Our study demonstrated an improvement in LBP levels (VAS and ODI) and postural balance in patients with HSS following THR surgery. No significant changes have been noted in radiographic spinal sagittal alignment postoperatively. The improvement in LBP levels does not correlate with post-operative changes in spinopelvic alignment or postural balance.

BackgroundSpinal deformities affect the overall alignment of the spine and thus the vectors of loading on the lumbar region and intervertebral discs. Due to wedging of the disc or vertebrae of unbalanced spinal segments, alignment change may affect the range of motion (ROM) of individual spinal segments or the global spine. This is particularly important in adolescent idiopathic scoliosis (AIS) patients who may suffer from early degeneration, back stiffness and pain. Hence, this study aimed to determine the correlation between spine range of motion (ROM) and adolescent idiopathic scoliosis (AIS) curve magnitude.MethodsConsecutive recruitment of all AIS patients with Lenke 5 (thoracolumbar/lumbar) curves within one month was performed with ROM assessments in the coronal, sagittal and axial planes using the change in C7-S1 distance on standing upright, active flexion and extension positions, change in finger-floor distance on forward bending position and lateral bending, lateral bending angles, modified Schober’s test, and trunk rotation in seating position. Patients were further stratified into two groups based on their lumbar spine curve magnitude: Group A with curves of 10 to 39 degrees and Group B with 40 degrees or greater. Univariate and multivariate analyses were conducted, with lumbar curve magnitude severity being the dependent variable.ResultsIn total, 58 patients (n = 12 males, n = 46 females; mean age: 15.7 years) were recruited. The mean curve magnitudes were 25 ± 6.5 degrees in Group A and 48 ± 10.6 degrees in Group B. Mean axial rotation (Group A: 90 ± 21.7 degree; Group B: 76 ± 19.6 degrees; p = 0.038) and lateral bending ROM (Group A: 67 ± 13.4 degrees; Group B: 58 ± 14.3 degrees; p = 0.045) decreased in more severe curves. These two parameters continued to remain significant irrespective of the curve severity cut-off values.ConclusionsThis is the first study to determine associations between spinal ROM parameters with the lumbar curve magnitude in AIS patients. We found that the coronal curve severity is associated with reduced axial and coronal ROM. This is a platform for future studies assessing lumbar spine biomechanics in AIS and to determine the effects of altered spine motion in this context and its implication in patient management and outcomes.

Objective: To share the outcomes of closed reduction and early mobilization in patients with simple elbow dislocation.Methods: From 2008 to 2015, 18 adult patients with simple elbow dislocations were enrolled in the Emergency Department of our hospital. All the patients received closed reduction under sedation. After reduction, a long arm cast was applied to all patients for one week. Early active movement was begun at the end of this week. Patients were not allowed to do passive stretching exercises for three weeks. All patients were followed up at the first week, sixth week and first year. Patients were evaluated both radiographically and functionally with Quick-DASH and Oxford Elbow Score. The results were evaluated by comparison with patients' contralateral elbow.Results: Quick-DASH scores at 1 year were 5.0 in the dislocation group versus 4.0 in the contralateral elbow. Oxford Elbow Scores at 1 year were 91 in the dislocation group versus 95 in the contralateral elbow. There was no significant relationship between the two groups at the first year controls (p>0.05). There was no significant difference in terms of range of motion (p>0.05). Patients returned to work sooner after early mobilization (average of 12 days). No recurrent dislocations occurred. After one year, there was no significant deterioration with radiographic joint integrity in any patient. Conclusion:Early active mobilization is a safe and effective treatment for simple elbow dislocations. Patients recovered faster and returned to work earlier compared to plaster immobilization.

SummaryObjective: The aim of this study was to investigate the effect of long term oral warfarin sodium treatment on bone mineral density (BMD) and spinal sagittal alignment. Materials and Methods: Sixty four participants were enrolled for this retrospective study. Participants were divided into two groups-participants who had taken warfarin sodium for at least two years (n=33) and participants who had never taken warfarin sodium (n=31). All of the individuals were evaluated at the same center. Dual X-ray absorptiometry (DXA) was used for measuring BMD. Whole spine x-rays were obtained for sagittal assessment and the following parameters were measured: Cervical lordosis, thoracic kyphosis, lumbar lordosis, pelvic incidence, pelvic tilt, sacral slope and sagittal vertical axis (SVA). Results: The mean BMD value was significantly higher in participants who had not taken warfarin sodium compared to participants who had taken warfarin sodium. The differences between the average values were 0.1552 g/cm 2 in BMD; 2.1 in T scores; 1.4 in Z scores. On the radiological evaluation of the spine, cervical lordosis was 7.1 degrees lower, lumbar lordosis was 4.7 degrees lower and thoracic kyphosis was 5.3 degrees higher in the patients using drug. C7 plumb line was interchanged forward in the patients using drug. Conclusions: This study shows that warfarin sodium use worsens bone quality in the lumbar region and does not affect bone quality in the femoral region. Furthermore, warfarin sodium use also reduces physiological lordosis and enhances thoracic kyphosis. Consequences of these changes are the likely cause of sagittal spinal anterior imbalance. Long-term oral warfarin sodium use affect bone mineral density and spinal alignment. Our conclusion about giving clear message and show exactly mechanism we need prospective randomized multicentre studies in future. We strongly believe this study will be pioneer for future researches. Keywords: Secondary osteoporosis, warfarin sodium, sagittal spinal alignment, spinal sagittal imbalance, ageing spine Amaç: Bu çalışmada, uzun dönem oral varfarin sodyum tedavisinin, kemik mineral yoğunluğu (KMY) ve omurganın sagittal dizilimi üzerindeki etkisini araştırmak amaçlanmıştır. Gereç ve Yöntem: Retrospektif olarak, çalışmaya 64 katılımcı dahil edildi. Katılımcılar iki grupta değerlendirildi. En az iki yıl varfarin sodyum kullanan hastalar (n=33) ve varfarin sodyum kullanmamış hastalar (n=31). Tüm katılımcılar aynı merkezde değerlendirildi. KMY dual X-ray absorbsiyometri ile değerlendirildi. Omurganın radyolojik değerlendirilmesi, iki yönlü tüm omurga grafisinde uygun parametreler ölçülerek yapıldı; servikal lordoz, torakal kifoz, lomber lordoz, pelvik insidans, pelvik tilt, sakral slop ve sakral vertikal aks hattı. Bulgular: Gruplar arası değerlendirmede, KMY'nin ilaç kullanmayan grupta istatistiksel olarak anlamlı derecede daha iyi olduğu görüldü. Ortalama değerler arasındaki farkın, KMY değerlerinde 0,1552 g/cm 2 , T skorlarında 2,1 puan, Z skorlarda 1,4 puan olmuştur. Omurganın radyolo...