Spine
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Randomized Controlled Trial Clinical Trial
One versus two BAK fusion cages in posterior lumbar interbody fusion to L4-L5 degenerative spondylolisthesis: a randomized, controlled prospective study in 25 patients with minimum two-year follow-up.
We accomplish posterior lumbar interbody fusion using posterolateral insertion of a single BAK fusion cage (Sulzer Spine-Tech, Minneapolis, MN) with unilateral facetectomy and hemilaminectomy. ⋯ Posterior lumbar interbody fusion using diagonal insertion of a single threaded cage by a posterior approach with unilateral facetectomy enables sufficient decompression and solid interbody arthrodesis to be achieved while maintaining a majority of the posterior elements. It is a clinically safe, easy, and economic technique to treat lumbar degenerative spondylolisthesis.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Use of recombinant human bone morphogenetic protein-2 to achieve posterolateral lumbar spine fusion in humans: a prospective, randomized clinical pilot trial: 2002 Volvo Award in clinical studies.
A prospective randomized clinical study was conducted. ⋯ Consistently, rhBMP-2 with the biphasic calcium phosphate granules induced radiographic posterolateral lumbar spine fusion with or without internal fixation in patients whose spondylolisthesis did not exceed Grade 1. Statistically greater and quicker improvement in patient-derived clinical outcome was measured in the rhBMP-2 groups.
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Randomized Controlled Trial Comparative Study Clinical Trial
Circumferential lumbar spinal fusion with Brantigan cage versus posterolateral fusion with titanium Cotrel-Dubousset instrumentation: a prospective, randomized clinical study of 146 patients.
A prospective randomized clinical study with a 2-year follow-up period was conducted. ⋯ Circumferential lumbar fusion restored lordosis, provided a higher union rate with significantly fewer repeat operations, showed a tendency toward better functional outcome, and resulted in less peak back pain and leg pain than instrumented posterolateral fusion. The clinical perspective of the current study implies a recommendation to favor circumferential fusion as a definitive surgical procedure in complex lumbar pathology involving major instability, flatback, and previous disc surgery in younger patients, as compared with posterolateral fusion with pedicle screws alone.