 community-dwelling persons with dementia and their primary carers in eight European countries (12-month follow-up). Comprehensive assessments included the Positive Affect Index (PAI) to assess RQ, persons with dementia’s neuropsychiatric symptoms, persons with dementia and carers’ unmet needs, carers’ anxiety and depression, social support, sense of coherence and stress.RESULTSCarers’ mean PAI scores decreased over the 12 -month period. The person with dementia neuropsychiatric symptoms and unmet needs, and carers’ perceived social support were significant predictors of carers’ RQ change.DISCUSSION AND CONCLUSIONWe analysed carer-reported RQ variation over time and predictors in a large European sample of persons with dementia and their family carers. As expected, RQ decreased over the oneyear follow-up period as the disease progressed. Its main predictors in this sample (neuropsychiatric symptoms and the person’s unmet needs, together with carers’ social support) can all influence the impact that caregiving has on the carer and on how time and energy-consuming caregiving is. The role of increased clinical symptoms (also affecting communication difficulties), together with carers’ exhaustion, must be equated. Overall, these results may help us to tailor interventions addressing RQ and potentially improve dementia outcomes.

scholarly journals Prognosis and Course of Disability in Patients With Chronic Nonspecific Low Back Pain: A 5- and 12-Month Follow-up Cohort Study

2013 ◽  
Vol 93 (12) ◽  
pp. 1603-1614 ◽  
Author(s):  
Karin Verkerk ◽  
Pim A.J. Luijsterburg ◽  
Martijn W. Heymans ◽  
Inge Ronchetti ◽  
Annelies L. Pool-Goudzwaard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Low Back Pain ◽  
Prognostic Factors ◽  
Back Pain ◽  
Short Form ◽  
Low Back ◽  
Multidisciplinary Therapy ◽  
Patient Reported ◽  
Specific Disability

Background Few data are available on the course of and predictors for disability in patients with chronic nonspecific low back pain (CNSLBP). Objective The purpose of this study was to describe the course of disability and identify clinically important prognostic factors of low-back-pain–specific disability in patients with CNSLBP receiving multidisciplinary therapy. Design A prospective cohort study was conducted. Methods A total of 1,760 patients with CNSLBP who received multidisciplinary therapy were evaluated for their course of disability and prognostic factors at baseline and at 2-, 5-, and 12-month follow-ups. Recovery was defined as 30% reduction in low back pain–specific disability at follow-up compared with baseline and as absolute recovery if the score on the Quebec Back Pain Disability Scale (QBPDS) was ≤20 points at follow-up. Potential prognostic factors were identified using multivariable logistic regression analysis. Results Mean patient-reported disability scores on the QBPDS ranged from 51.7 (SD=15.6) at baseline to 31.7 (SD=15.2), 31.1 (SD=18.2), and 29.1 (SD=20.0) at 2, 5, and 12 months, respectively. The prognostic factors identified for recovery at 5 and 12 months were younger age and high scores on disability and on the 36-Item Short-Form Health Survey (SF-36) (Physical and Mental Component Summaries) at baseline. In addition, at 5-month follow-up, a shorter duration of complaints was a positive predictor, and having no comorbidity and less pain at baseline were additional predictors at 12-month follow-up. Limitations Missing values at 5- and 12-month follow-ups were 11.1% and 45.2%, respectively. Conclusion After multidisciplinary treatment, the course of disability in patients with CNSLBP continued to decline over a 12-month period. At 5- and 12-month follow-ups, prognostic factors were identified for a clinically relevant decrease in disability scores on the QBPDS.

A sacral arachnoid cyst causing holocord syringomyelia

2011 ◽  
Vol 8 (3) ◽  
pp. 299-302 ◽  
Author(s):  
Sumit Thakar ◽  
Narayanam Anantha Sai Kiran ◽  
Alangar S. Hegde
Keyword(s):  
Mr Imaging ◽  
Arachnoid Cyst ◽  
Complete Resolution ◽  
Spastic Paraparesis ◽  
Arachnoid Cysts ◽  
Sensory Loss ◽  
Low Back ◽  
Filum Terminale ◽  
Sensory Deficits

Spinal extradural arachnoid cysts (ACs) have an infrequent predilection for the sacrum. As with their counterparts in other regions of the spine, cysts in this location are mostly asymptomatic. Common presentations in symptomatic cases include pain in the low back or perineum, radiculopathy, and sphincteric dysfunction. The authors report a hitherto undescribed presentation in which the predominant symptoms are those related to an associated holocord syrinx. This 15-year-old boy presented with fluctuating, spastic paraparesis and a dissociated sensory loss in the trunk. Admission MR imaging of the spine showed an extradural AC from S-2 to S-4 and a holocord, nonenhancing syrinx. The patient underwent S-2 laminectomy, fenestration of the cyst, and partial excision of its wall. Intradural exploration revealed a normal-looking filum terminale and the absence of any dural communication with the cyst. At a follow-up visit 6 months after surgery, his motor and sensory deficits had resolved. Follow-up MR imaging showed complete resolution of the syrinx in the absence of the sacral AC. This is the first report of a sacral extradural AC causing holocord syringomyelia. Because conventional theories of syrinx formation were not helpful in elucidating this case, a hypothesis is postulated to explain the clinicoradiological oddity.

Surgical management of giant sacral schwannomas

1986 ◽  
Vol 65 (3) ◽  
pp. 286-295 ◽  
Author(s):  
Chad D. Abernathey ◽  
Burton M. Onofrio ◽  
Bernd Scheithauer ◽  
Peter C. Pairolero ◽  
Thomas C. Shives
Keyword(s):  
Preoperative Assessment ◽  
Daily Activities ◽  
Joint Involvement ◽  
Complete Relief ◽  
Minimal Risk ◽  
Low Back ◽  
Content Type ◽  
Benign Schwannoma ◽  
Anterior Aspect

✓ Thirteen cases of giant sacral schwannomas with erosion of the anterior aspect of the sacrum and associated intrapelvic extension are reviewed. These tumors showed no sex predilection; the patients' mean age was 38.6 years at the time of diagnosis, and their symptoms predated the diagnosis by an average of 5.2 years. The most common symptoms were low-back pain and lower-extremity dysesthesiae. Plain roentgenograms, myelography, and computerized tomography constituted essential and complementary studies in the preoperative assessment. Choice of surgical approach (anterior transabdominal vs. posterior transsacral) was dependent upon the amount of sacral destruction, intrapelvic extension, and sacroiliac joint involvement. Microscopic examination revealed classic features of benign schwannoma in all but three cases, which were classified as cellular schwannomas. Patients who presented with pain and dysesthesiae reported immediate and complete relief of symptoms following surgery. In addition, all 13 patients were ambulatory and able to resume their routine daily activities postoperatively. At the last reported follow-up examination, which ranged from 5 months to 33 years and 3 months (mean 9 years) after surgery, two patients had died of unrelated causes, two reported return of preoperative symptoms, and the remainder were asymptomatic. This experience suggests that these histologically benign but neurologically devastating tumors should be aggressively resected with the intent of complete extirpation, and that this goal may be accomplished with minimal risk and an excellent prognosis.

scholarly journals Evaluation of the EQ-5D-3L and 5L versions in low back pain patients

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
A. M. Garratt ◽  
H. Furunes ◽  
C. Hellum ◽  
T. Solberg ◽  
J. I. Brox ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Missing Data ◽  
Measurement Properties ◽  
Low Back ◽  
Improve Measurement ◽  
Multicenter Randomized Controlled Trial ◽  
Patient Reported ◽  
Ceiling Effects

Abstract Background The EuroQol EQ-5D is one of the most widely researched and applied patient-reported outcome measures worldwide. The original EQ-5D-3L and more recent EQ-5D-5L include three and five response categories respectively. Evidence from healthy and sick populations shows that the additional two response categories improve measurement properties but there has not been a concurrent comparison of the two versions in patients with low back pain (LBP). Methods LBP patients taking part in a multicenter randomized controlled trial of lumbar total disc replacement and conservative treatment completed the EQ-5D-3L and 5L in an eight-year follow-up questionnaire. The 3L and 5L were assessed for aspects of data quality including missing data, floor and ceiling effects, response consistency, and based on a priori hypotheses, associations with the Oswestry Disability Index (ODI), Pain-Visual Analogue Scales and Hopkins Symptom Checklist (HSCL-25). Results At the eight-year follow-up, 151 (87%) patients were available and 146 completed both the 3L and 5L. Levels of missing data were the same for the two versions. Compared to the EQ-5D-5L, the 3L had significantly higher floor (pain discomfort) and ceiling effects (mobility, self-care, pain/discomfort, anxiety/depression). For these patients the EQ-5D-5L described 73 health states compared to 28 for the 3L. Shannon’s indices showed the 5L outperformed the 3L in tests of classification efficiency. Correlations with the ODI, Pain-VAS and HSCL-25 were largely as hypothesized, the 5L having slightly higher correlations than the 3L. Conclusion The EQ-5D assesses important aspect of health in LBP patients and the 5L improves upon the 3L in this respect. The EQ-5D-5L is recommended in preference to the 3L version, however, further testing in other back pain populations together with additional measurement properties, including responsiveness to change, is recommended. Trial registration: retrospectively registered: https://clinicaltrials.gov/ct2/show/NCT01704677.

scholarly journals A Novel Placement Technique of S2 Screw (from S2 to Promontorium) and Double Screwing from S2

2021 ◽  
Author(s):  
Sedat Dalbayrak ◽  
Ahmet Öğrenci ◽  
Ezgi Akar ◽  
Orkun Koban ◽  
Mesut Yılmaz
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Revision Surgery ◽  
Chronic Low Back Pain ◽  
Screw Placement ◽  
Low Back ◽  
Screw Loosening ◽  
Dynamic Instrumentation ◽  
Placement Technique

AbstractSince pseudoarthrosis or screw loosening is frequently seen in lumbosacral stabilizations ending in S1, S2 screws are used more frequently to support S1 screws. This study aims to describe a new screw placement technique and location from S2. Revision surgery was applied to the patient who had previously undergone surgery with the rigid instrumentation system and encountered pseudoarthrosis during the follow-up period. Instrumentation was performed from S2 to the promontorium. The patient’s chronic low back pain arising due to pseudoarthrosis was reduced and a strong lumbosacral dynamic instrumentation was performed to the patient. Dual screw placement from S2 and/or screw placement in the S2-promontorium direction is a new alternative to provide a powerful instrumentation.

Thoracolumbar Fascia Enthesopathy as a Cause of Low Back Pain: A Retrospective and Follow-up Study

2021 ◽  
Author(s):  
Ouidade A. Tabesh ◽  
Roba Ghossan ◽  
Soha H Zebouni ◽  
Rafic Faddoul ◽  
Michel Revel ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Iliac Crest ◽  
Pain Syndrome ◽  
Clinical Findings ◽  
Complete Relief ◽  
Low Back ◽  
Thoracolumbar Fascia ◽  
The Mean

Abstract Aim. To evaluate ultrasonography findings of Thoracolumbar Fascia (TLF) enthesis in patients with low back pain (LBP) due to iliac crest pain syndrome (ICPS). Method. The ultrasonographic and clinical findings of 60 patients with LBP due to ICPS were compared to those of 30 healthy volunteers with no LBP. Thickness of the TLF was measured with ultrasound (US) at its insertion on the iliac crest. Results. Forty-eight women and 12 men with a mean age of 42.1±11.3 years were diagnosed with ICPS. In patients, the mean thickness of the TLF was 2.51±0.70mm in affected sides compared to 1.81±0.44mm in the contralateral unaffected sides. The mean thickness difference of 0.82mm between the affected and non-affected sides was statistically significant (95%CI, 0.64-0.99, P<0.0001). In volunteers, the mean thickness of the TLF was 1.6±0.2mm. The mean thickness difference of 0.89mm between the affected sides of patients and volunteers was statistically significant (95%CI, 0.73-1.06, P<0.0001). Forty-two patients who didn’t improve with conservative therapy, received injections of methylprednisolone acetate and 1% lidocaine around the TLF enthesis. All patients reported complete relief of their LBP within 20 minutes of the injections thanks to the lidocaine anesthetic effect. Fifty-six (93.3%) patients were reached by phone for a long-term follow-up. Among them, 33 (58.9%) patients experienced a sustained complete pain relief after a mean follow-up of 45±19.3 months (range, 3-74 months). Conclusion. our findings suggest that TLF enthesopathy is a potential cause of nonspecific LBP that can be diagnosed using US.

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