Psychosocial Mechanisms of Cognitive-Behavioral-Based Physical Therapy Outcomes After Spine Surgery: Preliminary Findings From Mediation Analyses.

Objective: Changing Behavior through Physical Therapy (CBPT), a cognitive-behavioral-based program, has been shown to improve outcomes after lumbar spine surgery in patients with a high psychosocial risk profile; however, little is known about potential mechanisms associated with CBPT treatment effects. The purpose of this study was to explore potential mediators underlying CBPT efficacy after spine surgery.

Methods: In this secondary analysis, 86 participants were enrolled in a randomized trial comparing a postoperative CBPT (n = 43) and education program (n = 43).

Impact of occupational characteristics on return to work for employed patients after elective lumbar spine surgery.

Background Context: Low back pain has an immense impact on the US economy. A significant number of patients undergo surgical management in order to regain meaningful functionality in daily life and in the workplace. Return to work (RTW) is a key metric in surgical outcomes, as it has profound implications for both individual patients and the economy at large.

Cognitive-Behavioral-Based Physical Therapy for Patients With Chronic Pain Undergoing Lumbar Spine Surgery: A Randomized Controlled Trial.

Unlabelled: The purpose of this study was to determine the efficacy of a cognitive-behavioral-based physical therapy (CBPT) program for improving outcomes in patients after lumbar spine surgery. A randomized controlled trial was conducted on 86 adults undergoing a laminectomy with or without arthrodesis for a lumbar degenerative condition. Patients were screened preoperatively for high fear of movement using the Tampa Scale for Kinesiophobia.

A primer for workers' compensation.

Background Context: A physician's role within a workers' compensation injury extends far beyond just evaluation and treatment with several socioeconomic and psychological factors at play compared with similar injuries occurring outside of the workplace. Although workers' compensation statutes vary among states, all have several basic features with the overall goal of returning the injured worker to maximal function in the shortest time period, with the least residual disability and shortest time away from work.

Purpose: To help physicians unfamiliar with the workers' compensation process accomplish these goals.

Cognitive-behavioral-based physical therapy to improve surgical spine outcomes: a case series.

Background And Purpose: Fear of movement is a risk factor for poor postoperative outcomes in patients following spine surgery. The purposes of this case series were: (1) to describe the effects of a cognitive-behavioral-based physical therapy (CBPT) intervention in patients with high fear of movement following lumbar spine surgery and (2) to assess the feasibility of physical therapists delivering cognitive-behavioral techniques over the telephone.

Case Description: Eight patients who underwent surgery for a lumbar degenerative condition completed the 6-session CBPT intervention.

Whole-body vibration: is there a causal relationship to specific imaging findings of the spine?

Study Design: Systematic review.

Objective: To perform a systematic review of the available literature for those studies that evaluated the role of whole-body vibration (WBV) on the spine, using imaging modalities as well as an estimation of WBV exposure.

Summary Of Background Data: Numerous comparative studies have reported a possible association between the occurrence of spinal symptoms and exposure to WBV.

Synthesis, characterization of calcium phosphates/polyurethane composites for weight-bearing implants.

Calcium phosphate (CaP)/polymer composites have been studied as an alternative graft material for the treatment of bone defects. In this study, lysine-triisocyanate-based polyurethane (PUR) composites were synthesized from both hydroxyapatite (HA) and β-tricalcium phosphate (TCP) to reduce the brittleness of CaP and increase the bioactivity of the polymer. The mechanical properties and in vitro cellular response were investigated for both HA/PUR and TCP/PUR composites.

Reduced surgical site infections in patients undergoing posterior spinal stabilization of traumatic injuries using vancomycin powder.

Background Context: Despite improvements through the use of prophylactic systemic antibiotics, surgical site infections remain a significant problem in the treatment of traumatic spine injuries. Infection rates as high as 10% have been reported in this population. The impact on patients and cost of treating such infections is profound.

A sustained release of lovastatin from biodegradable, elastomeric polyurethane scaffolds for enhanced bone regeneration.

Scaffolds prepared from biodegradable polyurethanes (PUR) have been investigated as a supportive matrix and delivery system for skin, cardiovascular, and bone tissue engineering. In this study, we combined reactive two-component PUR scaffolds with lovastatin (LV), which has been reported to have a bone anabolic effect especially when delivered locally, for effective bone tissue regeneration. To incorporate LV into PUR scaffolds, LV was combined with the hardener component before scaffold synthesis.

Pain drawing scoring is not improved by inclusion of patient-reported pain sensation.

Study Design: This is a retrospective study of 250 patients who describe low back pain with pain drawings. A computer application using artificial neural networks was designed to analyze pain drawings and evaluate the contribution of pain sensation to drawing classification.

Objective: The primary goal of this study was to assess the contribution of patient recorded pain sensation marks in classifying pain drawings into one of five broadly defined categories.

Experimental studies on the effects of recombinant human matrix metalloproteinases on herniated disc tissues--how to facilitate the natural resorption process of herniated discs.

Purpose: Recently, MMP-7 and MMP-3 have been found to play a crucial role in the natural resorption process of herniated discs. We therefore examined the role of these recombinant human matrix metalloproteinases (rh MMPs) in the treatment of herniated discs.

Methods: (a) Surgical samples of herniated disc were cultured in the presence or absence of rh MMPs, and wet weight was measured 24h later.

The impact of adjacent level disc degeneration on health status outcomes following lumbar fusion.

Study Design: A retrospective review of patient outcomes after lumbar spinal fusion.

Objective: To determine whether patients with a fusion ending adjacent to a "degenerated disc" (DDD group) had worse clinical outcomes than patients with fusions ending adjacent to "normal" discs (NL group).

Summary Of Background Data: Although it has been suggested that creating a rigid motion segment adjacent to a degenerated segment may negatively impact clinical outcomes after lumbar fusion, this question has not been addressed to our knowledge in the English literature.

Evaluation of calcium sulfate paste for augmentation of lumbar pedicle screw pullout strength.

Background Context: Many authors have evaluated the components responsible for ultimate pullout strength of pedicle screws. In these studies, one important variable has been the screw fixation. Because pedicle screw fixation has increased in popularity over recent years, so has the need for augmentation in difficult situations.