Биомеханическое обоснование заднего спондилодеза имплантируемым стержневым аппаратом при патологии позвоночника

Приводятся результаты моделирования заднего спондилодеза с использованием имплантируемого стержневого аппарата для лечения заболеваний и повреждений позвоночника. Проведенные стендовые биомеханические исследования на физической модели позвоночника подтверждают возможность обеспечения достаточно надежного уровня его стабильности.The results of simulation of posterior spondylodesis with the use of implanted pin apparatus for treatment spine diseases and injuries are reported. Biomechanical study on the physical model of the spine prove the capability to provide sufficiently reliable level of its stability

Expert System for Diagnosing Spine Diseases Using the Forward Chaining Method

An expert system is a technology that is able to integrate medical knowledge and data processing to diagnose spinal cord diseases. With various algorithms and a carefully structured knowledge base, this expert system can identify spinal cord diseases based on the symptoms presented by the patient. The main advantage of this expert system is its ability to process data quickly and provide diagnostic recommendations consistently. The results provided from this research are an expert system for identifying spinal cord disease which was built using the Visual Basic software application system. From patient data and symptom data applied to the expert system for in spinal cord disease, it is known that the accuracy of the system for diagnosing spinal cord disease is 95% of patients

Frequency of Incidental Durotomy during Surgery for Degenerative Lumbar Spine Disease

Objective:  One of the most common treatments performed in a neurosurgical facility for lower back pain and claudication is degenerative lumbar spine surgery. The study aimed to determine the frequency of incidental durotomy during surgery for degenerative lumbar spine diseases. Materials and Methods:  In this study, a total of 95 patients were included from the Department of Neurosurgery, Ayub Teaching Hospital, Abbottabad. After the patient’s selection, their history, examination, and investigations, surgery was carried out by consultant neurosurgeons. Per-operatively unintentional dural tears were identified as rent in dura with or without CSF leak and were either repaired primarily or by applying fibrin glue if the repair was not possible. Results:  The mean age was 38 ± 12.62 years. Fifty-eight percent of patients were male and 42% of patients were females. More than 6% of patients had incidental durotomy while 94% of patients didn’t have incidental durotomy. Recurrent disc prolapse was found in 5% of the cases. One percent of incidental durotomy patients were also recurrent instances, accounting for 6% of the total. Whereas 95% of patients did not require a durotomy, the surgery went smoothly. Conclusion:  The frequency of incidental durotomy was 6% during surgery for degenerative lumbar spine diseases. Keywords:  Incidental durotomy, Degenerative Lumbar Spine, Spinal Stenosis, Spinal Surger

Diagnosis-Specific Work Disability before and after Lumbar Spine Decompression Surgery—A Register Study from Sweden

Low back pain (LBP) patients undergoing lumbar spine decompression surgery (LSDS) often suffer from multi-comorbidity and experience high work disability. This study aimed to identify diagnosis-specific work disability patterns in all LBP-patients before and after LSDS during 2008–2010, that were aged 19–60 years and living in Sweden (n = 10,800) and compare these patterns to LBP-patients without LSDS (n = 109,179), and to matched individuals without LBP (n = 472,191). Work disability days (long-term sickness absence (LTSA), disability pension (DP)) during the three years before to three years after the cohort’s entry date were identified by generalised estimating equations. LBP-patients undergoing LSDS had higher overall work disability during the three years following surgery (LTSA: 23.6%, DP: 6.3%) than LBP-patients without LSDS (LTSA: 19.5%, DP: 5.9%), and those without LBP (LTSA: 7.9%, DP: 1.7%). Among patients undergoing LSDS, the prevalence of work disability due to dorsopathies increased from 20 days three years before surgery to 70 days in the year after and attenuated to 30 days in the third year following surgery. Work disability for other diagnoses remained stable at a low level in this group

Diagnosis-Specific Work Disability before and after Lumbar Spine Decompression Surgery—A Register Study from Sweden

Low back pain (LBP) patients undergoing lumbar spine decompression surgery (LSDS) often suffer from multi-comorbidity and experience high work disability. This study aimed to identify diagnosis-specific work disability patterns in all LBP-patients before and after LSDS during 2008–2010, that were aged 19–60 years and living in Sweden (n = 10,800) and compare these patterns to LBP-patients without LSDS (n = 109,179), and to matched individuals without LBP (n = 472,191). Work disability days (long-term sickness absence (LTSA), disability pension (DP)) during the three years before to three years after the cohort’s entry date were identified by generalised estimating equations. LBP-patients undergoing LSDS had higher overall work disability during the three years following surgery (LTSA: 23.6%, DP: 6.3%) than LBP-patients without LSDS (LTSA: 19.5%, DP: 5.9%), and those without LBP (LTSA: 7.9%, DP: 1.7%). Among patients undergoing LSDS, the prevalence of work disability due to dorsopathies increased from 20 days three years before surgery to 70 days in the year after and attenuated to 30 days in the third year following surgery. Work disability for other diagnoses remained stable at a low level in this group

Educational recommendations for the conduct, content and format of EULAR musculoskeletal ultrasound Teaching the Teachers Courses

To produce educational guidelines for the conduct, content and format of theoretical and practical teaching at EULAR musculoskeletal ultrasound (MSUS) Teaching the Teachers (TTT) Courses

Realizacja programu edukacyjnego wśród chorych leczonych operacyjnie z powodu schorzeń części szyjnej kręgosłupa

Introduction. Treatment of patients with spine disorders is a subject of interest to many medical disciplines. Most patients complaining of back pain are successfully cured with conservative methods, some require surgical procedures. In the entire therapy process, regardless of the method of treatment, patient education cannot be ignored.Aim. Evaluation of the implementation of the educational program conducted among patients treated surgically for diseases of the cervical spine.Material and Methods. The research was conducted among 156 patients on the Neurosurgery and Neurotraumatology Ward of The University Hospital No. 2 in Bydgoszcz, treated surgically for diseases of the cervical spine. The original educational program was carried out during the hospitalization of the patient in the ward. The program evaluations were planned through a preliminary and final verifying survey for each participant of the program. The collected material was subject to statistical analysis.Results. Women constituted a larger group — 102 respondents (64.6%). The average age of the respondents was — 54.2 years. Before the implementation of the program, 92 people (58.2%) said they had partial knowledge of cervical spine diseases, but 48 respondents (30.4%) said they knew very little and only 6 patients (3.8%) indicated that they knew a lot. After the education, the vast majority of respondents claimed that their knowledge about life with cervical spondylosis disorders had improved significantly — 149 people (94.3%).Conclusions. The respondents evaluated the program very well; almost all of them acknowledged that their state of knowledge about the life and prevention of spine diseases had definitely improved. There was a significant improvement of the respondents’ knowledge on the causes of back pain, mainly in people with primary education. (JNNN 2018;7(3):96–103)Wstęp. Leczenie chorych ze schorzeniami kręgosłupa jest przedmiotem zainteresowania wielu dyscyplin medycznych. Większość chorych skarżących się na bóle kręgosłupa udaje się wyleczyć metodami zachowawczymi, część wymaga postępowania operacyjnego. W całym procesie terapii, niezależnie od metody leczenia, nie można pominąć kwestii edukacji pacjenta.Cel. Ocena realizacji programu edukacyjnego prowadzonego wśród chorych leczonych operacyjnie z powodu schorzeń części szyjnej kręgosłupa.Materiał i metody. Badania przeprowadzono wśród 156 pacjentów Oddziału Neurochirurgii i Neurotraumatologii Szpitala Uniwersyteckiego nr 2 w Bydgoszczy, leczonych operacyjnie z powodu schorzeń części szyjnej kręgosłupa. Autorski program edukacyjny realizowano w trakcie hospitalizacji pacjenta w oddziale. Ewaluacje programu zaplanowano poprzez wstępną i końcową ankietę sprawdzającą u każdego uczestnika programu. Zebrany materiał poddano analizie statystycznej.Wyniki. Kobiety stanowiły liczniejszą grupę — 102 osoby (64,6%). Średnia wieku badanych wyniosła — 54,2 lat. Przed realizacją programu 92 osoby (58,2%), stwierdziły, że mają częściową wiedzę w zakresie chorób części szyjnej kręgosłupa, ale już 48 badanych (30,4%) uznało, że wie bardzo mało, a tylko 6 pacjentów (3,8%) wskazało, że wie bardzo dużo. Po przeprowadzonej edukacji, zdecydowana większość respondentów twierdziła, że ich stan wiedzy na temat życia ze schorzeniami kręgosłupa szyjnego zdecydowanie się poprawił — 149 osób (94,3%).Wnioski. Badani ocenili program bardzo dobrze; niemal wszyscy uznali, że ich stan wiedzy na temat życia i profilaktyki schorzeń kręgosłupa zdecydowanie się poprawił. Istotnie poprawiła się wiedza badanych na temat przyczyn bólu kręgosłupa, głównie u osób z wykształceniem podstawowym. (PNN 2018;7(3):96–103

How does a cadaver model work for testing ultrasound diagnostic capability for rheumatic-like tendon damage?

To establish whether a cadaver model can serve as an effective surrogate for the detection of tendon damage characteristic of rheumatoid arthritis (RA). In addition, we evaluated intraobserver and interobserver agreement in the grading of RA-like tendon tears shown by US, as well as the concordance between the US findings and the surgically induced lesions in the cadaver model. RA-like tendon damage was surgically induced in the tibialis anterior tendon (TAT) and tibialis posterior tendon (TPT) of ten ankle/foot fresh-frozen cadaveric specimens. Of the 20 tendons examined, six were randomly assigned a surgically induced partial tear; six a complete tear; and eight left undamaged. Three rheumatologists, experts in musculoskeletal US, assessed from 1 to 5 the quality of US imaging of the cadaveric models on a Likert scale. Tendons were then categorized as having either no damage, (0); partial tear, (1); or complete tear (2). All 20 tendons were blindly and independently evaluated twice, over two rounds, by each of the three observers. Overall, technical performance was satisfactory for all items in the two rounds (all values over 2.9 in a Likert scale 1-5). Intraobserver and interobserver agreement for US grading of tendon damage was good (mean κ values 0.62 and 0.71, respectively), with greater reliability found in the TAT than the TPT. Concordance between US findings and experimental tendon lesions was acceptable (70-100 %), again greater for the TAT than for the TPT. A cadaver model with surgically created tendon damage can be useful in evaluating US metric properties of RA tendon lesions

Rola obrazowania ultrasonografi cznego w diagnozowaniu schorzeń oraz monitorowaniu efektów terapii fi zjoterapeutycznych kręgosłupa lędźwiowo-krzyżowego : przegląd badań

Obrazowanie ultrasonograficzne (USG) narządu ruchu jest metodą coraz częściej wykorzystywaną w fizjoterapii. Stosowane jest z powodzeniem w badaniu zarówno stawów, ścięgien jak i mięśni. Badanie USG mięśni jest pomocne w diagnozowaniu oraz doborze leczniczych i terapeutycznych terapii schorzeń narządu ruchu oraz pozwala monitorować efekty zastosowanych metod fizjoterapeutycznych. W związku z tym, jest wykorzystywane przez lekarzy, a także coraz częściej przez fizjoterapeutów. Celem opracowania jest ukazanie roli obrazowania USG mięśni brzucha w diagnozowaniu schorzeń odcinka lędźwiowo-krzyżowego kręgosłupa na podstawie najnowszych, dostępnych w literaturze wyników badań. Badanie literaturowe zrealizowane zostało na podstawie przeglądu badań krajowych i zagranicznych z analizowanego zakresu. Pierwsza część artykułu zawiera teoretyczne aspekty badania USG narządu ruchu, w tym podstawy jego zastosowania i zasady wykonywania oraz przedstawia możliwości zastosowania obrazowania USG jako metody badania mięśni skośnych i poprzecznych brzucha. Drugą część artykułu stanowi z kolei zagregowany zbiór dostępnych wyników badań z zakresu skuteczności, wiarygodności oraz niezawodności tej metody w diagnozowaniu schorzeń odcinka lędźwiowo-krzyżowego kręgosłupa jak również w monitorowaniu efektów terapii fizjoterapeutycznych. Zwieńczenie drugiej części artykułu stanowi opracowanie katalogu wad i zalet metody obrazowania ultrasonograficznego w leczeniu schorzeń narządu ruchu. Finalną częścią opracowania jest z kolei analiza aspektu przyszłościowego ze szczególnym uwzględnieniem kierunków rozwoju obrazowania USG narządu ruchu zarówno w ortopedii, reumatologii jak i fizjoterapii.Ultrasound Imaging (USG) is a method being increasingly used in physiotherapy. It is applied successfully in the study of joints, tendons and muscles. Muscle ultrasound examination is helpful in diagnosing and the choice of medicinal and therapeutic methods for the treatment of motion organ diseases and monitoring the effects of the utilised physiotherapeutic methods. Therefore, it is used by doctors and increasingly, by physiotherapists. The aim of the study is to present the role of abdominal muscle ultrasound imaging in the diagnosis of lumbar-spine disorders on the basis of the latest available research findings. Literary research was carried out on the basis of a systematic review of domestic and foreign studies in the analysed area. The first part of the paper contains theoretical aspects of the USG examination, including the basics of its use and the principles of exercise, illustrating the potential for using ultrasound imaging as a method of examining the oblique and transverse abdominal muscles. The second part of the article is, in turn, an aggregated set of available results of research on the effectiveness, credibility and reliability of this method in the diagnosis of lumbar spine diseases as well as in monitoring the effects of physiotherapy. The second part of the article ends with the development of a catalogue of drawbacks and advantages of ultrasound imaging in the treatment of motion organ illnesses. The final part of the study is an analysis of the future aspect, with particular emphasis on the direction of development of ultrasound imaging in both orthopaedics, rheumatology and physiotherapy