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1.
Appl Ergon ; 99: 103612, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34743974

RESUMO

Manual handling training may be improved if it relied on the provision of individualized, augmented feedback about key movement features. The purpose of this study was to compare the reduction in sagittal spine motion during manual lifting tasks following two training approaches: didactic (DID) and augmented feedback (AUG). Untrained participants (n = 26) completed lifting tests (box, medication bag, and paramedic backboard) and a randomly-assigned intervention involving 50 practice box lifts. Lifting tests were performed immediately before and after training, and one-week after interventions. Both groups exhibited reductions in spine motions immediately and one-week after the interventions. However, the AUG intervention group elicited significantly greater reductions in 5 of 12 between-group comparisons (3 tasks × 4 spine motion variables). The results of the current study support the use of augmented feedback-based approaches to manual handling training over education-based approaches.


Assuntos
Remoção , Coluna Vertebral , Fenômenos Biomecânicos , Retroalimentação , Humanos , Movimento
2.
Neurosurg Clin N Am ; 33(1): 49-59, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34801141

RESUMO

Connective tissue disorders represent a varied spectrum of syndromes that have important implications for the spine deformity surgeon. Spine surgeons must be aware of these diverse and global manifestations of disease because they have significant impact on perioperative and postoperative outcomes.


Assuntos
Tecido Conjuntivo , Coluna Vertebral , Tecido Conjuntivo/cirurgia , Humanos , Coluna Vertebral/cirurgia
3.
Appl Ergon ; 98: 103550, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34450458

RESUMO

Prior research has found that office workers may not be fully utilizing their chair's back support. This may be due in part to cognitive demands or other psychological stressors. Not using the back support may increase the muscle tension and contribute to muscle fatigue and discomfort. Historically, footrests have been advocated to address anthropometric disparities in office settings. In this laboratory study, it was hypothesized that a footrest may facilitate the use of the backrest and mediate the biomechanical demands on the back and neck muscles, especially when cognitive workload is elevated. Twenty participants performed computer tasks, which varied in their complexity levels, both with and without an angled footrest. Using a footrest increased workers' use of a chair's backrest, increased pelvic rotation towards the backrest, and had a corresponding change in spine flexion. However, no changes were found in the sampled electromyographic activities due to the footrest.


Assuntos
Fadiga Muscular , Coluna Vertebral , Computadores , Eletromiografia , Humanos , Amplitude de Movimento Articular
4.
Appl Ergon ; 98: 103581, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34592635

RESUMO

The number of older adults unable to transfer or ambulate independently is increasing. High support chairs enable people experiencing loss of mobility to be mobile, but current chair designs are associated with global functional loss and pressure ulcers. This pilot study compared the functionality of a traditional design high support chair to a new design of motorised high support chair: 1) a motion laboratory study compared joint angles and pressure at the hip, knee, ankle, elbow and spine when pushing each chair, and 2) a pressure mapping study compared the interface pressure when older people with limited mobility used the chairs. Significant reduction in joint angles for the person pushing the chair (degree difference range -3.6 to 14.2) and decreased seated pressure (w/kg difference range -0.2 to 2.1) for the seated user were identified for the motorised chair. Longitudinal investigations are required to determine if the significant differences identified in this pilot study result in less manual handling injuries and pressure areas.


Assuntos
Postura , Coluna Vertebral , Idoso , Humanos , Joelho , Articulação do Joelho , Projetos Piloto
5.
Rev. colomb. anestesiol ; 49(4): e500, Oct.-Dec. 2021. tab, graf
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1341245

RESUMO

Abstract Introduction Hip fracture pain is frequently acute and disabling and increases perioperative complications in the patient; hence it requires a multimodal analgesia approach. This case series describes the continuous erector spinae plane block at the lumbar level for hip fracture analgesia. Methods A search was conducted of patients with hip fracture referred to the pain service of Hospital Universitario San Vicente Fundación (HUSVF) from August 2019 to March 2020, who had undergone continuous erector spinae plane block as part of their analgesic regimen. Results A total of 6 patients, 4 females and 2 males with an average age of 75 years were identified. A reduction in pain intensity from acute to mild or absent was observed in every case, up to 24 hours after the initial injection. 66 % experienced a relapse of severe pain after 24 hours and 2 patients the catheter functionality failed after 24 hours. One patient underwent dermatome pinprick assessment. Conclusions The continuous erector spinae plane block with a single injection provided analgesic efficacy similar to other single injection peripheral blocks, although continuous analgesia for more than 24 hours was not achieved. Some variations in the block technique described may improve the analgesic effectiveness in patients with hip fracture pain.


Resumen Introducción El dolor de la fractura de cadera suele ser fuerte e incapacitante y aumenta las complicaciones perioperatorias en el paciente, lo que hace indispensable el enfoque de analgesia multimodal. En esta serie de casos se describe la experiencia del bloqueo continuo del plano erector de la espina a nivel lumbar para analgesia en fractura de cadera. Métodos Se realizó una búsqueda de los pacientes con fractura de cadera remitidos al servicio de dolor del Hospital Universitario San Vicente fundación (HUSVF) desde agosto de 2019 hasta marzo de 2020, a quienes se les realizó bloqueo continuo del plano erector de la espina como parte de su esquema analgésico. Resultados Se encontraron 6 pacientes, 4 mujeres y 2 hombres, con una edad promedio de 75 años. Se observó reducción de la intensidad del dolor de fuerte a leve o ausente en todos los casos hasta las 24 horas posteriores a la inyección inicial. El 66 % tuvo recaída del dolor fuerte posterior a las 24 horas y en 2 pacientes no se logró funcionalidad del catéter por más de 24 horas. En un paciente se hizo evaluación dermatómica por pinprick (prueba de pinchazo). Conclusiones El bloqueo continuo del plano erector de la espina con inyección única ofreció eficacia analgésica similar a otros bloqueos periféricos en inyección única, aunque no se logró analgesia continua con el catéter por más de 24 horas. Ciertas variaciones en la técnica del bloqueo descrita podrían mejorar la efectividad analgésica en pacientes con dolor por fractura de cadera.


Assuntos
Humanos , Masculino , Feminino , Idoso , Dor , Fraturas do Quadril , Coluna Vertebral , Analgesia , Anestesia por Condução
6.
J Int Med Res ; 49(11): 3000605211058879, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34791917

RESUMO

Spinal cord infarction (SCI) is a catastrophic neurologic deficit following spine surgery. Because of the opposite management regimens used for SCI and acute epidural hematoma, accurate diagnosis of SCI is of great importance to maximally reserve neurologic functions and improve outcomes. A 21-year-old man developed acute paralysis and sensory deficits of the bilateral lower limbs shortly after undergoing two-stage combined posterior and anterior multilevel en bloc corpectomy. An emergency second-look surgery revealed wide-spectrum blackness of the thecal sac with no signs of an epidural hematoma. The patient underwent anticoagulation therapy, ventilation support, microcirculation perfusion, and fluid optimization. He regained an ambulatory status without other severe complications. Upon discharge, his muscle strength had returned to grade 4 and his Eastern Cooperative Oncology Group performance score had decreased to 0. At the final 48-month follow-up, the implants were in good position without local recurrence, and the patient was able to lead an independent life and work in his full capacity. An epidural hematoma did not appear to be the cause of SCI after spinal tumor surgery in this case; however, SCI was a possible reason for the acute paralysis. Anticoagulation treatment with adjuvant therapies may be an effective option in managing SCI.


Assuntos
Hematoma Epidural Espinal , Recidiva Local de Neoplasia , Adulto , Hematoma Epidural Espinal/diagnóstico por imagem , Hematoma Epidural Espinal/etiologia , Hematoma Epidural Espinal/cirurgia , Humanos , Infarto/etiologia , Masculino , Medula Espinal , Coluna Vertebral , Adulto Jovem
8.
Medicina (Kaunas) ; 57(11)2021 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-34833437

RESUMO

Background and objectives: The influence of changes in spinal alignment after total hip arthroplasty (THA) on improvement in lower back pain (LBP) remains controversial. To evaluate how changes in spinal malalignment correlate with improvement in preoperative LBP in patients who underwent THA for hip osteoarthritis. Materials and Methods: From November 2015 to January 2017, 104 consecutive patients who underwent unilateral THA were prospectively registered. Whole spine X-rays and patient-reported outcomes (PROs) were obtained preoperatively and 12 months postoperatively. The PROs used were the Numerical Rating Scale (NRS) for back pain, EuroQol 5 Dimension, and Short Form-12. Results: Seventy-four (71%) patients with complete data were eligible for the analysis. The sagittal parameters changed slightly but significantly. Coronal alignment significantly improved. Twenty-six (37%) patients had LBP preoperatively. These patients had smaller lumbar lordosis (LL), larger PT, and larger PI minus LL than the patients without LBP. Fourteen (54%) of the 26 patients with preoperative LBP showed pain improvement, but there were no significant differences in the radiographic parameters. Conclusions: Although preoperative LBP was likely to be resolved after THA, there were no significant correlations between alignment changes and LBP improvement. The cause of LBP in patients with hip osteoarthritis (OA) patients might be multifactorial.


Assuntos
Artroplastia de Quadril , Lordose , Dor Lombar , Osteoartrite do Quadril , Humanos , Dor Lombar/etiologia , Dor Lombar/cirurgia , Osteoartrite do Quadril/complicações , Osteoartrite do Quadril/diagnóstico por imagem , Osteoartrite do Quadril/cirurgia , Coluna Vertebral
9.
Medicina (Kaunas) ; 57(11)2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34833442

RESUMO

Background and Objectives: Hyponatremia is the most common electrolyte disorder in elderly and associated with increased risk of falls. Clinical studies as well as small animal experiments suggested an association between chronic hyponatremia and osteoporosis. Furthermore, it has been assumed that subtle hyponatremia may be an independent fracture risk in the elderly. Therefore, this study was designed to evaluate the possible influence of chronic hyponatremia on osteoporosis and low-energy fractures of the spine. Materials and Methods: 144 patients with a vertebral body fracture (mean age: 69.15 ± 16.08; 73 females and 71 males) due to low-energy trauma were treated in a level one trauma center within one year and were included in the study. Chronic hyponatremia was defined as serum sodium < 135 mmol/L at admission. Bone mineral density (BMD) of the spine was measured using quantitative computed tomography in each patient. Results: Overall, 19.44% (n = 28) of patients in the low-energy trauma group had hyponatremia. In the group with fractures caused by low-energy trauma, the proportion of hyponatremia of patients older than 65 years was significantly increased as compared to younger patients (p** = 0.0016). Furthermore, there was no significant gender difference in the hyponatremia group. Of 28 patients with chronic hyponatremia, all patients had decreased bone quality. Four patients showed osteopenia and the other 24 patients even showed osteoporosis. In the low-energy trauma group, the BMD correlated significantly with serum sodium (r = 0.396; p*** < 0.001). Conclusions: The results suggest that chronic hyponatremia affects bone quality. Patients with chronic hyponatremia have an increased prevalence of fractures after low-energy trauma due to a decreased bone quality. Therefore, physicians from different specialties should focus on the treatment of chronic hyponatremia to reduce the fracture rate after low-energy trauma, particularly with elderly patients.


Assuntos
Fraturas Ósseas , Hiponatremia , Osteoporose , Fraturas da Coluna Vertebral , Absorciometria de Fóton , Idoso , Idoso de 80 Anos ou mais , Densidade Óssea , Feminino , Fraturas Ósseas/complicações , Fraturas Ósseas/epidemiologia , Humanos , Hiponatremia/complicações , Hiponatremia/epidemiologia , Masculino , Pessoa de Meia-Idade , Osteoporose/complicações , Osteoporose/epidemiologia , Fraturas da Coluna Vertebral/complicações , Fraturas da Coluna Vertebral/epidemiologia , Coluna Vertebral
10.
BMC Musculoskelet Disord ; 22(1): 988, 2021 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-34836518

RESUMO

BACKGROUND: Studies explaining the relationship between hip and spine reported that spinal corrective surgery affected acetabular orientation and changes in pelvic tilt were capable of influencing radiographic measures of acetabular coverage. This study aimed to assess the change in coronal parameters for acetabular coverage as a result of adult spinal deformity (ASD) correction and to analyze the relationship between the postoperative changes in sagittal spinopelvic parameters and coronal acetabular coverage parameters. METHODS: Fifty-two consecutive patients who had undergone multilevel spinal surgical correction were enrolled and evaluated. Coronal acetabular coverage parameters included Tönnis angle (TA), lateral center edge angle (LCEA), and the angle of Sharp (SA). All radiographic parameters were evaluated at the preoperative and the postoperative 1 year. Paired t test was used to determine whether there were significant changes between the time points. Bivariate correlation and linear regression analysis were used to assess the relationship between the postoperative changes of spinal alignment and acetabular orientation. RESULTS: The surgical correction resulted in significant decrease of TA, increase of LCEA and SA, respectively (p < 0.001). The changes in pelvic tilt (PT) demonstrated weak correlation on TA (ß = 0.117, p < 0.001 for right; ß = 0.111, p < 0.001 for left). CONCLUSIONS: Although the surgical correction of ASD significantly changed PT resulting in increased acetabular lateral coverage parameters, the correlation between the changes of PT following sagittal correction of ASD and acetabular coverage parameters was low. TRIAL REGISTRATION: This study was retrospectively registered with approval by the institutional review board (IRB) of our institution (approval number: KHNMC-2020-10-010).


Assuntos
Acetábulo , Cabeça do Fêmur , Acetábulo/diagnóstico por imagem , Acetábulo/cirurgia , Adulto , Humanos , Osteotomia , Postura , Estudos Retrospectivos , Coluna Vertebral
11.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 38(12): 1237-1240, 2021 Dec 10.
Artigo em Chinês | MEDLINE | ID: mdl-34839515

RESUMO

OBJECTIVE: To analyze the clinical features and molecular genetic etiology of a patient with 3-M (Miller McKusick Malvaux) syndrome from a consanguineous parentage family, and to explore the relationship between genotype and phenotype. METHODS: After the consent of the proband's guardian and the informed consent form was signed, DNA was extracted from peripheral blood samples of the proband and her parents for chromosome microarray analysis, medical exome sequencing and parental verification. RESULTS: A total of 247.1 Mb loss of heterozygosity was found in the proband with a CytoScan 750K array. Furthermore, a homozygous variant (c.458dupG) of the OBSL1 gene was found using high-throughput sequencing, which was inherited from her parents. Based on the criteria and guidelines of genetic variation of American College of Medical Genetics and Genomics, the variant is predicted to be pathogenic (PVS1+PM2+PP4), and only one case was reported previously. CONCLUSION: Spina bifida occulta and lower eyelid fat pad may be a special phenotype of c.458dupG variant of the OBSL1 gene. Our study may provide a useful reference for evaluating the relationship between genotype and phenotype of 3-M syndrome type 2.


Assuntos
Genômica , Biologia Molecular , Proteínas do Citoesqueleto , Nanismo , Feminino , Humanos , Hipotonia Muscular , Mutação , Linhagem , Coluna Vertebral/anormalidades , Sequenciamento Completo do Exoma
12.
Medicine (Baltimore) ; 100(41): e27515, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34731139

RESUMO

ABSTRACT: Retrospective cohort studyTo characterize the learning curve of a spine surgeon during the first 2 years of independent practice by comparing to an experienced colleague. To stratify learning curves based on procedure to evaluate the effect of experience on surgical complexity.The learning curve for spine surgery is difficult to quantify, but is useful information for hospital administrators/surgical programs/new graduates, so appropriate expectations and accommodations are considered.Data from a retrospective cohort (2014-2016) were analyzed at a quaternary academic institution servicing a geographically-isolated, mostly rural area. Procedures included anterior cervical discectomy and fusion, posterior cervical decompression and stabilization, single and 2-level posterior lumbar interbody fusion, lumbar discectomy, and laminectomy. Data related to patient demographics, after-hours surgery, and revision surgery were collected. Operative time was the primary outcome measure, with secondary measures including cerebrospinal fluid leak and early re-operation. Time periods were stratified into 6 month quarters (quarter [Q] 1-Q4), with STATA software used for statistical analysis.There were 626 patients meeting inclusion criteria. The senior surgeon had similar operative times throughout the study. The new surgeon demonstrated a decrease in operative time from Q1 to Q4 (158 minutes-119 minutes, P < .05); however, the mean operative time was shorter for the senior surgeon at 2 years (91 minutes, P < .05). The senior surgeon performed more revision surgeries (odds ratio [OR] 2.5 [95% confidence interval [CI] 1.7-3.6]; P < .001). Posterior interbody fusion times remained longer for the new surgeon, while laminectomy surgery was similar to the senior surgeon by 2 years. There were no differences in rates of cerebrospinal fluid leak (OR 1.2 [95% CI 0.6-2.5]; P > .05), nor reoperation (OR 1.16 [95% CI 0.7-1.9]; P > .05) between surgeons.A significant learning curve exists starting spine practice and likely extends beyond the first 2 years for elective operations.


Assuntos
Vazamento de Líquido Cefalorraquidiano/epidemiologia , Associações de Prática Independente/estatística & dados numéricos , Reoperação/estatística & dados numéricos , Coluna Vertebral/cirurgia , Cirurgiões/estatística & dados numéricos , Adulto , Idoso , Canadá/epidemiologia , Vértebras Cervicais/cirurgia , Competência Clínica/estatística & dados numéricos , Descompressão Cirúrgica/métodos , Discotomia/métodos , Discotomia/tendências , Feminino , Humanos , Associações de Prática Independente/tendências , Laminectomia/métodos , Curva de Aprendizado , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Avaliação de Resultados em Cuidados de Saúde , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/cirurgia , Reoperação/tendências , Estudos Retrospectivos , População Rural , Fusão Vertebral/métodos
13.
Radiographics ; 41(7): 2176-2192, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34723699

RESUMO

Congenital anomalies of the spine are associated with substantial morbidity in the perinatal period and may affect the rest of the patient's life. Accurate early diagnosis of spinal abnormalities during fetal imaging allows prenatal, perinatal, and postnatal treatment planning, which can substantially affect functional outcomes. The most common and clinically relevant congenital anomalies of the spine fall into three broad categories: spinal dysraphism, segmentation and fusion anomalies of the vertebral column, and sacrococcygeal teratomas. Spinal dysraphism is further categorized into one of two subtypes: open spinal dysraphism and closed spinal dysraphism. The latter category is further subdivided into those with and without subcutaneous masses. Open spinal dysraphism is an emergency and must be closed at birth because of the risk of infection. In utero closure is also offered at some fetal centers. Sacrococcygeal teratomas are the most common fetal pelvic masses and the prognosis is variable. Finally, vertebral body anomalies are categorized into formation (butterfly and hemivertebrae) and segmentation (block vertebrae) anomalies. Although appropriate evaluation of the fetal spine begins with US, which is the initial screening modality of choice, MRI is increasingly important as a problem-solving tool, especially given the recent advances in fetal MRI, its availability, and the complexity of fetal interventions. Online supplemental material is available for this article. ©RSNA, 2021.


Assuntos
Disrafismo Espinal , Coluna Vertebral , Feminino , Feto , Humanos , Recém-Nascido , Imageamento por Ressonância Magnética , Gravidez , Diagnóstico Pré-Natal
14.
Arch Argent Pediatr ; 119(6): 364-369, 2021 12.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34813228

RESUMO

Introduction: Spinal pain is one of the main reasons for seeking care; it usually appears during school age, increases with age, and is related to certain risk factors. The objective of this study is to analyze the prevalence of spinal pain among schoolchildren and examine associated factors. Population and methods: Cross-sectional study with a questionnaire administered to schoolchildren aged 9-11 years. The prevalence of pain, physical activity, spine self-care, backpack use, and electronic device use were analyzed. Results: A total of 329 subjects were analyzed. The prevalence of spinal pain is 34.3%, with no differences observed between sexes. Pain severity is considered mild, with a mean severity of 1.99 ± 2.54 over 10 according to the Wong-Baker FACES® scale; in more than 50% of cases, pain had a short duration (less than 12 hours). Cervical pain was referred by 22.2% of schoolchildren, whereas dorsal and lumbar pain were reported by 14% and 11.9%, respectively. In addition, 47.9% referred pain in more than one region of the spine. Also, 73.3% of schoolchildren did physical activity outside school hours and 90.6% used electronic devices. An association was observed between the presence of pain and adequate postural hygiene habits. Conclusions: Schoolchildren referred spinal pain that was mild and short in duration, often in the cervical region. The association with risk factors indicates that children who referred pain have better postural habits.


Assuntos
Dor Lombar , Coluna Vertebral , Criança , Estudos Transversais , Humanos , Prevalência , Instituições Acadêmicas , Espanha/epidemiologia
15.
Behav Neurol ; 2021: 2684855, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34777631

RESUMO

Spine surgeries impose risk to the spine's surrounding anatomical and physiological structures especially the spinal cord and the nerve roots. Intraoperative neuromonitoring (IONM) is a technology developed to monitor the integrity of the spinal cord and the nerve roots via the surgery. Transcranial motor evoked potential (TcMEP) (one of the IONM modalities) is adopted to monitor the integrity of the motor pathway of the spinal cord and the motor nerve roots. Recent research suggested that the IONM is conducive as a prognostic tool towards the patient's functional outcome. This paper summarizes the researches of IONM being adopted as a prognostic tool. In addition, this paper highlights the problems associated with the signal parameters as the improvement criteria in the previous researches. Lastly, we review the challenges of TcMEP to achieve a prognostic tool focusing on the factors that could interfere with the generation of a stable TcMEP response. The final section will discuss recommendations for IONM technology to achieve an objective prognostic tool.


Assuntos
Potencial Evocado Motor , Monitorização Neurofisiológica Intraoperatória , Humanos , Procedimentos Neurocirúrgicos , Medula Espinal , Coluna Vertebral/cirurgia
16.
Sensors (Basel) ; 21(21)2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34770451

RESUMO

Human movement patterns were shown to be as unique to individuals as their fingerprints. However, some movement characteristics are more important than other characteristics for machine learning algorithms to distinguish between individuals. Here, we explored the idea that movement patterns contain unique characteristics that differentiate between individuals and generic characteristics that do not differentiate between individuals. Layer-wise relevance propagation was applied to an artificial neural network that was trained to recognize 20 male triathletes based on their respective movement patterns to derive characteristics of high/low importance for human recognition. The similarity between movement patterns that were defined exclusively through characteristics of high/low importance was then evaluated for all participants in a pairwise fashion. We found that movement patterns of triathletes overlapped minimally when they were defined by variables that were very important for a neural network to distinguish between individuals. The movement patterns overlapped substantially when defined through less important characteristics. We concluded that the unique movement characteristics of elite runners were predominantly sagittal plane movements of the spine and lower extremities during mid-stance and mid-swing, while the generic movement characteristics were sagittal plane movements of the spine during early and late stance.


Assuntos
Corrida , Fenômenos Biomecânicos , Humanos , Extremidade Inferior , Masculino , Movimento , Coluna Vertebral
17.
Acta Neurochir (Wien) ; 163(12): 3279-3286, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34633546

RESUMO

BACKGROUND: Spontaneous spinal epidural hematoma (SSEDH) is a rare condition with potentially devastating consequences. Known prognostic factors are short time to surgery, preoperative neurologic condition, and age. The aim of this study was to investigate the impact of the transversal hematoma extent with its subsequent spinal canal obliteration on outcome in patients with SSEDH. METHODS: A retrospective study including all patients that underwent surgery due to SSEDH at the University Hospital of St. Poelten between 1/7/2005 and 30/6/2020 was conducted. The percentage of spinal canal obliteration at the level where the hematoma was most prominent was calculated and correlated to functional outcome. RESULTS: A total of 17 patients could be included in this study. Preoperative ASIA impairment scale showed positive correlation with postoperative outcome (p = 0.005). Patients with a favorable outcome (ASIA D and E) showed a statistically significant lower mean obliteration of the spinal canal by the hematoma with 46.4% (± 8%) in comparison to patients with an unfavorable outcome with 62.1% (± 6%, p = 0.001). A cut-off of 51% yielded a sensitivity and specificity for favorable outcome of 100% and 70% respectively (area under the ROC 0.93, p < 0.001). CONCLUSION: Preoperative percentage of spinal canal obliteration is statistically significant lower in patients with favorable outcome in surgically treated patients with spontaneous spinal epidural hematoma.


Assuntos
Hematoma Epidural Espinal , Hematoma Epidural Espinal/diagnóstico por imagem , Hematoma Epidural Espinal/cirurgia , Humanos , Imageamento por Ressonância Magnética , Prognóstico , Estudos Retrospectivos , Canal Medular/diagnóstico por imagem , Canal Medular/cirurgia , Coluna Vertebral
18.
Radiographics ; 41(7): 2136-2156, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34623944

RESUMO

The fields of both radiology and radiation oncology have evolved considerably in the past few decades, resulting in an increased ability to delineate between tumor and normal tissue to precisely target and treat vertebral metastases with radiation therapy. These scientific advances have also led to improvements in assessing treatment response and diagnosing toxic effects related to radiation treatment. However, despite technological innovations yielding greatly improved rates of palliative relief and local control of osseous spinal metastases, radiation therapy can still lead to a number of acute and delayed posttreatment complications. Treatment-related adverse effects may include pain flare, esophageal toxic effects, dermatitis, vertebral compression fracture, radiation myelopathy, and myositis, among others. The authors provide an overview of the multidisciplinary approach to the treatment of spinal metastases, indications for surgical management versus radiation therapy, various radiation technologies and techniques (along with their applications for spinal metastases), and current principles of treatment planning for conventional and stereotactic radiation treatment. Different radiologic criteria for assessment of treatment response, recent advances in radiologic imaging, and both common and rare complications related to spinal irradiation are also discussed, along with the imaging characteristics of various adverse effects. Familiarity with these topics will not only assist the diagnostic radiologist in assessing treatment response and diagnosing treatment-related complications but will also allow more effective collaboration between diagnostic radiologists and radiation oncologists to guide management decisions and ensure high-quality patient care. ©RSNA, 2021.


Assuntos
Fraturas por Compressão , Radioterapia (Especialidade) , Fraturas da Coluna Vertebral , Neoplasias da Coluna Vertebral , Humanos , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/radioterapia , Coluna Vertebral
19.
PLoS One ; 16(10): e0258796, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34665845

RESUMO

Traffic police riders are exposed to prolonged static postures causing significant angular deviation of the musculoskeletal, including the lumbar angle (L1-L5). This postural alteration contributes to awkward posture, musculoskeletal disorders and spinal injury, especially in the lower back area, as it is one of the most severe modern diseases nowadays. Thus, the study aimed to evaluate the effect of lumbar support with a built-in massager system on spinal angle profiles among traffic police riders. A randomised controlled trial (pre-testpost-test control design) was used to assess spinal angle pattern while riding the high-powered motorcycle for 20 minutes. Twenty-four traffic police riders were randomly selected to participate and 12 riders were assigned to the control group and 12 riders to the experimental group. The pre-test and post-test were conducted at a one-week interval. Each participant was required to wear a TruPosture Smart Shirt (to monitor spinal posture). The TruPosture Apps recorded the spinal angle pattern. The data indicated that the police riders using motorcycle seat with lumbar support and built-in massager system showed a huge improvement in maintaining posture which only involves slight spinal angle deviation changes from the spinal reference angle throughout the 20 minutes ride. The data collected then were analysed using the Mann-Whitney test and Wilcoxon signed-ranked test to verify a statistically significant difference between and within the control and experimental groups. There were significant differences in all sensors between the control group and experimental groups (p<0.05) and within the experimental group. According to the findings, it can be said that the ergonomic intervention prototype (lumbar support with built-in massager system) successfully helps to maintain and improve the natural curve of the spinal posture. This indirectly would reduce the risk of developing musculoskeletal disorders and spinal injury among traffic police riders.


Assuntos
Ergonomia/instrumentação , Massagem/instrumentação , Motocicletas , Postura/fisiologia , Coluna Vertebral/anatomia & histologia , Adulto , Desenho de Equipamento , Feminino , Humanos , Masculino , Aplicativos Móveis , Polícia , Coluna Vertebral/fisiologia , Tecnologia sem Fio , Adulto Jovem
20.
Aust J Gen Pract ; 50(11): 807-810, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34713281

RESUMO

BACKGROUND: 'What is "good" posture?' is a common question from patients and a contentious topic among health professionals that is further complicated by commercial interests. Reconciling the evidence regarding posture with a patient's individual context is important to optimally manage presenting patients. OBJECTIVE: The aim of this article is to provide a summary of the latest evidence regarding posture and spinal pain and its clinical applicability to individual patients. DISCUSSION: This article provides a viewpoint on the mounting yet established research evidence suggesting posture deserves less focus when managing pain, and the importance of understanding when to provide specific postural advice. It argues that, in general, posture is less relevant than movement itself, and creating change in patients' behaviour and beliefs requires understanding, physical examination, clear communication and not necessarily deeming the role of posture as irrelevant.


Assuntos
Postura , Coluna Vertebral , Humanos , Exame Físico
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