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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While much evidence suggests that adjacent segment degeneration is merely a manifestation of the natural degenerative process unrelated to any spine fusion, a significant body of literature supports the notion that it is a process due in part to the altered biomechanics adjacent to fused spine segments. The purpose of this study was to review and critically analyze the published literature that investigated the in vivo kinematics of the adjacent segments and entire lumbar spine in patients receiving spinal fusion or motion-preserving devices. ⋯ There appears to be no overall kinematic changes at the rostral or caudal levels adjacent to a fusion, but some patients (~20-30%) develop excessive kinematic changes (i.e., instability) at the rostral adjacent level. The overall lumbar ROM after fusion appears to decrease after a spinal fusion.
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Review
Factors that may affect outcome in cervical artificial disc replacement: a systematic review.
To identify the factors that may affect outcome in C-ADR and provide the pooled results of postoperative success rate of implanted segment range of motion (ROM), incidence of heterotopic ossification (HO), incidence of radiographic adjacent segment degeneration (r-ASD)/adjacent segment disease (ASD), and surgery rate for ASD. ⋯ The available evidence showed that most of the pre-selected factors had no effect on outcome after C-ADR, and the ROM success rate, incidence of HO and r-ASD/ASD, and surgery rate for ASD are acceptable. There is a lack of evidence from RCTs for some factors.
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To assess the efficacy of a novel preemptive multimodal analgesic regimen for reducing postoperative pain and complications after primary lumbar fusion surgery. Preemptive multimodal analgesia is revealed to be an effective alternative to conventional morphine administration providing improved postoperative pain control with diminished side effects. However, an optimal regimen for spinal fusion surgery remains unknown. ⋯ The preemptive multimodal analgesic combination in this study appears to be safe and effective after lumbar fusion surgery.
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To report our 11-year minimum clinical and radiological outcomes, as well as complications of the Charite III total disc replacement (TDR). ⋯ The cumulative survival was 100% at a mean follow-up of 11.8 years. Clinical and radiological results were satisfactory and long-term clinical results were maintained for a mean follow-up of 11.8 years. Reoperation and complication rates are acceptable, and our study does not substantiate the fear of reoperation or late complications. The results of our long-term follow-up indicate that, with strict indication, TDR is a safe and effective procedure as an alternative to lumbar fusion.
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To investigate the regional tensile properties of human annulus fibrosus (AF) and relate them to magnetic resonance imaging (MRI) findings. ⋯ Weakening of degenerated AF may be caused by accumulating structural defects, and enzymatic degradation. MRI has the potential to identify local weakening of the AF.