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Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_I | Pages 150 - 150
1 Mar 2008
Stas V Lewis S Khattab N Davey R Mahomed N
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Purpose: The primary objective of this study was to determine if surgical treatment for spinal stenosis is comparable to total hip arthroplasty in improving patients’ self-reported quality of life.

Methods: An age, sex and time of surgery matched cohort of patients who had undergone elective primary 1–2 level spinal decompression (n=90) with (n=30/90) or without fusion for spinal stenosis (n=40 with degenerative spondylolisthesis) and elective primary total hip arthroplasty for osteoarthritis (n=90) were compared. The primary outcome measure was the preoperative and one year postoperative Medical Outcomes Study Short Form-36 (SF-36) questionnaire.

Results: The mean Physical Component Summary (PCS) / Mental Component Summary (MCS) for the stenosis compared to hip patients were 32.0/43.3 vs. 30.5/46.2 preoperatively (analysis between groups: p = 0.2/0.1) and 39.1/47.3 vs.44.1/46.1 postoperatively (analysis between groups: p = 0.003/0.4). The pre- and postoperative PCS significantly improved for both groups (p < 0.0001);however, the pre- and postoperative MCS improved in the stenosis group only (p = 0.04).

Conclusions: Studies have shown the significant impact on overall patient quality of life and cost-effectiveness of primary total hip arthroplasty. The results of this unique study show that surgical intervention for spinal stenosis also has a very positive overall effect on patients’ self-reported quality of life at one year follow up. This study provides data that supports the need for a long term prospective study and advocacy regarding waiting time initiatives and surgical resources for the treatment of patients with symptomatic spinal stenosis with a similar demographic to those with primary OA of the hip.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_II | Pages 230 - 231
1 May 2006
Dangerfield PH Davey R Chockalingam N Cochrane T Dorgan JC
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Background: To compare height-adjusted fat and fat-free mass components of body composition in girls with adolescent idiopathic scoliosis to young adolescents with eating disorders. Adolescent idiopathic scoliosis (AIS) has been linked with low bone densities. Animal and human studies have shown that bone densities are influenced by a wide variety of inter-related factors that includes body fat, oestrogen levels, nutritional status and energy balance. Anthropometric studies have reported girls with AIS as being taller and more slender than their age-matched peers and that they also exhibit complex patterns of body asymmetry, particularly in the upper limb. There are also some studies report eating disorders in this population.

Methods: Height-adjusted fat and fat-free mass components of body composition were examined. Fat mass index (FMI) and fat-free mass index (FFMI) were calculated and normalised for height and were superimposed onto UK 1990 growth reference data. The data for left and right limb length was also compared. A sample of 325 girls with AIS referred to the specialist spinal unit in Liverpool during the period 1970–1990.

Results: The fat mass index and fat-free mass index were reduced in this sample of AIS subjects compared with normal reference children, but were similar to those diagnosed with eating disorders (anorexia nervosa). The cohort also exhibited significant upper limb asymmetry.

Conclusion: The findings suggest that this population has significantly low fat mass compared to normal, healthy reference values. Since fat mass reflects energy balance, nutritional status (possibly eating disorders) and is closely linked to endocrine function, the implications of reduced fat mass on growth, bone mass accretion and the aetiology of AIS merit further investigation.