Conversely L4/5 PLIF showed minimal change at adjacent levels but greater overall lordosis increase. Lumbar lordosis assessment requires monosegmental assessment as well as overall measure of the Lumbar Lordosis. PLIF surgery changes both lumbar lordosis and segmental lordosis at adjacent levels. LEVEL OF EVIDENCE 3.STUDY DESIGN A retrospective multicenter observational study. OBJECTIVE To investigate correction surgeries that were performed in relatively aged patients in terms of mechanical complications (MCs) and their predictive factors. SUMMARY OF BACKGROUND DATA The risk factors associated with MCs have not yet been well examined, especially in aged populations. METHODS We retrospectively reviewed 230 surgically treated ASD patients with an average age of 72.2 years. Twenty-eight patients with ASD caused by vertebral fractures were excluded. The minimum follow-up was two years.  https://www.selleckchem.com/Proteasome.html  Postoperative MCs were defined as proximal junction kyphosis, distal junction kyphosis, pseudoarthrosis, rod breakage, and vertebral fractures. We divided all the ASD patients into two groups patients with MC (the MC (+) group) and patients without MC (the MC (-) group). Radiographic parameters were evaluated before and immediately after surgery. The SRS-Schwab ASD classification and global alignment and proportion (GAP) score were also evaluated. RESULTS Of the 202 patients, ninety-one (45.0%) had MCs. The age at surgery was significantly higher in the MC (+) group than in the MC (-) group. Regarding radiographic parameters, postoperative global tilt (GT), pre- and postoperative thoracolumbar kyphosis (TLK), and postoperative thoracic kyphosis (TK) were significantly higher in the MC (+) group than in the MC (-) group. Other parameters, such as the proposed ideal alignment target of PI-LL less then 10, did not significantly affect MC rates. The GAP score was high in both groups and not significantly related to a higher rate of MC. Forward stepwise logistic regression indicated that the age at surgery, postoperative GT, and preoperative TLK were significant risk factors for MCs. CONCLUSIONS Older age, higher postoperative GT, and higher pre and postoperative TLK can be risk factors for MCs. The GAP score was high in both groups and not significantly related to a higher rate of MC. LEVEL OF EVIDENCE 4.STUDY DESIGN Observational cross-sectional study. OBJECTIVE To analyse the association between low back pain and biomedical beliefs in physiotherapy students of the first and last year. SUMMARY OF BACKGROUND DATA There is a hypothesis that the presence of low back pain may be a risk factor for biomedical beliefs in physiotherapy academics. METHODS Three hundred and sixty five students of first and last year of the physiotherapy course from three universities in city of Fortaleza completed a questionnaire with sociodemographic factors and a Pain Attitude and Beliefs Scale used to determine the orientation (biopsychosocial or biomedical approach) of practitioners to the management of people with low back pain. RESULTS The mean age of participants was 23.57 ± 4.77 years, with a predominance of females (80,27%, n = 239). 23.84% reported low back pain, 18.9% had undergone imaging tests at the site and 36.71% reported that family members with low back pain also underwent these exams. The means of the biopsychosocia lower levels of biomedical beliefs than the academics of the last year without low back symptoms. LEVEL OF EVIDENCE 4.STUDY DESIGN Randomized-clinical trial OBJECTIVE. To evaluate the efficacy of the post-operative single-shot bolus of epidural Fentanyl and Bupivicaine in providing pain relief post-lumbar decompression surgery. SUMMARY OF BACKGROUND DATA Despite lumbar decompression's success in alleviating symptoms of sciatica, radiculopathy, and neurogenic claudication, transient back and buttock pain has been a common complaint postoperatively. Providing good post-operative pain alleviation predicts patient's quality of recovery. METHODS We performed a randomized, double-blinded, clinical trial. Forty-five patients scheduled for lumbar decompression for a years period who were randomly assigned to receive a postoperative bolus of 10-mL solution of 50 mcg of Fentanyl, 0.125% Bupivacaine, and 0.9% saline solution via an intraoperatively placed epidural catheter immediately after wound closure, before dressing application. Facial pain scale scores (from 0 to 10) were measured at 3 time points after surgery (fully awake at replications of opiod administration. LEVEL OF EVIDENCE 2.BACKGROUND Error within imaging measurements can be due to processing, magnification, measurement performance, or patient-specific factors. Previous length measurement studies based on radiographs have shown good intraclass correlation coefficients (ICCs) on single images; but have not assessed interimage distortion. In our study, "image distortion in biplanar slot scanning technology-specific factors" we determined that there is minimal image distortion due to the image acquisition when using biplanar slot scanning. In this study, we aim to determine the role of patient-specific factors in image distortion, specifically evaluating interimage distortion. METHODS Digital radiographs and biplanar slot scanner images were reviewed in 43 magnetically controlled growing rod (MCGR) patients. Fifty-five postoperative anteroposterior digital radiographs, 184 follow-up biplanar slot-scanner scanner posteroanterior and 76 biplanar slot-scanner scanner laterals were measured by 2 residents and 1 attending. The manufactus clinically. Unlike the clinically insignificant error that we noted in our previous study "image distortion in biplanar slot scanning technology-specific factors" (0.5% to 1.5% of the measurement), the error noted in this study (0.2% to 38.5% of the measurement) has the potential to be clinically significant. Patients who have abnormal muscle tone had larger measurement errors, likely stemming from motion during the slot scanning process. LEVEL OF EVIDENCE Level III.BACKGROUND We aimed to evaluate the effect of tibialis anterior tendon transfer (TATT) on foot motion in children with clubfoot recurrence after initial Ponseti treatment. METHODS Children with dynamic clubfoot recurrence after initial Ponseti treatment who underwent TATT between 2014 and 2017 were considered for inclusion. Exclusion criteria were neurological disease, split transfer of the tendon, additional bone or joint invasive surgery, and initial treatment abroad. Of 94 children (143 TATT), 36 met the inclusion criteria. Seventeen (47%) of the 36 children with 25 clubfeet and a mean age at the time of surgery of 6.8 years participated in the study. Gait analysis, including the Oxford foot model, was conducted preoperatively and postoperatively. Furthermore, kinematic and kinetic data were compared with those of age-matched healthy children (n=18). RESULTS Forefoot supination in relation to the hindfoot and tibia was reduced during swing and at initial contact after TATT compared with preoperative values.