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Lumbar fusion

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https://www.readbyqxmd.com/read/28074438/is-there-variation-in-procedural-utilization-for-lumbar-spine-disorders-between-a-fee-for-service-and-salaried-healthcare-system
#1
Andrew J Schoenfeld, Heeren Makanji, Wei Jiang, Tracey Koehlmoos, Christopher M Bono, Adil H Haider
BACKGROUND: Whether compensation for professional services drives the use of those services is an important question that has not been answered in a robust manner. Specifically, there is a growing concern that spine care practitioners may preferentially choose more costly or invasive procedures in a fee-for-service system, irrespective of the underlying lumbar disorder being treated. QUESTIONS/PURPOSES: (1) Were proportions of interbody fusions higher in the fee-for-service setting as opposed to the salaried Department of Defense setting? (2) Were the odds of interbody fusion increased in a fee-for-service setting after controlling for indications for surgery? METHODS: Patients surgically treated for lumbar disc herniation, spinal stenosis, and spondylolisthesis (2006-2014) were identified...
January 10, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28072709/tranexamic-acid-reduces-perioperative-blood-loss-of-posterior-lumbar-surgery-for-stenosis-or-spondylolisthesis-a-randomized-trial
#2
Houyin Shi, Yunsheng Ou, Dianming Jiang, Zhengxue Quan, Zenghui Zhao, Yong Zhu
BACKGROUND: A prospective, randomized, double-blind, placebo-controlled study was performed. The routine usage of TA in spinal surgery is controversial. Only a few studies have focused on patients undergoing posterior lumbar surgery for stenosis or spondylolisthesis, although a large clinical cohort exists in the population. This study aimed to evaluate the effect and safety of TA in reducing perioperative blood loss in posterior lumbar surgery for stenosis or spondylolisthesis. METHODS: 100 eligible patients out of 126 were randomized to receive either a bolus dose of 30 mg/kg TA i...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28067696/multidisciplinary-evaluation-leads-to-the-decreased-utilization-of-lumbar-spine-fusion-an-observational-cohort-pilot-study
#3
Vijay Yanamadala, Yourie Kim, Quinlan D Buchlak, Anna K Wright, James Babington, Andrew Friedman, Robert S Mecklenburg, Farrokh Farrokhi, Jean-Christophe Leveque, Rajiv K Sethi
STUDY DESIGN: Observational cohort pilot study. OBJECTIVE: To determine the impact of multidisciplinary conference on treatment decisions for lumbar degenerative spine disease. SUMMARY OF BACKGROUND DATA: Multidisciplinary decision making improves outcomes in many disciplines. The lack of integrated systems for comprehensive care for spinal disorders has contributed to the inappropriate overutilization of spine surgery in the United States...
January 6, 2017: Spine
https://www.readbyqxmd.com/read/28067693/intraoperative-ketamine-reduces-immediate-postoperative-opioid-consumption-after-spinal-fusion-surgery-in-chronic-pain-patients-with-opioid-dependency-a-randomized-blinded-trial
#4
Rikke Vibeke Nielsen, Jonna Storm Fomsgaard, Hanna Siegel, Robertas Martusevicius, Lone Nikolajsen, Jørgen Berg Dahl, Ole Mathiesen
Perioperative handling of surgical patients with opioid dependency represents an important clinical problem. Animal studies suggest that ketamine attenuates central sensitization and hyperalgesia and thereby reduces postoperative opioid tolerance. We hypothesized that intraoperative ketamine would reduce immediate postoperative opioid consumption compared to placebo in chronic pain patients with opioid dependency undergoing lumbar spinal fusion surgery. Primary outcome was morphine consumption 0-24 h postoperatively...
January 6, 2017: Pain
https://www.readbyqxmd.com/read/28067466/anterior-lumbar-interbody-fusion-integrated-screw-cages-intrinsic-load-generation-subsidence-and-torsional-stability
#5
Yusuf Assem, Matthew H Pelletier, Ralph J Mobbs, Kevin Phan, William R Walsh
OBJECTIVE: To perform a repeatable idealized in vitro model to evaluate the effects of key design features and integrated screw fixation on unloaded surface engagement, subsidence, and torsional stability. METHODS: We evaluated four different stand-alone anterior lumbar interbody fusion (ALIF) cages with two, three, and four screw designs. Polyurethane (saw-bone) foam blocks were used to simulate the vertebral bone. Fuji Film was used to measure the contact footprint, average pressure, and load generated by fixating the cages with screws...
January 9, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28061485/comparison-of-the-effects-of-sufentanil-and-fentanyl-intravenous-patient-controlled-analgesia-after-lumbar-fusion
#6
Do Keun Kim, Seung Hwan Yoon, Ji Yong Kim, Chang Hyun Oh, Jong Kwon Jung, Jin Kim
OBJECTIVE: Postoperative pain is one of the major complaints of patients after lumbar fusion surgery. The authors evaluated the effects of intravenous patient controlled analgesia (IV-PCA) using fentanyl or sufentanil on postoperative pain management and pain-related complications. METHODS: Forty-two patients that had undergone surgery with lumbar instrumentation and fusion at single or double levels constituted the study cohort. Patients were equally and randomly allocated to a sufentanil group (group S) or a fentanyl group (group F) for patient controlled analgesia (PCA)...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28059982/morbidity-of-adult-spinal-deformity-surgery-in-elderly-has-declined-over-time
#7
Peter G Passias, Gregory W Poorman, Cyrus M Jalai, Brian Neuman, Rafael de la Garza-Ramos, Emily Miller, Amit Jain, Daniel Sciubba, Shearwood McClelland, Louis Day, Subbu Ramachadran, Shaleen Vira, Bassel Diebo, Evan Isaacs, Olivia Bono, Shay Bess, Michael Gerling, Virginie Lafage
STUDY DESIGN: A retrospective review of a prospectively collected database, the Nationwide Inpatient Sample (NIS), years 2003 to 2012. OBJECTIVES: The aim of this study was to examine trends in the management of scoliosis in elderly (age >75 yrs) patients from 2003 to 2012. SUMMARY OF BACKGROUND DATA: Scoliosis incidence rises with increasing age, and age has been shown to be an independent risk factor for surgical complications in scoliosis surgery...
January 4, 2017: Spine
https://www.readbyqxmd.com/read/28059949/the-influence-of-single-level-versus-multilevel-decompression-on-the-outcome-in-multisegmental-lumbar-spinal-stenosis-analysis-of-the-lumbar-spinal-outcome-study-lsos-data
#8
Nils H Ulrich, Jakob M Burgstaller, Ulrike Held, Sebastian Winklhofer, Mazda Farshad, Giuseppe Pichierri, Johann Steurer, François Porchet
STUDY DESIGN: This is prospective multicenter cohort study. OBJECTIVE: To assess whether patients with confirmed multisegmental lumbar spinal stenosis benefit more from a single-level or a multilevel decompression. SUMMARY OF BACKGROUND DATA: In multisegmental lumbar spinal stenotic cases, the decision as to how many levels of stenosis need to be operated to achieve the best possible clinical outcome is still unknown and remains a controversy between spine surgeons...
January 4, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28059946/comparative-study-of-the-difference-of-perioperative-complication-and-radiologic-results-mis-dlif-minimally-invasive-direct-lateral-lumbar-interbody-fusion-versus-mis-olif-minimally-invasive-oblique-lateral-lumbar-interbody-fusion
#9
Jie Jin, Kyeong-Sik Ryu, Jung-Woo Hur, Ji-Hoon Seong, Jin-Sung Kim, Hyun-Jin Cho
STUDY DESIGN: Retrospective observatory analysis. OBJECTIVE: The purpose of this study was to compare the incidence of perioperative complication, difference of cage location, and sagittal alignment between minimally invasive oblique lateral lumbar interbody fusion (MIS-OLIF) and MIS-direct lateral lumbar interbody fusion (DLIF) in the cases of single-level surgery at L4-L5. SUMMARY OF BACKGROUND DATA: MIS-DLIF using tubular retractor has been used for the treatment of lumbar degenerative diseases; however, blunt transpsoas dissection poses a risk of injury to the lumbar plexus...
January 4, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28059687/congenital-hypoplasia-of-the-lumbar-pedicle-with-spondylolisthesis-report-of-2-cases
#10
Chang-Sheng Hsieh, Sang-Ho Lee, Hyung Chang Lee, Hyeong-Seok Oh, Byeong-Wook Hwang, Sang-Joon Park, Jian-Han Chen
Congenital hypoplasia of the spinal pedicle is a rare condition. Previously reported cases were treated conservatively or with posterior instrumented fusion. However, the absence or hypoplasia of the lumbar pedicle may increase the difficulty of pedicle screw fixation and fusion. Herein, the authors describe 2 cases of rare adult congenital hypoplasia of the right lumbar pedicles associated with spondylolisthesis. The patients underwent anterior lumbar interbody fusion with a stand-alone cage as well as percutaneous pedicle screw fixation...
January 6, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28059683/spinopelvic-sagittal-imbalance-as-a-risk-factor-for-adjacent-segment-disease-after-single-segment-posterior-lumbar-interbody-fusion
#11
Tomiya Matsumoto, Shinya Okuda, Takafumi Maeno, Tomoya Yamashita, Ryoji Yamasaki, Tsuyoshi Sugiura, Motoki Iwasaki
OBJECTIVE The importance of spinopelvic balance and its implications for clinical outcomes after spinal arthrodesis has been reported in recent studies. However, little is known about the relationship between adjacent-segment disease (ASD) after lumbar arthrodesis and spinopelvic alignment. The purpose of this study was to clarify the relationship between spinopelvic radiographic parameters and symptomatic ASD after L4-5 single-level posterior lumbar interbody fusion (PLIF). METHODS This was a retrospective 1:5 matched case-control study...
January 6, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28052066/effects-of-strontium-ranelate-on-spinal-interbody-fusion-surgery-in-an-osteoporotic-rat-model
#12
Tsung-Ting Tsai, Ching-Lung Tai, Natalie Yi-Ju Ho, Po-Liang Lai, Tsai-Sheng Fu, Chi-Chien Niu, Lih-Huei Chen, Wen-Jer Chen
Osteoporosis is a bone disease that afflicts millions of people around the world, and a variety of spinal integrity issues, such as degenerative spinal stenosis and spondylolisthesis, are frequently concomitant with osteoporosis and are sometimes treated with spinal interbody fusion surgery. Previous studies have demonstrated the efficacy of strontium ranelate (SrR) treatment of osteoporosis in improving bone strength, promoting bone remodeling, and reducing the risk of fractures, but its effects on interbody fusion surgery have not been adequately investigated...
2017: PloS One
https://www.readbyqxmd.com/read/28043852/surgical-techniques-for-lumbo-sacral-fusion
#13
REVIEW
P Tropiano, H Giorgi, A Faure, B Blondel
Lumbo-sacral (L5-S1) fusion is a widely performed procedure that has become the reference standard treatment for refractory low back pain. L5-S1 is a complex transition zone between the mobile lordotic distal lumbar spine and the fixed sacral region. The goal is to immobilise the lumbo-sacral junction in order to relieve pain originating from this site. Apart from achieving inter-vertebral fusion, the main challenge lies in the preoperative determination of the fixed L5-S1 position that will be optimal for the patient...
December 30, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28043848/surgical-treatment-of-degenerative-spondylolisthesis
#14
REVIEW
P Guigui, E Ferrero
Degenerative spondylolisthesis is a common pathology, often causing lumbar canal stenosis. There is, however, no strong consensus regarding the various medical and surgical treatments available. Surgery is indicated mainly for perceived functional impairment; when the indication is accepted, several questions determine the choice of surgical strategy. Improvement in neurological symptoms is one of the main treatment objectives. For this, it is useful to perform radicular decompression. Some authors recommend indirect decompression by interbody fusion (ALIF, TLIF, XLIF), others by means of an interspinous spacer but the most frequent technique is direct posterior decompression...
December 30, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28040872/cost-effectiveness-of-conservative-versus-surgical-treatment-strategies-of-lumbar-spinal-stenosis-in-the-swiss-setting-analysis-of-the-prospective-multicenter-lumbar-stenosis-outcome-study-lsos
#15
A Aichmair, J M Burgstaller, M Schwenkglenks, J Steurer, F Porchet, F Brunner, M Farshad
PURPOSE: To evaluate the cost-effectiveness of conservative versus surgical treatment strategies for lumbar spinal stenosis (LSS). METHODS: Patients prospectively enrolled in the multicenter Lumbar Stenosis Outcome Study (LSOS) with a minimum follow-up of 12 months were included. Quality adjusted life years (QALY) were calculated based on EQ-5D data. Cost data were retrieved retrospectively. Cost-effectiveness was calculated via decision tree analysis. RESULTS: A total of 434 patients were included, treated surgically (n = 170) or conservatively (n = 264) for LSS...
December 31, 2016: European Spine Journal
https://www.readbyqxmd.com/read/28039550/application-of-a-three-dimensional-graft-of-autologous-osteodifferentiated-adipose-stem-cells-in-patients-undergoing-minimally-invasive-transforaminal-lumbar-interbody-fusion-clinical-proof-of-concept
#16
E Fomekong, D Dufrane, B Vande Berg, W André, N Aouassar, S Veriter, C Raftopoulos
BACKGROUND: The authors applied a scaffold-free osteogenic three-dimensional (3D) graft made of adipose-derived mesenchymal stem cells (AMSCs) in patients undergoing minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). METHODS: Three patients (two patients and one patient with 1 and 2 levels, respectively) with degenerative spondylolisthesis underwent MI-TLIF with 3D graft made of AMSCs. To obtain the AMSCs, fatty tissue was collected from the abdomen by lipoaspiration and differentiated afterwards in our Cell/Tissue bank...
December 30, 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28038695/national-trends-in-the-surgical-management-of-adolescent-idiopathic-scoliosis-analysis-of-a-national-estimate-of-60-108-children-from-the-national-inpatient-sample-over-a-13-year-time-period-in-the-united-states
#17
Alexander A Theologis, David C Sing, Faraaz Chekeni, Mohammad Diab
STUDY DESIGN: Analysis of Nationwide Inpatient Sample (NIS). OBJECTIVE: Evaluate evolution of operative treatment of adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: Spinal surgery is one of the most rapidly evolving branches of surgery. Changes in AIS operations are incompletely defined. METHODS: Children (10-18 years) with ICD-9 diagnosis of idiopathic scoliosis who underwent thoracic and/or lumbar spinal fusion identified in the NIS (1998-2011) were analyzed...
January 2017: Spine Deformity
https://www.readbyqxmd.com/read/28038691/strain-in-posterior-instrumentation-resulted-by-different-combinations-of-posterior-and-anterior-devices-for-long-spine-fusion-constructs
#18
Christopher J Kleck, Damian Illing, Emily M Lindley, Andriy Noshchenko, Vikas V Patel, Cameron Barton, Todd Baldini, Christopher M J Cain, Evalina L Burger
STUDY DESIGN: Clinically related experimental study. OBJECTIVE: Evaluation of strain in posterior low lumbar and spinopelvic instrumentation for multilevel fusion resulting from the impact of such mechanical factors as physiologic motion, different combinations of posterior and anterior instrumentation, and different techniques of interbody device implantation. SUMMARY OF BACKGROUND DATA: Currently different combinations of posterior and anterior instrumentation as well as surgical techniques are used for multilevel lumbar fusion...
January 2017: Spine Deformity
https://www.readbyqxmd.com/read/28033299/factors-predicting-venous-thromboembolism-after-spine-surgery
#19
Tao Wang, Si-Dong Yang, Wen-Zheng Huang, Feng-Yu Liu, Hui Wang, Wen-Yuan Ding
BACKGROUND: A meta-analysis was performed to explore predicted factors of venous thromboembolism (VTE) after surgery in the treatment for spine degeneration diseases. SUMMARY OF BACKGROUND DATA: Many scholars have focused on VTE after spine surgery, but as for the risk factors of VTE have not reached a consensus. METHODS: An extensive search of literature, "spine or spinal," "degeneration," "after surgery or postoperation," and "venous thromboembolism" as key words, was performed in PubMed/MEDLINE, Embase, the Cochrane library, CNKI, and WANFANG databases...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28033151/spinal-realignment-for-adult-deformity-three-column-osteotomies-alter-total-hip-acetabular-component-positioning
#20
Jeffrey J Barry, Altug Yucekul, Alexander A Theologis, Erik N Hansen, Christopher Ames, Vedat Deviren
INTRODUCTION: A goal of adult spinal deformity surgery is correction of sagittal imbalance by increasing lumbar lordosis (LL), allowing a previously retroverted pelvis to normalize as evidenced by decreases in pelvic tilt (PT). Realignment of pelvic orientation may alter the position of preexisting total hip arthroplasties (THAs). METHODS: Twenty-seven patients with unilateral THA who underwent thoracolumbar fusions for adult spinal deformity from the pelvis to L1 or above were retrospectively reviewed (levels fused, 10...
December 28, 2016: Journal of the American Academy of Orthopaedic Surgeons
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