Reliability and Validity of the Thai Version of the Modified Japanese Orthopaedic Association Score (mJOA score)

Objective: To evaluate the reliability and validity of the Thai version of the modified Japanese Orthopaedic Association scale. Methods: The modified Japanese Orthopaedic Association scale was translated into Thai language to create the Thai version of the Modified Japanese Orthopaedic Association (Thai-mJOA) scale. Translation was performed according to international standards using a forward-backward translation protocol. Translation was performed by 2 expert translators and 1 physician, and the final version was approved by an expert committee. Thai patients with cervical spondylosis with myelopathy were enrolled and evaluated using the Thai-mJOA scale, Nurick Grading, the Thai version of the Neck Disability Index (Thai-NDI), and the Thai version of the Short Form-36 (Thai-SF-36). Reliability and validity of the Thai-mJOA were assessed via comparison with the Nurick Grading and the Thai-NDI. Results: Ninety-two patients were included. The most common compression level was C5-C6 vertebral disc. Cronbach’s alpha of the total Thai-mJOA showed excellent internal consistency (0.991). The intraclass correlation coefficient (ICC) for test-retest reliability was 0.981 (95% confidence interval [CI]: 0.972-0.988). Regarding concurrent validity, the motor dysfunction score of the lower extremities and the total score of the Thai-mJOA were strongly correlated with Nurick Grading (r=0.825, r=0.712, respectively). The total score of the Thai-mJOA was moderately correlated with the Thai-NDI (r=0.670). Conclusion: The Thai-mJOA was found to be a valid and reliable tool for evaluating symptom severity in Thai patients with cervical spondylosis with myelopathy

Reliability and Validity of the Thai Version of the Modified Japanese Orthopaedic Association Score (mJOA score)

Objective: To evaluate the reliability and validity of the Thai version of the modified Japanese Orthopaedic Association scale. Methods: The modified Japanese Orthopaedic Association scale was translated into Thai language to create the Thai version of the Modified Japanese Orthopaedic Association (Thai-mJOA) scale. Translation was performed according to international standards using a forward-backward translation protocol. Translation was performed by 2 expert translators and 1 physician, and the final version was approved by an expert committee. Thai patients with cervical spondylosis with myelopathy were enrolled and evaluated using the Thai-mJOA scale, Nurick Grading, the Thai version of the Neck Disability Index (Thai-NDI), and the Thai version of the Short Form-36 (Thai-SF-36). Reliability and validity of the Thai-mJOA were assessed via comparison with the Nurick Grading and the Thai-NDI. Results: Ninety-two patients were included. The most common compression level was C5-C6 vertebral disc. Cronbach’s alpha of the total Thai-mJOA showed excellent internal consistency (0.991). The intraclass correlation coefficient (ICC) for test-retest reliability was 0.981 (95% confidence interval [CI]: 0.972-0.988). Regarding concurrent validity, the motor dysfunction score of the lower extremities and the total score of the Thai-mJOA were strongly correlated with Nurick Grading (r=0.825, r=0.712, respectively). The total score of the Thai-mJOA was moderately correlated with the Thai-NDI (r=0.670). Conclusion: The Thai-mJOA was found to be a valid and reliable tool for evaluating symptom severity in Thai patients with cervical spondylosis with myelopathy

Predictive Factors for Vertebroplasty in Osteoporotic Vertebral Compression Fractures

Objective: To identify predictive factors for performing percutaneous vertebroplasty (PVP) after osteoporotic vertebral compression fractures (OVCFs). Methods: A retrospective review of medical record of patients who presented with OVCF between April 2007 and March 2010 was conducted. Specific data collected in each group such as gender, age, and radiographic parameters were analyzed by statistical methods. Results: Fifty six patients (28 vertebroplasty, 28 conservative treatment) were enrolled. Severity of collapsed osteoporotic fracture more than 40% showed significant association with vertebroplasty (p=0.002). Other factors such as gender, age, fracture age, mechanism of trauma, and kyphotic angle had no statically significant associa- tion with vertebroplasty. Conclusion: Our findings suggested that osteoporotic patients who had severe vertebral fracture collapse more than 40% significantly underwent percutaneous vertebroplasty. Because of small sample size, further prospective systematic multicenter trials intended to investigate other risk factors are needed

Current Trend of Treatment for Incidental Durotomy in Lumbar Spine Surgery in Thailand: National Survey

Objective: To determine current decision making in treatment for incidental durotomy (ID) in Thailand. Methods: A questionnaire was sent to all orthopedic surgeons who attended the annual meeting of the Spine Society of Thailand 2016. The questionnaire had 2 parts including demographic data and 15 questions about details of ID repairing technique and postoperative treatment. Results: Sixty-seven responses were received from 213 participants (31.45% response rate). All respondents were male and performed lumbar spine surgery. Twenty-seven (40.30%) respondents work in a regional hospital. When ID occurred, most of the respondents (87.93%) provided further treatment. Sixty-one percent of respondents preferred prolene. Nylon and silk were used in 20% and 15%, respectively. The preferred size of repairing material was 6-0 (52.23%) and 5-0 (28.36%). The interrupted suture was used in 68.65 percent (46/67). The augmentation included fat graft (29/58, 50%), fibrin glue (12/58, 20.69%) and spongiostan (9/58, 15.5%). Seventy-five percent of respondents (48/64) used vacuum drain and 80% of respondents (54/67) prescribed bed rest after every dural repair. The durations of bed rest were 24 hrs (14/66, 21.2%), 48 hrs (27/66, 40.9%), 72 hrs (16/66, 24.2%) and more than 72 hrs (9/66, 13.6%). Conclusion: The perioperative management of lumbar ID in Thailand has substantial heterogeneity. Most of the participants prefer using interrupted suture, prolene, 6-0 in diameter, fat graft augmentation and placing wound drainage with vacuum. Duration of best rest varied between 24 to more than 72 hours

Long-term multiple metabolic abnormalities among healthy and high-risk people following nonsevere COVID-19

Abstract Few studies have identified the metabolic consequences of the post-acute phase of nonsevere COVID-19. This prospective study examined metabolic outcomes and associated factors in nonsevere, RT-PCR-confirmed COVID-19. The participants’ metabolic parameters, the prevalence of long-term multiple metabolic abnormalities (≥ 2 components), and factors influencing the prevalence were assessed at 1, 3, and 6 months post-onset. Six hundred individuals (mean age 45.5 ± 14.5 years, 61.7% female, 38% high-risk individuals) with nonsevere COVID-19 attended at least one follow-up visit. The prevalence of worsening metabolic abnormalities was 26.0% for BMI, 43.2% for glucose, 40.5% for LDL-c, 19.1% for liver, and 14.8% for C-reactive protein. Except for lipids, metabolic-component abnormalities were more prevalent in high-risk hosts than in healthy individuals. The prevalence of multiple metabolic abnormalities at the 6-month follow-up was 41.3% and significantly higher in high-risk than healthy hosts (49.2% vs 36.5%; P = 0.007). Factors independently associated with a lower risk of these abnormalities were being female, having dyslipidemia, and receiving at least 3 doses of the COVID-19 vaccine. These findings suggest that multiple metabolic abnormalities are the long-term consequences of COVID-19. For both high-risk and healthy individuals with nonsevere COVID-19, healthcare providers should monitor metabolic profiles, encourage healthy behaviors, and ensure complete vaccination