Journal of spinal disorders & techniques
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J Spinal Disord Tech · Jun 2010
The relationship of intrapsoas nerves during a transpsoas approach to the lumbar spine: anatomic study.
A cadaveric study. ⋯ This study suggests that the intrapsoas nerves are a safe distance from the radiographic center of the intervertebral disc in a majority of cases; however, anatomic variations in the location of these nerves place them at injury risk in a small number of cases. These results suggest that neural monitoring whereas traversing the psoas may be important to enhance the safety of the transpsoas approach. Care is particularly warranted at the L4-5 level.
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J Spinal Disord Tech · Jun 2010
Analysis of the relationship between facet joint angle orientation and lumbar spine canal diameter with respect to the kinematics of the lumbar spinal unit.
Retrospective cross-sectional study. ⋯ We demonstrated the relationship among facet orientation, osseous canal diameter, kinematics of a spinal unit, and change in lumbar spine canal diameter. Patients with sagittally oriented facets had narrow osseous canals with mobility, whereas those with coronally oriented facets had stable and wider osseous canals. This finding is helpful in understanding the mechanism underlying lumbar spinal canal stenosis and degenerative spondylolisthesis.
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J Spinal Disord Tech · Jun 2010
Implant removal for the management of infection after instrumented spinal fusion.
We operated on 21 patients with a postoperative deep wound infection. All the patients underwent implant removal and wide debridement. One patient lost to follow-up was excluded. ⋯ Our results indicate that implant removal and wide debridement for postoperative infection after posterior instrumented spine fusion can provide satisfactory results and could be one treatment option. However, the collapse of the disc space, loss of normal lordosis, and pseudoarthrosis are inevitable in patients with early postoperative infection.
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J Spinal Disord Tech · Jun 2010
Randomized Controlled Trial Comparative StudyMicrodecompressive laminatomy with a 5-year follow-up period for severe lumbar spinal stenosis.
The 2 groups of patients with severe lumbar spinal stenosis were prospectively compared as a case control study. ⋯ Compared with classic approaches, bilateral MDL provides adequate and safe decompression in lumbar spinal stenosis. It significantly reduces clinical symptoms and disability. However, TL shows higher perioperative complications and postoperative instability. To the best of our knowledge, this is the first study to define a bilateral MDL approach to treat the stenotic lumbar spine without a herniated disc.
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J Spinal Disord Tech · Jun 2010
Radiostereometric analysis of postoperative motion after application of dynesys dynamic posterior stabilization system for treatment of degenerative spondylolisthesis.
Prospective case series ⋯ The Dynesys dynamic instrumentation system seems to stabilize degenerative spondylolisthesis. As expected in the degenerative lumbar spine, the segmental motion of the implanted level in this study was limited and considerably less than normal spinal motion.