Spine
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Multicenter Study
Surgical Site Infection following Primary Definitive Fusion for Pediatric Spinal Deformity: A Multicenter Study of Rates, Risk Factors, and Pathogens.
A retrospective multicenter study. ⋯ The overall infection rate was low. The most common causative bacteria were methicillin-resistant followed by gram-negative rods. Independent risk factors for SSI in pediatric patients undergoing spinal deformity surgery were scoliosis etiology, ASA class 3, and administration of antibiotic therapy twice daily.Level of Evidence: 3.
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A consecutive series of patients who underwent minimally invasive spinal surgery by a single surgeon at a high-volume academic medical center were studied. ⋯ We report a 4.1% rate of return to the operating room for failed indirect decompression after LLIF for refractory radiculopathy. Graft subsidence and osteoporosis were common in these patients. All five patients who required secondary decompressive laminectomy or foraminotomy underwent stand-alone primary LLIF, and the persistent radiculopathy was consistently contralateral to the initial side of the LLIF approach.Level of Evidence: 4.
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Randomized Controlled Trial
Equal Ratio Ventilation Reduces Blood Loss During Posterior Lumbar Interbody Fusion Surgery.
A prospective randomized double-blinded study. ⋯ Compared to conventional ratio ventilation, ERV provided lower PIP and reduced intraoperative surgical blood loss in patients undergoing PLIF surgery.Level of Evidence: 2.
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Multicenter Study
A Risk Benefit Analysis of Increasing Surgical Invasiveness Relative to Frailty Status in Adult Spinal Deformity Surgery.
Retrospective review of a prospectively enrolled multicenter Adult Spinal Deformity (ASD) database. ⋯ Increasing invasiveness is associated with increased odds of major complications and reoperations. Risk-benefit cutoffs for successful outcomes were 79.3 for NF, 111 for F, and 53.3 for SF patients. Above these, increasing invasiveness has increasing risk of major complications or reoperations and not meeting MCID at 3Y.Level of Evidence: 3.
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Retrospective review. ⋯ The patients with baseline MW had inferior HRQoL for up to 3 years compared with that of those without MW; however, the amount of improvement in HRQoL was comparable. Timely follow-up is important to find out the deterioration of motor function.Level of Evidence: 4.