Segmental Stability Research Articles

Effectiveness of McKenzie approach and segmental spinal stabilization exercises on neck pain in individuals with cervical postural syndrome: An experimental study.

This study "Effectiveness of Mckenzie approach and segmental spinal stabilization exercises on neck pain in individuals with cervical postural syndrome: an experimental study" was conducted to study and find the effectiveness of Mckenzie approach and segmental spinal stabilization exercises on reduction of pain, correction of rounded shoulder, and disability. Pain, disability, and rounded shoulders are the major limiting factors as it affects the quality of life and reduces efficiency and social participation. The study was conducted among 120 individuals with cervical postural syndrome, and fulfilling the inclusion and exclusion criteria was included. The outcome measures were Visual Analogue Scale (VAS), Neck Disability Index (NDI), and Vernier caliper to evaluate pain, functional disability, and rounded shoulder, respectively. Subjects were randomly divided into two groups, Group A and Group B, by using SPSS software. Interventional training was given for 6 weeks to the patients. Group A subjects were given spinal stabilization exercises. Group B subjects were given Mckenzie approach. The statistical analysis was performed using SPSS; pre-test and post-test were used to calculate the results, followed by data presentation and analysis. The result showed that at the end of the 6 weeks on comparison between pre- and post-intervention of Group A and Group B, both the techniques were effective, but group B was significantly effective than Group A. It was noted that McKenzie approach and segmental spinal stabilization exercises were effective on neck pain in individuals with cervical postural syndrome, but on comparing both techniques, Mckenzie protocol is more beneficial than segmental spinal stabilization exercises. The study accepts the alternate hypothesis that there is significant effect of McKenzie approach and segmental spinal stabilization exercises on neck pain in individuals with cervical postural syndrome.

"Only fixation" in cases with failed decompression for lumbar canal stenosis - Analysis of outcome in 14 cases.

The rationale of "only fixation" of affected spinal segments without any form of bone or soft-tissue decompression in cases with failed decompressive laminectomy for lumbar canal stenosis is discussed on the basis of an experience with 14 cases. During the period between 2010 and 2022, 14 patients who symptomatically worsened or did not improve following a long-segment "wide" decompressive laminectomy for multisegmental lumbar canal stenosis were identified. All patients were treated by segmental spinal stabilization aimed at arthrodesis by facetal distraction by Goel's facetal spacers (6 cases) or Camille's transarticular facetal fixation (8 cases). No bone, soft tissue, or disc resection was done for spinal or neural canal "decompression." Oswestry Disability Index and Visual Analog Scale were used to clinically assess the patients before and after the surgery and at follow-up. In addition, video recordings of patient's self-assessment of clinical outcome were used to monitor the outcome. During the average period of follow-up of 71 months (range 6 months to 16 years), all patients recovered in majority of their major symptoms, the recovery was observed in the immediate postoperative period. During the period of follow-up, none of the patients complained of recurrent symptoms or needed any additional surgery. There was firm stabilization and evidences of bone fusion of the treated spinal segments in all patients. There were no infections or implant failure. No patient worsened after treatment. Instability of the spinal segments is the primary issue in cases with lumbar canal stenosis and stabilization in the treatment.

Lumbar Interbody Fusion and Osteobiologics for Lumbar Fusion.

Lumbar interbody fusion (LIF) is an excellent treatment option for a number of lumbar diseases. LIF can be performed through posterior, transforaminal, anterior, and lateral or oblique approaches. Each technique has its own pearls and pitfalls. Through LIF, segmental stabilization, neural decompression, and deformity correction can be achieved. Minimally invasive surgery has recently gained popularity and each LIF procedure can be performed using minimally invasive techniques to reduce surgery-related complications and improve early postoperative recovery. Despite advances in surgical technology, surgery-related complications after LIF, such as pseudoarthrosis, have not yet been overcome. Although autogenous iliac crest bone graft is the gold standard for spinal fusion, other bone substitutes are available to enhance fusion rate and reduce complications associated with bone harvest. This article reviews the surgical procedures and characteristics of each LIF and the osteobiologics utilized in LIF based on the available evidence.

The Impact of Isocyanate Index and Filler Functionalities on the Performance of Flexible Foamed Polyurethane/Ground Tire Rubber Composites.

The structure and performance of polyurethane (PU) foams are strongly driven by the stoichiometry of the polyaddition reaction, quantitatively described by the isocyanate index. It determines the balance between isocyanate and hydroxyl groups in the reacting system and is affected by the introduction of additional functionalities originated, e.g., from applied fillers. Nevertheless, this issue is hardly taken into account in research works. Herein, the structure and performance of PU/ground tire rubber (GTR) composites differing in their isocyanate index (from 0.8 to 1.2) and prepared with and without considering the GTR functionalities in formulation development were investigated. Incorporating GTR into the PU matrix led to a reduction in average cell diameter (from 2 to 30% depending on the isocyanate index) compared to unfilled foams. However, formulation adjustments did not show a significant impact on cellular structure. The only decrease in open cell content was noted, from 10% for the 0.9 index to 40% for 1.2. Such changes were related to the increasing strength of the PU cellular structure able to maintain inside the increasing amount of carbon dioxide. On the other hand, considering hydroxyl values of GTR noticeably affected the thermomechanical performance of composites. The shift of glass transition temperature (Tg), even by 10 °C for 1.2 isocyanate index, enhanced the performance of materials, which was expressed in an 8-62% drop in the composite performance factor, pointing to the enhanced reinforcing effect resulting from filler incorporation. The stiffening of foams, related to the variations in PU segmental structure, also caused minor changes in the course of thermal degradation of PU/GTR composites due to the inferior thermal stability of hard segments. The obtained results provide important insights into the development of formulations of PU composites filled with materials containing reactive functional groups able to disrupt the stoichiometric balance of the polyaddition reaction.

Polyacrylate Thermoplastic Elastomer Replacing SBS for Modified Asphalt

Poly (styrene-butadiene-styrene) block copolymer (SBS) is the most common thermoplastic elastomer (TPE) used for modified asphalt. The unsaturated double bond of its polybutadiene block is prone to crosslinking and aging, which affects the performance and service life of modified asphalt. To solve this problem, acrylate soft monomers are used to replace butadiene, and hard monomers with high glass transition temperature (<I>T</I>_g) are used to replace styrene. Such new TPEs are designed to improve the chemical stability of the soft segment and improve the modification high and low temperature properties of asphalt. Firstly, the monomers used for flexible block and rigid block are screened out based on monomer price and <I>T</I>_g, and the polymerization method of each monomer is analyzed. Then, the polymerization methods and topological structures of block-type TPE prepared by rigid and flexible monomers are summarized and compared. The most suitable topological structure is linear or comb type. For linear TPE, a living polymerization method should be used, and each block is selected for copolymerization with monomers to adjust <I>T</I>_g. For comb-type TPE, the proposed synthetic route is: firstly prepare the telechelic graft chain, and then carry out free radical copolymerization. Finally, several schemes for the preparation of telechelic graft chains are proposed. A synthesis scheme of polyacrylate thermoplastic elastomer is proposed by summarizing the existing monomers, polymerization methods and initiator molecular structures, which provides a guideline for replacing SBS and for improving the comprehensive performance and service life of modified asphalt.

An injectable and self-strengthening nanogel encapsuled hydrogel gene delivery system promotes degenerative nucleus pulposus repair

Local inflammatory responses, a gradual imbalance in anabolic/catabolic activities as well as progressive functional impairment within the nucleus pulposus (NP) are responsible for the progression of intervertebral disc degeneration (IDD). Antagomir-21, a cholesterol-modified inhibitor of miRNA-21, has the potential to regenerate the extracellular matrix (ECM), but the absence of suitable delivery systems limits its applications for IDD treatment. In this study, one type of antagomir-21-loaded nanogel (NG@antagomir-21) was encapsulated in injectable self-strengthening hydrogel gene delivery system for the controlled and sustained delivery of the drug into the NP for over 14 days. The hybrid hydrogel also displayed intelligent and sustained release of antagomir-21 via a three-stage mechanism. The hydrogels were designed to be easily injected into the intervertebral disc with lower mechanical strength. After a strength-enhancing process, the resulting fully gelatinized hydrogels of higher mechanical strength had the ability to prevent leakage, provide sufficient mechanical support and maintain the stability of the spinal segment. In addition, the physicochemical properties of the hybrid hydrogels as well as their excellent biocompatibility, degradability, anti-inflammatory effects and strong ability to regulate the ECM's metabolic balance in vitro were demonstrated. In vivo testing highlighted the synergy between the anti-inflammatory and ECM regenerative effects effectively promoted the hydrogels' efficacy for IDD therapy. This hydrogel gene delivery system showed great promise for applications in IDD repair.

Variable seismic responsiveness to stress perturbations along the shallow section of subduction zones: The role of different slip modes and implications for the stability of fault segments

Assessing the stability state of fault interfaces is a task of primary interest not only for seismic hazards, but also for understanding how the earthquake machine works. Nowadays it is well known that a relationship exists between slow and fast earthquakes; moreover, it is more and more evident that such a connection is quite diffuse all over the Earth. In this paper, we perform a spatial and temporal analysis of both geodetic and seismic—non-volcanic tremors, low-frequency events (LFEs), and regular earthquakes—time series. We focus on the relationship between the clustering of properties of the different kinds of seismicity and their response to stress perturbations. Earth tides and large earthquakes are used as a source of additional stress. Seismic activity hosted in the Cascadia subduction zone, Manawatu region in New Zealand, and Japan during the last two decades is considered. Our analysis suggests that tremors become more and more sensitive to Earth-tide perturbations as the fault interface is seismically locked. Therefore, tremors and regular events show a similar response to tidal stress perturbations. This feature is also accompanied by relatively lower spatial and temporal coefficients of variation. A series of recordings by several GNSS stations along the Hikurangi Trench, North Island, New Zealand, and along the Nankai coasts in Japan is taken into account for studying how large thrust-faulting earthquakes affect silent events and geodetic signals and vice versa. In the last section, a simple model for grasping a glimpse of the local stability condition of the Earth’s crust and for explaining previous observations is provided.

Long segment versus short segment stabilization in thoracolumbar spine fracture: A retrospective clinical and radiological analysis

Introduction: Thoracolumbar spine fracture is one of the commonest spinal fractures. The treatment of choice of surgery is still controversial. This is a retrospective analysis of clinical and radiological outcomes of long and short segment stabilization for patients admitted with thoracolumbar fracture in our hospitals. Material and Method: Inclusion criteria included a single level of thoracolumbar fracture, excluding pre-existing deformity or spinal surgery, osteoporosis, and pathological fracture. Clinical parameters included visual analogue scale (VAS), operative time, intraoperative blood loss, and postoperative length of stay. Radiological parameters included wedge angle and anterior and posterior vertebral height ratio. Results: From June 2007 to May 2020, 56 patients (male = 31, female = 25) were recruited. There were 25 patients in the short segment group (open = 11, minimal invasive surgery (MIS) = 14) and 31 patients in the long segment group. Clinically, significantly better VAS at 6 months (1 vs. 1.96; p = 0.041), shorter post-op length of stay (16 days vs. 25 days; p = 0.01), and less blood loss (178 ml vs. 824 ml; p &lt; 0.01) were found in the short segment group. Radiologically, the short segment group showed significantly better wedge angle at immediate (5° vs. 9.23°; p = 0.002) and long-term follow-up (7.41° vs. 11.43°; p = 0.01). Moreover, the short segment group has significantly better post-op anterior and posterior vertebral height ratios. Within the short segment group, the MIS group showed significantly less blood loss (82 ml vs. 303 ml; p &lt; 0.01). However radiological parameters favour the open group. Discussion and Conclusion: For single-level thoracolumbar fracture, both long and short stabilizations were effective in reducing and stabilizing the fracture. However, the short segment group showed significantly superior results. Moreover, a minimally invasive technique in short segment stabilization showed even less blood loss but less optimal radiological results. Therefore, short segment stabilization could be the treatment of choice for traumatic thoracolumbar spine fractures.

A Review of the Effectiveness of Exercise Protocols on Proprioception and Pain in People With Nonspecific Chronic Low Back Pain

Background and Objectives Chronic low back pain is one of the most common and costly musculoskeletal disorders in societies and is an important clinical and socio-economic epidemic, mostly in industry and non-industry. The aim of this study was to a systematic review of the effectiveness of exercise protocols on lumbar proprioception in patients with chronic nonspecific low back pain. Subjects and Methods From internal and external search engines, including Scopus, Semantic Scholar, Google Scholar, Pubmed, ISC, SID, Magiran, Irandoc, and Doaj with time limit 2010 to 2021 and the keywords exercises, proprioception, non-specific, and chronic low back pain, the present study was done using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes). Results Nine articles were selected based on inclusion criteria. These studies mainly focused on systematic review effectiveness of exercise protocols on sensation and low back pain in people with non-specific chronic low back pain. Conclusion According to the research reviewed in the present study, it seems that exercise rehabilitation protocols activate, strengthen, maintain, and increase the central region of the body, especially deep muscles, particularly the multifidus and transverse abdomen, by retraining the pelvic lumbar region. The diaphragm and diagonal of the abdomen and pelvic floor, which play a role in the important segmental stability of the lumbar spine, improve the sense of depth and pain in patients with chronic nonspecific low back pain.

Clinical effect of channel assisted cervical key hole technology combined with ultrasonic bone osteotome in the treatment of single segment cervical spondylotic radiculopathy.

To explore the clinical effect and operating skills of channel assisted Cervical Key Hole technology combined with Ultrasonic Bone Osteotome (CKH-UBO) in the treatment of single segment cervical spondylotic radiculopathy (CSR). From June 2018 to June 2020, 14 patients diagnosed with CSR and treated with channel assisted CKH-UBO were collected. The duration of the disease, the length of the incision, the operation time, the amount of bleeding during the operation, the length of hospitalization and the complications were recorded. The Range Of Motion (ROM) and the stability of the surgical segment were recorded before and after the operation. Visual analog scale (VAS), neck disability index (NDI) and modified macnab efficacy evaluation criteria were used to evaluate the surgical efficacy. The operative segments of the enrolled patients were all lower cervical vertebrae. The average incision length was 2.0 ± 0.1 cm, the operation time was 42.2 ± 5.7 min, the intraoperative bleeding volume was 32.7 ± 4.1 ml, and the hospital stay was 5.6 ± 1.2 days. There was no difference in ROM between preoperative and 3 months and 1 year after operation (P > 0.05), and all patients did not have segmental instability. The VAS scores of neck pain before surgery, 3 days after surgery, 3 months after surgery, and 1 year after surgery were 5.6 ± 1.2, 1.6 ± 0.6, 1.1 ± 0.7, 0.6 ± 0.5, and the VAS scores of upper limb pain were 6.2 ± 1.2, 1.7 ± 0.7, 1.1 ± 0.6, 0.6 ± 0.5. The NDI scores of upper limb pain before surgery, 3 days after surgery, 3 months after surgery, and 1 year after surgery were 36.7 ± 3.5, 9.8 ± 2.4, and 3.9 ± 1.5, 1.8 ± 1.0, The VAS and NDI scores at all follow-up time points after operation were significantly lower than those before operation (P < 0.001). One year after operation, the curative effect was evaluated according to the modified macnab evaluation standard, and the excellent and good rate was 100%. The complication rate was 6.25%. Channel assisted CKH-UBO for single segment CSR has the advantages of short operation time, reliable clinical effect, high safety and low complication rate, which is worthy of clinical promotion.

Three-Dimensional-Printed Splint for Use in Pediatric Mandibular Fracture.

Mandibular fractures are the most common type, accounting for about 71% of facial fractures in children. The mandible is the only movable bone in the craniomaxillofacial region. The injury of the mandible has a serious impact on the functions of children's mouth opening, chewing, pronunciation, and occlusion. Therefore, the treatment of children's mandibular fractures is particularly important. Because of the characteristics of children with permanent tooth germ blocking and strong skeletal development, the treatment methods of adults cannot simply be used in children with mandibular fractures. Here, we demonstrate the simple, reliable method using 3-dimensional-printing splint for stability of the fracture segments in pediatric patients.

Insights into Stoichiometry Adjustments Governing the Performance of Flexible Foamed Polyurethane/Ground Tire Rubber Composites.

Polyurethanes (PU) are widely applied in the industry due to their tunable performance adjusted by changes in the isocyanate index—stoichiometric balance between isocyanate and hydroxyl groups. This balance is affected by the incorporation of modifiers of fillers into the PU matrix and is especially crucial for PU foams due to the additional role of isocyanates—foaming of the material. Despite the awareness of the issue underlined in research works, the contribution of additives into formulations is often omitted, adversely impacting foams’ performance. Herein, flexible foamed PU/ground tire rubber (GTR) composites containing 12 different types of modified GTR particles differing by hydroxyl value (LOH) (from 45.05 to 88.49 mg KOH/g) were prepared. The impact of GTR functionalities on the mechanical, thermomechanical, and thermal performance of composites prepared with and without considering the LOH of fillers was assessed. Formulation adjustments induced changes in tensile strength (92–218% of the initial value), elongation at break (78–100%), tensile toughness (100–185%), compressive strength (156–343%), and compressive toughness (166–310%) proportional to the shift of glass transition temperatures (3.4–12.3 °C) caused by the additional isocyanates’ reactions yielding structure stiffening. On the other hand, formulation adjustments reduced composites’ thermal degradation onset due to the inferior thermal stability of hard segments compared to soft segments. Generally, changes in the composites’ performance resulting from formulation adjustments were proportional to the hydroxyl values of GTR, justifying the applied approach.

Is "Bite force" a reliable parameter to compare masticatory efficiency restoration following ORIF of anterior mandibular fractures?

ObjectivesMandible is an integral part of masticatory system, and it is expected that it’s fracture will have a significant impact on occlusal forces, range of motion, muscle activity levels, and occlusion. The main objective of this study was to compare the efficacy of 3-dimensional (3D) miniplate and conventional miniplates for fixation of anterior mandibular fractures on the basis of bite force as a main parameter.Methods66 patients having isolated anterior mandibular fractures were randomized into two groups equally: Conventional miniplates and 3D miniplates. The bite force at incisor, canine, and molar regions was measured preoperatively and postoperatively at weekly intervals until the sixth week, and the mean bite force as well as changes in mean bite force were compared between two groups.ResultsAn increase in bite force was noted at each subsequent follow up in both the groups across all sites. Statistically significant difference was found in mean bite force values between both the groups during mid-follow up period. The difference in changes in the mean bite force too was observed to be statistically significant during the mid to late follow up period.Interpretation & conclusionBite force is a reliable parameter to assess restoration of masticatory efficiency following open reduction and internal fixation (ORIF). 3D miniplates when used in anterior mandibular fractures management are efficient enough to withstand masticatory forces throughout the healing process, providing better stability of fractured segments against torsional forces during immediate post-operative period.

Patient-specific numerical investigation of the correction of cervical kyphotic deformity based on a retrospective clinical case

Little research has been reported on evaluating the safety of the fixation construct in cervical kyphosis correction. In this study, we proposed a principal-strain criterion to evaluate the safety of the fixation construct and validated the modeling method against a retrospective case of anterior cervical discectomy fusion (ACDF). From C2 to T2 vertebra bodies, fixation instruments were reconstructed and positioned as per postoperative computed tomography (CT) scans. Head weight (HW) and various moments estimated from isometric strength data were imposed onto the C2. The postoperative stability of non-surgical segments, deformations surrounding the screw trajectories, and contact slipping on zygapophysial joints were analyzed. The model was validated against the reality that the patient had a good fusion and deformity correction. The ACDF restricted the range of motions (ROMs) of cervical segments and lent stability to vertebra fusion, no failure was found in the finite element (FE) model of cervical vertebrae. The deformation surrounding the screw trajectories were concentrated to the lateral sides of trajectories, recommending that the shape of the anterior cervical plate conforming to the curvature of the vertebra and screws fully inserted into vertebrae reduced the deformation concentration around the screw trajectories.

An ex-vivo model for the biomechanical assessment of cement discoplasty.

Percutaneous Cement Discoplasty (PCD) is a surgical technique developed to relieve pain in patients with advanced degenerative disc disease characterized by a vacuum phenomenon. It has been hypothesized that injecting bone cement into the disc improves the overall stability of the spinal segment. However, there is limited knowledge on the biomechanics of the spine postoperatively and a lack of models to assess the effect of PCD ex-vivo. This study aimed to develop a biomechanical model to study PCD in a repeatable and clinically relevant manner. Eleven ovine functional spinal units were dissected and tested under compression in three conditions: healthy, injured and treated. Injury was induced by a papain buffer and the treatment was conducted using PMMA cement. Each sample was scanned with micro-computed tomography (CT) and segmented for the three conditions. Similar cement volumes (in %) were injected in the ovine samples compared to volumes measured on clinical PCD CT images. Anterior and posterior disc heights decreased on average by 22.5% and 23.9% after injury. After treatment, the anterior and posterior disc height was restored on average to 98.5% and 83.6%, respectively, of their original healthy height. Compression testing showed a similar stiffness behavior between samples in the same group. A decrease of 51.5% in segment stiffness was found after injury, as expected. The following PCD treatment was found to result in a restoration of stiffness—showing only a difference of 5% in comparison to the uninjured state. The developed ex-vivo model gave an adequate representation of the clinical vacuum phenomena in terms of volume, and a repeatable mechanical response between samples. Discoplasty treatment was found to give a restoration in stiffness after injury. The data presented confirm the effectiveness of the PCD procedure in terms of restoration of axial stiffness in the spinal segment. The model can be used in the future to test more complex loading scenarios, novel materials, and different surgical techniques.

Current understanding of intervertebral space height in anterior cervical fusion

Anterior cervical fusion surgery is the first choice for spine surgeons in the treatment of cervical spine diseases. It has significant effects in treating cervical degenerative diseases, trauma and tumors and other cervical diseases. In anterior cervical fusion, it is necessary to use a distractor to properly distract the intervertebral space, so as to fully expose and relieve the compressive factors, restore the physiological height, curvature and stability of the lesion segment, and achieve the best surgical effect. However, there is currently no consensus on the standard distraction height for the intervertebral space during anterior cervical surgery. This article reviewsed the progress of intervertebral space height in anterior cervical fusion from three dimensions:the relationship between intervertebral space height and cervical disc degeneration mechanism, the selection of intervertebral space height during operation, the recovery of intervertebral space height and the postoperative effect, so as to provide theoretical basis and reference for spinal surgeons when performing intervertebral distraction during operation.

Thermo-torsional postbuckling of CNT-reinforced composite toroidal shell segments with surrounding elastic media and tangentially restrained edges

An analytical investigation on the nonlinear stability of toroidal shell segment (TSS) made of carbon nanotube (CNT)-reinforced composite, surrounded by an elastic medium, exposed to elevated temperature and subjected to uniform torsion is presented in this paper. The properties of constituents are assumed to be temperature dependent and effective properties of composite are determined using an extended rule of mixture. CNTs are embedded into matrix phase according to functionally graded or uniform distributions. Basic equations in terms of deflection and stress function are established within the framework of classical shell theory including geometrical nonlinearity in von Kármán–Donnell sense and interactive pressure from surrounding elastic medium. Two boundary edges of the shell are assumed to be simply supported and tangentially restrained. Multi-term analytical solutions are assumed and Galerkin method is used to derive expressions of buckling load and nonlinear relation between torsional load and deflection. Parametric studies are carried out to analyze the effects of material and geometry properties, in-plane boundary condition, elevated temperature and surrounding elastic medium on the buckling resistance and postbuckling behavior of torsionally loaded TSS. Novel finding of this study is that tangential edge constraints have no and negative effects on critical torsional loads at room and elevated temperatures, respectively, and profoundly beneficial influences on postbuckling load capacity of TSSs.

Neurofibromatosis type 1 manifesting with adolescent idiopathic scoliosis: a case report and literature review

&lt;p class="abstract"&gt;Type 1 neurofibromatosis (NF 1) may present with a constellation of symptoms but literature has recorded that the commonest manifestations are orthopedic symptoms with spinal presentations taking the lead. Of the spinal manifestations, scoliosis is frequently found compared to others which could include spondylolisthesis or defective pedicles and dural ectasia on radiographs. We reported is a 15-year-old girl with NF 1 coexisting with severe thoracolumbar scoliosis. She complains of dull aching pain in her upper back and hips with progressively worsening bending of the back and slight difficulty with breathing. On examination, multiple Café au lait spots on the trunk and legs. No neurological deficits noted. There was no family history of neurofibromatosis. There was severe thoracolumbar scoliosis on X-ray of the low back. The patient then had long segment fusion and stabilization. Bone graft was used to achieve solid arthrodesis. Scoliosis is the commonest manifestation of NF 1 with different severities and degrees of Cobb's angle adolescent females are mostly affected and management is dependent of degree of curvature, comorbidities like NF 1 and type of scoliosis.&lt;/p&gt;

Investigation of the effectiveness of neck stabilization exercises in patients with chronic neck pain: A randomized, single-blind clinical, controlled study.

This study aims to compare the efficacy of neck stabilization exercises versus a conventional exercise program on pain, range of motion, disability, and depression in patients with chronic neck pain. This prospective, single-blind, randomized controlled study included 60 patients with chronic neck pain, 58 (21 males, 37 females; mean age: 36.7±8.5 years; range, 18 to 55 years) of whom completed the study. The patients were randomized into two groups. Patients in one group were given neck stabilization exercises, while the patients in the other group were given conventional neck exercises. Neck pain due to activities of daily living (Visual Analog Scale), neck range of motion in sagittal, transverse, and frontal planes, disability (Neck Disability Index), and depression (Beck Depression Inventory) were evaluated at the beginning, at the end of the treatment, and at the first and third months after the end of treatment. Significant improvement was achieved in both groups in terms of Visual Analog Scale, Neck Disability Index, neck range of motion in the sagittal, transverse, and frontal planes, and Beck Depression Inventory compared to the beginning of treatment (p<0.05). In the stabilization exercise group, statistically significant improvement was found in the range of motion of the neck in the transverse plane (p<0.05). Stabilization exercise programs, which show their effect by maintaining segmental stabilization, postural control, and balance between the superficial and deep muscles of the neck region, contribute to reduced pain in daily activities and improved function similar to conventional exercise programs.

37. Anatomic contributions to the stability of the L5-S1 segment under combined shear and compression: implications to isthmic/lytic spondylolisthesis

37. Anatomic contributions to the stability of the L5-S1 segment under combined shear and compression: implications to isthmic/lytic spondylolisthesis