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Lumbar spine fusion

K J Schnake, D Rappert, B Storzer, S Schreyer, F Hilber, C Mehren
BACKGROUND: Lumbar spinal fusion is an established surgical technique in spine surgery. The goal of spinal fusion is a biomechanically lasting interbody union, which can be accomplished through different surgical approaches, implants and grafts. TECHNIQUES: The mainly surgical techniques used are: posterior lumbar fusion (PLF), posterior interbody lumbar fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), anterior lumbar interbody fusion (ALIF), oblique lumbar interbody fusion (OLIF) and extreme lateral interbody fusion (XLIF)...
December 14, 2018: Der Orthopäde
Kyle Mueller, Jason McGowan, Stephen Kane, Jean-Marc Voyadzis
BACKGROUND: Complications associated with the lateral lumbar transpsoas approach largely comprise various nerve-related syndromes particularly at L4-5. Quadriceps weakness can occur from stretch injury to the femoral nerve during retraction. OBJECTIVE: The purpose of this study is to evaluate the role of retraction time in the development of postoperative neuropathic motor weakness at the L4-5 level. METHODS: A retrospective review of a prospectively collected database at a single institution was reviewed over a two-year period (March 2014-2016) for a single surgeon...
December 11, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Rushabh M Vakharia, Chester J Donnally, Augustus J Rush, Ajit M Vakharia, Derek D Berglund, Neil V Shah, Michael Y Wang
Background: Primary lumbar fusion (LF) is a treatment option for degenerative disc disease. The literature is limited regarding postoperative complications in opioid abusers undergoing LF. The purpose of this study was to compare 2-year short term implant-related complications, infection rates, 90-day readmission rates, in-hospital length of stay, and cost of care amongst opioid abusers (OAS) and non-opioid abusers (NAS) undergoing primary 1- to 2-level primary lumbar fusion (1-2LF). Methods: A retrospective review was performed using the Medicare Standard Analytical Files from an administrative database...
September 2018: Journal of Spine Surgery (Hong Kong)
Azeem Tariq Malik, Nikhil Jain, Jeffery Kim, Safdar N Khan, Elizabeth Yu
Background: Chronic obstructive pulmonary disease (COPD) is a common cause of morbidity and mortality worldwide. Past literature has demonstrated that patients with COPD are at an increased risk of post-operative complications. We assessed the impact of COPD on 30-day outcomes following a 1- to 2-level posterior lumbar fusion (PLF). Methods: The 2012-2016 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database was queried using current procedural terminology (CPT) codes 22612, 22630 and 22633 to identify patients undergoing PLFs...
September 2018: Journal of Spine Surgery (Hong Kong)
Chester J Donnally, Augustus J Rush, Sebastian Rivera, Rushabh M Vakharia, Ajit M Vakharia, Dustin H Massel, Frank J Eismont
Background: To determine if the timing of a lumbar epidural steroid injection (LESI) effects rates of post-operative infection in patients receiving a non-fusion lumbar decompression (LDC) due to degenerative disc disease (DDD). Lumbar pain due to DDD can frequently be temporized or definitively treated with epidural injections. While there is ample literature regarding the infection risks associated with corticosteroid injections prior to hip/knee replacements, there are few studies relating to the spine...
September 2018: Journal of Spine Surgery (Hong Kong)
Darshan Vora, Matthew Kinnard, David Falk, Michael Hoy, Sachin Gupta, Christine Piper, Warren Yu, Faisal Siddiqui, Joseph O'Brien
Background: Instrumented lumbar fusion can be accomplished through open or minimally invasive techniques. The focus of this study was to compare perioperative narcotic usage and length of hospital stay between patients undergoing open versus minimally invasive spinal surgery (MISS). Methods: A retrospective chart review was performed on 110 patients who underwent instrumented lumbar fusion over 2 years at our institution. These patients were divided into two groups: those that received open transforaminal interbody fusion (n=69), and those whose surgeries were performed minimally invasively with lateral lumbar transpsoas interbody fusion (LLIF) and percutaneous pedicle screws (n=41)...
September 2018: Journal of Spine Surgery (Hong Kong)
(no author information available yet)
OBJECTIVEThe AANS launched the Quality Outcomes Database (QOD), a prospective longitudinal registry that includes demographic, clinical, and patient-reported outcome (PRO) data to measure the safety and quality of spine surgery. Registry data offer "real-world" insights into the utility of spinal fusion and decompression surgery for lumbar spondylolisthesis. Using the QOD, the authors compared the initial 12-month outcome data for patients undergoing fusion and those undergoing laminectomy alone for grade 1 degenerative lumbar spondylolisthesis...
November 1, 2018: Journal of Neurosurgery. Spine
Patrick Strube, Michael Putzier, Jan Siewe, Sven Oliver Eicker, Marc Dreimann, Timo Zippelius
INTRODUCTION: Surgical treatment methods for degenerative spondylolisthesis (decompression versus decompression and fusion) have been critically debated. The medical care situation is almost unknown for either treatment. Therefore, the aim of the present study was to provide information regarding the use of parameters for decision-making and the employment of surgical techniques. MATERIALS AND METHODS: A web-based survey was performed among members of the German-Spine-Society (DWG)...
December 12, 2018: Archives of Orthopaedic and Trauma Surgery
Graham Seow-Hng Goh, Ming Han Lincoln Liow, William Yeo, Zhixing Marcus Ling, Guo Chang Ming, Wai Mun Yue, Seang Beng Tan, Li Tat John Chen
STUDY DESIGN: Retrospective study using prospectively collected registry data. OBJECTIVES: The authors examine the influence of preoperative mental health on outcomes after anterior cervical discectomy and fusion (ACDF) and determine the impact of ACDF on postoperative mental health. SUMMARY OF BACKGROUND DATA: While studies have reported a negative correlation between preoperative mental health and outcomes following lumbar spine surgery, the influence on outcomes following cervical spine surgery remains relatively understudied...
December 11, 2018: Spine
F Cuzzocrea, A Ivone, E Jannelli, A Fioruzzi, E Ferranti, R Vanelli, F Benazzo
BACKGROUND: Low back pain and sciatica represent a common disabling condition with a significant impact on the social, working and economic lives of patients. Transforaminal lumbar interbody fusion (TLIF) is a surgical procedure used in degenerative spine conditions. Several types of cages were used in the TLIF procedure. PURPOSE: To determine whether there is a difference in terms of symptomatology improvement, return to daily activities and fusion rate between metal cages and polyetheretherketone (PEEK) cages...
December 10, 2018: Musculoskeletal Surgery
S Ruetten, M Komp
BACKGROUND: The most frequent causes of degenerative constrictions of the spinal canal are disk herniations and spinal stenoses. The lumbar and cervical spine is the most affected. SURGICAL PROCEDURES: After conservative treatments have been exhausted, surgical intervention may be necessary. Today, microsurgical decompression is regarded as the standard procedure in the lumbar region, while in the cervical spine, microsurgical anterior decompression and fusion are standard...
December 7, 2018: Der Orthopäde
Anuj Patel, Robert P Runner, J Taylor Bellamy, John M Rhee
BACKGROUND CONTEXT: Exposure of unintended levels (defined as a spinal segment outside the intended surgical levels) is unnecessary and potentially adds to operative time and patient morbidity. Wrong-level surgery (defined as decompression, instrumentation, or fusion of a spinal segment not part of the intended surgical procedure) clearly adds to morbidity as well as putting the surgeon at medicolegal risk. PURPOSE: To describe a localization technique for posterior lumbar spine surgery to minimize both unintended-level exposure and wrong-level surgery...
December 7, 2018: Spine Journal: Official Journal of the North American Spine Society
Christos Koutserimpas, Kalliopi Alpantaki, Maria Chatzinikolaidou, Gregory Chlouverakis, Michael Dohm, Alexander G Hadjipavlou
INTRODUCTION: A variety of biodegradable implants (screws, rods, plates and cages) are available which are composed of many different biodegradable polymers with varying characteristics. The present review of animal and clinical studies examines the efficacy and safety of biodegradable implants in spinal fracture intervention. METHODS: A review of the literature through March 2018 was performed using PubMed and Cochrane databases. Success rates were calculated according to sufficient tissue biocompatibility, solid clinical fusion and propensity for osseointegration...
December 2018: Injury
Chao Yuan, Jian Wang, Yue Zhou, Yong Pan
Both percutaneous endoscopic lumbar discectomy (PELD) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) have been demonstrated as two common and effective choices for lumbar disc herniation (LDH) minimally invasive surgery. In order to get a better understanding of these two procedures, we made this contrastive review. By looking up recent literature and combining it with our clinical practice, the indications/contraindications, advantages/disadvantages as well as complications/recurrences of PELD and MIS-TLIF were summarized in this review...
December 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Ian A Harris, Adrian Traeger, Ralph Stanford, Christopher G Maher, Rachelle Buchbinder
Lumbar spine fusion is a common procedure associated with a high cost burden and risk of serious complications. We aimed to summarise systematic reviews on the effectiveness of lumbar spine fusion for most diagnoses. We found no high-quality systematic reviews and the risk of bias of the randomised controlled trials in the reviews was generally high. The available evidence does not support a benefit from spine fusion compared to non-operative alternatives for back pain associated with degeneration. The available evidence does not support a clinical benefit from spine fusion compared to non-operative treatment or stabilisation without fusion for thoracolumbar burst fractures...
December 2018: Internal Medicine Journal
Vivek Palepu, Melvin Helgeson, Michael Molyneaux-Francis, Srinidhi Nagaraja
Several approaches (anterior, posterior, lateral, and transforaminal) are used in lumbar fusion surgery. However, it is unclear whether one of these approaches has the greatest subsidence risk as published clinical rates of cage subsidence vary widely (7-70%). Specifically, there is limited data on how a patient's endplate morphometry and trabecular bone quality influences cage subsidence risk. Therefore, this study compared the subsidence between anterior (ALIF), lateral (LLIF), posterior (PLIF), and transforaminal (TLIF) lumbar interbody fusion cage designs to understand the impact of endplate and trabecular bone quality on subsidence...
December 5, 2018: Journal of Biomechanical Engineering
Lisbeth Storm, Rikke Rousing, Mikkel O Andersen, Leah Y Carreon
INTRODUCTION: The Subgroups for Targeted Treatment (STarT) Back Screening Tool is used in general practice to stratify patients with acute back pain into either a low, medium or a high risk of developing complex pain. This study determines if the STarT Back Screening Tool can identify patients who are at a high risk of developing complex pain after spine surgery. METHODS: The STarT Back Screening Tool was administered pre-operatively to a consecutive series of patients who had lumbar spine surgery between 29 October 2012 and 1 February 2013...
December 2018: Danish Medical Journal
Jianzhong Jiang, Fengping Gan, Haitao Tan, Zhaolin Xie, Xiang Luo, Guoxiu Huang, Yin Li, Shengbin Huang
The benefits of navigation-assisted technologies are not entirely understood. Therefore, this study aimed to examine the outcomes of patients with lumbar tuberculosis who received computer navigation-assisted minimally invasive direct lateral interbody fusion (DLIF).This was a retrospective study of 33 patients with lumbar tuberculosis who underwent minimally invasive DLIF at the Department of Spine and Orthopedics of Guigang People's Hospital (Guangxi, China) between January 2015 and December 2016. The patients were pathologically diagnosed as lumbar tuberculosis and grouped into the navigation-assisted fluoroscopy (NAV; n = 18) and non-navigation-assisted fluoroscopy (non-NAV; n = 15) groups...
November 2018: Medicine (Baltimore)
Joseph Meyerson, Andrew O'Brien, Nicholas Calvin, Rajiv Chandawarkar
BACKGROUND: Reconstruction of complex back defects, especially after corrective spine surgery, is a challenging problem. In these patients hardware issues predominate and flap failure has serious consequences. Certain subunits of the back pose even greater problems, specifically the central region between T9 and T12. The purpose of this article is to present a novel technique for reconstruction of such spinal defects using a newly described trapezius muscle propeller flap based on the dorsal scapular vessels...
December 3, 2018: Microsurgery
Ju-Eun Kim, Dae-Jung Choi
Foraminal decompression using a minimally invasive technique to preserve facet joint stability and function without fusion reportedly improves the radicular symptoms in approximately 80% of patients and is considered one of the good surgical treatment choices for lumbar foraminal or extraforaminal stenosis. However, proper decompression was not possible because of the inability to access the foramen at the L5-S1 level due to prominence of the iliac crest. To overcome this challenge, endoscopy-based minimally invasive spine surgery has recently gained attention...
December 2018: Clinics in Orthopedic Surgery
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