Journal of spinal disorders & techniques
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J Spinal Disord Tech · Aug 2008
Comparative Study Clinical TrialRevision lumbar arthrodesis for the treatment of lumbar cage pseudoarthrosis: complications.
A study documenting major complications encountered in revision procedures for lumbar cage pseudoarthrosis. ⋯ Circumferential revision including cage removal, structural allograft placement, and posterior stabilization is associated with increased perioperative complications. Although an anterior approach showed increased interbody fusion rates, this technique did not lead to more superior clinical outcomes based on VAS scores. It remains to be shown by larger prospective studies if there is a true difference in outcome between these 2 groups that will justify the increased perioperative morbidity associated with attempted cage removal.
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J Spinal Disord Tech · Aug 2008
The effect of parallax on intraoperative positioning of the Charité artificial disc.
Fluoroscopy imaging evaluation for total disc arthroplasty. ⋯ The spinous process is an unreliable anatomic midline marker. In contrast, the borders of the vertebral bodies can more reliably be used to calculate the displacement of the prosthesis from centerline to determine prosthesis position. Fluoroscopic parallax can cause an ideally placed prosthesis to appear more displaced with increasing rotation and distance away from the true anteroposterior image. The spinous process was determined to be an unreliable midline marker. The vertebral borders provided a more dependable anatomic reference point to establish the disc-space midline.
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J Spinal Disord Tech · Aug 2008
Comparative StudyFinancial incentives for lumbar surgery: a critical analysis of physician reimbursement for decompression and fusion procedures.
Retrospective case-control study/economic analysis. ⋯ These findings challenge the assertion that spine surgeons have an undue financial incentive to recommend a combined decompression and instrumented fusion procedure over an isolated decompression to patients with symptomatic lumbar degeneration, especially when considering the greater time, effort, and risk characteristic of this more complex operation.
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J Spinal Disord Tech · Aug 2008
Randomized Controlled Trial Multicenter StudyMotion analysis of bryan cervical disc arthroplasty versus anterior discectomy and fusion: results from a prospective, randomized, multicenter, clinical trial.
Prospective, randomized, multicenter clinical trial. ⋯ The Bryan disc treatment, on average, maintained flexion/extension range of motion without degradation over 24 months. No ectopic bridging ossification was seen in any of the Bryan discs and no subsidence or displacement of the Bryan disc occurred.
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J Spinal Disord Tech · Aug 2008
Case ReportsSevere hypotension associated with the prone position in a child with scoliosis and pectus excavatum undergoing posterior spinal fusion.
Case report. ⋯ Pediatric deformity surgery requires a multidisciplinary approach.