New model to explain the EQ-5D VAS in patients who have undergone spinal fusion

BACKGROUND

In the health sector, the EQ-5D has been widely used to evaluate health-related quality of life, mainly due to its simplicity, robustness and plasticity in calculating years of life adjusted for quality.

METHODS

However, its model has remained stable over time and knowledge of the influence of such biodemographical variables as age and gender has not been incorporated. This information, along with the well-known non-linear behavior of the VAS, which measures the self-concept of the 'General State of Health', forms the basis for a new model, which we present here from a sample of patients who were operated on for chronic low back pain.

RESULTS

These are obtained using multiple regression analysis are consistent in terms of goodness-of-fit given that this new model is able to explain 91.3% of the self-concept of the 'general state of health'.

CONCLUSIONS

Above leads to an improvement of 21.6% compared to the available models more robust and meets most of the restrictions for this type of statistical modeling.

Histomorphometric study of femoral heads in hip osteoarthritis and osteoporosis

During the period from 2000 to 2003, ninety eight samples of femoral heads were collected. In these pieces, two zones were analyzed: a high-load zone (the hard core of the head) and a low-load zone (the round ligamentum teres zone). As control group, 6 femoral heads (3 of women and 3 of men), proceeding from autopsy in peoples without pathological antecedents and youngs, were studied. After the samples had been embedded in methylmethacrylate and stained, they were subjected to an histomorphometric study. By means of histomorphometry, trabecular bone volume (TBV) and osteoid substance (OSV) was determined. Statistically significant differences were found as for peripheral osteoid volume (low-load zone) (p=0.036) and trabecular bone volume, both peripheral and central. Both volumes decreased in osteoporotic samples and in those from women (p=0.000), in comparison with control group. Regarding the relationship between the high-load and low-load zone, significant data were obtained. The high-load zone had a greater trabecular bone volume than the low-load zone, regardless of the pathology and sex, but this increase was more pronounced in the arthrosic samples and in those from men. Additionally, this trabecular bone volume in the high-load zone decreased with increasing age of the donor (p=0.037), when the control group is compared. In sum, we observed a reduction in the formation of TBV and OSV in osteoporosis but also a decrease in the arthrosic, in samples from older subjects, in women, and in the low-load zone of the samples, when the control group is compared. These data suggest the coexistence of both pathologies, which is more pronounced in older subjects and women.

Conservative management of burst fractures of the fifth lumbar vertebra

Isolated fractures of the lumbar fifth vertebrae (L5) are very rare, and there is little information in the literature regarding comparisons between conservative management and surgical treatment of this entity. This retrospective analysis reports on five cases of isolated burst fractures of the fifth lumbar vertebra without neurologic deficit. All cases were managed nonoperatively with a short period of bed rest followed by protected mobilization. The current study reveals that conservative management is appropriate in the cases of burst fractures of the fifth lumbar vertebra with minimal canal compromise, with little deformity, and without neurologic damage.

Periosteal ganglion in a child

A case of periosteal ganglion in a 10-year-old boy is reported. The diagnosis of periosteal ganglion was made on roentgenographic and MR appearance and histologic evidence. The patient was successfully treated by excision. The follow-up examination showed no recurrence. Periosteal ganglia must be considered a cause of expanding cortical erosions. This lesion may mimic other peripheral expanding lesions.