Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jun 2014
ReviewMinimally invasive versus open posterior lumbar interbody fusion: a systematic review.
Although conventional open posterior lumbar interbody fusion (open PLIF) is efficacious in management of lumbar spinal instability, concerns exist regarding lengthy hospital stays, blood loss, and postoperative complications. Minimally invasive posterior lumbar interbody fusion (MIS PLIF) may be able to address these concerns, but the research on this topic has not been systematically reviewed. ⋯ Based on the available evidence, which we restricted to prospective and retrospective studies with control groups, but did not include any well-designed randomized trials, MIS PLIF might lead to better perioperative parameters, but there was little evidence for improved patient-reported outcomes in the MIS groups. Randomized controlled trials are needed to compare these two surgical techniques.
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Clin. Orthop. Relat. Res. · Jun 2014
ReviewDoes less invasive spine surgery result in increased radiation exposure? A systematic review.
Radiation exposure to patients and spine surgeons during spine surgery is expected. The risks of radiation exposure include thyroid cancer, cataracts, and lymphoma. Although imaging techniques facilitate less invasive approaches and improve intraoperative accuracy, they may increase radiation exposure. ⋯ There is increased radiation exposure during less invasive spine surgery, which affects the surgeon, patient, and operating room personnel. Being cognizant of radiation exposure risks, the spine surgeon can potentially minimize radiation risks by optimizing variables such as the use of barriers, knowledge of position, distance from the radiation source, and use of advanced image guidance navigation-assisted technology to minimize radiation exposure. Continued research is important to study the long-term risk of radiation exposure and its relationship to cancer, which remains a major concern and needs further study as the popularity of less invasive spine surgery increases.
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Clin. Orthop. Relat. Res. · Jun 2014
Comparative StudyDoes fluoroscopy with anterior hip arthroplasty decrease acetabular cup variability compared with a nonguided posterior approach?
The direct anterior approach for THA offers some advantages, but is associated with a significant learning curve. Some of the technical difficulties can be addressed by the use of intraoperative fluoroscopy which may improve the accuracy of acetabular component placement. ⋯ 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
Minimally invasive transforaminal lumbar interbody fusion for spondylolisthesis and degenerative spondylosis: 5-year results.
Multiple studies have reported favorable short-term results after treatment of spondylolisthesis and other degenerative lumbar diseases with minimally invasive transforaminal lumbar interbody fusion. However, to our knowledge, results at a minimum of 5 years have not been reported. ⋯ Level IV, 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
Is circumferential minimally invasive surgery effective in the treatment of moderate adult idiopathic scoliosis?
Outcomes for minimally invasive scoliosis correction surgery have been reported for mild adult scoliosis. Larger curves historically have been treated with open surgical procedures including facet resections or posterior column osteotomies, which have been associated with high-volume blood loss. Further, minimally invasive techniques have been largely reported in the setting of degenerative scoliosis. ⋯ Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.