Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jun 2014
Evaluating the affect and reversibility of opioid-induced androgen deficiency in an orthopaedic animal fracture model.
Opioid pain medications are the basis for analgesia after orthopaedic injuries and procedures. However, opioids have many adverse effects, including opioid-induced androgen deficiency. ⋯ Opioid-induced androgen deficiency occurs during the perioperative orthopaedic period. Although its clinical relevance remains unknown, further evaluation is needed to determine if supplementation is warranted during the perioperative period.
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Clin. Orthop. Relat. Res. · Jun 2014
What is the learning curve for robotic-assisted pedicle screw placement in spine surgery?
Some early studies with robotic-assisted pedicle screw implantation have suggested these systems increase accuracy of screw placement. However, the relationship between the success rate of screw placement and the learning curve of this new technique has not been evaluated. ⋯ Level III, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Jun 2014
Biography Historical ArticleObituary: John Phillip Nelson MD (1936-2013).
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Clin. Orthop. Relat. Res. · Jun 2014
ReviewComparative outcomes of minimally invasive surgery for posterior lumbar fusion: a systematic review.
Although minimally invasive surgical (MIS) approaches to the lumbar spine for posterior fusion are increasingly being utilized, the comparative outcomes of MIS and open posterior lumbar fusion remain unclear. ⋯ Current evidence examining MIS versus open TLIF/PLIF is of low to very low quality and therefore highly biased. Results of this systematic review suggest equipoise in surgical and clinical outcomes with equivalent rates of intraoperative surgical complications and perhaps a slight decrease in perioperative medical complications. However, the quality of the current literature precludes firm conclusions regarding the comparative effectiveness of MIS versus open posterior lumbar fusion from being drawn and further higher-quality studies are critically required.