Vertebral Related Diseases in Healthcare: The Role of Pain Management and Rehabilitation

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (18 April 2022) | Viewed by 51348

Special Issue Editors


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Guest Editor
Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", 88100 Catanzaro, Italy
Interests: rehabilitation; sports medicine; injuries; physical exercise; pain management; physical therapy; biomechanics; musculoskeletal disorders; sports sciences; spine
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", 88100 Catanzaro, Italy
Interests: rehabilitation; orthopaedics; sports medicine; spine; physical exercise; scoliosis; biomechanics; osteoarthritis; gait; musculoskeletal disorders
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

Vertebral related diseases are considered as a serious medical, social, and economic problems, due to their high prevalence and incidence with rising life expectancy of the general population. They might be represented by several disabling conditions as scoliosis, vertebral fractures, spondyloarthropathy, that could have a negative impact in terms of pain, functioning, and health related quality of life. Firstly, an adequate diagnosis could change the therapeutic and rehabilitative framework with a potentially negative impact on functional recovery. Secondly, an adequate pain management is crucial in treating patients with vertebral related diseases. In this context, rehabilitation provides different approaches for remodeling functions affected by spine disorders. Taken together, the present special issue aims to evaluate the role of pain management and rehabilitation on reducing clinical manifestations due to vertebral related diseases, currently considered as a main challenge of healthcare.

Dr. Nicola Marotta
Prof. Dr. Antonio Ammendolia
Prof. Dr. Alessandro de Sire
Guest Editors

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Keywords

  • Rehabilitation
  • Spine
  • Scoliosis
  • Vertebral fractures
  • Osteoporosis
  • Osteoarthritis
  • Pain management
  • Gait
  • Posture

Published Papers (14 papers)

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Editorial

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6 pages, 662 KiB  
Editorial
Vertebral Related Diseases in Healthcare: The Role of Pain Management and Rehabilitation
by Alessandro de Sire, Nicola Marotta and Antonio Ammendolia
Healthcare 2022, 10(6), 1109; https://doi.org/10.3390/healthcare10061109 - 14 Jun 2022
Cited by 1 | Viewed by 1367
Abstract
The increase in the life expectancy of the general population implied for vertebral diseases an impacting role for the medical condition of the person, not only in the clinical context, but also from a social and economic point of view, due to the [...] Read more.
The increase in the life expectancy of the general population implied for vertebral diseases an impacting role for the medical condition of the person, not only in the clinical context, but also from a social and economic point of view, due to the underestimation of primary prevention and complex secondary prevention rehabilitation frameworks [...] Full article
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Research

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10 pages, 568 KiB  
Article
The Mediating Effects of Social Support on the Relationship between Uncertainty and Quality of Life among Patients with Chronic Low Back Pain: A Cross-Sectional Survey
by Jin-Won Choi, Wi-Young So and Kyoung-Mi Kim
Healthcare 2022, 10(9), 1805; https://doi.org/10.3390/healthcare10091805 - 19 Sep 2022
Cited by 1 | Viewed by 1420
Abstract
Background: This study aimed to investigate the mediating effects of social support on the relationship between uncertainty and quality of life (QOL) in patients with chronic low back pain (LBP). Methods: From 1 July 2019 to 25 March 2020, data were collected using [...] Read more.
Background: This study aimed to investigate the mediating effects of social support on the relationship between uncertainty and quality of life (QOL) in patients with chronic low back pain (LBP). Methods: From 1 July 2019 to 25 March 2020, data were collected using a structured questionnaire from inpatients and outpatients > 20 years of age with chronic LBP lasting > 3 months. Inpatients included patients waiting for surgery and those recovering after surgery. The exclusion criteria were cancer and other serious pathological diseases. The relationships between uncertainty, social support, and QOL were analyzed using Pearson’s correlation coefficients. Results: Uncertainty, the independent variable, exerted a significant effect on social support, the mediator (B = 0.33, p < 0.001). In addition, both uncertainty (B = 0.37, p < 0.001) and social support (B = 0.45, p < 0.001) exerted statistically significant effects on QOL, the dependent variable. Conclusions: Disease-related uncertainty can reduce QOL in patients with chronic LBP, and this relationship is mediated by the level of social support. To develop strategies for strengthening social support from healthcare providers, family, and friends, future studies should examine the experiences of patients with chronic LBP from various perspectives, including pain intensity and duration. Full article
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14 pages, 1369 KiB  
Article
The Effect of the Schroth Rehabilitation Exercise Program on Spinal and Feet Alignment in Adolescent Patients with Idiopathic Scoliosis: A Pilot Study
by Jaeyong Park and Wi-Young So
Healthcare 2022, 10(2), 398; https://doi.org/10.3390/healthcare10020398 - 20 Feb 2022
Cited by 9 | Viewed by 4541
Abstract
Background: This study investigated the therapeutic effects of 12-week Schroth rehabilitation exercises (SRE) in improving Cobb’s angle, scoliometer readings, lumbar lordosis, and the calcaneal valgus angle of patients with idiopathic scoliosis. Methods: This pilot study included 60 adolescent patients diagnosed with idiopathic scoliosis [...] Read more.
Background: This study investigated the therapeutic effects of 12-week Schroth rehabilitation exercises (SRE) in improving Cobb’s angle, scoliometer readings, lumbar lordosis, and the calcaneal valgus angle of patients with idiopathic scoliosis. Methods: This pilot study included 60 adolescent patients diagnosed with idiopathic scoliosis by a rehabilitation physician based on a Cobb’s angle of ≥10° using total anteroposterior plain radiography. Patients were classified into groups with a Cobb’s angle of 10–19° (G1), 20–29° (G2), and ≥30° (G3). Cobb’s angle, scoliometer readings, lumbar lordosis, and calcaneal valgus angles were analyzed before and after the 12-week SRE. Results: SRE improved Cobb’s angle (−6.85), scoliometer readings (−2.80), lumbar lordosis (4.23), and calcaneal valgus angles (left, −3.76; right, −2.83) regardless of the initial scoliosis angle, and within-group changes were significant (p < 0.001). In this study, participants in all three groups had undergone SRE, regardless of initial scoliosis severity, and the findings were significant. Conclusion: SRE can be used for patients with idiopathic scoliosis to improve asymmetric musculoskeletal morphology and the patient’s quality of life. Full article
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12 pages, 2309 KiB  
Article
Application of Machine Learning in Developing Decision-Making Support Models for Decompressed Vertebroplasty
by Pei-Hung Liao, Yu-Chuan Tsuei and William Chu
Healthcare 2022, 10(2), 214; https://doi.org/10.3390/healthcare10020214 - 23 Jan 2022
Cited by 4 | Viewed by 2508
Abstract
Background: The common treatment methods for vertebral compression fractures with osteoporosis are vertebroplasty and kyphoplasty, and the result of the operation may be related to the value of various measurement data during the operation. Material and Method: This study mainly uses machine learning [...] Read more.
Background: The common treatment methods for vertebral compression fractures with osteoporosis are vertebroplasty and kyphoplasty, and the result of the operation may be related to the value of various measurement data during the operation. Material and Method: This study mainly uses machine learning algorithms, including Bayesian networks, neural networks, and discriminant analysis, to predict the effects of different decompression vertebroplasty methods on preoperative symptoms and changes in vital signs and oxygen saturation in intraoperative measurement data. Result: The neural network shows better analysis results, and the area under the curve is >0.7. In general, important determinants of surgery include numbness and immobility of the lower limbs before surgery. Conclusion: In the future, this association model can be used to assist in decision making regarding surgical methods. The results show that different surgical methods are related to abnormal vital signs and may affect the length of hospital stay. Full article
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12 pages, 1313 KiB  
Article
Functional Shoulder Outcome and Quality of Life Following Modified Muscle-Sparing Pectoralis Major Flap Surgery
by Tina Rauchenwald, Dominik Knierzinger, Daniel Dejaco, Clemens Hengg, Volker H. Schartinger, Gerhard Pierer, Herbert Riechelmann and Dolores Wolfram
Healthcare 2021, 9(9), 1158; https://doi.org/10.3390/healthcare9091158 - 3 Sep 2021
Cited by 4 | Viewed by 1805
Abstract
Background: The pedicled pectoralis major muscle flap (PMMF) is a well established flap for fistula prophylaxis after salvage laryngectomy. To reduce donor site morbidity, we established a modified muscle-sparing harvesting technique. We herein investigate postoperative shoulder function and health-related quality of life (HRQOL). [...] Read more.
Background: The pedicled pectoralis major muscle flap (PMMF) is a well established flap for fistula prophylaxis after salvage laryngectomy. To reduce donor site morbidity, we established a modified muscle-sparing harvesting technique. We herein investigate postoperative shoulder function and health-related quality of life (HRQOL). Methods: A chart review of patients receiving the modified muscle-sparing pectoralis major muscle flap between 2013–2020 was performed. Nineteen patients (male = 18, female = 1) were potentially eligible and six male patients were ultimately enrolled. Postoperative shoulder function was assessed on both sides (flap side versus non-flap side) using the Constant Murley Score and the Bak criteria. Health-related quality of life was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire in cancer patients (EORTC QLQ-C30) and head and neck cancer patients (EORTC H&N35). Results: No Constant Murley Score subscale was statistically significant (p ≥ 0.180). Bak criteria was overall rated “Good“. Solely upper extremity adduction force was significantly altered on the flap side (p = 0.039). Median EORTC QLQ-C30 score was 82.2 (IQR 11.1) on the functional scale and 10.3 (IQR 2.6) on the symptomatic scale. Median quality of life score was 75.0 (IQR 33.3) and median EORTC QLQ-H&N35 was 20.6 (IQR 9.8). Conclusions: Postoperative shoulder function after modified muscle-sparing pectoralis major muscle flap surgery is comparable to function of the healthy side with a significant deficiency in adduction force not compromising daily life in this small study cohort. Full article
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10 pages, 1551 KiB  
Article
Mechanical Changes of the Lumbar Intervertebral Space and Lordotic Angle Caused by Posterior-to-Anterior Traction Using a Spinal Thermal Massage Device in Healthy People
by Yong-Soon Yoon, Jong-Hoo Lee, Mihyun Lee, Ka-Eun Kim, Hong-Young Jang, Kyu-Jae Lee, Johny Bajgai, Cheol-Su Kim and Il-Young Cho
Healthcare 2021, 9(7), 900; https://doi.org/10.3390/healthcare9070900 - 15 Jul 2021
Cited by 5 | Viewed by 4073
Abstract
Background: The axial (horizontal) traction approach has been traditionally used for treatment of low back pain-related spinal disorders such as nuclear protrusion, primary posterolateral root pain, and lower thoracic disc herniation; however, it is known to have some technical limitations due to reductions [...] Read more.
Background: The axial (horizontal) traction approach has been traditionally used for treatment of low back pain-related spinal disorders such as nuclear protrusion, primary posterolateral root pain, and lower thoracic disc herniation; however, it is known to have some technical limitations due to reductions of the spinal curve. Lumbar lordosis plays a pivotal function in maintaining sagittal balance. Recently, vertical traction and combination traction have been attracting attention due to improving therapeutic outcomes, although evidence of their clinical application is rare; therefore, this study was conducted to investigate the mechanical changes of lumbar intervertebral space, lordotic angle, and the central spinal canal area through vertical traction treatment using a spinal massage device in healthy participants. Methods: In total, 10 healthy subjects with no musculoskeletal disorders and no physical activity restrictions participated. The participants lay on the experimental device (CGM MB-1901) in supine extended posture and vertical traction force was applied in a posterior-to-anterior direction on the L3–4 and L4–5 lumbar sections at level 1 (baseline) and level 9 (traction mode). Magnetic resonance (MR) images were recorded directly under traction mode using the MRI scanner. The height values of the intervertebral space (anterior, center, and posterior parts) and lordosis angle of the L3–4 and L4–5 sections were measured using Image J software and the central spinal canal area (L4–5) was observed through superimposition method using the MR images. All measurement and image analyses were conducted by 2 experienced radiologists under a single-blinded method. Results: The average height values of the intervertebral space under traction mode were significantly increased in both L3–4 and L4–5 sections compared to baseline, particularly in the anterior and central parts but not in the posterior part. Cobb’s angle also showed significant increases in both L3–4 and L4–5 sections compared to baseline (p < 0.001). The central spinal canal area showed a slightly expanded feature in traction mode. Conclusions: In this pilot experiment, posterior-to-anterior vertical traction on L3–4 and L4–5 sections using a spinal massage device caused positive and significant changes based on increases of the intervertebral space height, lumbar lordosis angle, and central spinal canal area compared to the baseline condition. Our results are expected to be useful as underlying data for the clinical application of vertical traction. Full article
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11 pages, 603 KiB  
Article
Spinal Orthoses Prescription for Vertebral Fragility Fractures by Italian Physical and Rehabilitation Medicine Physicians: The SPIN-VER Survey
by Alessandro de Sire, Antonio Ammendolia, Alessandra Gimigliano, Roberto Tiberi, Carlo Cisari and Marco Invernizzi
Healthcare 2021, 9(7), 892; https://doi.org/10.3390/healthcare9070892 - 15 Jul 2021
Cited by 10 | Viewed by 2178
Abstract
Vertebral fragility fractures (VFFs) are the most common type of osteoporotic fractures, related to pain and disability. In this scenario, physical and rehabilitative medicine (PRM) physicians prescribe a patient-tailored rehabilitation plan, including spinal orthoses. However, there is a high heterogeneity in the clinical [...] Read more.
Vertebral fragility fractures (VFFs) are the most common type of osteoporotic fractures, related to pain and disability. In this scenario, physical and rehabilitative medicine (PRM) physicians prescribe a patient-tailored rehabilitation plan, including spinal orthoses. However, there is a high heterogeneity in the clinical indications of spinal orthoses. Thus, the aim of this survey was to investigate common clinical practice in terms of the prescription of spinal orthoses. This nationwide cross-sectional survey recruited Italian PRM physicians commonly involved in the management of patients with VFFs. One hundred twenty-six PRM physicians completed the survey. The results showed that most PRM physicians prescribe spinal orthoses in outpatients suffering from VFFs (n = 106; 83.9%). The most prescribed spinal orthosis for acute VFF patients was the three-point rigid orthosis (n = 64; 50.8%), followed by the semirigid thoraco-lumbar orthosis (n: 20; 15.9%). However, most PRM physicians prescribed dynamic orthoses in outpatients with chronic VFFs (n = 66; 52.4%). Albeit that a correct management of VFFs is mandatory to improve pain and reduce disability, our findings highlighted uncertainty in the type of spinal orthosis prescription in both the acute and chronic VFF phase. Therefore, high-quality research trials are warranted to provide clear recommendations for the correct clinical management of VFF. Full article
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10 pages, 1811 KiB  
Article
Natural History of Scoliosis in Children with NF1: An Observation Study
by Giuseppe Toro, Claudia Santoro, Daniele Ambrosio, Giovanni Landi, Martina Scilipoti, Antimo Moretti, Marco Paoletta, Sara Liguori, Alfredo Schiavone Panni, Stefania Picariello and Giovanni Iolascon
Healthcare 2021, 9(7), 881; https://doi.org/10.3390/healthcare9070881 - 13 Jul 2021
Cited by 18 | Viewed by 2638
Abstract
(1) Background. Scoliosis is the most common musculoskeletal manifestation of Neurofibromatosis type 1 (NF1), and it might be dystrophic (D) or non-dystrophic (ND) depending on the presence of dysplastic changes of the spine. The aim of our study was to describe the characteristics [...] Read more.
(1) Background. Scoliosis is the most common musculoskeletal manifestation of Neurofibromatosis type 1 (NF1), and it might be dystrophic (D) or non-dystrophic (ND) depending on the presence of dysplastic changes of the spine. The aim of our study was to describe the characteristics and natural history of patients with NF1 and scoliosis. (2) Methods. We retrospectively reviewed records from patients with NF1 and scoliosis. Scoliosis was classified as D if at least two dystrophic changes were documented at imaging. (3) Results. Of the 438 patients reviewed, 43 fulfilled inclusion criteria; 17 were classified in D group and 26 in ND. The groups did not differ in age and localization of scoliosis curvature. Surgery was needed more often in D group, but the between-group difference was not significant. Male-to-female ratios of 3:1 and 4:1 were reported in surgically treated NF1 patients with ND and D scoliosis, respectively. (4) Conclusions. Our data suggests independently by the presence of dysplastic changes affecting the spine that males with NF1 are more often affected by scoliosis that requires surgery. Full article
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Review

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25 pages, 3224 KiB  
Review
Interventional Procedures for Vertebral Diseases: Spinal Tumor Ablation, Vertebral Augmentation, and Basivertebral Nerve Ablation—A Scoping Review
by Vincius Tieppo Francio, Benjamin Gill, Adam Rupp, Andrew Sack and Dawood Sayed
Healthcare 2021, 9(11), 1554; https://doi.org/10.3390/healthcare9111554 - 15 Nov 2021
Cited by 9 | Viewed by 3175
Abstract
Low back pain is consistently documented as the most expensive and leading cause of disability. The majority of cases have non-specific etiologies. However, a subset of vertebral diseases has well-documented pain generators, including vertebral body tumors, vertebral body fractures, and vertebral endplate injury. [...] Read more.
Low back pain is consistently documented as the most expensive and leading cause of disability. The majority of cases have non-specific etiologies. However, a subset of vertebral diseases has well-documented pain generators, including vertebral body tumors, vertebral body fractures, and vertebral endplate injury. Over the past two decades, specific interventional procedures targeting these anatomical pain generators have been widely studied, including spinal tumor ablation, vertebral augmentation, and basivertebral nerve ablation. This scoping review summarizes safety and clinical efficacy and discusses the impact on healthcare utilization of these interventions. Vertebral-related diseases remain a top concern with regard to prevalence and amount of health care spending worldwide. Our study shows that for a subset of disorders related to the vertebrae, spinal tumor ablation, vertebral augmentation, and basivertebral nerve ablation are safe and clinically effective interventions to decrease pain, improve function and quality of life, and potentially reduce mortality, improve survival, and overall offer cost-saving opportunities. Full article
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25 pages, 3663 KiB  
Review
Ergonomic Consideration in Pillow Height Determinants and Evaluation
by Jia-Xing Lei, Peng-Fei Yang, Ai-Ling Yang, Yan-Feng Gong, Peng Shang and Xi-Chen Yuan
Healthcare 2021, 9(10), 1333; https://doi.org/10.3390/healthcare9101333 - 7 Oct 2021
Cited by 9 | Viewed by 6957
Abstract
(1) Background: Sleep problems have become one of the current serious public health issues. Pillow height affects the alignment of the cervical spine and is closely related to the mechanical environment of the cervical spine. An appropriate pillow height can provide adequate support [...] Read more.
(1) Background: Sleep problems have become one of the current serious public health issues. Pillow height affects the alignment of the cervical spine and is closely related to the mechanical environment of the cervical spine. An appropriate pillow height can provide adequate support for the head and neck to reduce the stress in the cervical spine and relax the muscles of the neck and shoulder, thereby relieving pain and improving sleep quality. (2) Methods: We reviewed the current trends, research methodologies, and determinants of pillow height evaluation, summarizing the evidences published since 1997. In particular, we scrutinized articles dealing with the physiological and mechanical characteristics of the head-neck-shoulder complex. (3) Results: Through the investigation and analysis of these articles, we presented several quantitative and objective determinants for pillow height evaluation, including cervical spine alignment, body dimension, contact pressure, and muscle activity. The measurement methods and selection criteria for these parameters are described in detail. However, the suggested range for achieving optimal cervical spine alignment, appropriate pressure distribution, and minimal muscle activity during sleep cannot yet be identified considering the lack of sufficient evidence. Moreover, there remain no firm conclusions about the optimal pillow height for the supine and lateral positions. (4) Conclusions: A comprehensive evaluation combining the above determinants provides a unique solution for ergonomic pillow design and proper pillow height selection, which can effectively promote the public sleep health. Therefore, it is necessary to develop a reasonable algorithm to weigh multiple determinants. Full article
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15 pages, 587 KiB  
Review
Muscle Energy Technique in the Rehabilitative Treatment for Acute and Chronic Non-Specific Neck Pain: A Systematic Review
by Silvia Sbardella, Chiara La Russa, Andrea Bernetti, Massimiliano Mangone, Andrea Guarnera, Letizia Pezzi, Marco Paoloni, Francesco Agostini, Valter Santilli, Raoul Saggini and Teresa Paolucci
Healthcare 2021, 9(6), 746; https://doi.org/10.3390/healthcare9060746 - 17 Jun 2021
Cited by 25 | Viewed by 8409
Abstract
Background: Non-specific neck pain (NNP) affects 30–50% of the general population, and it often leads to severe disability. Several manual therapy techniques are available to reduce pain and disability and to improve cervical range of motion and functional activities. Muscle Energy Technique (MET) [...] Read more.
Background: Non-specific neck pain (NNP) affects 30–50% of the general population, and it often leads to severe disability. Several manual therapy techniques are available to reduce pain and disability and to improve cervical range of motion and functional activities. Muscle Energy Technique (MET) showed more evidence for treating such a disorder. The aim of this current scientific literature analysis was to compare the clinical effects of MET with the other manual or rehabilitative treatments for non-specific acute and chronic neck pain. Methods: The literature search was conducted using the following databases: PubMed, Medline, PEDro, Cochrane Database, and Google Scholar from 2010 to January 2020. Clinical trials about MET were included. The quality of the trials was assessed according to the PEDro scale. Results: Twenty-one papers according to inclusion and exclusion criteria were selected: 15 studies about non-specific acute neck pain and 6 studies about non-specific chronic neck pain. Conclusions: This analysis suggests that the MET approach has a good clinical effect on reducing neck pain in patients with acute neck pain and improves cervical range of motion in patients with chronic neck pain, and is better if combined with a traditional rehabilitative approach. This review’s findings should be considered with caution for physiotherapy practice because of the studies’ methodologic limitations. On the basis of the current available and limited evidence, clinicians could combine MET with traditional physiotherapy and other manual techniques when treating people with non-specific neck pain. Full article
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Other

11 pages, 998 KiB  
Systematic Review
Antidepressants and Vertebral and Hip Risk Fracture: An Updated Systematic Review and Meta-Analysis
by Renato de Filippis, Michele Mercurio, Giovanna Spina, Pasquale De Fazio, Cristina Segura-Garcia, Filippo Familiari, Giorgio Gasparini and Olimpio Galasso
Healthcare 2022, 10(5), 803; https://doi.org/10.3390/healthcare10050803 - 26 Apr 2022
Cited by 3 | Viewed by 3078
Abstract
Although antidepressant drugs appear to play an active role in increasing fracture risk, their weight is still unclear. We conducted a PRISMA compliant systematic review and meta-analysis through PubMed/Scopus/Cochrane libraries and registered with PROSPERO (registration number CRD42021254006) to investigate the relationship between antidepressant [...] Read more.
Although antidepressant drugs appear to play an active role in increasing fracture risk, their weight is still unclear. We conducted a PRISMA compliant systematic review and meta-analysis through PubMed/Scopus/Cochrane libraries and registered with PROSPERO (registration number CRD42021254006) to investigate the relationship between antidepressant drugs categories, including SSRIs, SNRIs, and TCAs, and the risk of hip and vertebral fractures. After screening 3122 items, we finally found 26 papers for qualitative analysis and 11 for quantitative synthesis. A total of 15,209,542 adult and elderly patients were identified, with a mean follow-up of 51 months and a major prevalence of women. We identified results largely for SSRIs, with only a small amount of data for SNRIs, TCAs, and NaSSA. No data were found among the most recent categories of antidepressants, such as vortioxetine and esketamine. All included studies reported hip fractures, while three of them also included vertebral fractures. Overall, we observed a significant effect of SSRIs on fracture risk with a mean effect of 0.98 (95% CI = 0.75–1.20). This meta-analysis reveals that the use of SSRIs increases the risk of fractures. Clinicians’ awareness in antidepressant prescription should optimize their potential while reducing this risk. Full article
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13 pages, 692 KiB  
Systematic Review
Effects of Occlusal Splints on Spinal Posture in Patients with Temporomandibular Disorders: A Systematic Review
by Martina Ferrillo, Nicola Marotta, Amerigo Giudice, Dario Calafiore, Claudio Curci, Leonzio Fortunato, Antonio Ammendolia and Alessandro de Sire
Healthcare 2022, 10(4), 739; https://doi.org/10.3390/healthcare10040739 - 15 Apr 2022
Cited by 32 | Viewed by 3547
Abstract
There is still a gap in the scientific knowledge on the linkage between craniofacial structure and spinal postural control in temporomandibular disorder (TMD) patients. This systematic review aimed to assess the role of occlusal splints on spinal posture of TMD patients. PubMed, Web [...] Read more.
There is still a gap in the scientific knowledge on the linkage between craniofacial structure and spinal postural control in temporomandibular disorder (TMD) patients. This systematic review aimed to assess the role of occlusal splints on spinal posture of TMD patients. PubMed, Web of Science, and Scopus were systematically searched from inception until 5 January 2022 to identify observational studies with a longitudinal study design presenting: patients with diagnosis of TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD); occlusal splint therapy as intervention; postural assessment as outcome. Out of 133 records identified, 104 were suitable for data screening, and only 7 articles were included satisfying the eligibility criteria. We found that occlusal splints might have a positive effect on posture in TMD patients, albeit there is little evidence of appropriate investigation for postural assessment. This systematic review suggested that the occlusal splint might be considered a non-invasive therapeutic approach for patients with TMD. However, the low number of studies with high-quality methodology in these patients showed an urgent need for further research using combined force platform stabilometry and kinematic evaluation of the spine to investigate the impact of occlusal splints on posture. Full article
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8 pages, 834 KiB  
Case Report
Multidisciplinary Care of a Vertebral Fracture in a Patient with Hematopoietic Stem Cell Transplant: Safety Appropriateness in Interventional Pain Management and Rehabilitation Considerations
by Vinicius Tieppo Francio, Brandon Barndt, Usman Latif and Sarah M. Eickmeyer
Healthcare 2022, 10(3), 497; https://doi.org/10.3390/healthcare10030497 - 8 Mar 2022
Cited by 1 | Viewed by 3965
Abstract
Bone loss leading to fragility fracture is a highly prevalent late effect in hematopoietic stem-cell transplant patients, who are affected 8–9 times more than the general population, particularly for vertebral compression fractures. Spinal interventions such as lumbar epidural steroid injections and vertebral augmentation [...] Read more.
Bone loss leading to fragility fracture is a highly prevalent late effect in hematopoietic stem-cell transplant patients, who are affected 8–9 times more than the general population, particularly for vertebral compression fractures. Spinal interventions such as lumbar epidural steroid injections and vertebral augmentation may be helpful for providing pain relief and improved function, quality of life and return to ambulation. However, interventional procedures should be approached with caution in these patients. Our study found that there is a paucity of scientific studies addressing the risks of spinal injections in these patients and there is no absolute recommendation specific to spinal injections in patients receiving immunosuppressive agents or who have a history of solid organ or hematopoietic stem cell transplant. It is imperative to consider proper timing of the intervention to minimize risks while optimizing the benefits of the intervention combined with a well-defined post-transplant rehabilitation plan. Moreover, the decision to proceed with spinal interventions should be done case by case and with caution. Therefore, this article reports the case of a multidisciplinary treatment for a vertebral compression fracture in a patient with a hematopoietic stem-cell transplant, in particular discussing safety appropriateness in interventional pain management and rehabilitation considerations for this condition in this patient population. Full article
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