Journal of neurosurgery. Spine
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Clinical Trial
Safety of transforaminal lumbar interbody fusion and intervertebral recombinant human bone morphogenetic protein-2.
Recombinant human bone morphogenetic protein-2 (rhBMP-2) is being increasingly used for spinal fusion. There are few data regarding its clinical safety, effectiveness, and clinical outcome when applied on an absorbable collagen sponge (ACS) in conjunction with allograft for transforaminal lumbar interbody fusion (TLIF). ⋯ Analysis of the results demonstrated that TLIF combined with a BMP-2-soaked ACS is a feasible, effective, and safe method to promote lumbar fusion. There were no significant intergroup differences in clinical outcome between patients who underwent open compared with minimally invasive procedures. Patient satisfaction rates, however, were higher in the minimally invasive procedure group. The efficacy of BMP-2 was not dependent on which approach was used or the number of spinal levels that were treated.
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Clinical Trial
Computerized tomography-guided kryorhizotomy in 76 patients with lumbar facet joint syndrome.
The authors prospectively evaluated the therapeutic effect of computerized tomography (CT)-guided kryorhizotomy in the treatment of patients with lumbar facet joint syndrome (LFJS) and assessed prognostic factors that predict this effect. ⋯ Computerized tomography-guided kryorhizotomy is a minimally invasive and repeatable treatment that yields good long-term results in patients with LFJS.
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Clinical Trial
Assessment of adjacent-segment disease in patients treated with cervical fusion or arthroplasty: a prospective 2-year study.
The authors compared the incidence of radiologically documented changes and symptomatic adjacent-level cervical disc disease after single-level discectomy and subsequent cervical fusion or arthroplasty in two independent prospective clinical studies. ⋯ In comparing these prospective studies the authors demonstrated that maintaining motion rather than fusion will prevent symptomatic adjacent-disc disease and will decrease adjacent-level radiological indicators of disease at a 24-month postoperative interval.
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The purpose of this clinical study was to evaluate prospectively surgical and neurological outcomes after endoscopic thoracic disc surgery. ⋯ Thoracoscopic discectomy can be used to achieve acceptable results. It has several distinct advantages such as reduced postoperative pain, morbidity, and LOS compared with traditional open procedures.
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Case Reports
Spinal pelvic reconstruction after total sacrectomy for en bloc resection of a giant sacral chordoma. Technical note.
Although radical resection prolongs the disease-free survival period, surgical management of primary sacral tumors is challenging because of their location and often large size. Moreover, in cases of lesions for which a radical resection necessitates total sacrectomy, reconstruction is required. ⋯ In the present report the authors present the case of a patient who underwent spinal pelvic reconstruction after a total sacrectomy was performed to remove a giant sacral chordoma. They describe a novel spinal pelvic reconstruction technique that addresses some of the biomechanical limitations.