Spine
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Intermittent pneumatic compression stockings (IPC) alone were prospectively used to avoid deep venous thrombosis (DVT) and pulmonary embolism (PE) in 100 consecutive patients undergoing single-level anterior corpectomy/fusion (ACF) and in 100 patients having multilevel ACF/posterior fusion. ⋯ IPCs were as effective for prophylaxis against DVT/PE for 100 patients undergoing single-level ACF and for 100 having circumferential procedures as existing therapies (mini-heparin and low-dose heparin), without the risk of hemorrhage. However, the 1% and 2% respective rates of PE were comparable to frequencies of PE encountered in other cranial/spinal series using mini-heparin and/or low-dose heparin regimens but avoided the 2% to 4% risk of major postoperative hemorrhage.
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Comparative Study
In vitro stabilizing effect of a transforaminal compared with two posterior lumbar interbody fusion cages.
An in vitro biomechanical flexibility test on different lumbar interbody fusion cages using monosegmental lumbar spine specimens. ⋯ In terms of its stabilizing effect, TLIF using the MOON cage can be recommended as an alternative to PLIF using the cubic Stryker cages. Compared with the threaded BAK PLIF cages, however, the MOON TLIF cage provides a lower primary stability in lateral bending, flexion, and extension.
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An in vitro biomechanical study of different pedicle screw configuration usage on the thoracic spine using a cadaveric model. ⋯ Our results suggest that the most important factor for the acute postoperative stability of spinal fixation is the degree of preoperative or iatrogenic destabilization. The minimum amount of pedicle screws provides adequate stability when there is minimal destabilization of the spine. On the other hand, when anterior column release has been performed or instability exists before surgery, segmental pedicle screw fixation may be necessary to achieve adequate stability.
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Prospective consecutive series. ⋯ To our knowledge, this study has been the first attempt to analyze anatomic changes in lateral spondylolisthesis using CT. It may offer further insight into the pathogenesis of adult lumbar scoliosis.
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Randomized Controlled Trial
A prospective, randomized, double-blind study evaluating the efficacy of postoperative continuous local anesthetic infusion at the iliac crest bone graft site after spinal arthrodesis.
Parallel design, prospective, double-blind, randomized, controlled trial composed of two independent groups treated with a continuous infusion catheter (saline vs. Marcaine) placed into the iliac crest bone graft (ICBG) site. ⋯ Continuous infusion of 0.5% Marcaine at the ICBG harvest site reduced postoperative parenteral narcotic usage by 50% and decreased overall pain scores. No complications were attributed to the infusion-catheter system. The use of continuous local anesthetic infusion at the iliac crest may help in alleviating acute graft-related pain, hastening patient recovery and improving short-term satisfaction.