Spine
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An anatomic and biomechanical bench-top basic scientific comparative analysis to determine the appropriateness of total disc replacement (TDR) in a lumbar spine with scoliotic tendencies. ⋯ The neutral zone of the intact cervical spine was restored even using an unconstrained cervical TDR. The greater inherent rotational constraints of the cervical spine make it more amenable to stable multilevel arthroplasty compared with the lumbar spine.
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Biomechanical analysis and retrospective chart review. ⋯ The advantages of cobalt chromium alloy wire over steel wire include greater tensile strength and titanium compatibility. Cobalt chromium alloy solid wires may be used as sublaminar implants with titanium spinal instrumentation with excellent clinical results.
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Randomized Controlled Trial Multicenter Study
Evaluation of surgical volume and the early experience with lumbar total disc replacement as part of the investigational device exemption study of the Charité Artificial Disc.
A prospective, randomized, multicenter, Food and Drug Administration regulated Investigational Device Exemption (IDE) clinical trial. ⋯ Surgeons and institutions with a high volume of lumbar total disc replacement cases have a reduction in key perioperative and postoperative parameters that provide a clinical and/or economic benefit. Surgeons may expect longer hospital stays, higher blood loss, and a higher rate of certain complications in their early experience with total disc replacement procedures, but there was no effect on clinical outcomes.
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Randomized Controlled Trial
Effects of perioperatively administered bupivacaine and bupivacaine-methylprednisolone on pain after lumbar discectomy.
A prospective, randomized, controlled trial that compared the efficacy of different protocols of local tissue infiltration with bupivacaine or bupivacaine-methylprednisolone at the surgical site for pain relief after lumbar discectomy. ⋯ In addition, our data suggest that preemptive infiltration of the wound site with bupivacaine alone provides similar pain control to preemptive infiltration of the wound site with bupivacaine and methylprednisolone combined.
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Multicenter Study Clinical Trial
Balloon kyphoplasty for symptomatic vertebral body compression fractures results in rapid, significant, and sustained improvements in back pain, function, and quality of life for elderly patients.
Prospective, single-arm interventional cohort. ⋯ Elderly patients with symptomatic VCFs had rapid, significant, and sustained improvements in back pain, back function, and quality of life following balloon kyphoplasty.