Spine
-
Randomized Controlled Trial Multicenter Study Clinical Trial
A pilot study evaluating the safety and efficacy of OP-1 Putty (rhBMP-7) as a replacement for iliac crest autograft in posterolateral lumbar arthrodesis for degenerative spondylolisthesis.
A prospective, randomized, controlled, multicenter clinical study was conducted. ⋯ Although the posterolateral spine is a challenging fusion environment in patients with degenerative spondylolisthesis, successful radiographic fusion was obtained using OP-1 Putty at a rate that was similar to autograft given the number of patients in this study. Importantly, there were no apparent adverse consequences related to the use of the OP-1 Putty implant in this patient population.
-
Review of the literature. ⋯ Biomechanical alterations likely play a primary role in causing adjacent segment disease. Radiographically apparent, asymptomatic adjacent segment disease is common but does not correlate with functional outcomes. Potentially modifiable risk factors for the development of adjacent segment disease include fusion without instrumentation, protecting the facet joint of the adjacent segment during placement of pedicle screws,fusion length, and sagittal balance. Surgical management, when indicated, consists of decompression of neural elements and extension of fusion. Outcomes after surgery, however, are modest.
-
Multicenter Study Comparative Study
The effect of previous low back surgery on general health status: results from the National Spine Network initial visit survey of patients with low back pain.
A cross-sectional study on 18,325 patients with back pain enrolled at first visit in the National Spine Network (NSN) database from January 1998 to April 2000. ⋯ Previous back surgery is associated with significantly worse general health status than those without surgery. Among patients who had previous surgeries, decompression seems to exert better effects on SF-36 health status. There is a positive correlation between time since last surgery and the SF-36 outcomes, although the SF-36 scores are significantly lower than those without previous surgery.
-
Comparative Study
Biomechanical analysis of transpedicular screw fixation in the subaxial cervical spine.
An in vitro biomechanical study to compare 2 different dorsal screw fixation techniques in the cervical spine with respect to primary stability and stability after cyclic loading. ⋯ The major finding of the current study was the higher stability of pedicle screws over lateral mass fixation with respect to primary stability and stability after cyclic loading. From a biomechanical point of view the use of pedicle screws in the subaxial cervical spine seems justified in patients with poor bone quality and need for multisegmental fixation.
-
Prospective consecutive series. ⋯ Video-assisted thoracoscopic surgery provides a safe and effective alternative to open thoracotomy in the treatment of thoracic pediatric spinal deformities. The procedure remains time consuming.