Spine
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A posterolateral lumbar fusion model in rats. ⋯ Alendronate inhibits spine fusion in rats. Fusion masses in alendronate-treated animals appeared radiographically larger and denser than those in control animals despite lower fusion rates. Quantitative histomorphometry confirmed that alendronate inhibited bone graft resorption and incorporation. We recommend that patients undergoing spine arthrodesis should not take alendronate until fusion is achieved.
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Randomized Controlled Trial
A prospective, randomized, double-blind study evaluating the efficacy of postoperative continuous local anesthetic infusion at the iliac crest bone graft site after spinal arthrodesis.
Parallel design, prospective, double-blind, randomized, controlled trial composed of two independent groups treated with a continuous infusion catheter (saline vs. Marcaine) placed into the iliac crest bone graft (ICBG) site. ⋯ Continuous infusion of 0.5% Marcaine at the ICBG harvest site reduced postoperative parenteral narcotic usage by 50% and decreased overall pain scores. No complications were attributed to the infusion-catheter system. The use of continuous local anesthetic infusion at the iliac crest may help in alleviating acute graft-related pain, hastening patient recovery and improving short-term satisfaction.
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Literature review. ⋯ Physician recommendations for work and activity have important health and financial implications. Systemic, multidimensional approaches are necessary to improve performance.
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Prospective study of patients with lumbar disc herniations who were operated on with a full-endoscopic uniportal transforaminal approach using an extreme lateral access. ⋯ The technique presented is an adequate and safe alternative to conventional procedures, and has the advantages of a truly minimally invasive procedure. The extreme lateral access is required for the indications described. There are clear limitations outside these indications. The possibility of selecting an access from posterolateral to extreme lateral now enables surgery of lumbar disc herniations inside and outside the spinal canal.
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A biomechanical study on a pneumatically controlled 7-axis spine simulator using Delron and human cadaveric spine models. ⋯ This extension plate appears to be biomechanically equivalent to the ABC cervical plates with which it was compared in this study.