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Sökning: hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Klinisk medicin) hsv:(Ortopedi) > Strömqvist Björn

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1.
  • Strömqvist, Björn, et al. (författare)
  • Ansiktsskydd for buklägesoperationer
  • 2001
  • Ingår i: Ortopediskt Magasin. - 0349-733X. ; :1, s. 18-18
  • Tidskriftsartikel (populärvet., debatt m.m.)
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3.
  • Londos, Elisabet, et al. (författare)
  • Internal fixation of femoral neck fractures in Parkinson's disease. 32 patients followed for 2 years
  • 1989
  • Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 60:6, s. 682-685
  • Tidskriftsartikel (refereegranskat)abstract
    • 32 patients, suffering from Parkinson's disease, had internal fixation of femoral neck fractures. In 24 displaced fractures, 6 nonunions and 3 segmental collapses were seen; and in 8 undisplaced fractures, 1 case of segmental collapse was diagnosed. Healing complications were thus seen in one third. Total hip replacement for healing complication was performed in 3 of 32 patients. 9 patients died within 2 years. No difference in the rate of healing or mortality was detected compared with hip fracture patients without Parkinson's disease. Our study does not support primary arthroplasty for femoral neck fracture in patients with Parkinson's disease.
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4.
  • 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.
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5.
  • Hareni, Niyaz, et al. (författare)
  • Back pain is also improved by lumbar disc herniation surgery
  • 2021
  • Ingår i: Acta Orthopaedica. - : Taylor & Francis. - 1745-3674 .- 1745-3682. ; 92:1, s. 4-8
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and purpose: Indication for lumbar disc herniation (LDH) surgery is usually to relieve sciatica. We evaluated whether back pain also decreases after LDH surgery.Patients and methods: In the Swedish register for spinal surgery (SweSpine) we identified 14,097 patients aged 20-64 years, with pre- and postoperative data, who in 2000-2016 had LDH surgery. We calculated 1-year improvement on numeric rating scale (rating 0-10) in back pain (Nback) and leg pain (Nleg) and by negative binomial regression relative risk (RR) for gaining improvement exceeding minimum clinically important difference (MCID).Results: Nleg was preoperatively (mean [SD]) 6.7 (2.5) and Nback was 4.7 (2.9) (p < 0.001). Surgery reduced Nleg by mean 4.5 (95% CI 4.5-4.6) and Nback by 2.2 (CI 2.1-2.2). Mean reduction in Nleg) was 67% and in Nback 47% (p < 0.001). Among patients with preoperative pain ≥ MCID (that is, patients with significant baseline pain and with a theoretical possibility to improve above MCID), the proportion who reached improvement ≥ MCID was 79% in Nleg and 60% in Nback. RR for gaining improvement ≥ MCID in smokers compared with non-smokers was for Nleg 0.9 (CI 0.8-0.9) and -Nback 0.9 (CI 0.8-0.9), and in patients with preoperative duration of back pain 0-3 months compared with > 24 months for Nleg 1.3 (CI 1.2-1.5) and for Nback 1.4 (CI 1.2-1.5).Interpretation: LDH surgery improves leg pain more than back pain; nevertheless, 60% of the patients with significant back pain improved ≥ MCID. Smoking and long duration of pain is associated with inferior recovery in both Nleg and Nback.
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7.
  • Sigmundsson, Freyr Gauti, 1972-, et al. (författare)
  • Determinants of patient satisfaction after surgery for central spinal stenosis without concomitant spondylolisthesis : a register study of 5100 patients
  • 2017
  • Ingår i: European spine journal. - : Springer. - 0940-6719 .- 1432-0932. ; 26:2, s. 473-480
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: Satisfaction with the outcome of treatment is a widely used outcome measure but information about the determinants of patient satisfaction after surgery for central spinal stenosis (CSS) are lacking. The aim of the study was to analyze determinants of patient satisfaction 1 year after surgery for CSS without degenerative spondylolisthesis (DS).METHODS: This prospective register study included 5100 patients operated for CSS without DS. 88 % received decompression only (D) and 12 % had decompression and fusion (DF). The patient reported outcome measures were the EuroQol-5D, the Short-Form 36, the visual analogue scale for leg and back pain, the Oswestry disability index and the self-estimated walking distance. Logistic regression reporting odds ratios (OR) for being satisfied was utilized.RESULTS: There were significant baseline differences between satisfied and dissatisfied patients in all patient reported outcome measures except leg pain. Factors decreasing the likelihood for satisfaction included previous spine surgery OR: 0.4 (95 % CI: 0.3-0.5), smoking OR: 0.6 (95 % CI: 0.4-0.8), unemployment OR: 0.6 (95 % CI: 0.4-0.9), back pain exceeding 1 year OR: 0.6 (95 % CI: 0.4-0.9), back pain predominance OR: 0.7 (95 % CI: 0.5-0.8). Fusion surgery did not predict satisfaction OR: 1.3 (95 % CI: 0.9-1.9). Preoperative self-estimated walking distance >1000 m predicted satisfaction, OR: 2.4 (95 %: 1.6-3.6).CONCLUSIONS: Numerous factors have predictive value for satisfaction of outcome after surgery for CSS without DS. The results from this study can constitute background data in the shared decision making process when discussing surgery with patients suffering from CSS.
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8.
  • Sigmundsson, Freyr Gauti, et al. (författare)
  • Preoperative Pain Pattern Predicts Surgical Outcome more than Type of Surgery in Patients With Central Spinal Stenosis Without Concomitant Spondylolisthesis: A Register Study of 9,051 Patients.
  • 2014
  • Ingår i: Spine. - : Lippincott Williams & Wilkins. - 0362-2436 .- 1528-1159. ; 39:3, s. 199-210
  • Tidskriftsartikel (refereegranskat)abstract
    • Study Design. A register cohort study.Objective. To evaluate outcome of surgery for lumbar spinal stenosis without concomitant degenerative spondylolisthesis according to predominance of pain and to analyze the role of spinal fusion in conjunction with decompression in patients with predominant back or leg pain.Summary of Background Data. Predominance of back pain is associated with inferior outcome of surgery for central spinal stenosis (CSS). It is unknown if adding spinal fusion improves outcomes.Methods. In a register study of 9,051 patients we studied outcome of surgery in terms of back and leg pain (VAS), function (the Oswestry disability index and self-estimated walking distance), health-related quality of life (SF-36 and EQ-5D), and patient satisfaction. Outcome was analyzed for 4 groups at 1 and 2 year follow up; preop back pain ≥ leg pain and decompression, preop back pain ≥ leg pain and decompression and fusion, preop back pain < leg pain and decompression, preop back pain < decompression and fusion.Results. Patients with concomitant fusion were younger and had higher back pain and ODI scores and lower preoperative EQ-5D. Predominant back pain was associated with inferior outcome in terms of pain, health-related quality of life and function. Patients most often satisfied (69%) were patients with back pain < leg pain treated with decompression and fusion and the least satisfied group was patients with back pain ≥ leg pain treated with decompression (54%). Fusion was associated with higher EQ-5D at 1-year follow up for patients with predominant back pain up but was also associated with increased leg pain at 2- year follow up in patients with predominant leg pain. Patients with predominant back pain experienced small gains in the physical component summary with fusion.Conclusion. Predominance of back pain is associated with inferior outcome. Adding spinal fusion improves unadjusted outcome but the benefit is small and not clinically significant and generally disappears in the adjusted analysis.
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9.
  • Sigmundsson, Freyr Gauti, 1972-, et al. (författare)
  • Prognostic factors in lumbar spinal stenosis surgery
  • 2012
  • Ingår i: Acta Orthopaedica. - : Taylor & Francis. - 1745-3674 .- 1745-3682. ; 83:5, s. 536-542
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND AND PURPOSE: A considerable number of patients who undergo surgery for spinal stenosis have residual symptoms and inferior function and health-related quality of life after surgery. There have been few studies on factors that may predict outcome. We tried to find predictors of outcome in surgery for spinal stenosis using patient- and imaging-related factors.PATIENTS AND METHODS: 109 patients in the Swedish Spine Register with central spinal stenosis that were operated on by decompression without fusion were prospectively followed up 1 year after surgery. Clinical outcome scores included the EQ-5D, the Oswestry disability index, self-estimated walking distance, and leg and back pain levels (VAS). Central dural sac area, number of levels with stenosis, and spondylolisthesis were included in the MRI analysis. Multivariable analyses were performed to search for correlation between patient-related and imaging factors and clinical outcome at 1-year follow-up.RESULTS: Several factors predicted outcome statistically significantly. Duration of leg pain exceeding 2 years predicted inferior outcome in terms of leg and back pain, function, and HRLQoL. Regular and intermittent preoperative users of analgesics had higher levels of back pain at follow-up than those not using analgesics. Low preoperative function predicted low function and dissatisfaction at follow-up. Low preoperative EQ-5D scores predicted a high degree of leg and back pain. Narrow dural sac area predicted more gains in terms of back pain at follow-up and lower absolute leg pain.INTERPRETATION: Multiple factors predict outcome in spinal stenosis surgery, most importantly duration of symptoms and preoperative function. Some of these are modifiable and can be targeted. Our findings can be used in the preoperative patient information and aid the surgeon and the patient in a shared decision making process.
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10.
  • Strömqvist, Björn, et al. (författare)
  • X-Stop Versus Decompressive Surgery For Lumbar Neurogenic Intermittent Claudication: A Randomized Controlled Trial With 2 Years Follow-Up.
  • 2013
  • Ingår i: Spine. - 0362-2436 .- 1528-1159. ; 38:17
  • Tidskriftsartikel (refereegranskat)abstract
    • ABSTRACT: Study Design. Prospective randomized controlled study.Objective. To compare the outcome of indirect decompression by means of the X-Stop implant to conventional decompression in patients with neurogenic intermittent claudication due to lumbar spinal stenosis.Summary of Background Data. Decompression is the golden standard for lumbar spinal stenosis nowadays but afflicted with complications and a certain number of dissatisfied patients. Interspinous implants have been on the market for more than 10 years but no prospective study comparing its outcome to decompression has been performed.Methods. After power calculation 100 patients were included, 50 in X-Stop group and 50 in decompression group. Patients with symptomatic one- or two-level lumbar spinal stenosis and neurogenic claudication relieved on flexion were included. X-Stop operations were performed under local anaesthesia.Mean Patient Age. 69 (49-89) years, male/female distribution 56/44. Minimal dural sac area was in all cases except two ≤ 80 mm.Non-Inferiority Hypothesis. Six, 12, and 24 months follow-up. Intention-to-treat (ITT) as well as As-Treated (AT) analyses.Primary Outcome Measure. Zürich Claudication Questionnaire. Secondary outcome measures: VAS pain, SF-36, complications and re-operations.Results. Patients in both groups improved significantly regarding primary and secondary outcome measures. The results were similar at 6, 12 and 24 months and at no time point any statistical difference between the two types of surgery could be identified. Three patients (6%) in the decompression group had further surgery, compared to 13 patients (26%) in the X-Stop group (p = 0.04). Results were identical in ITT and AT analysis.Conclusion. For spinal stenosis with neurogenic claudication, decompressive surgery as well as X-Stop are rewarding procedures. Similar results were achieved in both groups, however, with a higher number of re-operations in the X-Stop group. Patients having X-Stop removal and decompression experienced results similar to those randomized to primary decompression.
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