RESUMEN
INTRODUCTION: Balance and fall risk before and after lumbar surgery was assessed to determine whether balance at baseline predicts long-term postsurgical outcomes. METHODS: Forty-three patients in the United States and Israel performed the single-leg stance (SLS) test, four square step test (FSST), and 8-foot up-and-go (8FUG) test before and 2 to 4 months after lumbar spine surgery. They completed the Oswestry Disability Index (ODI) and pain rating before and 12 months after lumbar surgery. RESULTS: From baseline to follow-up, the SLS time was 3.74 seconds longer (P = 0.01), the FSST time was 1.94 seconds faster (P < 0.001), and the 8FUG time was 1.55 seconds faster (P = 0.02). Before surgery, 26% of the patients were considered high fall risk according to the FSST and 51% according to the 8FUG. Postsurgery, all patients could complete the physical tests, but 26% remained at high fall risk according to the 8FUG and 7.5% according to the FSST. The three physical measures together explained 30% of the variance in postsurgical ODI scores (P = 0.02). Age was not correlated with performance. DISCUSSION: Risk of falling is higher than surgeons suspect. Balance tests (ie, SLS, FSST, and 8FUG) are quick and easy to administer. The findings support the importance of screening for balance and fall risk in adults undergoing lumbar spine surgery.
Asunto(s)
Accidentes por Caídas/prevención & control , Dolor de la Región Lumbar/fisiopatología , Dolor de la Región Lumbar/cirugía , Vértebras Lumbares/fisiopatología , Vértebras Lumbares/cirugía , Equilibrio Postural , Posición de Pie , Adulto , Anciano , Discectomía , Humanos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Valor Predictivo de las Pruebas , Estudios Prospectivos , Riesgo , Fusión Vertebral , Factores de Tiempo , Resultado del TratamientoRESUMEN
A series of functionalized 2,6-dialkyl-cis-1,3,5,7-tetraoxadecalin podands (3-10, alkyl = hydroxy-, mesyloxy-, halo-, azido- and aminomethyl and -ethyl) were prepared, characterized, and used as precursors for a new and interesting class of macrocycles and cryptands (12-21), with the aim to use these as host-guest inclusion systems. Extensive spectroscopic work was performed, structural endorsement was obtained from X-ray diffraction analyses and further insight into the structures was obtained from theoretical/computational studies. A number of macrocycles in the series exhibited good complexation with alkaline-earth metal ions.