Except for reduced donor site pain, the clinical outcome for the carbon fiber intervertebral fusion cage is the same as for the Cloward procedure. Use of the cage results in a more lordotic alignment and an increased disc height, but in a higher pseudarthrosis rate than use of the Cloward procedure.

Neck muscle activity during loaded arm lifts 2 Practice of applications• Evaluating potential impairments in individuals with persistent disorders following cervical surgery will permit a more structured approach to rehabilitative exercise for this understudied group.• Greater muscle mechanical activity levels were observed in the ventral muscles and dorsal multifidus muscle of patients with persistent symptoms following anterior cervical decompression and fusion.• The differences may indicate an altered motor strategy in this group when performing the upper limb task.• The altered motor strategy need to be considered when prescribing exercise for their rehabilitation.Neck muscle activity during loaded arm lifts 3 ABSTRACT Objective: To compare the mechanical activity of the neck muscles during loaded arm lifting tasks in individuals with longstanding disability after anterior cervical decompression and fusion (ACDF) to that of healthy controls.Methods: Ten individuals (mean age 60 years; SD 7.1) who underwent ACDF (10-13 years previously) for cervical disc disease and 10 healthy age-and gender-matched controls participated in the study. Ultrasonography were used to investigate the degree of deformation and deformation rate of ventral and dorsal neck muscles at the C4-segmental level during a single (1 x arm flexion to 120°) and repeated (10 x arm flexion to 90°) loaded arm elevation condition. Results:The ACDF group demonstrated greater deformation and deformation rate of the longus capitis (p=0.02) as well as deformation rate of the sternocleidomastoid (p=0.04) during the 120° arm lift. For repeated 90° arm lift, there was a significant effect of group with higher deformation rate values observed in the longus capitis (p=0.005-0.01) and multifidus (p=0.03) muscles in the ACDF group. Muscle behavior did not change the repeated arm lifts (no group x time interactions) for either the ventral or dorsal muscles. Conclusions:Greater muscle mechanical activity levels were observed in the ventral muscles as well as the multifidus muscle, of patients with persistent symptoms following ACDF.These differences may be indicative of an altered motor strategy in this patient group when performing the upper limb task and may need to be considered when prescribing exercise for their rehabilitation.

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BackgroundSlipped capital femoral epiphysis (SCFE) is the most common hip disorder in children 9–15 years old. This is a population-based study in Sweden presenting the epidemiology for SCFE.MethodsIn a prospective cohort study, we analysed pre- and postoperative radiographs, medical records for all children treated for SCFE in Sweden 2007–2013, demographic data, severity of slip and surgical procedures performed.ResultsWe identified 379 Swedish children with primary SCFE 2007–2013; 162 girls, median age 11.7 (7.2–15.4) years, and 217 boys, median age 13 (3.8–17.7) years. The average annual incidence was 4.4/10000 for girls and 5.7/10000 for boys 9–15 years old. Obesity or overweight was found in 56% of the girls and in 76% of the boys. As an initial symptom, 66% of the children had hip/groin pain and 12% knee pain. At first presentation, 7% of the children had bilateral SCFE. Prophylactic fixation was performed in 43%. Of the remaining children, 21% later developed a contralateral slip.Fixation with implants permitting further growth was used in >90% of the children. Femoral neck osteotomy was performed for 11 hips.ConclusionsThe annual average incidence 2007–2013 in Sweden showed a mild increase for girls. The male-to-female ratio was lower than previous regional data from Sweden. Overweight or obesity is one major characteristic for boys with SCFE but to a less extent for girls. Knee pain as initial symptom cause a delay in diagnosis. Most hospitals in Sweden treat <2 children annually.