ABSTRACT
STUDY DESIGN: Retrospective review of prospectively collected outcome data. PURPOSE: To compare 5-year outcomes following decompression with fusion (FU) and microendoscopic decompression (MED) in patients with degenerative lumbar spondylolisthesis (DLS) and to define surgical indication limitations regarding the use of MED for this condition. OVERVIEW OF LITERATURE: There have been no comparative studies on mid- or long-term outcomes following FU and MED for patients with DLS. METHODS: Forty-one consecutive patients with DLS were surgically treated. Sixteen patients first underwent FU (FU group), and 25 then underwent MED (MED group). The 5-year clinical outcomes following the two surgical methods were compared using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire. RESULTS: The degree of improvement (DOI) for social life function was significantly greater in the MED group than in the FU group. Although not statistically significant, DOIs for the other four functional scores were also greater in the MED group than in the FU group. However, patients with a large percentage of slippage in the neutral position might experience limited improvement in low back pain, those with a large percentage of slippage at maximal extension might experience limited improvement in three functional scores, and those with a small intervertebral angle at maximal flexion might have limited improvement in three functional scores after MED for DLS. Therefore, we statistically compared the DOIs between the FU and MED groups regarding the preoperative percentage of slippage in the neutral position among patients with greater than 20% slippage, the preoperative percentage of slippage at maximal extension among patients with greater than 15% slippage, and the intervertebral angle at flexion among patients with angles lesser than −5°; however, there were no statistically significant differences between the two groups. CONCLUSIONS: MED is a useful minimally invasive surgical procedure that possibly offers better clinical outcomes than FU for DLS.
Subject(s)
Humans , Asian People , Back Pain , Decompression , Low Back Pain , Prospective Studies , Retrospective Studies , Spinal Stenosis , SpondylolisthesisABSTRACT
Twelve young boys as an experimental group and seven as a control group, aged 5-6 years, participated in a study to clarify whether circulorespiratory trainability exists in young children. The subjects in the experimental group performed a 915 m endurance run on an agricultural road every day except Sundays for six months. During the run, heart rates (HR) equivalent to 3-4 mmol⋅<I>l</I><SUP>-1</SUP> of blood lactate concentration (LA) were maintained for at least 3-4 min⋅m<SUP>-1</SUP>. The control group was given no special training.<BR>Before and after the training period, both groups were subjected to increased stepwise running velocity on a flat treadmill till subjective exhaustion to determine circulorespiratory variables such as heart rate (HR), oxygen uptake (Vo<SUB>2</SUB>) and blood lactate concentration (LA) at all steps.<BR>From the above mentioned procedure, the following findings were obtained :<BR>1) After the 6-month endurance run training, Vo<SUB>2</SUB>max/TBW was significantly (p<0.05) increased from 47.5 to 50.4 m<I>l</I>⋅kg<SUP>-1</SUP>⋅min<SUP>-1</SUP> and also the peak LA was significantly (p<0.05) increased from 5.41 to 6.36 mmol⋅<I>l</I><SUP>-1</SUP>in the experimental group. On the other hand, no significant increases were observed in the control group.<BR>2) Running velocity in the final stages (Vmax) was significantly (p<0.001) improved from 190.0 to 205.0 m⋅min<SUP>-1</SUP>in the experimental group. Such effects were due partly to the improvement of circulorespiratory function and partly to improved efficiency of running motion. However, no significant differences were found in the control group.<BR>3) Submaximal V, HR, and Vo<SUB>2</SUB>/TBW equivalent to 3 and 4 mmol⋅<I>l</I><SUP>-1</SUP> and their values relative to the maximum values showed no significant differences before and after the training period in both groups. The improvement of maximal circulorespiratory variables observed in the experimental group suggests the existence of trainability even in young children.
ABSTRACT
Six male and seven female children, aged five or six years, ran on the flat treadmill increasing running speeds every two minutes by 20 m/min till their subjective exhaustions. The first steps were started with the speeds of 80 or 100 m/min and the rest periods of 30 seconds were inserted between each successive step for the blood sampling. Expired airs for the determination of oxygen uptakes were collected during the last 30 seconds of every stage. Heart rates were recorded for each subject throughout the whole test session.<BR>Two male and two female subjects were selected in order to determine their physical activity levels in the nursery school. Their heart rates were recorded from Monday to Saturday in a given week.<BR>Analyses of physical activity patterns were tried by relating heart rate levels to circulorespiratory variables which were equivalent to 3 or 4 mmo<I>l</I>/<I>l</I> blood lactate concentration (3m MLA or 4m MLA) .<BR>By so doing, the following results were obtained:<BR>1) Mean values of blood lactate concentrations observed immediately after the cessation of the last exhaustive steps were 5.16 m MLA for males and 4.70 m MLA for females.<BR>2) Relative values of heart rate to 3 and 4 m MLA against maximal heart rate (% HRmax-3 m MLA and % HRmax-4 m MLA) were respectively 92.2% HRmax-3 m MLA and 97.5% HRmax-4m MLA for males and 94.9% HRmax-3 m MLA and 98.2% HRmax-4 m MLA for females.<BR>The corresponding relative values of oxygen uptakes were 85.2% Vo<SUB>2</SUB>max-3 m MLA and 94.3% Vo<SUB>2</SUB>max-4 m MLA for males and 89.7% Vo<SUB>2</SUB>max-3 m MLA and 96% Vo<SUB>2</SUB>max-4 m MLA for females.<BR>3) Mean values of heart rate recorded in the nursery through a given week except Sunday ranged from 89 to 114 beats/min for males and 106 to 126 beats/min for females. In the relative value of a heart rate against the heart rate equivalent to 4 m MLA, that is, HR 4 m MLA these values correspond to 44-57% HR 4 m MLA and 57-67% HR 4 m MLA respectively.<BR>4) Accumulated duration time: Their hearts beat higher than 160 beats/min, except in the case of 800 m endurance run (only 0-4 and 0-6 minutes for males and 0-6 and 4-21 (touch of tachycardia) minutes for females) .<BR>Percentages of accumulated duration time lower than 120 beats/min occupied 72-94% and 77-91% of 6 or 7-hour nursing time for males and 51-91% and 51-78% for females.<BR>5) Absolute and relative values of mean heart rates in 800 m endurance run ranged from 183 beats/min (Net 83% HRmax, 90% HR 4 m MLA) to 199 beats/min (Net 98% HRmax, 104% HR 4 m MLA) for males and from 172 beats/min (Net 77% HRmax, 92% HR 4 m MLA) to 196 beats/min (Net 92% HRmax, 96% HR 4 m MLA), though the duration times were short.<BR>6) Optimal intensity of work load was proposed to be the heart rate level of at least 190 beats/min for favourable development and/or improvement of the circulo-respiratory system in young children.
ABSTRACT
The objectives of the present study were to find out peculiar cardiorespiratory adjustments of young children against relatively short duration of exhaustive run.<BR>Young four male and four female children, aged four or five years, ran on the flat treadmill firstly with the velocity where they could continue to run at least for five minutes (140m/min for male children and 120m/min for female children) and thereafter with three different kinds of velocities where they were forced to cease running because of their exhaustion (160, 180 and 200m/min for male children and 140, 160 and 180m/min for female children) .<BR>Increase rates and recovery rates converted from absolute values of of HR (bpm) and Vo<SUB>2</SUB> (1/min) in each phase were used for analysis.<BR>The results obtained were as follows;<BR>1) Also for young children changes of increase rates and recovery rates of HR and Vo<SUB>2</SUB> to the time course showed the exponential inclinations.<BR>2) Fifteen seconds after the commencement of running the increase rates of HR ranged from 56.0 to 65.0% and those of Vo<SUB>2</SUB> ranged from 42.5 to 53.3% for male children and on the other hand for female children ranged from 49.0 to 58.2% and 38.9 to 43.5% respectively.<BR>The increase rates of HR were, therefore, steeper than those of Vo<SUB>2</SUB> for both sexes.<BR>Significant differences were found in the velocities of 160, 180 and 200m/min for male children and 140 and 180m/min for female children.<BR>3) The increase rates of HR attained fifteen minutes after the start of running corresponded to one the second or two the third of 82.0 to 91.0% and 81.6 to 87.3% which were attained one minute after the start of running for male and female children respectively.<BR>4) In spite of the absolutely and relatively greater range of adjustment, which means the larger difference between values at rest and maximal effort, the increase rates of Vo<SUB>2</SUB> reached or surpassed those of HR one minute after the start of running.<BR>5) The ranges of adjustment of HR and Vo<SUB>2</SUB> were higher for male children, but the both increase rates exhibited till one minute after the start of running, though no significant differences were found, were higher for male children.<BR>6) On the contrary to the case of increase rates the recovery rates of Vo<SUB>2</SUB> were significantly higher than those of HR at least till two minutes after the cessation of running for both sexes.<BR>Vo<SUB>2</SUB> returned to the level of rest only five minutes after the cessation of running, but HR lied a little higher above the resting level even fifteen minutes later.<BR>7) The higher acceleration of increase rate and deceleration of recovery rate for young children are presumably much due to the smaller range of adjustment. Accordingly the experiments sould be designed by unifying exhaustion time.
ABSTRACT
In order to find out the criteria for the determination of maximal oxygen uptakes of very young children, five boys and five girls, aged four or five years, served as the subjects. They ran on the horizontal treadmill once a day for the constant three minutes on different days. The velocity was increased from the first 100m/min by 20m/min till the last where they could endure no longer for the three minutes. As the consequence, the velocities attained were 100m/min, 120m/min, 140m/min, 160m/min, 180m/min and 200m/min for boys and 100m/min, 120m/min, 140m/min, 160m/min and 180m/min for girls.<BR>The expired airs were collected at rest and whole through the treadmill running.<BR>Heart rates were also continuously registered not only at rest but also during the treadmill running.<BR>The following results were obtained:<BR>1) At the velocities of 100m/min, 120m/min and 140m/min apparent steady states of heart rates and Vo<SUB>2</SUB> were established within the three miuntes both for boys and girls.<BR>But boys showed lower heart rates and higher Vo<SUB>2</SUB> during the steady states at a given velocity than girls did.<BR>2) At the last velocity of 200m/min Vo<SUB>2</SUB>max were attained 30 seconds after the start of running for boys and also at the last of 180m/min girls reached Vo<SUB>2</SUB>max 60 seconds after the beginning.<BR>It was, therefore, confirmed that if the work intensity was sufficiently high, Vo<SUB>2</SUB> max could be reached at the latest between 30 and 60 seconds after the start of work for young children.<BR>3) At the one step lower velocity than the last, namely, 180m/min for boys and 160m/min for girls, the plateaus of Vo<SUB>2</SUB>max were found for the last minute.<BR>4) The heart rates simultaneously observed with Vo<SUB>2</SUB>max ranged from 202.4 to 206.4 bpm and also RQ were all above the unit. Accordingly these values could be regarded as the most important critieria for the evaluation of aerobic work capacity of young children.<BR>5) When the velocity was high, the respiratory frequency sharply rises immediately after the start of running. For the first thirty seconds the breath rates reached 60 to 90/min.<BR>6) If the duration of the running on the horizontal treadmill are constantly fixed three minutes, the upper limit of the velocity where the safe aerobic steady state can be established is 140m/min both for boys and girls.