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The functional relevance of neurological recovery after lumbar discectomy: a follow-up of more than 20 years
No full textWe have studied 180 patients (128 men and 52 women) who had undergone lumbar discectomy at a mean of 25.4 years (20 to 32) after operation. Pre-operatively, most patients (70 patients; 38.9%) had abnormal reflexes and/or muscle weakness in the leg (96 patients; 53.3%). At follow-up 42 patients (60%) with abnormal reflexes pre-operatively had fully recovered and 72 (75%) with pre-operative muscle impairment had normal muscle strength. When we looked at patient-reported outcomes, we found that the Short form-36 summary scores were similar to the aged-matched normative values. No disability or minimum disability on the Oswestry disability index was reported by 136 patients (75.6%), and 162 (90%) were satisfied with their operation. The most important predictors of patients' self-reported positive outcome were male gender and higher educational level. No association was detected between muscle recovery and outcome. Most patients who had undergone lumbar discectomy had long-lasting neurological recovery. If the motor deficit persists after operation, patients can still expect a long-term satisfactory outcome, provided that they have relief from pain immediately after surgery
Minimum 25-year outcome and functional assessment of lumbar discectomy
No full textSTUDY DESIGN: A retrospective, follow-up cohort study. OBJECTIVE: To evaluate the 25-year (or longer) outcome of discectomy for lumbar disc herniation by validated instruments. SUMMARY OF BACKGROUND DATA: A comprehensive patient-oriented evaluation should include measurements of pain and disability along with a reliable evaluation of the general health status. There is a paucity of data from validated measuring instruments on the very long-term outcome of lumbar discectomy. METHODS: We conducted a follow-up study of 201 patients an average of 27.8 years (range 25-32) after lumbar discectomy. The patient-oriented assessment included a Short Form-36 Health Survey questionnaire, Oswestry Disability Index, Cumulative Illness Rating Scale, and a study specific questionnaire dealing with daily life activities and satisfaction with the surgery. RESULTS: The Short Form-36 Health Survey physical scales and summary scores were similar to the normative values for healthy subjects and were better than the scores of patients with untreated sciatica with respect to reported pain. The mean Oswestry disability score was 17.5. Satisfaction with surgery was expressed by 181 of 201 patients (90%). CONCLUSIONS: Patients who had undergone lumbar discectomy a minimum of 25 years earlier have a satisfactory self-reported health-related quality of life and less pain than nonsurgically treated subjects
Does the neurological recovery parallel the patient self-reported outcome a minimum of 20 years after lumbar discectomy?
No full textThe objective of this study was to evaluate if the neurologic recovery is correlated with the
patient-oriented outcome a minimum of 20 years after surgery for lumbar disc herniation. Ninety
patients were examined an average of 25.4 years after lumbar discectomy (range: 20-32 years).
All patients underwent physical and neurological evaluation as well as a patient-oriented
assessment including: an SF-36 questionnaire, Oswestry Disability Index, Cumulative Illness
Rating Scale, and a study-specific questionnaire dealing with daily life activities and satisfaction
with the surgery. Relationships between changes in clinical and neurological signs and quality of
life, disability, or satisfaction with the surgery were checked by linear and logistic regression
analysis. Disappearance of preoperative Lasegue and Wassermann signs on follow-up was
noted in 64 of 80 (80%) and 19 of 31 (61.3%) patients, respectively, whereas preoperative
areflexia and motor disturbances were persistently improved in 16 of 31 (52%) and 33 of 44
(75%) subjects, respectively. The SF-36 indexes and Oswestry scores in our patients were
similar to normative data and/or postoperative results reported in other studies with much earlier
follow-up dates. Both satisfaction with surgery and willingness to undergo the same procedure
again were expressed by 81 of 90 patients (90 %). When possible differences in the selfreported
outcome were analysed in the study group, no sign of neurological recovery
independently predicted the subjective result in the patients.
In conclusion, patients who had undergone lumbar discectomy a minimum of 20 years earlier
have satisfactory self-reported outcomes and sustained improvement of the neurological
function. The long-term subjective outcome is independent of the neurological recovery
Risultati comparativi a breve termine della protesi d'anca di rivestimento Cormet versus protesi totale non cementata
No full text
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Risultati clinici e qualità della vita in pazienti sottoposti da oltre 20 anni a discectomia lombare. Lettura magistrale 100° Congresso SOTIMI
No full textMinimum 25-year outcome and functional assessment of lumbar discectomy
No full textStudy Design. A retrospective, follow-up cohort study. Objective. To evaluate the 25-year (or longer) outcome of discectomy for lumbar disc herniation by validated instruments. Summary of Background Data. A comprehensive patient-oriented evaluation should include measurements of pain and disability along with a reliable evaluation of the general health status. There is a paucity of data from validated measuring instruments on the very long-term outcome of lumbar discectomy. Methods. We conducted a follow-up study of 201 patients an average of 27.8 years (range 25-32) after lumbar discectomy. The patient-oriented assessment included a Short Form-36 Health Survey questionnaire, Oswestry Disability Index, Cumulative Illness Rating Scale, and a study specific questionnaire dealing with daily life activities and satisfaction with the surgery. Results. The Short Form-36 Health Survey physical scales and summary scores were similar to the normative values for healthy subjects and were better than the scores of patients with untreated sciatica with respect to reported pain. The mean Oswestry disability score was 17.5. Satisfaction with surgery was expressed by 181 of 201 patients (90%). Conclusions. Patients who had undergone lumbar discectomy a minimum of 25 years earlier have a satisfactory self-reported health-related quality of life and less pain than nonsurgically treated subjects
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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