European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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The ultrasonic BoneScalpel is a tissue-specific device that allows the surgeon to make precise osteotomies while protecting collateral or adjacent soft tissue structures. The device is comprised of a blunt ultrasonic blade that oscillates at over 22,500 cycles/s with an imperceptible microscopic amplitude. The recurring impacts pulverize the noncompliant crystalline structure resulting in a precise cut. The more compliant adjacent soft tissue is not affected by the ultrasonic oscillation. The purpose of this study is to report the experience and safety of using this ultrasonic osteotome device in a variety of spine surgeries. ⋯ Overall, the ultrasonic scalpel was safe and performed as desired when used as a bone cutting device to facilitate osteotomies in a variety of spine surgeries. However, caution should be taken to avoid potential thermal injury and dural tear. If used properly, this device may decrease the risk of soft tissue injury associated with the use of high speed burrs and oscillating saws during spine surgery.
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Neurogenic bladder is a common complication of several central nervous system injuries. Statins and phosphodiesterase-5 (PDE-5) inhibitors are reportedly beneficial in neural injuries and urinary system dysfunction. The effect of simvastatin, sildenafil and tadalafil on several renal function indices of an animal model of neurogenic bladder was investigated. ⋯ Statins can effectively improve the motor and renal functions in a condition of renal dysfunction in a rat model of neurogenic bladder. PDE-5 inhibitors could help to improve motor function, but are not helpful in renal function, at least in short time.
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Review Meta Analysis
Body mass index and risk of surgical site infection following spine surgery: a meta-analysis.
Inconsistent results have been reported in the literature on the association between obesity, expressed as increased body mass index (BMI), and risk for surgical site infection (SSI) following spine surgery. The objective of this study was to review and quantify the association between increased BMI and risk of spinal SSI in adults. ⋯ Higher BMI is associated with the increased risk of SSI following spine surgery. Prospective studies are needed to confirm this association and to determine whether other measures of fat distribution are better predictors of risk of SSI.
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Randomized Controlled Trial Comparative Study
Clinical outcomes of minimally invasive versus open approach for one-level transforaminal lumbar interbody fusion at the 3- to 4-year follow-up.
Supporters of minimally invasive approaches for transforaminal lumbar interbody fusion (TLIF) have reported short-term advantages associated with a reduced soft tissue trauma. Nevertheless, mid- and long-term outcomes and specifically those involving physical activities have not been adequately studied. The aim of this study was to compare the clinical outcomes of mini-open versus classic open surgery for one-level TLIF, with an individualized evaluation of the variables used for the clinical assessment. ⋯ Despite an improved functional status of MO-TLIF patients in the short term, the clinical outcomes of mini-open TLIF at the 3- to 4-year follow-up showed no clinically relevant differences to those obtained with open TLIF.