Rehab Centers: Osteoarthritis of the Spine: The Facet Joints.

Osteoarthritis of the spine: the facet joints.

Filed under: Rehab Centers

Nat Rev Rheumatol. 2012 Nov 13;
Gellhorn AC, Katz JN, Suri P

Osteoarthritis (OA) of the spine involves the facet joints, which are located in the posterior aspect of the vertebral column and, in humans, are the only true synovial joints between adjacent spinal levels. Facet joint osteoarthritis (FJ OA) is widely prevalent in older adults, and is thought to be a common cause of back and neck pain. The prevalence of facet-mediated pain in clinical populations increases with increasing age, suggesting that FJ OA might have a particularly important role in older adults with spinal pain. Nevertheless, to date FJ OA has received far less study than other important OA phenotypes such as knee OA, and other features of spine pathoanatomy such as degenerative disc disease. This Review presents the current state of knowledge of FJ OA, including relevant anatomy, biomechanics, epidemiology, and clinical manifestations. We present the view that the modern concept of FJ OA is consonant with the concept of OA as a failure of the whole joint, and not simply of facet joint cartilage.
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Assessment of hepatitis B vaccination and compliance with infection control among dentists in Saudi Arabia.

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Saudi Med J. 2012 Nov; 33(11): 1205-10
Al-Dharrab AA, Al-Samadani KH

To evaluate hepatitis B virus (HBV) vaccine coverage and the use of infection control among dentists in Saudi Arabia.This cross-sectional study was carried out during the Third International Conference at the King Abdulaziz University Faculty of Dentistry, held on March 2012 in Jeddah, Saudi Arabia. Saudi or expatriate dentists working in Saudi Arabia were included in the study. The questionnaires were designed to meet the objective of the study.A total of 402 dentists of whom 176 (44%) were male and 226 (56%) female took part in this study. Their mean age was 37.4 years. In all, 246 (61%) were general dentists and 156 (39%) specialists. Four-fifths (80.5%) of them had been vaccinated. Almost half (48.5%) had experience of needle stick injury, but none reported having been infected with HBV. Among the vaccinated dentists, 186 (57.5%) had not been screened for HBV antibodies. Younger dentists were more particular about vaccination and more careful in using protective wear. There was an association between protective barriers and HBV vaccination, but there was no association between history of needle stick injury and vaccination.Dental healthcare workers have a high risk of infection with HBV due to the nature of their work; so there should be a mandatory program to vaccinate dentists against HBV and to ensure application of protective measures during their practice.
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A comparison of hip dislocation rates and hip containment procedures after selective dorsal rhizotomy versus intrathecal baclofen pump insertion in nonambulatory cerebral palsy patients.

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J Pediatr Orthop. 2012 Dec; 32(8): 853-6
Silva S, Nowicki P, Caird MS, Hurvitz EA, Ayyangar RN, Farley FA, Vanderhave KL, Hensinger RN, Craig CL

: Spasticity is the major etiology for hip dislocation in nonambulatory cerebral palsy patients. Selective dorsal rhizotomy (SDR) was used to control lower extremity spasticity, but is now done infrequently in nonambulatory cerebral palsy. Current surgical treatment is usually intrathecal baclofen pump (ITBP) placement. A major theoretical difference between SDR and ITBP is the effect on the iliopsoas through the L1 nerve root. This study compares the rate of hip dislocation and the need for further hip surgeries in SDR and ITBP patients.: All nonambulatory cerebral palsy patients who had either an SDR or ITBP and had minimum follow-up of 2 years were retrospectively reviewed for demographic data and timing, total number, and type of hip procedures (soft tissue vs. bony), and occurrence of hip dislocation. ? test was used to assess for statistical significance.: Sixty-nine patients who underwent SDR (40 males) and 50 patients who underwent ITBP (27 males) were included in the study. Average age at spasticity intervention was 6 years 11 months for SDR and 9 years 8 months for ITBP. In the SDR group, 25% of hips underwent reconstruction versus 32% of hips in the ITBP group. There were a total of 19 hip procedures in the SDR group and 20 in the ITBP group (P=0.15). Seventeen soft-tissue procedures were performed in both SDR and ITBP groups (P=0.265). Six bony procedures (0 salvage) were performed in the SDR group and 10 in the ITBP group (4 salvage; P=0.075). At final follow-up the hip dislocation rate was 10.6% in the SDR group and 7.4% in the ITBP group.: There was no significant difference in the rate of secondary hip reconstructive surgery or dislocation between nonambulatory cerebral palsy patients who underwent SDR versus ITBP. Reconstruction was required for 25% to 32% of hips despite spasticity intervention with either procedure. This suggests that the L1 nerve root alone does not play a major role in the progression of hip dislocation.: Level 3-therapeutic study.
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