STUDY DESIGN: Retrospective study. PURPOSE: To analyze outcomes of posterior lumbar interbody fusion (PLIF) stand-alone cages. OVERVIEW OF LITERATURE: PLIF for degenerative disk disease using stand-alone cages has lost its popularity owing to implant-related complications and pseudoarthrosis. METHODS: We analyzed the records of 45 patients (18 women, 27 men), operated between January 1994 and December 1996, with a mean follow-up of 18 years 3 months (20 years 3 months–22 years 3 months). Clinical outcomes were measured using visual analogue score (VAS), Oswestry disability index (ODI), Odom's criteria, and radiological measurements of fusion rate, Cobb angle, and implant-related complications conducted at the preoperative evaluation, hospital discharge, 12-month follow-up, and final follow-up. RESULTS: Preoperative mean VAS (back) was 6.9 and VAS (radicular) was 7.2, with mean improvements (p <0.05) of 2.9 and 3.1, respectively, at the final follow-up. Median preoperative ODI was 64.5, with a mean improvement to 34 and 42 at the 12-month and final follow-ups, respectively (p <0.05). Odom's criteria at the 12-month follow-up were excellent in 11.2% patients, good in 57.7%, fair in 31.1%, and poor in none of the patients; at the final follow-up, no patient was classified as excellent, 71.1% as good, 22.2% as fair, and 6.7% as poor (p <0.05). Pseudoarthrosis was observed in five patients (11.1%), of whom, three (6.6%) required re-operation. Preoperative disk height was 9.23 mm, which increased to 13.33 mm in the immediate postoperative evaluation and was maintained at 10.0 mm at the final follow-up (p <0.05). The preoperative mean L1–S1 Cobb angle was 34.7°, which changed to 44.7° in the immediate postoperative evaluation and dropped to 39.7° at the final follow-up (p <0.005). CONCLUSIONS: PLIF stand-alone cages were associated with good clinical outcomes. Although the fusion rate was excellent, maintenance of disk heights and a lordotic alignment were not achieved in the long term.
Female ; Follow-Up Studies* ; Humans ; Intervertebral Disc Degeneration ; Pseudarthrosis ; Retrospective Studies ; Spinal Fusion ; Treatment Outcome

This An Ergonomic hazard often exists in any industry. However, majority of the employees are not aware of practicing good body posture until the MSDs symptoms become permanent and chronic. The main objective of this study is to determine the manual handling problems among workers at an electronic component manufacturing company. The scope of this study focused on the study entire body disorders among workers on electronic manufacturing company using the Rapid Entire Body Assessment (REBA). A cross sectional study involving observation of the workplace, the work task and the working environment, photographs and videos taken during the observation. Later, a survey questionnaire was given to the respondents to obtain their socio-demography information, work activity and health problems. Rapid Entire Body Assessment (REBA) was conducted on all respondents to determined REBA scores in different work positions. The study was conducted at an electronic component manufacturing company located in Klang Valley, Selangor. A total of 124 workers were surveyed and REBA assessment was performed on 20 workers at Company X production area. It includes 5 categories of position at Company X, such as:loading steel bar into casing; pushing the steel bar, turning movement while adjusting the steel bar, adjusting steel bar into the loading area, unloading steel bar from casing into the machine. The study found that turning section has the highest MSDs problems regarding manual handling because majority of the respondents in the turning department felt the pain while performing their work. This is due to their job demand, which they need to handle with tools weighing from 200 to 400 kg. The REBA scores showed that17 out of 20 respondents performing turning operations, moving and pushing the steel bar recorded the highest score of 11 or more which are categorize in the very high risk group. The position of pushing and turning steel bar while moving the steel bar has higher risk that contributed to the ergonomics risk factor, which in-turn can contribute to Muscular Skeletal Disorders (MSDs). More detailed investigation and remedial measures should be taken immediately, especially for the workers performing the manual handlings activities.

Purpose: Despite the significant role of varicocele in the pathogenesis of male infertility, the impact of varicocele repair (VR) on conventional semen parameters remains controversial. Only a few systematic reviews and meta-analyses (SRMAs) have evaluated the impact of VR on sperm concentration, total motility, and progressive motility, mostly using a before-after analytic approach. No SRMA to date has evaluated the change in conventional semen parameters after VR compared to untreated controls. This study aimed to evaluate the effect of VR on conventional semen parameters in infertile patients with clinical varicocele compared to untreated controls. Materials and Methods: A literature search was performed using Scopus, PubMed, Embase, and Cochrane databases following the Population Intervention Comparison Outcome (PICOS) model (Population: infertile patients with clinical varicocele; Intervention: VR [any technique]; Comparison: infertile patients with clinical varicocele that were untreated; Outcome: sperm concentration, sperm total count, progressive sperm motility, total sperm motility, sperm morphology, and semen volume; Study type: randomized controlled trials and observational studies). Results: A total of 1,632 abstracts were initially assessed for eligibility. Sixteen studies were finally included with a total of 2,420 infertile men with clinical varicocele (1,424 patients treated with VR vs. 996 untreated controls). The analysis showed significantly improved post-operative semen parameters in patients compared to controls with regards to sperm concentration (standardized mean difference [SMD] 1.739; 95% CI 1.129 to 2.349; p<0.001; I2=97.6%), total sperm count (SMD 1.894; 95% CI 0.566 to 3.222; p<0.05; I2=97.8%), progressive sperm motility (SMD 3.301; 95% CI 2.164 to 4.437; p<0.01; I2=98.5%), total sperm motility (SMD 0.887; 95% CI 0.036 to 1.738; p=0.04; I2=97.3%) and normal sperm morphology (SMD 1.673; 95% CI 0.876 to 2.470; p<0.05; I2=98.5%). All the outcomes showed a high inter-study heterogeneity, but the sensitivity analysis showed that no study was sensitive enough to change these results. Publication bias was present only in the analysis of the sperm concentration and progressive motility. No significant difference was found for the semen volume (SMD 0.313; 95% CI -0.242 to 0.868; I2=89.7%). Conclusions This study provides a high level of evidence in favor of a positive effect of VR to improve conventional semen parameters in infertile men with clinical varicocele. To the best of our knowledge, this is the first SRMA to compare changes in conventional semen parameters after VR with changes in parameters of a control group over the same period. This is in contrast to other SRMAs which have compared semen parameters before and after VR, without reference to a control group. Our findings strengthen the available evidence and have a potential to upgrade professional societies’ practice recommendations favoring VR to improve conventional semen parameters in infertile men.