레이블이 questionnaire인 게시물을 표시합니다. 모든 게시물 표시
레이블이 questionnaire인 게시물을 표시합니다. 모든 게시물 표시

2013년 10월 17일 목요일

Postoperative bracing after spine surgery for degenerative conditions: a questionnaire study

Brief review


이 연구는 한 학회에 참가한 척추전문의들에게 본인의 환자에게 보조기를 사용하는 것과 관련하여 설문을 진행한 질의연구 입니다. 
설문의 초점은 외과의들이 환자 수술 후에 사용하는 보조기의 종류, 치료기간, 사용이유 등에 관한 것 입니다.
응답자들이 수술을 마친 본인의 환자들에게 보조기를 사용 할 때에, 고정을 위한 가장 적절한 종류, 기간, 적응증에 따른 합의가 부족하다는 결론입니다.


*Title: Postoperative bracing after spine surgery for degenerative conditions
: a questionnaire study
퇴행성질환을 위한 척추수술 후의 보조기 착용: 질의 연구

*Author: Jesse E. Bible, Debdut Biswas, Peter G. Whang, Andrew K. Simpson, Glenn R. Rechtine, Jonathan N. Grauer




Background context:
-A variety of orthoses are routinely applied after spinal procedures.
-But the proper indications for postoperative bracing are not well established.

Purpose
To assess the postoperative bracing patterns of spine surgeons.

Study design/setting
Questionnaire study

Patient sample
Spine surgeons attending the “Disorders of the Spine” conference (January 2008, Whistler, Canada).

Outcome measures
Frequencies of bracing after specific surgical procedures.


Methods
▶Subject: spine surgeons attending the “Disorders of the Spine” conference.
▶Questionnaire contents: typically immobilize patients after specific spinal procedures, the type of orthosis used, the duration of treatment, the rationale for bracing.


Results
-Ninety-eight of 118 surgeons completed the survey (response rate: 83%).

1. The frequency of bracing in academic and private/ in orthopedic and neurosurgical practices
--> similar

2.The difference in the bracing tendencies of fellowship and non-fellowship trained surgeons: -----> statistically significant (61% vs. 46%, p<.0001).

3. The duration (clinical experience): no influence the propensity of surgeons to use orthoses.

4. Employed more regularly: after cervical surgery > lumbar surgery (63% vs. 49%, p<.0001).

6. In the anterior cervical spine, orthoses were used more often as the complex procedure.
(increased single --▶ multilevel constructs (55% vs. 76%, p<.0001) )

7. The frequencies of bracing in noninstrumented and instrumented lumbar fusions
-->not significantly different.


Conclusions
-Most of the respondents brace their patients postoperatively, there is an obvious lack of consensus regarding the most appropriate type, duration, and indications for immobilization.

-Clinical studies may play a helpful role in evaluating the efficacy of postoperative bracing protocols.

2013년 10월 15일 화요일

Interface corrective force measurements in Boston brace treatment

Brief review


*Title: Interface corrective force measurements in Boston brace treatment
Boston보조기 치료에서 정확한 힘의 측정 인터페이스

*Author: J. van den Hout, L. van Rhijn, R. van den Munckhof, A. van Ooy




Background:
Brace application has been reported to be effective in treating idiopathic adolescent scoliosis.

Problem:
The exact working mechanism of a thoracolumbo spinal orthosis is not completely understood.

In this article, working mechanisms is a direct compressive force working through the brace upon the body and thereby correcting the scoliotic deformity, achieving optimal fit of the individual orthosis.


Purpose:
Measured these direct forces exerted by the pads in a Boston brace.

Method:
▶Subject number: 16 patients (with idiopathic adolescent scoliosis)
▶Measurement method: using the electronic PEDAR measuring device (Novel, Munich, Germany).
(Designed as an inshoe measuring system. wired to a computer, recording static and dynamic pressure distribution under the plantar surface of the foot.)

-After positioning the inserts between the lumbar and thoracic pads and the body, measured the forces acting upon the body in 8 different postures.


Result:
-Mean corrective force (through the brace pad): lumbar > thoracic (in all positions)

-Changes in body posture: significant alterations in the exerted forces.

-Between the magnitude of the compressive force over the lumbar and thoracic brace-pad and the degree of correction of the major curve: no significant correlation

-Corrective forces in new (<6 months) and old (>6 months) brace: no statistically difference.


Conclusion:
-The use of this pressure measurement device is practicable and of value for studies of the working mechanism of brace treatment.


-In the future, it might be of help in achieving optimal fit of the individual orthosis.