Radiculopathy

The following patients were recruited from Austria (n = 295), Germany (n = 19), Slovakia (n = 2) and Serbia (n = 19) (Table 1): (1) a total of 45 NMO patients diagnosed according to the revised diagnostic criteria from Wingerchuk et al., 2006 [3 (link)], (2) 53 patients with a high risk of developing NMO (HR-NMO) including 28 monophasic LETM, 13 recurrent LETM and 12 recurrent ON subjects [3 (link),10 (link)], (3) 33 patients fulfilling the diagnostic criteria for ADEM [46 (link)], (4) 32 CIS patients comprising 19 myelitis (59%) and 13 ON (41%), (5) 71 patients with MS according to the revised "McDonald Criteria" 2005 [47 (link)] including 44 patients with relapsing remitting MS, 8 patients with primary progressive MS and 19 patients with secondary progressive MS, (6) 101 controls including 24 patients with OND (stroke, Parkinson's disease, epileptic seizure, radiculopathy, insomnia, sleep apnoea syndrome, CNS lymphoma, traumatic brain injury, myasthenia gravis, chronic inflammatory demyelinating polyneuropathy, vestibular neuritis, orthostatic syncope, psychogenic neurological symptoms, CNS vasculitis, hereditary neuropathy, analgesic-induced headache, neuroborreliosis, viral encephalitis, chronic tension-type headache, glioblastoma multiforme), 27 patients with SLE and 50 healthy blood donors obtained from the central institute for blood transfusion (Central Institute for Blood Transfusion and Immunological Department, Innsbruck University Hospital).
External serum samples were shipped on dry ice to Innsbruck and all samples were stored at -20°C until analysis. The present study was approved by the ethical committee of Innsbruck Medical University (study no. UN3041 257/4.8, 21.09.2007) and all Austrian patients or parents/legal guardians gave written informed consent to the study protocol. All Serbian and Slovakian patients gave their informed consent for serum sampling and this study was approved by the Institutional Review Board of the Clinic of Neurology, Clinical Center of Serbia, Belgrade. The Slovakian patients signed the translated informed consent form of the Innsbruck Medical University. All German samples were tested anonymously as requested by the institutional review board of the University of Heidelberg.

Two-hundred and two participants were consecutively recruited at four neurosurgery/neuro-orthopaedic clinics in Sweden between 2009 and 2012^{12 (link),13 (link)}, of which 201 underwent surgery (mean age 50; SD 8.4 years, 52% men, neck pain median duration 14 months; arm pain median duration 12 months; IQR 16). The inclusion criteria were: age 18–70 years, persistent radiculopathy symptoms for at least two months, clinical findings of nerve root compression based on examination by a neurosurgeon/neuro-orthopaedic surgeon and compatible with verified cervical disc disease determined by magnetic resonance imaging, and undergoing surgery for CR by either anterior approach (ACDF) or posterior approach with foraminotomy/laminectomy at one to three segmental levels. The exclusion criteria were: myelopathy, previous fracture or luxation of the cervical column, malignancy or spinal tumour, spinal infection, previous surgery in the cervical column, systematic disease or trauma that contraindicated either the rehabilitation programme or the measurements, diagnosis of a severe psychiatric disorder (such as schizophrenia or psychosis), known drug abuse and lack of familiarity with the Swedish language (unable to understand and answer the questionnaires). Of the 201 participants who underwent surgery, 163 were operated on with ACDF using standard cages (i.e. filled with bone substitute or autologous bone collected during decompression; no iliac crest graft was taken) at the clinic where the participant was included. In most cases of multilevel surgery, an anterior plate was added to achieve primary stability. Thirty-eight patients underwent posterior foraminotomy, with or without laminectomy (without fusion). Eight participants did not fulfil the clinical neurological examination at baseline and were excluded from this secondary analysis of outcomes. Thus, the present cohort consisted of 193 participants (Table 1). A total of 153 (79% response rate) and 135 (70% response rate) participants completed the clinical examination at one- and two-year follow-up (Fig. 1). Of the participants attending one-year follow-up, 83 (46%) were men and mean age was 50 (SD 8.2). At the two-year follow-up, 72 (53%) were men and mean age was 50 (SD 8.3). There was no difference in background variables or preoperative neurological outcomes between the patients who attended the neurological clinical examination at follow-up and those who were lost to follow-up (p > 0.194). Patients attending clinical examination at follow-up scored NDI mean value 21 (SD 16.7) at one-year follow-up, and 23 (SD 18.3) at two-year follow-up. There was also no difference in background variables or neurological outcomes at baseline between participants randomized to SPT or SA (p > 0.08) (Table 1).Table 1

Background variables for participants with cervical radiculopathy who underwent surgery and postoperative rehabilitation and were included in the secondary analysis of postoperative neurological outcomes.

	N	Total	SPT (N = 97)	SA (N = 96)
Age, mean (SD)	193	50 (8.4)	50 (8.3)	50 (8.6)
Sex male, n (%)	193	100 (52)	48 (50)	52 (54)
Anterior surgery, n (%)	193	155 (80)	73 (75)	82 (85)
NDI %, mean (SD)	184	43 (14.9)	42 (14.5)	44 (15.4)
Neck pain mm VAS, mean (SD)	188	56 (24.3)	55 (24.9)	57 (23.8)
Arm pain mm VAS, mean (SD)	185	50 (28.0)	52 (26.5)	48 (29.5)
Neurological impairment prick touch, n (%)	193	154 (80)	78 (80)	76 (80)
Neurological impairment light touch, n (%)	193	138 (72)	70 (72)	68 (71)
Neurological impairment motor function, n (%)	191	150 (79)	80 (83)	70 (74)
Neurological impairment arm reflex, n (%)	186	109 (59)	50 (53)	59 (64)
Positive Spurling test, n (%)	142	91 (64)	49 (67)	42 (61)

Results are presented with mean value and standard deviation (SD) or number (n) and percentage (%).

Figure 1

Flow chart of participants included in the analyses of secondary neurological outcomes.

The report of this trial followed the Consolidated Standards of Reporting Trials (CONSORT) 2010 updated guidelines for reporting randomized controlled trials [58 (link)]. This study was a single-centre, hospital-based, open-label, parallel-group randomized clinical trial to compare the effect of PRP injection with steroid injection in the treatment of Plantar fasciitis between August 2020 and March 2022. The study was conducted in the outpatient department of Nepal Orthopaedic Hospital, Kathmandu, Nepal. It is one of the Orthopaedic and Trauma care super-speciality centres in Nepal that provides only orthopaedic services. It is a 100 bedded charitable autonomous hospital run under the Nepal Disabled Association of Nepal with the support of the Patan Rotary club, Nepal, and different International Rotary Clubs [59 ]. The patients aged 18 to 60 years with a history of heel pain of more than six weeks with tenderness on palpation over medial calcaneum tuberosity and diagnosed as PF, those patients with failure of conservative treatment with physiotherapy, splints, and NSAIDs, those patients who were mentally fit, and those patients who provided written informed consent were included in the study. The patients with lumbar radiculopathy, existing trauma, previous surgery or any foot pathology, under aspirin treatment, bleeding disorders with low platelet counts, and systemic diseases like diabetes and rheumatoid arthritis were excluded.