Spine
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This is a retrospective single-center case study involving 115 obese and nonobese patients who underwent minimally invasive lumbar surgery between 2004 and 2007. ⋯ This is the first study comparing operative results from tubular microsurgery between obese and nonobese patients. No major differences were detected in outcome, operative and perioperative data including complication rates. With tubular microsurgery, obese patients experienced the same or equally beneficial outcome, compared to nonobese patients, while incision lengths, blood loss, operative times, and length of stay were less when compared to open procedures. Other comorbidities and age had no significant impact on perioperative complications and clinical outcome.
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A comparative analysis of paraspinal muscle damage and radiographic parameters after mini-open and conventional open posterior lumbar interbody fusion (PLIF). ⋯ Mini-open PLIF is safe and effective. Mini-open PLIF was less invasive than open PLIF with regard to the MF muscle.
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Database study using Nationwide Inpatient Sample (NIS) administrative data from 1993 to 2002. ⋯ Posterior lumbar fusion for acquired lumbar spondylolisthesis is safe. However, age and comorbidity independently increase in-hospital complications and complex disposition. These data may improve national estimates of surgical risk, patient selection, informed consent, and cost-efficacy analysis for posterior lumbar fusion operations for acquired spondylolisthesis.
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A case report of a spinal subarachnoid hematoma (SSAH) associated with hyperextension fractures complicating diffuse idiopathic skeletal hyperostosis (DISH). ⋯ The first case of a SSAH complicating spinal fracture in DISH is presented. The patient was successfully treated with a staged operation including posterior decompression with fusion and anterior interbody fusion.
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Review Meta Analysis
Rehabilitation after lumbar disc surgery: an update Cochrane review.
Cochrane systematic review of randomized controlled trials. ⋯ Exercise programs starting 4 to 6 weeks postsurgery seem to lead to a faster decrease in pain and disability than no treatment. High intensity exercise programs seem to lead to a faster decrease in pain and disability than low intensity programs. There were no significant differences between supervised and home exercises for pain relief, disability, or global perceived effect. There is no evidence that active programs increase the reoperation rate after first-time lumbar surgery.