Journal of spinal disorders & techniques
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J Spinal Disord Tech · Jul 2006
Randomized Controlled Trial Comparative StudyComparison of surgical outcomes between macro discectomy and micro discectomy for lumbar disc herniation: a prospective randomized study with surgery performed by the same spine surgeon.
A prospective study was conducted on the surgical procedures for lumbar disc herniation. ⋯ For herniotomy for lumbar disc herniation, both macro discectomy and microdiscectomy are appropriate, as long as surgeons have mastery of the procedures.
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J Spinal Disord Tech · Dec 2005
Randomized Controlled Trial Comparative StudyPosterior fixation of thoracolumbar burst fracture: short-segment pedicle fixation versus long-segment instrumentation.
The treatment of thoracolumbar burst fracture is a controversial issue. Short-segment (SS) pedicle fixation has become a popular treatment option. However, there are several studies regarding the high rate of failure. The aim of this prospective study was to compare SS versus long-segment (LS) instrumentation. ⋯ In conclusion, radiographic parameters demonstrated that LS instrumentation is a more effective management of thoracolumbar burst fractures. Nevertheless, clinical outcome was the same between the two groups. However, our conclusions were based on posterior-only surgery. Anterior column support would negate the need for LS fixation. Also, SS would have been more successful if two above and two below pedicle screws were used.
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J Spinal Disord Tech · Feb 2005
Randomized Controlled Trial Multicenter Study Clinical TrialIliac crest bone graft donor site pain after anterior lumbar interbody fusion: a prospective patient satisfaction outcome assessment.
Autogenous iliac crest bone is the gold-standard graft for spinal fusion surgery. Unfortunately, there is a frequent incidence of graft site pain that persists well into the postoperative period with complication rates reported in 2.8-39% of patients. Persistent pain lasting at least 2 years is reported in 15-39% of patients. ⋯ Persistent donor site pain remains a problem with harvest of autogenous iliac crest bone graft for spinal fusion. This prospective study, the first such study reported for ALIF, confirms that donor site pain remains a significant postoperative management problem.
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J Spinal Disord Tech · Feb 2005
Randomized Controlled Trial Comparative Study Clinical TrialAnterior versus posterior treatment of stable thoracolumbar burst fractures without neurologic deficit: a prospective, randomized study.
A prospective randomized study was conducted to determine whether there exist any differences in radiographic, clinical, or functional outcomes when individuals with stable burst fractures of the thoracolumbar junction without neurologic deficit are treated with either a posterior fusion with instrumentation or anterior reconstruction, fusion, and instrumentation. There exists relatively little literature evaluating the outcomes of individuals treated with anterior surgery, and no prospective randomized studies exist comparing the two treatment approaches. ⋯ Although patient outcomes are similar, anterior fusion and instrumentation for thoracolumbar burst fractures may present fewer complications or additional surgeries.
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J Spinal Disord Tech · Jun 2004
Randomized Controlled Trial Comparative Study Clinical TrialCorrelative analysis of the results of surgical treatment of thoracolumbar injuries with long Texas Scottish rite hospital construct: is the use of pedicle screws versus hooks advantageous in the lumbar spine?
This is a prospective, randomized study to compare the efficacy of two similar "long-segment" Texas Scottish Rite Hospital instrumentations with the use of hooks in the thoracic spine and pedicle screws versus laminar hook claw in the lumbar spine for thoracolumbar A3, B, and C injuries. Forty consecutive patients with such thoracolumbar fractures (T11-L1) associated with spinal canal encroachment underwent early operative postural reduction and stabilization. The patients were randomly sampled into two groups: Twenty patients received hooks in "claw configuration" in both the thoracic and the lumbar spine (group A), and 20 patients received hooks in the thoracic vertebrae and pedicle screws in the lumbar vertebrae (group B). ⋯ There was neither pseudarthrosis nor neurologic deterioration following surgery. Visual Analog Pain Scale and Short Form-36 scores were equally improved and did not differ between the two groups. The use of pedicle screws in the lumbar spine to stabilize the lowermost end of a long rigid construct applied for A3, B, and C thoracolumbar injuries was advantageous when compared with that using hook claws in the lumbar spine because the constructs with screws restored and maintained the fractured anterior vertebral body height better than the hooks without subsequent loss of correction and safeguarded postoperatively a continuous SCC at the injury level.