Koushan A, Sadat Mm, Golbakhsh Mr, Siavashi B, Mehran S, Tajik A,
Volume 68, Issue 5 (6 2010)
Abstract
Background: There are multiple diagnostic methods for evaluation of patients with low back pain with a radicular pattern, each one has it's own accuracy and diagnostic ability and so comparing them with each other would help the clinicians to find the best diagnostic method. The main objective of our study was to compare the diagnostic accommodation of electromyography (EMG) and Magnetic Resonance Imaging (MRI) findings in patients with low back pain and radiculopathy.
Methods: In this descriptive cross-sectional study, 101 patients with low back pain and radiculopathy attending to Sina Hospital in Tehran, Iran from 2007 to 2009 that had indication for both EMG and MRI were evaluated for their demographic characteristics and disease-related factors.
Results: Totally, 90 out of 101 patients (89%) had abnormal EMG findings and 94 out of 101 subjects (93%) had abnormal MRI results. The concordance rate was 88% (89 patients) with no significant difference (p> 0.05). The sensitivity and specificity of MRI were 95.6% and 27.3%, respectively, and the sensitivity and specificity of EMG were 91.5% and 60%, respectively.
Conclusion: According to the results of this study and in comparison with other studies it may be concluded that MRI and EMG are both accurate and use of them in a concomitant manner would result in increased diagnostic ability in patients with low back pain and radiculopathy.
Golbakhsh M, Siavashi B, Attar M, Ramim T,
Volume 71, Issue 1 (4 2013)
Abstract
Background: Severe spondylolisthesis is related to high degenerative changes in verte-bral spine. Degenerative spondylolisthesis often is seen with high-sacral slope. This study was conducted to investigate the relationship between high degenerative spondyl-olisthesis and sacral slope.
Methods: A cross-sectional prospective study was done in patients with low back pain in Shafa Yahyaian and Sina University Hospitals in Tehran, in 18 months (April 2010- October 2011). Intermittent or continuous low back pain for three months and history of two disable low back pain attacks since one year ago were inclusion criteria. Pregnant patients were excluded. Lumbar vertebra displacement to vertebra body size ratio was calculated in dynamic mode. The ratio higher than 8% was considered as a lumbar instability. Rotation angle more than 11 ° was considered abnormal.
Results: In this study, 52 patients (30 men, 22 women) with 38.35±9.49 years old were enrolled. Mean body mass index was 23.01±4.59kg/m2. Thirty cases had abnormal verte-bral displacement. Angulation of the disc space more than 11 degrees was seen in 20 patients. No statistically significant difference in pelvic index between normal and abn-ormal lumbar vertebra displacement (P=0.443). The mean pelvic index in normal and abnormal angulation groups were 55.97° and 53.58°, respectively the difference was not statistically significant (P=0.556).
Conclusion: The results of the study showed disc degeneration had no association with sacral slope. High sacral slope can intensify spondylolisthesis but does not affect the incidence of degenerative spondylolisthesis. Additional research is required to find the other causes of degenerative spondylolisthesis.
Darush Goran Savadkohi , Babak Siavashi , Mojgan Seifi , Tayeb Ramim ,
Volume 72, Issue 10 (January 2015)
Abstract
Background: Short-stem prosthesis for total hip arthroplasty (THA) have been designed to overcome the weakness of standard-stem prostheses and improve surgical outcomes. The aim of this study was to compare short-stem with standard-stem prosthesis outcomes.
Methods: This study was performed as a randomized clinical trial. Subjects were selected among patients referred to Sina University Hospital, Tehran, Iran from April 2010 to 2012. THA were performed with short-stem or standard-stem prostheses after obtaining written informed consent from patients. Balanced block randomization method was used to get a random sample in each group. Clinical outcomes were evaluated based on Harris Hip Score (HHS). Patients were followed up for at least one year. All patients were examined at 2 weeks, 6 weeks, 3 months, 6 months and one year after surgery. In each visit, Control X-ray was obtained and bone and prosthetic position were assessed. Also, the symptoms such as infection, pain, claudication, ability to climb stairs, using crutches and weight bearing were rechecked. Student t-test was used to compare outcomes in the two groups.
Results: A total of eighty four THA were studied. 13 patients were lost to follow-up or had infection and failure. One patient died with the prosthesis in situ from causes not related to the surgery. Therefore, a total of 70 patients were analyzed. Of these, 34 and 36 hips underwent small stem and standard stem THA, respectively. The mean age of the patients at the time of operation was 61.1±8.68 years (range, 48-86 years). Most common reasons for arthroplasty were osteoarthritis, avascular necrosis and dysplasia of hip. There were significant differences between the two study groups in bleeding during surgery (P=0.001). There were no significant differences among the study groups in HHS except for 6th week and 3th month (P=0.000).
Conclusion: The use of short-stem prosthesis can improve the performance of patients in short-term but no significant difference with standard-stem prosthesis in long- term.
