Clinical orthopaedics and related research
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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 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.
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Clin. Orthop. Relat. Res. · Jun 2014
Comparative StudyMinimally invasive versus open sacroiliac joint fusion: are they similarly safe and effective?
The sacroiliac joint has been implicated as a source of chronic low back pain in 15% to 30% of patients. When nonsurgical approaches fail, sacroiliac joint fusion may be recommended. Advances in intraoperative image guidance have assisted minimally invasive surgical (MIS) techniques using ingrowth-coated fusion rods; however, how these techniques perform relative to open anterior fusion of the sacroiliac joint using plates and screws is not known. ⋯ Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Jun 2014
Changes in the adjacent segment 10 years after anterior lumbar interbody fusion for low-grade isthmic spondylolisthesis.
Adjacent segment degeneration is a long-term complication of arthrodesis. However, the incidence of adjacent segment degeneration varies widely depending on the patient's age and underlying disease and the fusion techniques and diagnostic methods used. ⋯ Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.