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Study design Comparative effectiveness review.Study rationale Spinal fusion is believed to accelerate the degeneration of the vertebral segment above or below the fusion site, a condition called adjacent segment disease (ASD). The premise of dynamic stabilization is that motion preservation allows for less loading on the discs and facet joints at the adjacent, non-fused segments. In theory, this should decrease the rate of ASD. However, clinical evidence of this theoretical decrease in ASD is still lacking. We performed a systematic review to evaluate the evidence in the literature comparing dynamic stabilization with fusion.Clinical question In patients 18 years or older with degenerative disease of the cervical or lumbar spine, does dynamic stabilization lead to better outcomes and fewer complications, including ASD, than fusion in the short-term and the long-term?Methods A systematic search and review of the literature was undertaken to identify studies published through March 7, 2011. PubMed, Cochrane, and National Guideline Clearinghouse Databases as well as bibliographies of key articles were searched. Two individuals independently reviewed articles based on inclusion and exclusion criteria which were set a priori. Each article was evaluated using a predefined quality-rating scheme.Results No significant differences were identified between fusion and dynamic stabilization with regard to VAS, ODI, complications, and reoperations. There are no long-term data available to show whether dynamic stabilization decreases the rate of ASD.Conclusions There are no clinical data from comparative studies supporting the use of dynamic stabilization devices over standard fusion techniques.

Premenstrual symptomatology, stress, quality of life (QOL) and exercise frequency, volume, and intensity were assessed in 114 females (18-33 years). Based on premenstrual symptoms (PMS), women were divided into high and low PMS groups and compared on stress, QOL and exercise variables. Results revealed women with high PMS had significantly more stress and poorer QOL than women with low PMS (p < .05 for both comparisons). Groups did not significantly differ on any of the exercise variables. Further analyses were performed to determine if exercise variables impacted PMS symptoms, stress and QOL reports in the high PMS group. While exercise volume and intensity did not impact any of the variables assessed, women with high PMS who reported exercising 'sometimes' had more stress than women who reported exercising 'often' or 'never.' This nonlinear relationship suggests that women with the worst symptoms may respond by exercising, while women who exercise often or never do not associate exercise with their symptoms. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: Website: KEYWORDS. Stress, quality of life, physical activity, premenstrual syndrome