Journal of spinal disorders & techniques
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J Spinal Disord Tech · Feb 2005
Randomized Controlled Trial Multicenter Study Clinical TrialIliac crest bone graft donor site pain after anterior lumbar interbody fusion: a prospective patient satisfaction outcome assessment.
Autogenous iliac crest bone is the gold-standard graft for spinal fusion surgery. Unfortunately, there is a frequent incidence of graft site pain that persists well into the postoperative period with complication rates reported in 2.8-39% of patients. Persistent pain lasting at least 2 years is reported in 15-39% of patients. ⋯ Persistent donor site pain remains a problem with harvest of autogenous iliac crest bone graft for spinal fusion. This prospective study, the first such study reported for ALIF, confirms that donor site pain remains a significant postoperative management problem.
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J Spinal Disord Tech · Feb 2005
Randomized Controlled Trial Comparative Study Clinical TrialAnterior versus posterior treatment of stable thoracolumbar burst fractures without neurologic deficit: a prospective, randomized study.
A prospective randomized study was conducted to determine whether there exist any differences in radiographic, clinical, or functional outcomes when individuals with stable burst fractures of the thoracolumbar junction without neurologic deficit are treated with either a posterior fusion with instrumentation or anterior reconstruction, fusion, and instrumentation. There exists relatively little literature evaluating the outcomes of individuals treated with anterior surgery, and no prospective randomized studies exist comparing the two treatment approaches. ⋯ Although patient outcomes are similar, anterior fusion and instrumentation for thoracolumbar burst fractures may present fewer complications or additional surgeries.
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J Spinal Disord Tech · Feb 2005
Clinical TrialDirect repair of spondylolysis using a new pedicle screw hook fixation: clinical and CT-assessed study: an analysis of 19 patients.
A prospective analysis of 19 consecutive cases of spondylolysis repair using a new hook screw device is presented. The objective of the study was to assess the clinical, radiologic, and computed tomography (CT) scan outcomes to establish the indications of isthmic repair in the treatment of spondylolysis. ⋯ Twelve of 13 patients who were 20 years or younger at the time of the study (average age 17.2 years) had fusion (92%), whereas in the group of 6 patients age 21 and older (average age 27.5 years), no cases of fusion were observed. Clinical outcome was excellent to good in 15 patients, fair in 3 cases, and poor in 1. The group of patients age 20 or younger had significantly better clinical results (84% excellent or good) (P = 0.00097) than those obtained in the group of patients age 21 and older (66% excellent or good) (P = 0.016). According to the current findings, the authors believe that segmental pedicle screw hook fixation is a useful alternative in the treatment of spondylolysis in adolescents but do not recommend this procedure in patients over age 20.
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J Spinal Disord Tech · Feb 2005
Comparative StudyRadiofrequency heating of painful annular disruptions: one-year outcomes.
Although several studies have reported on outcomes following heating of annular tears with a thermoresistive catheter (SpineCATH), no data are available on the efficacy of thermal treatment with a flexible radiofrequency electrode (discTRODE). A prospective case-control study was conducted to determine the efficacy of radiofrequency heating of painful annular tears in the lumbar spine. ⋯ Radiofrequency heating of annular tears can lead to an improvement in the pain of internal disc disruption. The improvement gained by this treatment method is significantly better than that obtained from conservative management.
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J Spinal Disord Tech · Feb 2005
Clinical TrialMinimally invasive transforaminal lumbar interbody fusion (TLIF): technical feasibility and initial results.
Forty-nine patients underwent minimally invasive transforaminal lumbar interbody fusion (TLIF) from October 2001 to August 2002 (minimum 18-month follow-up). The diagnosis was degenerative disc disease with herniated nucleus pulposus (HNP) in 26, spondylolisthesis in 22, and a Chance-type seatbelt fracture in 1. The majority of cases (n = 45) were at L4-L5 or L5-S1. ⋯ Improvements in average Visual Analogue Pain Scale and Oswestry Disability Index (preoperative to last follow-up) scores were 7.2-2.1 and 46-14, respectively. At last follow-up, all patients had solid fusions by radiographic criteria. Results of this study indicate that minimally invasive TLIF is feasible and offers several potential advantages over traditional open techniques.