Spine
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Retrospective outcome measurement after circumferential reconstructive surgery with lumbar fusion in patients with chronic discogenic low back pain. ⋯ When using strict patient selection criteria that include independent determination of pain generators via pressure-controlled diskography and completion of a preoperative conditioning program for improving general health status, the number of levels in reconstructive lumbar surgery may not significantly impact overall clinical outcome.
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Comparative Study
Analysis of operative complications in a series of 471 anterior lumbar interbody fusion procedures.
This retrospective review compares the intraoperative and perioperative complications associated with the placement of threaded devices and nonthreaded devices used in anterior lumbar interbody fusions. ⋯ Placement of threaded devices, such as cages or bone dowels, was associated with a higher acute complication rate than was the placement of nonthreaded devices during anterior lumbar interbody fusion.
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A retrospective clinical study with a follow-up of more than 4 years was conducted. ⋯ All the intervertebral bone fusion after PLIF occurred inside the cages and in the posterior intervertebral space. We suggest the complete removal of discmaterial and deep insertion of the cages to create sufficient posterior intervertebral space for bone growth. PLIF using cages impacted with laminar bone chips is a useful method when considering the time required for surgery and the morbidity of the autograft donor sites.
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A prospective single arm cohort. OBJECTIVE.: To study the results of distraction reduction of high-grade isthmic dysplastic spondylolisthesis with posterior lumbar interbody fusion and posterior compression in a consecutive, prospectively collected series of adolescent patients. ⋯ The index procedure provided near-anatomic correction of high-grade spondylolisthesis, which is maintained at a minimum 2-year follow-up without significant complications. There were two structural complications. Anterior column structural support and posterior compressive instrumentation help restore the necessary biomechanics to allow clinical fusion and success. This series has led the senior author to evolve his technique too ften include caudad fixation to the pelvis and/or cephalad fixation to L4.
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Mechanical testing of cadaveric motion segments. ⋯ IDET has a significant but inconsistent effect on compressive stresses within intervertebral discs. These results may partly explain the variable clinical success of IDET.