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Lumbar fusion

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https://www.readbyqxmd.com/read/28343332/posterior-elements-disruption-with-hybrid-constructs-in-ais-patients-is-there-an-impact-on-proximal-junctional-kyphosis
#1
S Ghailane, Sebastien Pesenti, E Peltier, E Choufani, B Blondel, J L Jouve
PURPOSE: Proximal junctional kyphosis (PJK) is a frequent proximal adjacent segment disease following spinal fusion in adolescent idiopathic scoliosis (AIS) and its rate has been estimated to 28% in the literature. The etiology is multifactorial, and risk factors associated with PJK are controversial. The aim of this study was to demonstrate that the disruption of muscular and bony tissue above the upper instrumented vertebra (UIV) during surgery does not increase the rate of PJK in patients undergoing posterior fusion for adolescent idiopathic scoliosis...
March 25, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28343046/perioperative-hemoglobin-a1c-as-a-predictor-of-deep-infection-following-single-level-lumbar-decompression-in-patients-with-diabetes
#2
Jourdan M Cancienne, Brian C Werner, Dennis Q Chen, Hamid Hassanzadeh, Adam L Shimer
BACKGROUND CONTEXT: Although multiple studies have cited diabetes mellitus as a risk factor decreased functional outcomes, increased infectious complications, and overall increased reoperation rate following degenerative lumbar spinal surgery, few have investigated how perioperative glycemic control influences such complications. PURPOSE: The primary goal of the present study was to use a national database to evaluate the association of perioperative glycemic control as demonstrated by Hemoglobin A1c levels in patients with diabetes undergoing primary, single level decompression without concomitant fusion with the incidence of deep postoperative infection following requiring operative irrigation and debridement...
March 22, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28342920/which-is-the-more-appropriate-proximal-fusion-level-for-adult-lumbar-degenerative-flat-back
#3
Jeong-Hoon Choi, Jee-Soo Jang, Hyeun-Sung Kim, Il-Tae Jang
OBJECTIVE: To determine the optimal proximal fusion level after long instrumented fusion to the sacrum for lumbar degenerative flat back. METHODS: Data from 70 patients with lumbar degenerative flat back were reviewed retrospectively. Three groups were designated according to the upper instrumented vertebrae (UIV) : Group 1 (UIV = T10 or above), Group 2 (UIV = T11 to T12), and Group 3 (UIV = L1 or below). Preoperative and postoperative pelvic parameters, degree of correction, and prevalence of proximal junctional kyphosis (PJK) and its risk factors were evaluated...
March 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28338449/development-of-a-preoperative-predictive-model-for-major-complications-following-adult-spinal-deformity-surgery
#4
Justin K Scheer, Justin S Smith, Frank Schwab, Virginie Lafage, Christopher I Shaffrey, Shay Bess, Alan H Daniels, Robert A Hart, Themistocles S Protopsaltis, Gregory M Mundis, Daniel M Sciubba, Tamir Ailon, Douglas C Burton, Eric Klineberg, Christopher P Ames
OBJECTIVE The operative management of patients with adult spinal deformity (ASD) has a high complication rate and it remains unknown whether baseline patient characteristics and surgical variables can predict early complications (intraoperative and perioperative [within 6 weeks]). The development of an accurate preoperative predictive model can aid in patient counseling, shared decision making, and improved surgical planning. The purpose of this study was to develop a model based on baseline demographic, radiographic, and surgical factors that can predict if patients will sustain an intraoperative or perioperative major complication...
March 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28337448/percutaneous-transforaminal-endoscopic-lumbar-interbody-fusion-clinical-and-radiological-results-of-mean-46-month-follow-up
#5
Sang-Ho Lee, H Yener Erken, Junseok Bae
Background. Spinal fusion has been shown to be the preferred surgical option to reduce pain, recover function, and increase quality of life in the treatment of a variety of lumbar spinal disorders. The main goal of the present study is to report our clinical experience and results of percutaneous transforaminal endoscopic lumbar interbody fusion (PELIF) applications using the expandable spacer in a single institution. Methods. We performed a retrospective review of 18 patients with >12-month follow-up who had been operated on PELIF using expandable spacer from 2001 to 2007...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28334320/interbody-spacer-material-properties-and-design-conformity-for-reducing-subsidence-during-lumbar-interbody-fusion
#6
Lillian S Chatham, Vikas V Patel, Christopher M Yakacki, R Dana Carpenter
One major complication with lumbar spinal fusion surgery is subsidence, in which the interbody spacer penetrates the vertebral endplates. Towards reducing the risk of subsidence, the objective of this study was to investigate the effects of interbody spacer material and design on the stress in the lumbar spine after interbody fusion. A finite element model of the L4-L5 motion segment was developed from computed tomography images of a cadaveric lumbar spine. A spacer, pedicle screws, and posterior rods were incorporated into the model, and the system was loaded under axial compression...
March 23, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28328741/sagittal-plane-parameters-in-growing-rod-patients-following-final-fusion
#7
Robert F Murphy, John B Emans, Michael Troy, Patricia E Miller, Michael T Hresko, Lawrence I Karlin, Daniel J Hedequist, Michael P Glotzbecker
Almost half of growing rod (GR) patients that undergo final fusion (FF) have an extension of instrumented levels. The purpose of this study was to review sagittal plane radiographic parameters of patients with distal extension of instrumented levels at FF to those whose levels remained the same. Radiographs were assessed preoperatively, after GR insertion/first lengthening, following GR treatment before FFs, and after FF. Measurements included sagittal balance, lumbar lordosis, thoracic kyphosis, and distal junction angle (DJA)...
March 21, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28327997/lumbar-fusion-for-degenerative-disease-a-systematic-review-and-meta-analysis
#8
Daniel Yavin, Steven Casha, Samuel Wiebe, Thomas E Feasby, Callie Clark, Albert Isaacs, Jayna Holroyd-Leduc, R John Hurlbert, Hude Quan, Andrew Nataraj, Garnette R Sutherland, Nathalie Jette
BACKGROUND: Due to uncertain evidence, lumbar fusion for degenerative indications is associated with the greatest measured practice variation of any surgical procedure. OBJECTIVE: To summarize the current evidence on the comparative safety and efficacy of lumbar fusion, decompression-alone, or nonoperative care for degenerative indications. METHODS: A systematic review was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (up to June 30, 2016)...
March 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327960/geographic-and-hospital-variation-in-cost-of-lumbar-laminectomy-and-lumbar-fusion-for-degenerative-conditions
#9
Corinna C Zygourakis, Caterina Y Liu, Glenn Wakam, Christopher Moriates, Christy Boscardin, Christopher P Ames, Praveen V Mummaneni, John Ratliff, R Adams Dudley, Ralph Gonzales
BACKGROUND: Spinal surgery costs vary significantly across hospitals and regions, but there is insufficient understanding of what drives this variation. OBJECTIVE: To examine the factors underlying the cost variation for lumbar laminectomy/discectomy and lumbar fusions. METHODS: We obtained patient information (age, gender, race, severity of illness, risk of mortality, population of county of residence, median zipcode income, insurance status, elective vs nonelective admission, length of stay) and hospital data (region, hospital type, bed size, wage index) for all patients who underwent lumbar laminectomy/discectomy (n = 181 267) or lumbar fusions (n = 433 364) for degenerative conditions in the 2001 to 2013 National Inpatient Sample database...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327190/primary-pain-generator-identification-by-ct-spect-in-a-patient-with-low-back-pain-a-case-report
#10
Gabriel Tender, Adriana Constantinescu, Andrew Conger, Anthony DiGiorgio
BACKGROUND: Chronic low back pain is one of the most common conditions encountered in the middle-age population. Identifying the primary pain generator is notoriously difficult. The computed tomography-single-photon emission computed tomography (CT-SPECT) is emerging as a new diagnostic modality for this purpose. CASE PRESENTATION: This 68-year-old Caucasian male presented with intractable low back pain refractory to maximal conservative treatment, including medication and extensive physical therapy...
March 21, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28324328/interspinous-implants-to-treat-spinal-stenosis
#11
REVIEW
Raj J Gala, Glenn S Russo, Peter G Whang
PURPOSE OF REVIEW: Lumbar spinal stenosis has historically been treated with open decompressive surgery which is associated with significant morbidity and may give rise to various complications. Interspinous spacers (ISS) have been developed as a less invasive strategy which may serve to avoid many of these risks. The two current spacers that are FDA approved and commercially available are the Coflex and Superion devices. The goal is to review these two implants, their indications, and patient selection...
March 21, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28324327/lumbar-disc-replacement-surgery-successes-and-obstacles-to-widespread-adoption
#12
REVIEW
Stephan N Salzmann, Nicolas Plais, Jennifer Shue, Federico P Girardi
PURPOSE OF REVIEW: Lumbar disc replacement has been a surgical alternative to fusion surgery for the treatment of lumbar degenerative disc disease (DDD) for many years. Despite enthusiasm after the approval of the first devices, implantation rates have remained low, especially in the USA. The goal of this review is to provide a general overview of lumbar disc replacement in order to comprehend the successes and obstacles to widespread adoption. RECENT FINDINGS: Although a large amount of evidence-based data including satisfactory long-term results is available, implantation rates in the USA have not increased in the last decade...
March 21, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28324211/comparison-of-in-vitro-osteogenic-potential-of-iliac-crest-and-degenerative-facet-joint-bone-autografts-for-intervertebral-fusion-in-lumbar-spinal-stenosis
#13
Jeroen Geurts, Daniela Ramp, Stefan Schären, Cordula Netzer
PURPOSE: The promotion of spinal fusion using bone autografts is largely mediated by the osteoinductive potential of progenitors/mesenchymal stem cells (MSC) that reside in the marrow spaces of cancellous bone. Iliac crest is the common autograft donor site, but its use presents an increased risk for donor site pain, morbidity and infection. Degenerative bone samples harvested during facetectomy might provide an alternative viable source of osteoinductive autografts. In this study, we conducted an intra-individual comparison of the osteogenic potential of isolated low passage MSC from both sources...
March 21, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28323717/treatment-of-lumbar-split-fracture-dislocation-with-short-segment-or-long-segment-posterior-fixation-and-anterior-fusion
#14
Fei Chen, Yijun Kang, Haisheng Li, Guohua Lv, Chang Lu, Jing Li, Bing Wang, Weihua Chen, Zhehao Dai
STUDY DESIGN: Retrospective analysis of 16 patients. SUMMARY OF BACKGROUND DATA: The lumbar split fracture-dislocation is a rare but severe injury, which is type C1.2.1 fracture in the Association for the Study of Internal Fixation spine fracture classification. The axial compressive and torsional force shattered the vertebral body into 2 halves and displaced them rotationally. This kind of fracture is so highly unstable that the treatment is very challenging. PURPOSE: The purpose of this study was to report and compare on clinical outcome and complications of patients with lumbar split fracture-dislocation which had been treated either short-segment or long-segment posterior fixation and anterior fusion...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323700/electrophysiological-study-for-nerve-root-entrapment-in-patients-with-isthmic-spondylolisthesis
#15
Masahiro Morita, Akira Miyauchi, Shinya Okuda, Takenori Oda, Motoki Iwasaki
STUDY DESIGN: A case series study. OBJECTIVE: To investigate the electrophysiological location of nerve root entrapment in patients with isthmic spondylolisthesis. SUMMARY OF BACKGROUND DATA: Although the lesion of the nerve root in patients with isthmic spondylolisthesis has been thought to be located at the pars interarticularis due to proliferation of fibrous cartilage, there is no electrophysiological study in relation to this accomplished fact...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323699/use-of-nanocrystalline-hydroxyapatite-with-autologous-bma-and-local-bone-in-the-lumbar-spine-a-retrospective-ct-analysis-of-posterolateral-fusion-results
#16
Stephen Robbins, Carl Lauryssen, Matthew N Songer
STUDY DESIGN: A retrospective, multicenter, medical record review and independent analysis of computed tomographic scans was performed in 46 patients to determine radiographic arthrodesis rates after 1-segment, 2-segment, or 3-segment instrumented posterolateral fusions (PLF) using autograft, bone marrow aspirate (BMA), and a nanocrystalline hydroxyapatite bone void filler (nHA). OBJECTIVE: To determine the radiographic arthrodesis rates after instrumented lumbar PLF using local autograft, BMA, and nHA...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323239/biomechanical-analysis-of-lateral-interbody-fusion-strategies-for-adjacent-segment-degeneration-in-the-lumbar-spine
#17
Melodie F Metzger, Samuel T Robinson, Ruben C Maldonado, Jeremy Rawlinson, John Liu, Frank L Acosta
BACKGROUND CONTEXT: Surgical treatment of symptomatic adjacent segment disease (ASD) typically involves extension of previous instrumentation to include the newly-affected level(s). Disruption of the incision-site can present challenges and increases the risk of complication. Lateral-based interbody fusion techniques may provide a viable surgical alternative that avoids these risks. This study is the first to analyze the biomechanical effect of adding a lateral-based construct to an existing fusion...
March 17, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28323238/preoperative-retrolisthesis-as-a-predictive-risk-factor-of-reoperation-due-to-delayed-onset-symptomatic-foraminal-stenosis-after-central-decompression-for-lumbar-canal-stenosis-without-fusion
#18
Daisuke Ikegami, Noboru Hosono, Yoshihiro Mukai, Kosuke Tateishi, Takeshi Fuji
BACKGROUND CONTEXT: For patients diagnosed with lumbar central canal stenosis with asymptomatic foraminal stenosis (FS), surgeons occasionally only decompress central stenosis and preserve asymptomatic FS. These surgeries have the potential risk of converting preoperative asymptomatic FS into symptomatic FS postoperatively by accelerating spinal degeneration, which requires reoperation. However, little is known about delayed onset symptomatic FS postoperatively. PURPOSE: This study aimed to evaluate the rate of reoperation for delayed onset symptomatic FS after lumbar central canal decompression in patients with preoperative asymptomatic FS, and determine the predictive risk factors of those reoperations...
March 17, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28321409/could-the-topping-off-technique-be-the-preventive-strategy-against-adjacent-segment-disease-after-pedicle-screw-based-fusion-in-lumbar-degenerative-diseases-a-systematic-review
#19
REVIEW
Po-Hsin Chou, Hsi-Hsien Lin, Howard S An, Kang-Ying Liu, Wei-Ren Su, Cheng-Li Lin
The "topping-off" technique is a new concept applying dynamic or less rigid fixation such as hybrid stabilization device (HSD) or interspinous process device (IPD) for the purpose of avoiding adjacent segment disease (ASD) proximal to the fusion construct. A systematic review of the literature was performed on the effect of topping-off techniques to prevent or decrease the occurrence of ASD after lumbar fusion surgery. We searched through major online databases, PubMed and MEDLINE, using key words related to "topping-off" technique...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28320256/internal-decompression-for-spinal-stenosis-idss-for-decompression-and-use-of-interlaminar-dynamic-device-coflextm-for-stabilization-in-the-surgical-management-of-degenerative-lumbar-canal-stenosis-with-or-without-mild-segmental-instability-our-initial-results
#20
Sumeet G Pawar, Arjun Dhar, Apurva Prasad, Satyashiva Munjal, P S Ramani
INTRODUCTION: Internal decompression of spinal stenosis (IDSS) and Posterior dynamic stabilization (PDS) form a bridge between decompression laminectomy alone and rigid fusion, by attempting to sustain beneficial effects of decompression and stabilization in an attempt to prevent bad effects of relentless degeneration. OBJECTIVE: To evaluate the clinical outcome in operated patient of posterior dynamic stabilization. DESIGN: Data were collected over 1 year in prospective, nonrandomized follow-up study using outcome scales...
March 21, 2017: Neurological Research
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