European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Pedicle subtraction osteotomy (PSO) has a complication rate noticeably higher than other corrective surgical techniques used for the treatment of spinal sagittal imbalance. In particular, rod breakage and pseudoarthrosis remain burning issues of this technique. Goal of this study was to investigate the biomechanical performance of several hardware constructs. ⋯ The bilateral double parallel rods configuration resulted the best to reduce the stresses on the spinal fixators at the osteotomy site. However, the high loads acting on the rods with respect to the physiologic condition could slow down the bone healing at the osteotomy site.
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Lateral lumbar disc prosthesis (LLDP) is an innovative device used to restore motion in select patients through a lateral retroperitoneal approach. No in vitro biomechanical studies have been published. Further, the potential for in toto circumferential joint restoration when use of this anterior disc is combined with facet replacement remains unqualified but signifies a potentially interesting clinical direction. ⋯ After bilateral facetectomy, reconstruction of the three-joint complex achieved by combining the LLDP with BFJR may provide a viable alternative to current clinical treatment regimens.
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Randomized Controlled Trial Comparative Study
The effect of short (2-weeks) versus long (6-weeks) post-operative restrictions following lumbar discectomy: a prospective randomized control trial.
We sought to evaluate how short (2-week) versus long (6-week) post-operative restrictions following lumbar discectomy impacted outcomes and reherniation rates for a period up to 1 year following surgery. ⋯ The results of this randomized trial suggest equivalent clinical outcomes irrespective of the length of post-operative restriction. From a clinical perspective, if patients are deemed at low risk for a reherniation event they may be confidence that early return to activity at 2 weeks will not compromise outcomes and may not adversely impact the risk of reherniation. Level of Evidence II.
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Randomized Controlled Trial
Is a drain tube necessary for minimally invasive lumbar spine fusion surgery?
This study aimed to evaluate if closed suction wound drainage is necessary in minimally invasive surgery of transforaminal lumbar interbody fusion (MIS TLIF). ⋯ A drain tube can lead to pain, anxiety and discomfort during the postoperative period. We conclude that drain tubes are not necessary for MIS TLIF. Patients without drains had the benefit of earlier ambulation than those with drains.
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Randomized Controlled Trial
Addition of TLIF does not improve outcome over standard posterior instrumented fusion. 5-10 years long-term Follow-up: results from a RCT.
The use of inter-body device in lumbar fusions has been difficult to validate, only few long-term RCT are available. ⋯ In a long-term perspective, patients with TLIF's did not experience better outcome scores.