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RESULTS One hundred thirty patients were admitted to the hospital after visiting the ED and underwent an emergency discectomy after a median of 1.0 days from admittance. Six patients in the study group [4.6% (95% CI 2.1-9.7)] had recurrent LDH and nine patients in total [6.9% (95% CI 3.9-12.6)] were readmitted within 30 days. None of the baseline variables clearly predicted recurrence. Mean ODI difference between the study group and controls was 8.1 (95% CI -6.7-23.2). BMI and surgery by a non-spine surgeon were associated with higher ODI values. CONCLUSION An emergency discectomy is associated with a higher rate than expected of both recurrent LDHs and 30-day readmissions. Surgeon experience and patient-related factors had minor effects on the 30-day clinical outcome. LEVEL OF EVIDENCE 4.STUDY DESIGN Prospective cohort stud.y OBJECTIVE. Investigate the effect of surgical decompression and fusion on gait ground reaction forces (GRFs) parameters in patients with cervical spondylotic myelopathy (CSM) and to compare these values to those of healthy controls. SUMMARY OF BACKGROUND DATA Surgical intervention to alleviate spinal cord compression is typically recommended in cases of CSM. While the primary aim of surgery is to halt disease progression, the literature suggests that some symptomatic improvement is often observed post-operatively. Gait analysis via measurement of GRFs is a particularly sensitive means of quantifying changes in ambulatory function, but no comprehensive analysis has been published in the setting of CSM. METHODS Forty patients with symptomatic CSM underwent gait analysis with measurement of horizontal and vertical GRFs before and three months after surgery. Thirty healthy controls (H) underwent the same battery of tests. Comparisons were made between the pre- and post-operaar falls. Surgical intervention was observed to produce improvements in but not complete resolution of these gait disturbances. These data provide a more comprehensive understanding of gait in the setting of CSM. LEVEL OF EVIDENCE 3.STUDY DESIGN Retrospective case control study. OBJECTIVE The aim of this study was to analyze the appropriate traction period and preoperative halo traction (HT)-related factors in severe scoliosis SUMMARY OF BACKGROUND DATA. HT can reduce risks involved in severe scoliosis treatment, and its safety and efficacy are well known. However, a lack of evidence exists in guiding the appropriate traction period and other factors involved in HT. METHODS We retrospectively reviewed 59 patients who underwent preoperative HT, analyzed correction rate changes over time using HT, and assessed other factors by dividing the patients into two groups according to differences between the post-bending correction angle (PBC) and post-halo traction correction angle (PTC) group A (PBC ≒ PTC) and group B (PBC 8°, the maximum measurement error when measuring the Cobb angle. RESULTS The mean Cobb angle improved from 96.9° preoperatively to 72.9° post-bending to 63.3° post-traction and 32.5° postoperatively. The coronal correction of the major curve (change in curve from the start to each week/total change in curve after traction) was 28.2% at 1 week (n = 59), 34.0% at 2 weeks (n = 58), 33.8% at 3 weeks (n = 41), and 32.2% at 4 weeks (n = 13); a difference was noted between the first and second weeks (P  less then  0.001, less then 0.001, 0.244, and 0.082, respectively). Compared with group A, group B had a lower height (154.9 vs. 144.4 cm, P = 0.029), lower body weight (49.1 vs. 39.4 kg, P = 0.017), higher traction/body weight ratio (0.41 vs. 0.47, P = 0.025), and more halo-femoral traction (0 vs. 6, P = 0.018). CONCLUSION Traction for ≥3 weeks was unnecessary for optimal traction. In patients with low height and weight, halo-femoral traction with a heavy traction weight was effective. LEVEL OF EVIDENCE 4.STUDY DESIGN A cross-sectional study of the Northern Finland Birth Cohort 1966 (NFBC1966). OBJECTIVE The aim of this study was to evaluate the association between the type, size, and location of lumbar Modic changes (MC), and prolonged disabling low back pain (LBP). SUMMARY OF BACKGROUND DATA LBP is the leading cause of disability worldwide and it affects all age- and socioeconomical groups. Only a small proportion of LBP patients are diagnosed with a specific cause In most cases no single nociceptive cause for the pain can be identified. MC are visualized in magnetic resonance imaging (MRI) as a signal intensity change in vertebral bone marrow and have been proposed to represent a specific degenerative imaging phenotype associated with LBP. MC can be classified into several subtypes, of which inflammatory Type 1 (MC1) is suggested as being more likely to be associated with LBP. METHODS We assessed lumbar MRI (n = 1512) for the presence, type, and size of MC. The associations of MC characteristics with prolonged (≥30 days during the past year) and disabling (bothersomeness of LBP at least 6 on a 0-10 Numeric Rating Scale) LBP, evaluated at the time of imaging at 47 years, were analyzed using binary logistic regression, adjusted for sex, BMI, smoking, educational status, lumbar disc degeneration, and disc herniations. RESULTS Any MC and MC1 were associated with prolonged disabling LBP (odds ratio [OR] after full adjustments 1.50 [95% confidence interval, CI 1.05-2.15] and 1.50 [95% CI 1.10-2.05], respectively). [https://www.selleckchem.com/products/oleic-acid.html Oleic] Furthermore, MC covering the whole anterior-posterior direction or the whole endplate, as well as the height of MC, were significantly associated with prolonged disabling LBP (OR after full adjustments 1.59 [95% CI 1.14-2.20], 1.67 [95% CI 1.13-2.46] and 1.26 [95% CI 1.13-1.42], respectively). CONCLUSION Our study showed a significant and independent association between MC and clinically relevant LBP. LEVEL OF EVIDENCE 3.PURPOSE To evaluate the results of cataract extraction with primary intraocular lens (IOL) implantation in patients with juvenile idiopathic arthritis (JIA) and uveitis related cataract. SETTING Department of Ophthalmology, Helsinki University Hospital, Finland. DESIGN Retrospective case series. METHODS All consecutive patients younger than 20 years with JIA-uveitis-related cataract undergoing cataract extraction with primary IOL implantation in 1 or both eyes at the Department of Ophthalmology, Helsinki University Hospital, Finland, from February 2000 to April 2012 were included. Twenty eligible patients with 26 operated eyes were identified; 14 were girls and 6 were boys. All patients had a follow-up of 5 years and 13 patients (65%; 16 eyes) reached 10 years of follow-up. RESULTS Twenty-six eyes of 20 patients were studied. Preoperative median corrected distance visual acuity (CDVA) was 0.05 in decimal notation. Median CDVA was 1.0 at 5 years and 0.9 at 10 years of follow-up. Two eyes did not reach CDVA 0.5 with the operation, and in 2 eyes CDVA decreased below 0.