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Lumbar fusion

Jesse J Liu, Jeffrey S Raskin, Fran Hardaway, Katherine Holste, Sarah Brown, Ahmed M Raslan
BACKGROUND: Delivery of higher value healthcare is an ultimate government and public goal. Improving efficiency by standardization of surgical steps can improve patient outcomes, reduce costs, and lead to higher value healthcare. Lean principles and methodology have improved timeliness in perioperative medicine; however, process mapping of surgery itself has not been performed. OBJECTIVE: To apply Plan/Do/Study/Act (PDSA) cycles methodology to lumbar posterior instrumented fusion (PIF) using lean principles to create a standard work flow, identify waste, remove intraoperative variability, and examine feasibility among pilot cases...
March 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
Shengtao Zhang, Conglin Ye, Qi Lai, Xiaolong Yu, Xuqiang Liu, Tao Nie, Haibo Zhan, Min Dai, Bin Zhang
BACKGROUND: Lumbar spondylolysis and isthmic spondylolisthesis are common conditions. However, double-level lumbar spondylolysis and spondylolisthesis are rare. We report 24 cases of it along with a review of literature and a briefly description of the clinical and radiological features and integrated management of patients with this condition. METHODS: Of 1700 inpatients diagnosed with lumbar spondylolisthesis at our hospital between January 2008 and September 2015, we selected those with a diagnosis of double-level spondylolisthesis who underwent surgery...
March 16, 2018: Journal of Orthopaedic Surgery and Research
Heeren Makanji, Andrew J Schoenfeld, Amandeep Bhalla, Christopher M Bono
PURPOSE: Lumbar fusion for degenerative disorders is among the most common spine surgical procedures performed. The purpose of this study was to analyze fusion, complications, and clinical success for lumbar fusion performed with various surgical techniques as reported in the literature from 2000 to 2015 and compare with previous critical analysis of outcomes from 1980 to 2000. METHODS: A systematic review of the literature to identify all studies of adult lumbar fusion for degenerative disorders published between January 1, 2000, and August 31, 2015, was performed adhering to PRISMA guidelines...
March 15, 2018: European Spine Journal
Dexin Zou, Junlin Zhou, Xiaobing Jiang
Tuberculosis combined with brucellosis is a very rare condition. Overlapping clinical presentation and laboratory parameters of tuberculosis and brucellosis may lead to misdiagnosis or delayed diagnosis of the condition. The current study presents the case of a 45-year-old male with symptoms of lower back pain, non-tender swelling in the right flank, intermittent hyperpyrexia, sweating, body aches and numbness and weakness of right lower limb. A lumbar computed tomograph (CT) scan and magnetic resonance imaging indicated vertebral destruction and the formation of sequestra and thecal sac compression...
April 2018: Experimental and Therapeutic Medicine
Jack Zigler, Nicole Ferko, Chris Cameron, Leena Patel
AIM: To compare the efficacy and safety of total disc replacement, lumbar fusion, and conservative care in the treatment of single-level lumbar degenerative disc disease (DDD). MATERIALS & METHODS: A network meta-analysis was conducted to determine the relative impact of lumbar DDD therapies on Oswestry Disability Index (ODI) success, back pain score, patient satisfaction, employment status, and reoperation. Odds ratios or mean differences and 95% credible intervals were reported...
March 2018: Journal of Comparative Effectiveness Research
Matthew T Morris, Sandip P Tarpada, Vafa Tabatabaie, Woojin Cho
PURPOSE: In patients undergoing lumbar fusion, osteoporosis has been shown to lead to poorer outcomes and greater incidence of fusion-related complications. Given the undesirable effect of osteoporosis on lumbar fusion surgery, a number of medications have been proposed for use in the peri- and postoperative period to mitigate risks and enhance outcomes. The purpose of this review was to summarize and synthesize the current literature regarding medical management of osteoporosis in the context of lumbar fusion surgery...
March 14, 2018: Archives of Osteoporosis
Oliver P Gautschi, Martin N Stienen, Marco V Corniola, Granit Molliqaj, Enrico Tessitore
No abstract text is available yet for this article.
April 2018: Journal of Neurosurgical Sciences
Ahilan Sivaganesan, Brandon Hirsch, Frank M Phillips, Matthew J McGirt
Here, we systematically review clinical studies that report morbidity and outcomes data for cervical and lumbar surgeries performed in ambulatory surgery centers (ASCs). We focus on anterior cervical discectomy and fusion (ACDF), posterior cervical foraminotomy, cervical arthroplasty, lumbar microdiscectomy, lumbar laminectomy, and minimally invasive transforaminal interbody fusion (TLIF) and lateral lumbar interbody fusion, as these are prevalent and surgical spine procedures that are becoming more commonly performed in ASC settings...
March 12, 2018: Neurosurgery
Sven Hoppe, Christoph E Albers, Tarek Elfiky, Moritz C Deml, Helena Milavec, Sebastian F Bigdon, Lorin M Benneker
The aim of this study was to assess the performance of a new vacuum plasma sprayed (VPS) titanium-coated carbon/polyetheretherketone (PEEK) cage under first use clinical conditions. Forty-two patients who underwent a one or two segment transforaminal lumbar interbody fusion (TLIF) procedure with a new Ca/PEEK composite cage between 2012 and 2016 were retrospectively identified by an electronic patient chart review. Fusion rates (using X-ray), patient's satisfaction, and complications were followed up for two years...
March 14, 2018: Journal of Functional Biomaterials
Shingo Onda, Masahiro Kanayama, Tomoyuki Hashimoto, Fumihiro Oha, Akira Iwata, Masaru Tanaka, Kazuo Kaneko
PURPOSE: To compare peri-operative complication rates in ≥ 85-year-old patients who underwent decompression surgery with or without instrumented fusion for degenerative disorders. METHODS: This study involved 907 patients who underwent lumbar spine surgery for degenerative disorders between January 2006 and June 2012. Of these, 33 patients (3.6% of the entire population) were over 85 years of age (85-94 years). Decompression-alone and instrumentation groups were compared in terms of comorbidities, American Society of Anesthesiologists (ASA)-physical status (PS) class, peri-operative complications, and Japanese Orthopedic Association (JOA) scores...
March 13, 2018: International Orthopaedics
Rachid Madkouri, David Brauge, Anthony Vidon-Buthion, Elie Fahed, Klaus-Luc Mourier, Jacques Beaurain, Mickael Grelat
OBJECTIVE: The aim of this study was to evaluate modifications in static spinal status after posterior decompression surgery without fusion in patients with symptomatic central canal stenosis. MATERIAL & METHODS: From November 2014 to May 2016, 72 patients who underwent isolated decompression for lumbar spinal stenosis were prospectively enrolled in this monocentric study. All of the patients had lateral full-body x-rays using the EOS system (EOS Imaging, Paris, France) before surgery and after 12 months of follow-up...
March 9, 2018: World Neurosurgery
Haiying Wang, Bing Lv
PURPOSE: The purpose was to compare the outcomes between KDSS and PLIF for lumbar degenerative disease. METHODS: This study retrospectively reviewed 98 patients who were treated with lumbar surgery from March 2012 to June 2014, including 48 managed with KDSS (KDSS group) and 50 underwent PLIF (PLIF group). All patients were followed up for at least two years. Duration of operation, blood loss, hospital stay, complications and patient satisfaction survey were recorded and analyzed...
March 9, 2018: World Neurosurgery
John P Kleimeyer, Ivan Cheng, Todd F Alamin, Serena S Hu, Thomas Cha, Vijay Yanamadala, Kirkham B Wood
STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: To evaluate the long-term outcomes of selective one- to two-level anterior lumbar interbody fusions (ALIFs) in the lower lumbar spine versus continued nonsurgical management. SUMMARY OF BACKGROUND DATA: Low back pain associated with lumbar intervertebral disc degeneration is common with substantial economic impact, yet treatment remains controversial. Surgical fusion has previously provided mixed results with limited durable improvement of pain and function...
March 9, 2018: Spine
Longfei Wen, Daxiang Jin, Weixing Xie, Yue Li, Weijian Chen, Jinyong Ding, Jixi Xu, Dongcheng Ren
STUDY DESIGN: Descriptive study. OBJECTIVES: This study aimed to evaluate the hidden blood loss (HBL) of patients who underwent lumbar fusion surgery for degenerative spine and to analyze its risk factors. SUMMARY OF BACKGROUND DATA: When planning transfusion strategies, blood loss calculation is important. However, in clinical practice, spine surgeons usually ignore the possibility that a large amount of HBL may occur after lumbar fusion surgery...
March 9, 2018: Clinical Spine Surgery
A Guiroy, A Sícoli, N Gonzalez Masanés, A Morales Ciancio, M Gagliardi, A Falavigna
Background: The paraspinal, posterolateral, or Wiltse approach is an old technique that observes the principles of an MIS procedure. The aim of this study was to provide a step-by-step description from the literature of the Wiltse paraspinal approach and analyze its main advantages and limitations. Methods: Here, we provide a step-by-step description of the Wiltse approach. Utilizing PubMed and Lilacs and the Mesh terms "Wiltse approach," "paraspinal approach," "muscle sparing approach," and "lumbar spine," we identified 10 papers...
2018: Surgical Neurology International
Vinayak Narayan, Nasser Mohammed, Amey R Savardekar, Devi Prasad Patra, Anil Nanda
INTRODUCTION: Spinal tuberculosis [TB] is a common infectious disease prevalent in developing countries and a rising disaster in developed countries. The association of tuberculosis with spondylolisthesis is rarely reported in literature. The aim of our review is to analyse the clinical features and radiologic characteristics of TB spondylolisthesis along with providing a concise update on its surgical management, based on current literature. METHODS: A systematic review is performed after conducting a thorough search in the PubMed database...
March 8, 2018: World Neurosurgery
Ron N Alkalay, Robert Adamson, Michael W Groff
BACKGROUND CONTEXT: In the lumbar spine, end plate preparation for the interbody fusion cages may critically affect the cage's long term performance. This study investigated the effect of the interbody cage design on the compliance and cage subsidence of instrumented spines under cyclic compression. PURPOSE: To quantify the role of cage geometry and bone density on the stability of the spinal construct in response to cyclic compressive loads. STUDY DESIGN: Changes in the cage-bone interface and the effect of bone density on these changes were evaluated in a human cadaveric model for three intervertebral cage designs...
March 8, 2018: Spine Journal: Official Journal of the North American Spine Society
Anouar Bourghli, Safwat Abouhashem, Rami Abo Wali, Ibrahim Obeid, Louis Boissiere, Jean-Marc Vital, Mohammed Al Sarawan
PURPOSE: Gunshot injury to the spine can be devastating, and it has increased in the civilian population during the last decade. METHODS: We present the case of a 30-year-old male, who received a bullet in his back after exchange of fire with the police. Initial assessment revealed paraparesis with cerebrospinal fluid leak (CSF) from the bullet entry hole, CT scan showed metal debris with two bullet fragments in the L5/S1 right foramen and lateral recess, and another fragment in the central canal posteriorly, and also it revealed two fracture lines creating a right L5 "floating pedicle"...
March 10, 2018: European Spine Journal
Xi Chen, Liang Xu, Yong Qiu, Zhong-Hui Chen, Qing-Shuang Zhou, Song Li, Xu Sun
No abstract text is available yet for this article.
March 7, 2018: World Neurosurgery
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