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Prevalence of degenerative morphological changes in the sacro iliac joint
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BASS 2017 abstracts / The Spine Journal 17 (2017) S3–S22
28. Prevalence of degenerative morphological changes in the sacro iliac joint Ahmadi Sayed Abdullah, Hidetomi Terai, MD, PhD, Jawid Akhgar, MD, Suhrab Rahmani, MD, Akinobu Suzuki, MD, PhD, Hiromitsu Toyoda, MD, PhD, Masatoshi Hoshino, MD, PhD, Kazunori Hayashi, MD, Shinji Takahashi, MD, PhD, Hiroaki Nakamura, MD, PhD; Osaka City University BACKGROUND CONTEXT: The human pelvic ring consists of a strong annular bone structure, with the two articular structures of the sacroiliac joint and the pubic symphysis. Degeneration of these binding sites with aging leads to deterioration of the pelvic ring. Although the sacroiliac joint in the posterolateral part of the pelvic ring is a synovial joint, it may degenerate with age, possibly contributing to lower back pain. PURPOSE: Verify the sacaroiliac joint more effective side by degenerative change. STUDY DESIGN/SETTING: Anatomical study. PATIENT SAMPLE: 15 cadavers. OUTCOME MEASURES: No relevant. METHODS: 15 human cadavers from Osaka city university anatomic department the main age were 84 years old we dissected, at first we removed all soft tissue from pelvic ring and then we took CT and after that we opened the Sacroiliac joint and painted by Japanese Jogob day and then we took picture. RESULTS: In this study the localization of the joint degeneration, sclerosis was common on the upper and middle anterior of the articular surface of the ilium, and osteophytes were common on the anterior surface of the sacrum Degeneration had progressed further in women than in men in every age group, and tended to progress faster in parous than in nulliparous women. CONCLUSIONS: These data were used to trace the development of the sacroiliac joint until the occurrence of osteoarthritis with aging and we compare the area of sacroiliac joint by degenerative change. CONFLICTS OF INTEREST: None. FUNDING SOURCES: Osaka City University. http://dx.doi.org/10.1016/j.spinee.2016.12.036
29. Comparing corporate, clinical and subjective outcomes of patients undergoing non-complex cervical and lumbar spinal surgery in NHS and independent sector healthcare settings Ali Bakhsh, Himanshu Sharma; Peninsula College of Medicine & Dentistry, Tamar Science Park, Plymouth PL6 8BU BACKGROUND CONTEXT: The increase in spinal surgery volume in the UK is being met by expanding independent sector involvement. No study yet has compared spinal surgery outcomes between the independent sector and NHS. PURPOSE: Whether non-complex elective spinal surgery is safe, effective and timely by comparing outcomes in the NHS vs. independent sector. STUDY DESIGN/SETTING: Retrospective cohort study. PATIENT SAMPLE: Consecutive NHS and private practice patients from the caseload of a single surgeon between September 2013 and January 2016. OUTCOME MEASURES: Self-report Measures: VAS, ODI, demographics, patient care timeline, pathology, operation time, post-operative complications, revision rate. METHODS: Participants were split into NHS hospital, Choose & Book (C&B) and Private patient cohorts. Non-complex adult patients undergoing primary decompression, microdisectomy or anterior cervical discectomy & fusion surgery were included. T-test and ANOVA tests were applied. Peninsula Medical Foundation funded study ($1,500). No conflict of interest is declared. RESULTS: NHS hospital patients (n=74) had significantly higher number of comorbidities than private patients (p=.034 CI 0.2–0.52) but had similar duration and severity of leg and back pain. Both NHS and private patients benefitted from surgery equally. The average total patient period of care was
4 months longer in the NHS than in the independent sector. NHS patients had average referral of 16.5 weeks compared to 13.1 week average referral to treatment time in private cohort. CONCLUSIONS: NHS hospital and independent sector provide similar results with regards to patient safety, operative success and subjective patient outcomes. Independent sector outperforms NHS hospitals in meeting the 18week target and offer patients a significantly reduced total care period. CONFLICTS OF INTEREST: None. FUNDING SOURCES: Peninsula Medical Foundation, INSPIRE. http://dx.doi.org/10.1016/j.spinee.2016.12.037
30. Lumbar fusion for lytic spondylolisthesis: is an interbody cage necessary? Joseph Boktor, T. Ninan, S. Davies, R. Pockett, I. Collins, M. Sultan, W. Koptan, Y. El Meligui; Morriston hospital, Swansea SA6 6NL BACKGROUND CONTEXT: Many spinal surgeons routinely supplement pedicle screw fixation of lumbar spondylolisthesis with one or two cages. In developing countries, however, the high cost of interbody cages has precluded their use, with surgeons resorting to filling the interbody space with different types of bone graft instead. This retrospective study reports on the clinical and CT outcome of posterior lumbar interbody fusions (PLIF) for low-grade lytic spondylolisthesis using locally-sourced autologous bone graft. PURPOSE: To determine the radiologic and clinical outcome of using locallysourced autologous bone graft in the surgical management of single-level lumbar lytic spondylolisthesis. STUDY DESIGN/SETTING: Retrospective observational study. PATIENT SAMPLE: 20 patients. OUTCOME MEASURES: CT assessment of fusion with inter- and intraobserver validation by 2 radiological consultants blinded, Oswestry Disability Index (ODI), Back Pain Visual Analogue Score (VAS). METHODS: Posterior interbody fusion was performed in twenty consecutive patients over a two year period, using (BRAND) pedicle screw system and locally-sourced bone graft ie bone removed during neural decompression. There were no postoperative restrictions and all patients underwent clinical outcome measurements at a minimum follow up of 12 months and CT assessment at 6–12 months. 50% of population were smokers. RESULTS: The average clinical improvement was 40% as measured by ODI (range 33–47%) and 62% as measured by VAS (range 55–70%). By contrast, the radiologic fusion rate measured by CT was less satisfactory at 50% overall. CONCLUSIONS: These preliminary results indicate that the use of locallysourced bone graft in the surgical management of single-level lumbar lytic low-grade spondylolisthesis provides good clinical outcomes in comparison with PLIF using cages. The use of an interbody cage may not be clinically necessary. Our radiologic outcome, however, shows inferior fusion rates compared with published data. Future research will focus on longer term outcomes. CONFLICTS OF INTEREST: None. FUNDING SOURCES: None. http://dx.doi.org/10.1016/j.spinee.2016.12.038
31. Non operative management of massive lumbar disc prolapses, an observational study Anupkumar Shetty, Peter Craig, Shashank Chitgopkar; Robert Jones Agnes Hunt Orthopaedic Hospital, Oswestry SY10 7AG BACKGROUND CONTEXT: Most of the herniated discs resolve spontaneously, Although there are multiple papers on mild to moderate disc prolapses treated conservatively there are very few papers on massive lumbar disc prolapses treated conservatively. PURPOSE: To know the outcome following Non operative management of massive lumbar disc prolapses.
Refer to onsite annual meeting presentations and postmeeting proceedings for possible referenced figures and tables. Authors are responsible for accurately reporting disclosure and FDA device/drug status at time of abstract submission.
BASS 2017 abstracts / The Spine Journal 17 (2017) S3–S22
28. Prevalence of degenerative morphological changes in the sacro iliac joint Ahmadi Sayed Abdullah, Hidetomi Terai, MD, PhD, Jawid Akhgar, MD, Suhrab Rahmani, MD, Akinobu Suzuki, MD, PhD, Hiromitsu Toyoda, MD, PhD, Masatoshi Hoshino, MD, PhD, Kazunori Hayashi, MD, Shinji Takahashi, MD, PhD, Hiroaki Nakamura, MD, PhD; Osaka City University BACKGROUND CONTEXT: The human pelvic ring consists of a strong annular bone structure, with the two articular structures of the sacroiliac joint and the pubic symphysis. Degeneration of these binding sites with aging leads to deterioration of the pelvic ring. Although the sacroiliac joint in the posterolateral part of the pelvic ring is a synovial joint, it may degenerate with age, possibly contributing to lower back pain. PURPOSE: Verify the sacaroiliac joint more effective side by degenerative change. STUDY DESIGN/SETTING: Anatomical study. PATIENT SAMPLE: 15 cadavers. OUTCOME MEASURES: No relevant. METHODS: 15 human cadavers from Osaka city university anatomic department the main age were 84 years old we dissected, at first we removed all soft tissue from pelvic ring and then we took CT and after that we opened the Sacroiliac joint and painted by Japanese Jogob day and then we took picture. RESULTS: In this study the localization of the joint degeneration, sclerosis was common on the upper and middle anterior of the articular surface of the ilium, and osteophytes were common on the anterior surface of the sacrum Degeneration had progressed further in women than in men in every age group, and tended to progress faster in parous than in nulliparous women. CONCLUSIONS: These data were used to trace the development of the sacroiliac joint until the occurrence of osteoarthritis with aging and we compare the area of sacroiliac joint by degenerative change. CONFLICTS OF INTEREST: None. FUNDING SOURCES: Osaka City University. http://dx.doi.org/10.1016/j.spinee.2016.12.036
29. Comparing corporate, clinical and subjective outcomes of patients undergoing non-complex cervical and lumbar spinal surgery in NHS and independent sector healthcare settings Ali Bakhsh, Himanshu Sharma; Peninsula College of Medicine & Dentistry, Tamar Science Park, Plymouth PL6 8BU BACKGROUND CONTEXT: The increase in spinal surgery volume in the UK is being met by expanding independent sector involvement. No study yet has compared spinal surgery outcomes between the independent sector and NHS. PURPOSE: Whether non-complex elective spinal surgery is safe, effective and timely by comparing outcomes in the NHS vs. independent sector. STUDY DESIGN/SETTING: Retrospective cohort study. PATIENT SAMPLE: Consecutive NHS and private practice patients from the caseload of a single surgeon between September 2013 and January 2016. OUTCOME MEASURES: Self-report Measures: VAS, ODI, demographics, patient care timeline, pathology, operation time, post-operative complications, revision rate. METHODS: Participants were split into NHS hospital, Choose & Book (C&B) and Private patient cohorts. Non-complex adult patients undergoing primary decompression, microdisectomy or anterior cervical discectomy & fusion surgery were included. T-test and ANOVA tests were applied. Peninsula Medical Foundation funded study ($1,500). No conflict of interest is declared. RESULTS: NHS hospital patients (n=74) had significantly higher number of comorbidities than private patients (p=.034 CI 0.2–0.52) but had similar duration and severity of leg and back pain. Both NHS and private patients benefitted from surgery equally. The average total patient period of care was
4 months longer in the NHS than in the independent sector. NHS patients had average referral of 16.5 weeks compared to 13.1 week average referral to treatment time in private cohort. CONCLUSIONS: NHS hospital and independent sector provide similar results with regards to patient safety, operative success and subjective patient outcomes. Independent sector outperforms NHS hospitals in meeting the 18week target and offer patients a significantly reduced total care period. CONFLICTS OF INTEREST: None. FUNDING SOURCES: Peninsula Medical Foundation, INSPIRE. http://dx.doi.org/10.1016/j.spinee.2016.12.037
30. Lumbar fusion for lytic spondylolisthesis: is an interbody cage necessary? Joseph Boktor, T. Ninan, S. Davies, R. Pockett, I. Collins, M. Sultan, W. Koptan, Y. El Meligui; Morriston hospital, Swansea SA6 6NL BACKGROUND CONTEXT: Many spinal surgeons routinely supplement pedicle screw fixation of lumbar spondylolisthesis with one or two cages. In developing countries, however, the high cost of interbody cages has precluded their use, with surgeons resorting to filling the interbody space with different types of bone graft instead. This retrospective study reports on the clinical and CT outcome of posterior lumbar interbody fusions (PLIF) for low-grade lytic spondylolisthesis using locally-sourced autologous bone graft. PURPOSE: To determine the radiologic and clinical outcome of using locallysourced autologous bone graft in the surgical management of single-level lumbar lytic spondylolisthesis. STUDY DESIGN/SETTING: Retrospective observational study. PATIENT SAMPLE: 20 patients. OUTCOME MEASURES: CT assessment of fusion with inter- and intraobserver validation by 2 radiological consultants blinded, Oswestry Disability Index (ODI), Back Pain Visual Analogue Score (VAS). METHODS: Posterior interbody fusion was performed in twenty consecutive patients over a two year period, using (BRAND) pedicle screw system and locally-sourced bone graft ie bone removed during neural decompression. There were no postoperative restrictions and all patients underwent clinical outcome measurements at a minimum follow up of 12 months and CT assessment at 6–12 months. 50% of population were smokers. RESULTS: The average clinical improvement was 40% as measured by ODI (range 33–47%) and 62% as measured by VAS (range 55–70%). By contrast, the radiologic fusion rate measured by CT was less satisfactory at 50% overall. CONCLUSIONS: These preliminary results indicate that the use of locallysourced bone graft in the surgical management of single-level lumbar lytic low-grade spondylolisthesis provides good clinical outcomes in comparison with PLIF using cages. The use of an interbody cage may not be clinically necessary. Our radiologic outcome, however, shows inferior fusion rates compared with published data. Future research will focus on longer term outcomes. CONFLICTS OF INTEREST: None. FUNDING SOURCES: None. http://dx.doi.org/10.1016/j.spinee.2016.12.038
31. Non operative management of massive lumbar disc prolapses, an observational study Anupkumar Shetty, Peter Craig, Shashank Chitgopkar; Robert Jones Agnes Hunt Orthopaedic Hospital, Oswestry SY10 7AG BACKGROUND CONTEXT: Most of the herniated discs resolve spontaneously, Although there are multiple papers on mild to moderate disc prolapses treated conservatively there are very few papers on massive lumbar disc prolapses treated conservatively. PURPOSE: To know the outcome following Non operative management of massive lumbar disc prolapses.
Refer to onsite annual meeting presentations and postmeeting proceedings for possible referenced figures and tables. Authors are responsible for accurately reporting disclosure and FDA device/drug status at time of abstract submission.