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Lumbar spine fusion

Kyle Mueller, David Zhao, Osiris Johnson, Faheem A Sandhu, Jean-Marc Voyadzis
BACKGROUND: Surgical site infection (SSI) in spinal surgery contributes to significant morbidity and healthcare resource utilization. Few studies have directly compared the rate of minimally invasive surgery (MIS) SSI with open surgery. OBJECTIVE: To investigate whether MIS techniques had a lower SSI rate in degenerative lumbar procedures as compared with traditional open techniques. METHODS: A single-center, retrospective review of a prospectively collected database was queried from January 2013 to 2016 for adult patients who underwent lumbar decompression and/or instrumented fusion for which the surgical indication involved degenerative disease...
August 9, 2018: Operative Neurosurgery (Hagerstown, Md.)
Tetsuji Inoue, Masaya Mizutamari, Kazuaki Fukuda, Kuniaki Hatake
STUDY DESIGN: This was a single-institute retrospective study. OBJECTIVE: To evaluate postoperative complications in dialysis-dependent patients undergoing elective cervical and lumbar decompression surgery. SUMMARY OF BACKGROUND DATA: Spinal surgery in dialysis-dependent patients is very challenging due to the high risk of serious postoperative complications and mortality associated with their fragile general condition. However, the outcome of decompression surgery alone has not been evaluated in such patients...
September 1, 2018: Spine
Benjamin Khechen, Brittany E Haws, Mundeep S Bawa, Dil V Patel, Kaitlyn L Cardinal, Jordan A Guntin, Simon P Lalehzarian, Kern Singh
STUDY DESIGN: Retrospective Cohort OBJECTIVE.: To determine if comorbidity as determined by Charlson Comorbidity Index (CCI) is associated with inpatient complication rate, length of stay (LOS), or direct hospital costs after minimally-invasive transforaminal lumbar interbody fusion (MIS-TLIF). SUMMARY OF BACKGROUND DATA: In the spine literature, comorbidity burden has been associated with an increased risk for complications, prolonged LOS, and greater hospital costs...
August 7, 2018: Spine
Hiroki Ushirozako, Tomohiko Hasegawa, Shigeto Ebata, Hiroki Oba, Tetsuro Ohba, Keijiro Mukaiyama, Yukihiro Isogai, Eisaku Okada, Toshiyuki Ojima, Jun Takahashi, Hirotaka Haro, Yukihiro Matsuyama
STUDY DESIGN: A multicenter case control study. OBJECTIVE: To investigate the independent predictors of osseous union after posterior lumbar interbody fusion (PLIF). SUMMARY OF BACKGROUND DATA: PLIF is usually performed to treat lumbar degenerative diseases in elderly patients. Some patients exhibit intervertebral pseudoarthrosis. METHODS: We analyzed 66 elderly patients with osteoporosis who underwent PLIF from 2011 to 2014 (all women, mean age 71 years, follow-up period ≥6 months)...
August 7, 2018: Spine
Stavros Oikonomidis, Ghazi Ashqar, Thomas Kaulhausen, Christian Herren, Jan Siewe, Rolf Sobottke
BACKGROUND: Dynamic spine implants were developed to prevent adjacent segment degeneration (ASD) and adjacent segment disease (ASDi). Purpose of this study was to investigate the clinical and radiological outcomes of "topping off" devices following lumbar spinal fusion procedure using a PEEK-based dynamic rod system. Moreover, this study focused on the hypothesis that "topping off" devices can prevent ASD. METHODS: This prospective nonrandomized study included patients with indication for single-level lumbar fusion and radiological signs of ASD without instability...
August 9, 2018: Journal of Orthopaedic Surgery and Research
Fengping Gan, Jianzhong Jiang, Zhaolin Xie, Shengbin Huang, Ying Li, Guoping Chen, Haitao Tan
BACKGROUND: To investigate the clinical efficacy of minimally invasive direct lateral approach debridement, interbody bone grafting, and interbody fusion in the treatment of the thoracic and lumbar spinal tuberculosis. METHODS: From January 2013 to January 2016, 35 cases with thoracic and lumbar spinal tuberculosis received direct lateral approach debridement, interbody bone grafting, and interbody fusion. Of the 35 cases, 16 patients were male and 19 were female and the median age was 55...
August 7, 2018: BMC Musculoskeletal Disorders
Ryan Adams, Sarah Herrera-Nicol, Arthur L Jenkins
Background  Advancements in radiological imaging and diagnostic criteria enable doctors to more accurately identify lumbosacral transitional vertebrae (LSTV) and their association with back and L5 distribution leg pain. It is considered the most common congenital anomaly of the lumbosacral spine with an incidence between 4 and 35%, 3 although many practitioners describe 10 to 12% overall incidence. LSTVs include sacralization of the L5 vertebral body and lumbarization of the S1 segment while demonstrating varying morphology, ranging from broadened transverse processes to complete fusion...
July 2018: Journal of Neurological Surgery Reports
Ronen Blecher, Emre Yilmaz, Marc Moisi, Rod J Oskouian, Jens Chapman
The authors describe a 67-year-old man with a prior history of alcohol abuse who presented with a complaint of worsening low back pain. Four months prior to his presentation, the patient had undergone extreme lateral interbody fusion (XLIF) of his lumbar 3-4 segment for the treatment of his chronic low back and legs pain. Imaging revealed a loosening of his interbody fusion implant on top of his prior lumbar spine instrumentation. In surgery, the removal of his loose implant was followed by decompression, the stabilization of the collapsed segment, and the implant of antibiotic-impregnated polymethyl-methacrylate (PMMA) spacer and beads...
May 31, 2018: Curēus
Lei Kong, Xi-Fu Shang, Wen-Zhi Zhang, Li-Qun Duan, Yang Yu, Wei-Jian Ni, Yan Huang
BACKGROUND: Sufficient decompression of the nerve root canal is still regarded as the method of choice when operating on patients with lumbar disc herniation (LDH) with lumbar lateral recess stenosis; however, tissue-sparing procedures are becoming more popular. Endoscopic techniques offer advantages and the benefits of rehabilitation, which have become the standard in many surgical operations when operating on the spine. A significant issue has been the upgrading of instruments to provide enough bone resection under continuous visual control...
August 3, 2018: Der Orthopäde
Jeremiah Easley, Christian M Puttlitz, Ross Palmer, Nicole Ramo, Celeste Abjornson, Frank P Cammisa, Kirk McGilvray
BACKGROUND CONTEXT: Screw loosening is a prevalent failure mode in orthopaedic hardware, particularly in osteoporotic bone or revision procedures where the screw-bone engagement is limited. PURPOSE: The objective of this study was to evaluate the efficacy of a novel screw retention technology (SRT) in an ovine lumbar fusion model. STUDY DESIGN/SETTING: This was a biomechanical, radiographic, and histology study utilizing an ovine lumbar spine model...
July 31, 2018: Spine Journal: Official Journal of the North American Spine Society
Evan Rhea, Gazanfar Rahmathulla
BACKGROUND: Facet dislocations, or jumped facets, are part of a spectrum of flexion-distraction spine injuries. Bilateral and unilateral facet dislocations are commonly seen in the cervical spine. Traumatic jumped facets in the lumbar spine are rare injuries, and a majority of these involve the lumbosacral junction. Lumbar facet subluxations occur commonly in younger patients, due to the flexion-distraction forces on the lumbar spine at the time of the injury combined with ligamentous laxity that exists in these patients...
July 31, 2018: World Neurosurgery
Azeem Tariq Malik, Nikhil Jain, Jeffery Kim, Elizabeth Yu, Safdar N Khan
STUDY DESIGN: Retrospective review of prospective registry OBJECTIVE.: To analyze the impact of metabolic syndrome (MetS) on 30-day outcomes following elective anterior cervical discectomy and fusions (ACDFs). SUMMARY OF BACKGROUND DATA: MetS is defined as the presence of a combination of hypertension, diabetes mellitus and obesity. Past literature has reported MetS to complicate post-operative care in patients undergoing various surgical procedures, including lumbar fusions...
August 2, 2018: Spine
Tatsuya Yasuda, Tomohiko Hasegawa, Yu Yamato, Daisuke Togawa, Sho Kobayashi, Go Yoshida, Tomohiro Banno, Hideyuki Arima, Shin Oe, Yukihiro Matsuyama
OBJECTIVE The purpose of this study was to evaluate the effect of position on lumbar lordosis (LL) in adult spinal deformity (ASD) patients. METHODS The authors evaluated the radiographic data of ASD patients who underwent posterior corrective fusion surgery from the thoracic spine to L5, S1, or the ilium for the treatment of ASD of the lumbar spine. The spinopelvic parameters were measured in the standing position preoperatively. LL was also evaluated in the supine position preoperatively and in the prone position on the surgical frame...
August 3, 2018: Journal of Neurosurgery. Spine
Azeem T Malik, Nikhil Jain, Jeffery Kim, Elizabeth Yu, Safdar N Khan
STUDY DESIGN: This was a retrospective cohort study. OBJECTIVE: The main objective of this article was to investigate the impact of discharge destination on postdischarge outcomes following an elective 1- to 2-level posterior lumbar fusion (PLF) for degenerative pathology. BACKGROUND DATA: Discharge to an inpatient care facility may be associated with adverse outcomes as compared with home discharge. MATERIALS AND METHODS: The 2012-2016 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database was used to query for patients undergoing PLFs using Current Procedural Terminology (CPT) codes (22612, 22630, and 22633)...
July 31, 2018: Clinical Spine Surgery
Qasim Zaidi, Olumide Danisa, Wayne Cheng
STUDY DESIGN: Systematic Review OBJECTIVE.: To evaluate the clinical utility of assessing bone quality using computed tomography (CT) attenuation in Hounsfield units (HU). SUMMARY OF BACKGROUND DATA: Assessing bone quality prior to spine instrumentation is an essential step of preoperative planning. Dual energy x-ray absorptiometry (DEXA) has been the gold standard for assessing bone mineral density (BMD), however DEXA can result in spuriously elevated BMD measurements in patients with degenerative disease, compression fractures and/or vascular calcifications...
July 30, 2018: Spine
Chester J Donnally, Rushabh M Vakharia, Augustus J Rush, Dhanur Damodar, Ajit J Vakharia, Vadim Goz, Nathan H Lebwohl
STUDY DESIGN: Retrospective review. OBJECTIVE: To identify if a concomitant diagnosis of fibromyalgia influences post-operative complications, readmission rates or cost following primary 1 to 2 level lumbar fusions in an elective setting. SUMMARY OF BACKGROUND DATA: Patients with fibromyalgia often are limited by chronic lower back pain, many of whom will seek operative treatment. No prior study has evaluated if patients with a concomitant diagnosis of fibromyalgia have more complications following spine surgery...
July 27, 2018: Spine
Jeremy Steinberger, Jeffrey Gilligan, Branko Skovrlj, Christopher A Sarkiss, Javier Z Guzman, Samuel K Cho, John M Caridi
Study Design: Retrospective Database Analysis. Objective: The purpose of this study was to assess characteristics and outcomes of patients with Parkinson's disease (PD) undergoing lumbar spine surgery for degenerative conditions. Methods: The Nationwide Inpatient Sample was examined from 2002 to 2011. Patients were included for study based on ICD-9-CM procedural codes for lumbar spine surgery and substratified to degenerative diagnoses. Incidence and baseline patient characteristics were determined...
2018: Parkinson's Disease
Gordon Mao, Nouman Aldahak, Dorian Kusyk, Matthew Yeager, Daniel Cook, Jeffrey Cameron, Boyle Cheng, Michael Oh
Sacroiliac joint (SIJ) dysfunction and its surgical treatment remain a controversial topic in spine surgery. Determining success after SIJ fusion may be difficult due to preexisting back pain, lumbar fusion (LF), and functional disability. We examine the utility of Oswestry Disability Index (ODI) as a measure of clinical outcomes after minimally invasive SIJ fusion. A retrospective review of 24 patients with at least 12- months follow-up. Patients were divided into two groups based on presence of previous LF...
June 14, 2018: Orthopedic Reviews
Chi Heon Kim, Chun Kee Chung, Myo Jeong Kim, Yunhee Choi, Min-Jung Kim, Sukyoun Shin, Jong-Myung Jung, Sung Hwan Hwang, Seung Heon Yang, Sung Bae Park, Jun Ho Lee
OBJECTIVE: Examining spine surgery patterns over time is crucial to provide insights into variations and changes in clinical decision making. Changes in the number of surgeries, surgical methods, reoperation rates and cost-effectiveness were analyzed for all patients who underwent surgery for lumbar spinal stenosis without spondylolisthesis in 2003 (2003 cohort) and 2008 (2008 cohort). METHODS: The national health insurance database was used to create the 2003 cohort (n = 10,990) and 2008 cohort (n = 27,942)...
July 24, 2018: World Neurosurgery
Ahilan Sivaganesan, Silky Chotai, Scott L Parker, Matthew J McGirt, Clinton J Devin
BACKGROUND: Considerable variability exists in the cost of surgery following spine surgery for common degenerative spine diseases. This variation in the cost of surgery can affect the payment bundling during the postoperative 90 d. OBJECTIVE: To determine the drivers of variability in total 90-d cost for laminectomy and fusion surgery. METHODS: A total of 752 patients who underwent elective laminectomy and fusion for degenerative lumbar conditions and were enrolled into a prospective longitudinal registry were included in the study...
July 25, 2018: Neurosurgery
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