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6 years (SD 1.4, range, 11.2 to 17.7). The mean Cobb angle was 54.4° (SD 13.8°, range, 29° to 92°). Mean MSA was 11.7° (SD 4.0°, range, 4° to 23°). Mean VBR was 14.3° (SD 4.3°, range, 8° to 24°). Through linear regression techniques, the relationships between Cobb angle, MSA and VBR were examined. The R
between Cobb angle and MSA was 9%, between Cobb angle and VBR was 23% and between MSA and VBR was 16%. A multiple regression analysis did not improve these results.
Whilst AIS features both VBR and torso asymmetry, they are poorly related to each other. This may help to explain why surgical de-rotation of the spine does not fully address the rib hump as other factors, yet to be defined, must be involved.
Whilst AIS features both VBR and torso asymmetry, they are poorly related to each other. This may help to explain why surgical de-rotation of the spine does not fully address the rib hump as other factors, yet to be defined, must be involved.
Lumbar spinal stenosis is treated with decompression directly such as laminectomies and indirectly with an interspinous device through distraction and extension block. Interspinous devices (IPD) have also been used as an adjunct to spinal fusion. However, the design for IPD to treat spinal stenosis does not fixate the spine while the design for spinal fusion is designed to fixate the spine. Selleck Eprosartan There is a paucity of data on a single device that has been used for both fusion and stenosis. Authors aim to demonstrate the long-term outcomes of interspinous fixation at L4-5 for degenerative spinal stenosis.
We evaluated patients with spinal stenosis and degenerative disc disease who were treated with open decompression and distraction of the spinous processes at L4-L5 using an interspinous device. All patients complained of lower back pain and neurogenic claudication. This is a retrospective review of prospectively collected data (level 3) under an IRB approved study cohort. The charts of patient undergoing lumbar. There were no complications or blood transfusions.
Long term results demonstrated improved outcomes in patients who underwent Interspinous distraction decompression in an ambulatory surgery center using the INSPAN IPD at L4-L5 for Degenerative Spinal Stenosis. There was one revision converted to hemilaminectomy. There were no complications or blood transfusions.
Recurrent laryngeal nerve (RLN) palsy is a common and potentially debilitating complication of anterior cervical discectomy and fusion (ACDF). The relationship between the risk of RLN palsy and the number of operated levels remains unclear, and no previous studies address potential differences between short- and long-term RLN injury following ACDF.
Electronic searches of PubMed, Cochrane, ScienceDirect and Google Scholar were performed from database inception to June 2019. Relevant studies reporting the rate of RLN palsy for patients undergoing ACDF for cervical spine pathology were identified according to predetermined inclusion and exclusion criteria. Statistical analysis was performed using fixed effects and random effects modelling. I2 and Q statistics were used to explore heterogeneity.
Five studies with a total of 3,514 patients were included in the meta-analysis. The incidence of RLN palsy was found to be 1.2%. There were no statistically significant differences in the rate of RLN palsy between multiple- and single-level ACDF [odds ratio (OR) 1.04; 95% CI 0.56-1.95; P=0.891, I2=0%]. There were similarly no statistically significant differences in RLN palsy rates for multiple- and single-level ACDF when patients were stratified based on length of follow-up of less than or greater than 12 months.
This analysis suggests that there is no statistically significant association between the number of ACDF operative levels and the risk of short- or long-term RLN palsy.
This analysis suggests that there is no statistically significant association between the number of ACDF operative levels and the risk of short- or long-term RLN palsy.
During lumbar spinal fusion, spacer cages are implanted to provide vertebral stability, restore sagittal alignment, and maintain disc and foraminal height. Polyetheretherketone (PEEK) is commonly used by most spine surgeons. Silicon nitride (Si
N
) is a less well-known alternative although it was first used as a spacer in lumbar fusion over 30 years ago. The present study was designed to see if Si
N
cages would perform similarly to PEEK in a randomized controlled trial.
A non-inferiority multicenter 100-patient study was designed where both the observer and patient were blinded. Single- or double-level transforaminal lumbar interbody fusion with pedicle screw fixation using an oblique PEEK or Si
N
cage was performed. The primary non-inferiority outcome was the Roland-Morris Disability Questionnaire (RMDQ). Secondary measures included the Oswestry Disability Questionnaire, Visual Analogue Scales (VAS) for back and leg pain, SF-36 Physical and Mental Function indices, patient and surgeon Likert scor a revised clinically justified non-inferiority margin; and using this method, the non-inferiority of Si
N
was affirmed.
This study demonstrated that the use of either PEEK or Si
N
cages is safe and effective for patients undergoing lumbar spine fusion for chronic degenerative disc disease.
This study demonstrated that the use of either PEEK or Si3N4 cages is safe and effective for patients undergoing lumbar spine fusion for chronic degenerative disc disease.
The increase in newly diagnosed patients with cancer in South Africa and globally, may contribute to the increase in patients living with chemotherapy-induced peripheral neuropathy (CIPN). Chemotherapy-induced peripheral neuropathy negatively impacts on quality of life (QoL) during and post chemotherapy treatment. Physiotherapy management of CIPN helps patients to manage symptoms and improves function in activity- and participation-levels to ultimately improve QoL. However, little evidence exists regarding the type or combination of physiotherapy management strategies in South Africa.
The purpose of our study was to determine how the symptoms of CIPN were managed by physiotherapists in Pretoria, South Africa.
A quantitative, descriptive study design was used. Electronic questionnaires were distributed to physiotherapists who worked with cancer patients and who treated patients with CIPN.
Physiotherapists used massage, proprioceptive neuromuscular facilitation, sensory integration, activities of daily opathy; intervention; management; cancer.
physiotherapy; chemotherapy-induced peripheral neuropathy; intervention; management; cancer.
Stroke is one of the major causes of physical disability worldwide. Whilst physiotherapy interventions are important for the recovery of stroke survivors, the uptake remains inconsistent and factors contributing to these inconsistencies are not well documented, especially in South Africa.
The overall objective was to determine the intrinsic and extrinsic factors associated with adult stroke survivors' inconsistent uptake of physiotherapy interventions at Turton Community Health Centre, Ugu District, KwaZulu-Natal, South Africa.
This was a cross-sectional study involving 50 stroke survivors who missed one or more of their physiotherapy appointments and 25 who attended all their appointments (comparison group) within a 2-year period. A researcher-administered semi-structured questionnaire was used to collect data, which was captured and analysed using SPSS v25. Results were summarised using descriptive statistics. Pearson's chi-square test was used for bivariate analysis.
Only two intrinsic factors were significantly associated with the outcome variable, namely believed in exercises recommended by physiotherapists (χ
= 3.86,
= 0.049) and improvements noted from the start of recommended exercises (χ
= 9.439,
= 0.007). Transportation, including hiring of private cars (74%) and being far away from the health facility (48%), were key extrinsic challenges affecting access to health facilities.
Personal reasons and the difficulty in accessing health facilities were main factors affecting stroke survivors' uptake of physiotherapy interventions.
Design of patient-tracking and family support systems may potentially improve the stroke survivors' uptake of physiotherapy interventions.
Design of patient-tracking and family support systems may potentially improve the stroke survivors' uptake of physiotherapy interventions.
Stroke affects upper trunk postural stability and upper limb function in approximately 85% of stroke survivors. Upper trunk postural stability is essential for functioning of the upper limb and is a prerequisite for hand function. The rehabilitation of the upper limb and upper trunk post-stroke remains a challenge because of poor recovery of motor and sensory function.
To determine the effect of Biodex© upper limb weight-bearing training on upper trunk postural stability in patients post-stroke.
A longitudinal randomised control pilot trial with single blinding was undertaken to assess postural stability on the Biodex© at baseline and 1-month post-baseline. In addition to standard rehabilitative care, upper limb weight-bearing training on the Biodex© was added for participants in the experimental group. Descriptive data analysis and the Mann-Whitney test for group comparisons were done using STATA (
< 0.05).
Fifteen participants took part, seven in the control and eight in the experimental group,mprove upper trunk postural stability in patients post-stroke. The addition of Biodex© training to standard rehabilitative care for retraining and exercising upper trunk postural control in a weight-bearing position does not lead to better outcomes than standard care.
The scapular stabilisers, especially the actions of the force couples around the scapula, have an impact on the biomechanics of the scapula and the orientation of the glenoid.
The aim of our study was to determine both the muscle activity and the correlation between the muscle activity ratio of the lower force couple (the serratus anterior lower fibres and the lower trapezius).
This was a quantitative cross-sectional study. Muscle activity of the dominant serratus anterior lower fibres and the lower trapezius muscles was collected with surface electromyographic (EMG) sensors and an inertial motion capture system was used to measure the three-dimensional (3D) shoulder flexion in the sagittal plane and abduction in the frontal plane. Graph Pad 5 (Prism, San Diego, CA, USA) was used for the statistical analysis. The confidence level was set at 95% (
< 0.05).
Sixteen men and women participated in our study, with a mean (standard deviation) age of 25.4 (± 4.6) years, weight of 80.2 (± 25.1) kg and height of 171.6 (± 10.3) cm. A strong negative correlation was found at the start of the abduction (
= -0.623;
= 0.01) between the muscle activity of the serratus anterior lower fibres and the lower trapezius.
The only significant increase in the mean EMG ratio of serratus anterior lower fibres versus the lower trapezius was present at 60% (from baseline) of abduction (
= 0.03).
The EMG activity ratio of serratus anterior lower fibres and lower trapezius remains variable in different movement planes.
The EMG activity ratio of serratus anterior lower fibres and lower trapezius remains variable in different movement planes.
