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Lumbar spine fusion

H Bahadir Gokcen, Cagatay Ozturk
BACKGROUND: Achondroplasia, a genetic disorder of bone growth, produces specific clinical features of the extremities and spine. Spinal stenosis, seen in patients with achondroplasia, is a congenital disorder related to premature fusion of the pedicles to the lamina. It can be caused by ossification of the ligamentum flavum, which is rare in patients with achondroplasia. CASE PRESENTATION: We report a rare congenital spinal stenosis with ossification of the ligamentum flavum and thoracolumbar kyphosis deformity in a 24-year-old man with dwarfism and achondroplasia...
March 12, 2019: World Neurosurgery
Jianyu Hu, Yunsheng Ou, Yong Zhu, Wei Luo, Zenghui Zhao, Xing Du, Jianxiao Li
Objective: To explore the effectiveness of nano-hydroxyapatite/polyamide-66 (n-HA/PA66) Cage in interbody fusion for degenerative lumbar scoliosis. Methods: A retrospective analysis was designed and conducted for 43 patients, who underwent posterior decompression and n-HA/PA66 Cage interbody fusion with correction of deformity between January 2013 and June 2016. Eighteen cases were single-level fusion (single-level group) and 25 cases were double-level fusion (double-level group)...
March 1, 2019: Chinese Journal of Reparative and Reconstructive Surgery
Tao Liu, Shuiqiang Qiu, Zhigang Xu, Jisheng Gu, Qiang Chen, Zhendong Luo, Desheng Wu
Objective: To explore the effect on sagittal spine-pelvis balance of different fusion segments in anterior cervical discectomy and fusion (ACDF). Methods: The clinical data of 326 patients with cervical spondylotic myelopathy, treated by ACDF between January 2010 and December 2016, was retrospectively analysed. There were 175 males and 151 females with an average age of 56 years (range, 34-81 years). Fusion segments included single segment in 69 cases, double segments in 85 cases, three segments in 90 cases, and four segments in 82 cases...
March 1, 2019: Chinese Journal of Reparative and Reconstructive Surgery
Jared C Reese, Spencer Twitchell, Herschel Wilde, Mohammed A Azab, Jian Guan, Michael Karsy, William T Couldwell
BACKGROUND: Healthcare costs comprise a substantial portion of total national expenditure. Although cost-effectiveness analysis in neurosurgery has recently become popular, there has been little cross-comparison of neurosurgical procedures. Our objective was to compare costs across elective neurosurgical procedures to understand whether drivers of cost differ. METHODS: The Value Driven Outcome (VDO) database was used to evaluate treatment costs for resection of vestibular schwannoma, intracranial meningioma, gliomas, and pituitary adenoma; anterior cervical discectomy and fusion (ACDF) and lumbar spinal fusion; and aneurysm treatment...
March 11, 2019: World Neurosurgery
Mustfa Manzur, Sohrab S Virk, Bridget Jivanelli, Avani Vaishnav, Steven McAnany, Todd J Albert, Sravisht Iyer, Catherine Himo Gang, Sheeraz Qureshi
BACKGROUND: Anterior lumbar interbody fusion (ALIF) has been used for treatment of a variety of spinal conditions including degenerative disc disorders and low-grade spondylolisthesis. Expected fusion rate of stand-alone ALIF constructs is currently unclear. The aim of this study was to examine the fusion rate for anterior lumbar interbody fusion without supplemental posterior fusion or instrumentation (stand-alone ALIF). METHODS: We queried the MEDLINE, COCHRANE, and EMBASE databases for all literature related to spine fusion rates using a stand-alone ALIF procedure with a publication cutoff date of July 19, 2018...
March 11, 2019: Spine Journal: Official Journal of the North American Spine Society
Arjun S Sebastian, Nathan R Wanderman, Bradford L Currier, Mark A Pichelmann, Vickie M Treder, Jeremy L Fogelson, Michelle J Clarke, Ahmad N Nassr
Study Design: Prospective observational cohort study. Purpose: This study aims to evaluate the safety and efficacy of bone morphogenetic protein-2 (BMP-2) in transforaminal lumbar interbody fusion (TLIF) with regard to postoperative radiculitis. Overview of Literature: Bone morphogenetic protein (BMP) is being used increasingly as an alternative to iliac crest autograft in spinal arthrodesis. Recently, the use of BMP in TLIF has been examined, but concerns exist that the placement of BMP close to the nerve roots may cause postoperative radiculitis...
March 15, 2019: Asian Spine Journal
Zhengkuan Xu, Fangcai Li, Gang Chen, Qixin Chen
OBJECTIVE: To determine the feasibility of minimally invasive surgery (MIS) for severe adult spinal deformities and propose a re-assessment system and minimally invasive staged surgical strategy. METHODS: We operated on 53 patients from June 2016 to August 2017 using a re-assessment system and a staged surgical strategy with minimally invasive techniques in minimally invasive spinal deformity surgery (MISDEF) class III; patients with scoliotic apex vertebrae above L1-2 or spontaneous fusion of the facet joints were excluded...
March 9, 2019: World Neurosurgery
Min-Yung Chang, Yung Park, Joong Won Ha, Ho-Yeol Zhang, Sang Hoon Lee, Taek-Ho Hong, Seung Hyun Lee
OBJECTIVE: The purpose of this study was to compare paraspinal muscle mass between patients with and without adjacent segment disease (ASD) after lumbar fusion. MATERIALS AND METHODS: Fifty patients with ASD (mean age, 61.4 years; ratio of male to female patients: 13:37; mean body mass index [BMI; weight in kilograms divided by the square of height in meters], 25.1) were matched to 50 control patients on the basis of age, sex, BMI, and fusion segment. The total cross-sectional area (CSA) and functional CSA (FCSA; i...
March 12, 2019: AJR. American Journal of Roentgenology
Hongqi Zhang, Qiang Guo, Shaohua Liu, Chaofeng Guo, Qile Gao, Mingxing Tang
The anterior and middle columns instead of the posterior column of spine are usually destroyed by tuberculosis which could aggravate the kyphosis accompanying the growth imbalance of spine in children. The surgical method needs to be selected cautiously for effective treatment. To our knowledge, few studies have evaluated mid-term outcomes of 2 surgeries (posterior-only approach and combined posterior and anterior approaches) with allograft or shaped titanium mesh cages for the treatment of lumbar tuberculosis in children...
March 2019: Medicine (Baltimore)
Deeptee Jain, Paramjit Singh, Mayur Kardile, Sigurd H Berven
PURPOSE: To develop a model to predict 30-day readmission rates in elective 1-2 level posterior lumbar spine fusion (PSF) patients. METHODS: In this retrospective case control study, patients were identified in the State Inpatient Database using ICD-9 codes. Data were queried for 30-day readmission, as well as demographic and surgical data. Patients were randomly assigned to either the derivation or the validation cohort. Stepwise multivariate analysis was conducted on the derivation cohort to predict 30-day readmission...
March 9, 2019: European Spine Journal
Stacey M Cornelson, Edward D Johnnie, Norman W Kettner
Objective: This case report describes the clinical features, complications, imaging characteristics, and management of postoperative spinal adhesive arachnoiditis. Clinical Features: A 54-year-old woman presented with right posterior thigh and leg pain after a lumbar spine fusion surgery to correct a degenerative spondylolisthesis of L3/4. Her pain was sharp and shooting and worsened with knee extension. A lumbar computed tomography myelogram demonstrated clumping and adhesion of the nerve rootlets in the cauda equina at the surgical fusion levels...
December 2018: Journal of Chiropractic Medicine
Zachary B Adkins, Azeem T Malik, Nikhil Jain, Elizabeth Yu, Jeffery Kim, Safdar N Khan
STUDY DESIGN: Systematic review. OBJECTIVE: To assess the impact of hospital volume on postoperative outcomes in spine surgery. SUMMARY OF BACKGROUND DATA: Several strategies have recently been proposed to optimize provider outcomes, such as regionalization to higher volume centers and setting volume benchmarks. MATERIALS AND METHODS: We performed a systematic review examining the association between hospital volume and spine surgery outcomes...
February 11, 2019: Clinical Spine Surgery
Dae-Jung Choi, Ju-Eun Kim
Background: Biportal endoscopic spine surgery (BESS) is a recent addition to minimally invasive spine surgery treatments. It boasts excellent magnification and fine discrimination of neural structures. Selective decompression with preservation of facet joints for structural stability is also feasible owing to access to the spinal canal and foramen deeper inside. This study has a purpose to investigate clinical benefits of BESS for spinal stenosis in comparison to the other common surgical treatments such as microscopic decompression-only (DO) and fusion and instrumentation (FI)...
March 2019: Clinics in Orthopedic Surgery
Chia-Wei Chang, Tsai-Sheng Fu, Wen-Jer Chen, Chien-Wen Chen, Po-Liang Lai, Shih-Hao Chen
BACKGROUND: Postoperative infection rates for transforaminal lumbar interbody fusion (TLIF) range from <2% to 4 %; however, there is no consensus on treatment strategies. TLIF cages preservation or revision surgery for lumbar spine reconstruction are two possible treatments. This study aimed to determine the most effective method for organ/space infection (O/SI) control. METHODS: In total, 4,923 patients who underwent TLIF with cages and posterior pedicle-screw instrumentation for spondylolytic or degenerative spondylolisthesis from January 2008 to December 2015 were retrospectively analyzed...
February 26, 2019: World Neurosurgery
Arjun Sebastian, Anshit Goyal, Mohammed Ali Alvi, Waseem Wahood, Mohamed Elminawy, Elizabeth B Habermann, Mohamad Bydon
INTRODUCTION: The American College of Surgeons-National Surgical Quality Improvement Program(ACS-NSQIP) Surgical Risk Calculator(SRC) was a tool developed to use 21 individual patient characteristics to make predictions for occurrence of 13 general and 2 procedure-specific outcomes. The goal of this study was to evaluate the performance of the SRC in predicting outcomes in patients receiving posterior lumbar fusion. METHODS: The ACS-NSQIP Participant Use File for 2015 was queried for patients with age≥18 undergoing single level posterior lumbar fusion(PLF) surgery...
February 26, 2019: World Neurosurgery
Chang Hwa Hong, Ki Jin Jung, Jae Wan Soh, Sung Hun Won, Si John Hong, Chang Hyun Kim, Hong Seop Lee, Soon Do Wang, Won Seok Lee, Woo Jong Kim
RATIONALE: Degenerative spondylolisthesis is defined as forward slippage of a vertebra with respect to the underlying vertebra and is associated with the induction of lumbar canal stenosis. The use of anterior column support for degenerative lumbar conditions has been well documented. Direct lateral interbody fusion (DLIF) gains access via a lateral approach through the retroperitoneal fat and psoas muscle. It avoids many of the access-related complications yet comes with its own risks and limitations...
February 2019: Medicine (Baltimore)
Darryl C Whitney, Stephen J Ives, Garrett R Leonard, Douglas J VanderBrook, James P Lawrence
INTRODUCTION: Orthopaedic surgery can be a physically demanding occupation with high rates of fatigue and burnout. Fatigue has been shown to affect surgeon performance with higher rates of errors in fatigued surgeons. The metabolic cost of performing surgery has yet to be quantified. A better understanding of these costs may provide insights into surgeon fatigue and its effect on patient safety. METHODS: Eight subjects performed a one-level lumbar laminectomy and fusion on cadavers...
February 22, 2019: Journal of the American Academy of Orthopaedic Surgeons
Abhishek Kumar, Robert K Merrill, Samuel C Overley, Dante M Leven, Joshua J Meaike, Avani Vaishnav, Catherine Gang, Sheeraz A Qureshi
Background: Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) has comparable fusion rates and outcomes to the open approach, though many surgeons avoid the technique due to an initial learning curve. No current studies have examined the learning curve of MI-TLIF with respect to fluoroscopy time and exposure. Our objective with this retrospective review was to therefore use a repeatable mathematical model to evaluate the learning curve of MI-TLIF with a focus on fluoroscopy time and exposure...
January 2019: International Journal of Spine Surgery
Michael P Kelly, Jon D Lurie, Elizabeth L Yanik, Christopher I Shaffrey, Christine R Baldus, Oheneba Boachie-Adjei, Jacob M Buchowski, Leah Y Carreon, Charles H Crawford, Charles Edwards, Thomas J Errico, Steven D Glassman, Munish C Gupta, Lawrence G Lenke, Stephen J Lewis, Han Jo Kim, Tyler Koski, Stefan Parent, Frank J Schwab, Justin S Smith, Lukas P Zebala, Keith H Bridwell
BACKGROUND: The effectiveness of operative compared with nonoperative treatment at initial presentation (no prior fusion) for adult lumbar scoliosis has not, to our knowledge, been evaluated in controlled trials. The goals of this study were to evaluate the effects of operative and nonoperative treatment and to assess the benefits of these treatments to help treating physicians determine whether patients are better managed operatively or nonoperatively. METHODS: Patients with adult symptomatic lumbar scoliosis (aged 40 to 80 years, with a coronal Cobb angle measurement of ≥30° and an Oswestry Disability Index [ODI] score of ≥20 or Scoliosis Research Society [SRS]-22 score of ≤4...
February 20, 2019: Journal of Bone and Joint Surgery. American Volume
Jussi P Repo, Arja H Häkkinen, Tuukka Porkka, Keijo Häkkinen, Hannu Kautiainen, Kati Kyrölä, Marko H Neva
PURPOSE: Interleukin 6 (IL-6) and the acute phase C-reactive protein (CRP) blood concentrations after lumbar spine fusion may be affected by age. The purpose of this prospective observational study was to assess postoperative serum levels of pro-inflammatory IL-6 and CRP after instrumented lumbar spine fusion surgery. We hypothesized that older patients would have increased levels of IL-6 and CRP after surgery. METHODS: IL-6 and high-sensitive CRP biochemical marker levels were measured before instrumented spinal fusion, and postoperatively at 1 and 3 days, 6 weeks, and 3 months...
January 2019: Journal of Orthopaedic Surgery
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