Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jun 2014
Comparative StudyNationwide Inpatient Sample and National Surgical Quality Improvement Program give different results in hip fracture studies.
National databases are being used with increasing frequency to conduct orthopaedic research. However, there are important differences in these databases, which could result in different answers to similar questions; this important potential limitation pertaining to database research in orthopaedic surgery has not been adequately explored. ⋯ Level II, prognostic study. See the Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Jun 2014
ReviewMinimally invasive surgical techniques in adult degenerative spinal deformity: a systematic review.
Minimally invasive surgery (MIS) approaches have the potential to reduce procedure-related morbidity when compared with traditional approaches. However, the magnitude of radiographic correction and degree of clinical improvement with MIS techniques for adult spinal deformity remain undefined. ⋯ The literature on these techniques is scanty; only two of the 13 studies that met inclusion criteria were considered high quality; CT scans were not generally used to evaluate fusion, deformity correction was inconsistent, and complication rates were high. Future directions for analysis must include comparative trials, longer-term followup, and consistent use of CT scans to assess for fusion to determine the role of MIS techniques for adult spinal deformity.
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Clin. Orthop. Relat. Res. · Jun 2014
ReviewComplications associated with the initial learning curve of minimally invasive spine surgery: a systematic review.
There is an inherently difficult learning curve associated with minimally invasive surgical (MIS) approaches to spinal decompression and fusion. The association between complication rate and the learning curve remains unclear. ⋯ The quantitative assessment of the procedural learning curve for MIS techniques for the spine remains challenging because the MIS techniques have different learning curves and because they have not been assessed in a consistent manner across studies. Complication rates may be underestimated by the studies we identified because surgeons tend to select patients carefully during the early learning curve period. The field of MIS would benefit from a standardization of study design and collected parameters in future learning curve investigations.
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Clin. Orthop. Relat. Res. · Jun 2014
Comparative StudyDoes minimally invasive surgery have a lower risk of surgical site infections compared with open spinal surgery?
Surgical site infection (SSI) ranges from 1.9% to 5.5% in most large series. Minimally invasive surgery (MIS) has been postulated to reduce SSI rates. ⋯ Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Jun 2014
Comparative Study Observational StudyElderly patients have similar outcomes compared to younger patients after minimally invasive surgery for spinal stenosis.
Older patients undergo surgery for lumbar spinal stenosis in great numbers, but as a result of substantial diagnostic and surgical heterogeneity, the impact of age on results after surgery is poorly defined. ⋯ Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.