Spine
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Subgroup analysis of a prospective, randomized database. ⋯ Lumbar fusion and instrumentation were not associated with increased rate of reoperation at index or adjacent levels compared with nonfusion techniques. The only specific risk factor for reoperation after treatment of spinal stenosis was duration of pretreatment symptoms more than 12 months. The overall incidence of reoperations for spinal stenosis surgery was 13%, and reoperations were equally distributed between index and adjacent lumbar levels. Reoperation may be related to the natural history of spinal degenerative disease.
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Multicenter Study
A replication study for association of 5 single nucleotide polymorphisms with curve progression of adolescent idiopathic scoliosis in Japanese patients.
A genetic association study of single nucleotide polymorphisms (SNPs) previously reported to be associated with curve progression of adolescent idiopathic scoliosis (AIS). ⋯ The associations of the 5 SNPs with progression of AIS curve are not definite. Large-scale association studies based on appropriate criteria for progression would be necessary to identify SNPs associated with the curve progression.
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Comparative Study
Reoperation rate after surgery for lumbar herniated intervertebral disc disease: nationwide cohort study.
Retrospective cohort study using national health insurance data. ⋯ The cumulative reoperation rate after 5 years was 13.4% and half of the reoperations occurred during the first postoperative year. With the exception of laminectomy, the reoperation rates of the other procedures were not different from that of open discectomy.
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Case Reports Comparative Study
Is radiation-free diagnostic monitoring of adolescent idiopathic scoliosis feasible using upright positional magnetic resonance imaging?
Prospective clinical trial. ⋯ Our results show that uMRI is capable of producing coronal and sagittal plane measurements that highly correlate with traditional plain film radiographical measurements. This, in addition to reliable vertebral rotation measurements, makes uMRI a valuable, radiation-free alternative/substitute for diagnostic evaluation in AIS.
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Clinical Trial
Serum titanium, niobium, and aluminum levels after instrumented spinal arthrodesis in children.
A prospective cohort study. ⋯ We report abnormally elevated serum titanium and niobium levels in patients with titanium-based spinal instrumentation up to 12 months. The long-term systemic consequences of debris generated by wear and corrosion of spinal instrumentation is unclear but concerning, particularly as these implants inserted into the pediatric population may remain in situ for beyond 6 decades.