| 1. |
- Strömqvist, Fredrik, et al.
(författare)
-
Gender differences in lumbar disc herniation surgery
- 2008
-
Ingår i: Acta Orthopaedica. - Basingstoke, Hampshire, UK : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 79:5, s. 643-649
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Although there have been numerous publications on lumbar disc herniation (LDH) treated surgically, there has been little interest in sex differences. It has been shown in many studies that sex differences may be important in certain diseases. We therefore reviewed consecutive register material from one institution for possible gender differences in pre- and postoperative parameters in patients operated for lumbar disc herniation.PATIENTS AND METHODS: Pre- and postoperative parameters for all patients operated on at the Department of Orthopedics, Lund University Hospital over 6 years (2000-2005 inclusive) (301 patients, 165 males) were analyzed regarding sex differences.RESULTS: Statistically significant and clinically relevant sex differences were found. Preoperatively, females had more pronounced back pain and disability, and also lower quality of life in some respects. At 1-year followup, females reported a higher rate of consumption of analgesics, a higher degree of postoperative back and leg pain, and less improvement regarding disability and some aspects of quality of life. Relative improvement, rate of return to work, and satisfaction with the outcome of surgery were not, however, statistically significantly different between females and males.INTERPRETATION: There are statistically significant differences between the sexes in lumbar disc herniation surgery regarding basic demographic status and postoperative status, whereas the surgical effect is similar. Further investigations should focus on whether there is a true sex difference or whether these differences are due to selection for surgery, differences in proneness to seek medical advice or to accept/choose surgery, or other unknown factors.
|
|
| 2. |
|
|
| 3. |
- Axelsson, Paul, et al.
(författare)
-
Adjacent segment hypermobility after lumbar spine fusion: No association with progressive degeneration of the segment 5 years after surgery.
- 2007
-
Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 78:6, s. 834-839
-
Tidskriftsartikel (refereegranskat)abstract
- Background and purpose Increased intradiscal pressure and relative segmental hypermobility are in vitro observations supporting the idea of increased postoperative load being a reason for progressive degeneration of the free mobile segment adjacent to a lumbar fusion. These mechanisms have been difficult to confirm in clinical studies, and an alternative theory claims instead that the adjacent segment degeneration follows a natural degenerative course in patients who are predisposed. We examined 9 patients 5 years after lumbar fusion, to assess whether relative hypermobility of the segment adjacent to fusion could be correlated to progressive degeneration of the same segment. Patients and methods The 9 patients, all of whom had been treated with a lumbar fusion after a preoperative intervertebral mobility assessment by spinal RSA, were re-examined 5 years after surgery. The intervertebral translations of the vertebra proximal to the fusion were determined by RSA and compared to the mobility of the same lumbar segment before fusion. The disc height and any progressive reduction at the two levels proximal to the one fused were measured on conventional radiographs. Results Adjacent segment mobility 5 years after fusion - expressed as mean transverse, vertical, and sagittal translation of the vertebra proximal to fusion - was not significantly changed compared to the mobility measured before surgery. Increased mobility of the segment seen in 5 individual patients was not associated with progressive degeneration of the same segment or to a poor clinical outcome. Interpretation Hypermobility of the segment adjacent to fusion is not a general finding. Increased mobility that can be seen in certain individuals does not impair the 5-year result. The significance of mechanical alterations in adjacent segment degeneration is uncertain, and it is possibly overestimated.
|
|
| 4. |
- Axelsson, Paul, et al.
(författare)
-
Radiostereometry in lumbar spine research.
- 2006
-
Ingår i: Acta Orthopaedica. Supplementum. - : Medical Journals Sweden AB. - 1745-3690 .- 1745-3674 .- 1745-3682. ; 77:323, s. 3-42
-
Forskningsöversikt (refereegranskat)
|
|
| 5. |
- Breidegard, Björn, et al.
(författare)
-
Disclosing the secrets of braille reading: Computer-aided registration and interactive analysis
- 2006
-
Ingår i: Visual Impairment Research. - 1388-235X. ; 8:3, s. 49-59
-
Tidskriftsartikel (refereegranskat)abstract
- The pilot project reported here utilized the first technology ever developed for the computerized on-line registration and analysis of finger movements during Braille reading. Five congenitally blind subjects performed tactile reading of pedagogically carefully selected texts. Two specialists in visual impairments analyzed the computer-registered reading activities using specially designed interaction software. The subjects themselves were interviewed and contributed to discussions about their own individual reading styles. The analyses of this first handful of subjects reveal a number of important strategies and preferences with regard to on-line tactile reading. Further, the results challenge several assumptions and practices in Braille teaching. This pilot project lays the foundation for more comprehensive large-scale studies - both cross-sectional and longitudinal ones - studies long wanted in the domain of tactile reading.
|
|
| 6. |
- Breidegard, Björn, et al.
(författare)
-
Enlightened: The art of finger reading
- 2008
-
Ingår i: Studia Linguistica. - : Wiley. - 1467-9582 .- 0039-3193. ; 62:3, s. 249-260
-
Tidskriftsartikel (refereegranskat)abstract
- For some forty years the eye-tracking technology has facilitated the study of eye movement patterns for sighted people during reading and other visual activities. Today – a newly developed automatic finger tracking system makes it possible to reconstruct blind people’s tactile reading in real time and to automatically analyze finger movements during Braille text reading and tactile picture recognition. In this case study, the very first automatic finger tracking system is presented together with results indicating how Braille readers can increase awareness of their own reading styles. This opens up for future Braille education to become more evidence-based and, at the same time, for a new research field: contrastive studies of language in its auditory, visual and tactile manifestations.
|
|
| 7. |
- Feng, Haoyu, et al.
(författare)
-
Extracellular matrix in disc degeneration.
- 2006
-
Ingår i: Journal of Bone and Joint Surgery. American Volume. - 1535-1386. ; 88:Suppl 2, s. 25-29
-
Tidskriftsartikel (refereegranskat)abstract
- The extracellular matrix of the intervertebral disc structures contains many molecules also found in cartilage. The extremely polyanionic proteoglycans play a central role, particularly in the nucleus, by creating an osmotic environment leading to retention of water and ensuing resistance to deformation—important for the resilience of the tissue. Another major structural entity particularly important in the anulus is the network of collagen fibers; fibril-forming collagen 1 is a major constituent. The collagen fibrils in the anulus are largely oriented in sheets around the nucleus. A number of molecules present in the matrix regulate and direct the collagen fibril assembly by interacting with the collagen molecule and also the formed fibril. Several of these molecules bind by one domain to the collagen fiber and present another functional domain to interact either with other fibers or with other matrix constituents. In this manner the collagen fibers are cross-linked into a network that provides tensile strength and distributes load over large parts of the anulus. Diminished function in these cross-bridging molecules will lead to loss of mechanical properties of the collagen network and result in an impaired ability of the anulus to resist forces delivered by compression of the disc and particularly the nucleus. A different network abundant in the disc and in other load-bearing tissues is based on the beaded filaments of collagen 6. The basic building block is a tetramer of two pairs of antiparallel collagen-6 molecules arranged such that two N-terminal ends of collagen 6 are exposed at either end of the unit. Further assembly occurs both by end-to-end and side-to-side associations. This process is catalyzed by both biglycan and decorin, where the combined effect of direct binding of the core protein to the collagen-6 N-terminal globular domain and the presence of the glycosaminoglycan side chain is essential. These ligands are bound at the same site in complexes extracted from the tissue and then also have one bound molecule of matrilin-1, 2, or 3, in turn bound to a collagen fiber, a procollagen molecule, or an aggrecan. Interactions at the cell surface provide signals to the cells with regard to the conditions of the matrix. Such interactions include binding by matrix components to various receptors at the cell surface. Remodeling of the matrix takes place in response to various factors. An early event in disease is degradation of aggrecan by the members of the ADAMTS (a disintegrin-like and metalloprotease with thrombospondin motifs) family and degradation of molecules important in maintaining the collagen network.
|
|
| 8. |
- Forslund, Carina, et al.
(författare)
-
Effects of high-intensity focused ultrasound on the intervertebral disc: A potential therapy for disc herniations
- 2006
-
Ingår i: Journal of Clinical Ultrasound. - : Wiley. - 0091-2751 .- 1097-0096. ; 34:7, s. 330-338
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose. To determine the potential application of high-intensity focused ultrasound for the minimally invasive treatment of herniated intervertebral discs by developing a probe that produces sufficiently high temperature locally to shrink collagen fibers (65-75 degrees C). Materials and Methods. A 5-mm ultrasound probe was produced with a geometric focal length of 15 mm. The probe produced 2.5 W of acoustic power and was operated at a frequency of 4.1 MHz. Measurements of temperature increase were performed in discs from bovine tails. In vivo experiments were performed to assess histologic changes in the disc as well as in nerve root and muscle. Results. Sufficient temperature increase to produce collagen shrinkage was observed close to the focus of the ultrasound. Temperature measurements in vertebral end plates showed a temperature increase of only 4 degrees C after 60-second exposure of the disc. In vivo experiments revealed histologic changes in the disc consistent with collagen shrinkage, with no adverse effects seen in surrounding tissues. Conclusions. The experiments demonstrated the feasibility of high-intensity focused ultrasound in the treatment of contained herniated discs. This technique has several advantages over other thermal treatment modalities. (C) 2006 Wiley Periodicals, Inc.
|
|
| 9. |
- Fritzell, P., et al.
(författare)
-
A practical approach to spine registers in Europe: the Swedish experience
- 2006
-
Ingår i: Eur Spine J. - : Springer Science and Business Media LLC. - 0940-6719 .- 1432-0932. ; 15 Suppl 1, s. S57-63
-
Tidskriftsartikel (refereegranskat)abstract
- Today there is growing awareness among spine surgeons of the advantages in using registers to facilitate the analyses and reporting of treatment outcome. The Swedish Spine register is among the first to be used on a national scale and annual reports are published in international journals. In this paper we discuss our experiences and lessons learned from a paper-based version in 1993, to an online web-based solution in 2005. We emphasise the advantages of registers being owned by the national spine society, a support function available during working hours, online feedback to participating departments and professional assistance in designing a register program for web use. Hopefully, our experiences will be of help to colleagues who are planning to start registering.
|
|
| 10. |
- Millisdotter, Monica, et al.
(författare)
-
Early neuromuscular customized training after surgery for lumbar disc herniation: a prospective controlled study.
- 2007
-
Ingår i: European Spine Journal. - : Springer Science and Business Media LLC. - 0940-6719 .- 1432-0932. ; 16:1, s. 19-26
-
Tidskriftsartikel (refereegranskat)abstract
- A prospective and controlled study of training after surgery for lumbar disc herniation (LDH). The objective was to determine the effect of early neuromuscular customized training after LDH surgery. No consensus exists on the type and timing of physical rehabilitation after LDH surgery. Patients aged 15-50 years, disc prolapse at L4-L5 or L5-S1. Before surgery, at 6 weeks, 4, and 12 months postoperatively, the following evaluations were performed: low back pain and leg pain estimated on a visual analog scale, disability according to the Roland-Morris questionnaire (RMQ) and disability rating index (DRI). Clinical examination, including the SLR test, was performed using a single blind method. Consumption of analgesics was registered. Twenty-five patients started neuromuscular customized training 2 weeks after surgery (early training group=ETG). Thirty-one patients formed a control group (CG) and started traditional training after 6 weeks. There was no significant difference in pain and disability between the two training groups before surgery. Median preoperative leg pain was 63 mm in ETG and 70 mm in the CG. Preoperative median disability according to RMQ was 14 in the ETG and 14.5 in the CG. Disability according to DRI (33/56 patients) was 5.3 in the ETG vs. 4.6 in the CG. At 6 weeks, 4 months, and 12 months, pain was significantly reduced in both groups, to the same extent. Disability scores were lower in the ETG at all follow-ups, and after 12 months, the difference was significant (RMQ P=.034, DRI P=.015). The results of the present study show early neuromuscular customized training to have a superior effect on disability, with a significant difference compared to traditional training at a follow-up 12 months after surgery. No adverse effects of the early training were seen. A prospective, randomized study with a larger patient sample is warranted to ultimately demonstrate that early training as described is beneficial for patients undergoing LDH surgery.
|
|
