The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Feb 2015
Randomized Controlled Trial Multicenter Study Comparative Study Observational StudyEffectiveness of surgery for lumbar stenosis and degenerative spondylolisthesis in the octogenarian population: analysis of the Spine Patient Outcomes Research Trial (SPORT) data.
The purpose of this study was to determine whether surgery is an effective option for the treatment of stenosis of the lumbar spine and degenerative spondylolisthesis in the octogenarian population. ⋯ Operative treatment of lumbar stenosis and degenerative spondylolisthesis offered a significant benefit over nonoperative treatment in patients at least eighty years of age (p < 0.05). There were no significant increases in the complication and mortality rates following surgery in this patient population compared with younger patients (p > 0.05).
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J Bone Joint Surg Am · Feb 2015
Multicenter Study Comparative StudyRigid fixation improves outcomes of spinal fusion for C1-C2 instability in children with skeletal dysplasias.
Upper cervical instability is common in many skeletal dysplasias, and surgical treatment can be difficult because of small, fragile osseous elements. In this study of children with skeletal dysplasia and upper cervical instability, we compared fusion rates and complications between (1) patients treated with no instrumentation or with wiring techniques and (2) those who underwent rigid cervical spine instrumentation. We also sought to characterize the presentation and common parameters of upper cervical instability in this population. ⋯ The nonunion rate is relatively high after patients undergo spinal fusion for C1-C2 instability with nonrigid instrumentation, even if a halo-body jacket is applied. Rigid fixation with screws and rods improves fusion rates.