Background: Lumbar interbody fusion (IF) is a common procedure to fuse the anterior spine. However, a lack of consensus on image-based fusion assessment limits the validity and comparison of IF studies. This systematic review aims to (1) report on IF assessment strategies and definitions and (2) summarize available literature on the diagnostic reliability and accuracy of these assessments. Methods: Two searches were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Search 1 identified studies on adult lumbar IF that provided a detailed description of image-based fusion assessment. Search 2 analyzed studies on the reliability of specific fusion criteria/classifications and the accuracy assessed with surgical exploration. Results: A total of 442 studies were included for search 1 and 8 studies for search 2. Fusion assessment throughout the literature was highly variable. Eighteen definitions and more than 250 unique fusion assessment methods were identified. The criteria that showed most consistent use were continuity of bony bridging, radiolucency around the cage, and angular motion <5°. However, reliability and accuracy studies were scarce. Conclusion: This review highlights the challenges in reaching consensus on IF assessment. The variability in IF assessment is very high, which limits the translatability of studies. Accuracy studies are needed to guide innovations of assessment. Future IF assessment strategies should focus on the standardization of computed tomography-based continuity of bony bridging. Knowledge from preclinical and imaging studies can add valuable information to this ongoing discussion.@en

Current life cycle assessment methodologies for dwellings often do not address health damages of occupants related to local road traffic. In this study, a methodology has been developed to calculate damages to human health of occupants caused by substances and noise emitted by neighbourhood car traffic. This damage has been compared to the damage to human health associated with the rest of the life cycle of that dwelling. Fate, exposure and human health effects of road traffic noise, particulate matter (PM10), sulphur dioxide, benzene and benzo[a]pyrene emitted by cars were addressed in the calculation procedure. Health damages were calculated on the basis of disability adjusted life years (DALYs). Human health damage scores for changes in traffic situations have been calculated for differences between three traffic scenarios in residential areas and for the Dutch reference dwellings. Communication disturbances and sleep disturbances due to noise and health effects of PM10 appear to be dominant in the total damage to human health of occupants caused by neighbourhood car traffic. A sensitivity analysis has shown that a reduction of the car and truck density and an increase of the distance of the façade of the dwellings to the road axis have the largest positive effect on the human health of the occupants. Damages to human health of occupants due to indoor exposure to road traffic noise and pollutants appear to be in the same order of magnitude when compared with damages associated with the life cycle of dwellings. This emphasizes the importance to include the location of dwellings in the life cycle assessment of the dwelling.@en