脊椎ジャーナル

Study design: Retrospective case series including patient outcome assessment.

Objective: To study the safety and the efficacy of the Spine call spinal fixation system in comparison with similar series.

Background: The purpose was to determine the safety and the efficacy of a system which has been widely used in Brazil for over 15 years.

Methods: A total of 76 consecutive patients were treated by posterior instrumentation and arthrodesis from 2011 through 2017. Safety was evaluated by complications, reoperation type and occurrence. Efficacy was studied by the incidence of deformity corrections.

Results: There were no deaths, spinal cord or nerve root problems, or acute posterior wound infections. Proven pseudo-arthrosis occurred in one patient (1.3%) and in two cases was necessary debridement to remove infected tissue (2.6%). The implant-related reoperation rate was 1.3%, where an increased curvature was observed. The break of one screw (0.07% per screw) was reported, which did not lead to the need for reoperation. The largest Cobb angle averaged 57° pre-operative and 20.7° at latest follow-up, which means a 63.3% correction (p<0.001).

Conclusions: Spinecall spinal fixation system seems to be at least as safe and effective as other instrumentations as used for the surgical treatment of adolescent idiopathic scoliosis.

Study design: Prospective pre-post quasi experimental study design (Level of Evidence-IV).

Objectives: Objective was to find the effectiveness of Molded LSO on postural sway and Pain in subject with NSCLBP.

Background of the data: In orthotic treatment molded Lumbosecral orthosis (LSO) application is still controversial topic in Non-specific Chronic Low Back Pain (NSCLBP). Many studies are concentrated upon postural balance and pain with Spinal orthosis in NSCLBP have significant interrelationship but spinal orthosis with postural balance improvement have no strong evidence but this is an attempt to check the effect on COP and Pain using orthosis. This study will stabilized a clinical report on NSCLBP in terms with COP-sway and Pain in Indian scenario.

Materials and methods: 30 subjects with NSCLBP were included in this study by convenient sampling method. The Postural sway parameters (COP, RMS & Range) in mediolateral (Ax) and anterio-posterior (Ay) direction measured using Kistler force plate in Eye open (EO) and Eye Close (EC) condition and pain using VAS. All the measurements was acquired as baseline (pre) with and without molded LSO, and after (Post) 4 weeks following onset of Molded LSO use.

Results: There was significant difference between pre and post with & without Molded LSO postural sway in mediolateral (Ax) and anterio-posterior (Ay) of COP in both EO and EC condition, (p≤0.05). RMS was in without brace EC and EO and with brace EO in Ay and was in Ax, EO without brace and EC and EO with brace (p ≤ 0.05). Range in Ay EO without brace, and in with brace EO were Ax in EO with brace (p ≤ 0.05). VAS score mean differences were decreased in without and with braces but statistically not significant within groups.

Conclusion: As per present perspective clinical evident report it going to conclude that molded Lumbosacral Orthosis have a significance impact on positive influences for reducing postural sway and pain in short term orthotic treatment protocol. It have positive impact on static postural balance and pain with saliently maintaining the lower COG alignment and unloading lumbar spine by using molded Lumbosacral Orthosis in subjects. One center prospective short term clinical report cannot indiscriminate the positive impact of molded Lumbosacral Orthosis in NSCLBP. So the molded Lumbosacral Orthosis can be recommended as a RCT study on this prospect for short term use orthotic plan in NSCLBP.

Vertebral bony tumors are notorious for their ability to mimic each other. With ever changing treatment protocols and newer adjuvant therapies introduced at regular intervals of time, we considered a small but concise update on management of these entities with our own diagnostic algorhythm, along with brief details on management, and a quick access table for radiological diagnosis. We hope that this effort, prepared with an extensive literature review supplemented with images and tables will assist in updating spine surgeons of all hues and thus assist in treating their patients.