Spine
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Randomized Controlled Trial Comparative Study
The safety and efficacy of OP-1 (rhBMP-7) as a replacement for iliac crest autograft in posterolateral lumbar arthrodesis: a long-term (>4 years) pivotal study.
Randomized controlled trial comparing OP-1 (rhBMP-7) with iliac crest autograft in patients with symptomatic degenerative spondylolisthesis and spinal stenosis treated with decompression and uninstrumented posterolateral arthrodesis. ⋯ OP-1 Putty is a safe and effective alternative to autograft in the setting of uninstrumented posterolateral spinal arthrodesis performed for degenerative spondylolisthesis and symptomatic spinal stenosis.
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Comparative Study
Perioperative complications of combined anterior and posterior cervical decompression and fusion crossing the cervico-thoracic junction.
Retrospective review. ⋯ Complications are frequent following these procedures, although the majority were minor and resolved without lasting effect. Airway edema requiring prolonged intubation or reintubation was frequent. With the numbers available, we were unable to show a relationship between the need for extended intubation and variables including operative time, blood loss, or volume of fluid replacement.
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Comparative Study
Does superior-segment facet violation or laminectomy destabilize the adjacent level in lumbar transpedicular fixation? An in vitro human cadaveric assessment.
This is an in vitro biomechanical study. ⋯ There were significant changes in proximal level ROM immediately after posterior stabilization. However, an additional increase in supradjacent segment ROM was recorded during AR after bilateral facet breach.Subsequent complete laminectomy at the uppermostfixation level further destabilized the supradjacent segment in FE and AR. Therefore, meticulous preservation of the cephalad-most segment facet joints-is paramount to ensure stability.
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Randomized Controlled Trial Comparative Study
RhBMP-2 versus iliac crest bone graft for lumbar spine fusion: a randomized, controlled trial in patients over sixty years of age.
Prospective randomized controlled trial of rhBMP-2/ACS (Infuse bone graft) versus iliac crest bone graft (ICBG) for lumbar spine fusion in patients over 60 years of age. ⋯ RhBMP-2/ACS is a viable ICBG replacement in older patients in terms of safety, clinical efficacy, and cost-effectiveness.
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Comparative Study
Nonoperative management of type II odontoid fractures in the elderly.
Retrospective case series of elderly patients with Type II odontoid fractures, with prospective functional follow-up. ⋯ The nonoperative management of Type II odontoid fractures in elderly patients results in fracture stability, by either osseous union or fibrous union in almost all patients. Long-term clinical and functional outcomes seem to be more favorable when fractures have been treated with halothoracic bracing in preference to cervical collars. Stable fibrous union may be an adequate aim of management in elderly patients.