Spine
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Retrospective radiological study. ⋯ Our study showed that the orthogonal cage rotation in OLIF achieved adequate lateral cage placement. Although accurate cage rotation can be limited at the lower lumbar segments, radiological outcomes were not affected by cage obliquity.
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Retrospective cohort study. ⋯ A clear understanding that on-label BMP use is specific to single-level, anterior or anterolateral approaches between L2-S1 with vendor-specific cages is crucial for mitigating malpractice disputes. Though off-label use of BMP may incite litigation, the findings suggest court rulings are favorable for defendants as zero cases, resulting in plaintiff verdicts. Nevertheless, surgeons should balance the potential benefits of off-label use of BMP with the increased risk of litigation, and it may be advisable to disclose the use of BMP, whether on-label or off-label, in the informed consent.
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Retrospective chart review. ⋯ Patient sex and proximal LL can serve as early indicators of the size of the femoral nerve safe zone during a transpsoas LLIF approach at L4-L5.
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Finite element analysis based on computed tomography images from the lumbar spine. ⋯ Removal and reposition increased the pullout strength at 20% and 40% overlap, but decreased the pullout strength at 60% and 80% overlap. For clinical translation, we recommend removal and reposition of the screw when the overlap is in the range of 20% to 40% or less. In vitro specimen studies are needed to verify these preliminary findings.