Cross-cultural adaptation and validation of the Italian Spine Youth Quality of Life (ISYQOL) questionnaire's Arabic version.

ABSTRACT: Health-related quality of life (HRQOL) assessment is considered among the most relevant outcome measures following conservative and surgical interventions for various spinal conditions. Several questions are available to evaluate HRQOL in these conditions. A more recent Italian Spine Youth Quality of Life (ISYQOL) questionnaire was developed for this purpose and showed high validity in measuring HRQOL.To translate and adapt the ISYQOL questionnaire into Arabic language (ISYQOL-Ar) and evaluate its validity and reliability, and to correlate it with the validated revised Scoliosis Research Society (SRS-22r)'s Arabic questionnaire in a cross-sectional multicenter study.The ISYQOL was translated, back-translated, and reviewed by an expert committee. Reliability assessment for the questionnaire domains was performed using Cronbach's alpha. For construct validation, the Pearson's correlation coefficient was used.A total of 115 patients were enrolled in the study and completed the ISYQOL-Ar and Arabic SRS-22r questionnaires. A total of 72 patients (63%) completed the first set of questionnaires, and 2 weeks later, 63 patients (55%) completed both sets of questionnaires, with 15.8 a mean age, 39.5° mean Cobb angle of 88.9% females. ISYQOL-Ar showed excellent validity, good reliability, and internal consistency for spine health and brace wear, with Cronbach's alpha > 0.6, similar to SRS-22r in the same cohort. The correlation was significant between ISYQOL-Ar and Arabic SRS-22r (Pearson's coefficient = 0.708, P < .001).The ISYQOL-Ar questionnaire is a reliable and valid outcome measure for the assessment of young patients with spinal deformity among the Arabic-speaking population.

How Do Pelvic Parameters Correlate With Postoperative Outcomes When the Parameters Are Not Measured Preoperatively in Patients Undergoing Instrumented Lumbar Fusion?

OBJECTIVE: A normal age-adjusted sagittal alignment is an important factor in achieving long-term functional results after lumbar spinal fusion. We aim to determine if the changes in spino-pelvic alignment (SPA) correlate with post-operative functional outcomes in patients who underwent instrumented lumbar spine surgery when the parameters were not measured before. METHOD: A retrospective review of medical records from 2012 to 2016, and radiographs of the patients who underwent instrumented fusion of the lumbar spine. The X-rays of the available preoperative lumbar spine were reviewed for SPA and compared with the last follow-up postoperative images. The patients were contacted by telephone to complete the EuroQoL 5 Dimensions 5-level questionnaire and visual analog scale for evaluation of their functional outcomes during 2017. Correlation studies were performed using Pearson's coefficient. RESULTS: Forty-six patients were included with a mean age of 53 years and a follow-up of 47 months. There was a significant improvement in the functional outcomes and pain in the whole group. All the patients showed improvement in their SPA, and those who underwent more than two levels of fusion showed a significant improvement (P<0.05). Lumbar lordosis and sacral slope had a significant correlation with postoperative clinical improvement (R=0.8). CONCLUSION: The study showed that single or double fusion has significant improvement in pain and functional outcome with a significant change in SPA.

Genetic influence of vitamin D receptor gene polymorphisms on osteoporosis risk.

OBJECTIVE: Osteoporosis is the most common type of bone disorder characterized by low bone mineral density (BMD). It is a multifactorial disease and caused by the interaction of environmental and genetic factors. It has been reported that mutations in the vitamin D receptor (VDR) gene highly affect the metabolism of minerals, which reduces bone density. Therefore, this study aimed to determine the association of VDR gene polymorphisms TaqI (rs731236) and ApaI (rs7975232) with osteoporosis risk in the Saudi population. METHODS: This case-control study involved 73 individuals with osteoporosis and 73 healthy controls in Jeddah, KSA. DNA extracted from peripheral blood was used to determine the genotypes and allele frequencies of VDR variants by polymerase chain reaction-restriction fragment length polymorphisms. Osteoporosis was confirmed by measuring BMD using dual-energy X-ray absorptiometry. The results were interpreted using the Hardy-Weinberg equilibrium assumption with P < 0.05 considered as significant. RESULTS: A significant increase in the genotype frequencies of the ApaI (Aa) and (aa) was observed among osteoporotic patients compared to controls (P = 0.002 and P < 0.0001, respectively). Only the homozygous (tt) genotype of TaqI was significantly higher in those with osteoporosis than in the controls (P = 0.001). The minor "a" allele of ApaI and the "t" allele of TaqI were significantly more common in the patients as compared to controls (P < 0.0001 and P = 0.01, respectively). CONCLUSION: VDR polymorphisms ApaI and TaqI were found to be significantly determinant risk factors for osteoporosis progression in the Saudi population.

The surgical management of degenerative lumbar spondylolisthesis: a systematic review.

STUDY DESIGN: Systematic review. OBJECTIVE: To identify whether there is an advantage to instrumented or noninstrumented spinal fusion over decompression alone for patients with degenerative lumbar spondylolisthesis. SUMMARY OF BACKGROUND DATA: The operative management of degenerative spondylolisthesis includes spinal decompression with or without instrumented or noninstrumented spinal fusion. Evidence on the operative management of degenerative spondylolisthesis is still divisive. METHODS: Relevant RCT and comparative observational studies between 1966 and June 2005 were identified. Abstracted outcomes included clinical outcome, reoperation rate, and solid fusion status. Analyses were separated into: 1) fusion versus decompression alone and 2) instrumented fusion versus noninstrumented fusion. RESULTS: Thirteen studies were included. The studies were generally of low methodologic quality. A satisfactory clinical outcome was significantly more likely with fusion than with decompression alone (relative risk, 1.40; 95% confidence interval, 1.04-1.89; P < 0.05). The use of adjunctive instrumentation significantly increased the probability of attaining solid fusion (relative risk, 1.37; 95% confidence interval, 1.07-1.75; P < 0.05), but no significant improvement in clinical outcome was recorded (relative risk, 1.19; 95% confidence interval, 0.92-1.54). There was a nonsignificant trend toward lower repeat operations with fusion compared with both decompression alone and instrumented fusion. CONCLUSION: Spinal fusion may lead to a better clinical outcome than decompression alone. No conclusion about the clinical benefit of instrumenting a spinal fusion could be made. However, there is moderate evidence that the use of instrumentation improves the chance of achieving solid fusion.