Journal of spinal disorders & techniques
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J Spinal Disord Tech · Feb 2014
Use of Nanocrystalline Hydroxyapatite With Autologous BMA and Local Bone in the Lumbar Spine: A Retrospective CT Analysis of Posterolateral Fusion Results.
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). ⋯ The arthrodesis rates after instrumented lumbar fusion using local autograft mixed with BMA and the nHA is equivalent to the rates reported for iliac crest autograft in these indications, including stringent indications, such as 3-segment procedures. By approximately 12 months postoperatively, there was no significant difference in the rates of bridging bone between the 1-segment, 2-segment, and 3-segment procedures.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0.
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J Spinal Disord Tech · Feb 2014
Limited microdiscectomy for lumbar disk herniation: a retrospective long-term outcome analysis.
Surgical treatment of lumbar disk herniation is traditionally accomplished by removal of the extruded fragment as well as an aggressive decompression of the disk space. This retrospective study evaluates the long-term results of limited discectomy, otherwise known as fragmentectomy, for lumbar disk herniation using a minimally invasive technique. Although there are ample studies in literature regarding short-term outcome after limited microdiscectomy, there is a paucity of literature for long-term outcomes after fragmentectomy. We present long-term outcomes averaging 7 years after limited discectomy. ⋯ Our long-term outcome study shows that a minimally invasive approach to microdiscectomy with removal of the fragment only is an effective way to treat lumbar disk herniation. The rate of recurrence in our long-term study seems slightly higher compared with previously published studies, which generally had shorter follow-up periods. Long-term patient outcomes for back and leg pain were also very low. No appreciable difference in operative reherniation could be found with patients who had contained verses extruded fragments. It is difficult to predict from this study whether a simple fragmentectomy was the cause of the progression to further surgeries or whether this was the natural progression of a degenerative spine. Further prospective trials are necessary to fully understand the factors associated with limited microdiscectomy.
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Retrospective review of a case series. ⋯ The current study highlights the potential pitfalls in scoliosis surgery for patients with MFS. Surgery was performed using third-generation pedicle screw-based and hook-based systems for PSF and second-generation and third-generation implants for AISF. We illustrated that the treatment of scoliosis in MFS, taking into account the individual challenges of the underlying desmogenic disorder, can be performed with a moderately increased risk for surgical complications compared with adolescent idiopathic scoliosis.
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J Spinal Disord Tech · Feb 2014
Comparative StudyRadiation exposure for fluoroscopy-guided lumbosacral epidural steroid injections: comparison of the transforaminal and caudal approaches.
A retrospective investigation. ⋯ The longer the fluoroscopy time, the greater the KAP in both transforaminal and caudal ESIs. The fluoroscopy time for transforaminal ESI was longer than that for caudal ESI. However, KAP of transforaminal ESI was less than that of the caudal ESI, after being corrected for the length of fluoroscopy time.
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J Spinal Disord Tech · Feb 2014
Clinical TrialInfluence of the posterior lumbar interbody fusion on the sagittal spino-pelvic parameters in isthmic L5-S1 spondylolisthesis.
Prospective study of the sagittal spino-pelvic parameters and deformity parameters in low-grade isthmic spondylolisthesis preoperation and postoperation. ⋯ The improvement of PT may play an important role in the reconstruction of the sagittal alignment and therapeutic outcome. The restoration of the slip degree and height of the intervertebral disk would increase the LL with a wedged cage. To get a better LL, the size and geometry of the cage was recommended to be evaluated before surgical treatment.