Tsonga T, et al. Clin Orthop Surg. 2015 Dec;7(4):449-456. http://dx.doi.org/10.4055/cios.2015.7.4.449

Lumbar Facet Joints (LFJs) are diathrodial joints which provide articulation between two adjacent lumbar vertebrae. LFJs represent complex anatomic structures with multifaceted biomechanic and functional characteristics. They are theorized as structures of crucial clinical significance since their degenerative morphologic alterations are frequently related to emergence of low back pain. Despite the emerging interest in describing LFJs anatomy in recent years, precise description of LFJs innervation remains controversial. In this comprehensive review, anatomy and biomechanical importance of LFJs and associated adjacent extra-articular structures are thoroughly presented. Furthermore, LFJs innervation in respect to current literature data is punctually analyzed. Knowledge of anatomy and innervation LFJs of critical importance for clinicians and spine surgeons, so that patients are properly evaluated and related therapeutic procedures are rationally performed. Lumbar Facet Joints (LFJs) are diathrodial joints which provide articulation between two adjacent lumbar vertebrae. LFJs represent complex anatomic structures with multifaceted biomechanic and functional characteristics. They are theorized as structures of crucial clinical significance since their degenerative morphologic alterations are frequently related to emergence of low back pain. Despite the emerging interest in describing LFJs anatomy in recent years, precise description of LFJs innervation remains controversial. In this comprehensive review, anatomy and biomechanical importance of LFJs and associated adjacent extra-articular structures are thoroughly presented. Furthermore, LFJs innervation in respect to current literature data is punctually analyzed. Knowledge of anatomy and innervation LFJs of critical importance for clinicians and spine surgeons, so that patients are properly evaluated and related therapeutic procedures are rationally performed.

Background: The aim of this study was to evaluate the changes in quality of life of patients after total knee arthroplasty and to assess the changes in physical activity by using a self-reported questionnaire and by counting the number of steps 3-6 months after post-operatively. Methods: Included were fifty two elderly women (age 72.6±65.9 years, mean±SD) with knee osteoarthritis undergoing primary knee arthroplasty. Health-related quality of life, physical activity, pain and function and the number of steps were assessed before, 3 and 6 months post-operatively. We used the Medical Outcomes Study Short Form (SF-36), the Physical Activity Scale for the Elderly (PASE) and the pedometer SW200 Digiwalker of Yamax. Results: Patients showed a significant improvement ( p < 0.01, η 2 =0.22) in health–related quality of life, particularly in physical function, ( p <0 .001) body pain ( p < 0.001) and vitality scale ( p < 0.001) of SF-36 at 3 and 6 months after the procedure. Physical activity (PASE score) increased at 3 and 6 months after arthroplasty ( p < 0.001, η 2 =0.74), and the number of steps increased 6 months after, compared to the assessment that took place 3 months after operation ( p < 0.001). Conclusions: Our results suggest that total knee arthroplasty leads to a gradual improvement in quality of life of elderly patients over the first 6 post-operative months.

Background: Total Knee Arthroplasty (TKA)¹is a common surgical treatment for severe knee Osteoarthritis (OA)², which generally improves pain, physical function, quality of life and possibly fall risk. Fall risk increases for older adults with severe knee OA; however it has not been studied extensively whether this parameter is improved after TKA.Objective: To investigate: a) the history and frequency of falls, including mechanism or causes of falls, injuries sustained from falls reported, activity during falling and location of falls and, b) the factors affecting falls, a year after TKA in elderly patients with severe knee OA.Patients and Method: An observational prospective longitudinal study of 68 patients (11 males and 57 females) was conducted. The frequency of falls was recorded every month after knee replacement for a year period. A year after the TKA patients completed self-administered questionnaires (SF-36, Womac, FOF, ABC, PASE) and were assessed in physical performance tests (TUG and BBS).Results: There was significant improvement in falls frequency (p<0.001), differentiation of falling status to the benefit of non fallers (p<0.001) and risk of serious injuries (p<0.001). The factors that affected falling status was history of falls (p<0.0005), fear of falls (p<0.017) and advanced age, marginally (p<0.097).Conclusion: TKA generally improved a lot of aspects in patients’ life. One of these was the reduction of fall risk, which always co-exists in this population and can cause devastating problems threatening the benefits of the procedure.

To investigate the utility of full-endoscopic lumbar discectomy (FELD) in surgical treatment of recurrent lumbar disc herniation (RLDH). Forty-five patients were prospectively studied. All patients were subjected to FELD for RLDH. They were assessed preoperatively and in regular intervals at 6 weeks and 3 months, 6 months, and 12 months postoperatively. Evaluation was conducted with visual analogue scale for leg (VAS-LP) and low back (VAS-BP) pain. Short-Form 36 Health Survey Questionnaire was utilized for health-related quality of life assessment. All studied parameters featured statistically significant amelioration at all follow-up intervals. Maximal improvement was in general at 6 weeks observed, with subsequent lesser improvement until 6 months and stabilization until the end of follow-up. Comparative assessment indicated that VAS-BP displayed quantitatively lower improvement, whereas physical function, bodily pain, and role-emotional parameters demonstrated greater amelioration. FELD is associated with a favorable impact in postoperative daily life of patients with RLDH.