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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A retrospective database review was carried out to evaluate the trends and demographics of rhBMP utilization in single-level posterior lumbar fusion (PLF) in the United States. ⋯ The incidence of rhBMP utilization in single-level PLF increased from 2006 to 2009, but dropped to a low level in 2010 and 2011. The Northeast region had the lowest incidence of rhBMP utilization. The group aged 70-74 years trended to have the higher incidence of single-level PLF with rhBMP utilization.
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Severe rigid spine deformity with sharp curve can be effectively corrected by posterior vertebral column resection (PVCR). Meanwhile, high risk of this procedure also has been recognized generally. The aim of this study is to review and evaluate the role of preoperative skull-femoral traction prior to PVCR for extremely severe rigid spinal deformity with sharp angular curve >150°. ⋯ Preoperative skull-femoral traction effectively mitigates the neurological risks of PVCR for extremely severe rigid spinal deformity with sharp curve. During traction, scoliosis can be improved more significantly and easily than kyphosis.
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Observational Study
Burden of disease of reoperations in instrumental spinal surgeries in Germany.
To estimate the incidence of instrumental spinal surgeries (ISS) and consecutive reoperations and to calculate the related resource utilization and costs. ⋯ Costs of ISS and subsequent reoperations have a significant impact on health insurances budgets. The annual cost of reoperations exceeds the direct cost of the primary surgery driven by the need for further inpatient and outpatient care.
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The prognostic ability of the STarT Back Tool (SBT) reportedly varies, but the factors affecting this are unclear. This study investigated the influences of care setting (chiropractic, GP, physiotherapy, spine centre), episode duration (0-2, 3-4, 4-12, >12 weeks), and outcome time period (3, 6, 12 months) on SBT prognostic ability. ⋯ These results indicate that the prognostic ability of the SBT in these non-stratified care settings was unaffected by care setting on its own. However, the prognosis of patients is affected by diverse clinical characteristics that differ between patient populations, many of which are not assessed by the SBT. When controlling for some of those factors and testing potential interactions, the results showed that only episode duration affected the SBT prognostic ability and, specifically, that the SBT was less predictive in very acute patients (<2 weeks duration).
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Intraoperative ultrasound (IUS) has been described in numerous papers as an effective tool for spinal tumor resection, degenerative lesions and Chiari malformation surgery, but has not been routinely adopted by spine surgeons. We herein describe our experience with routine IUS application. ⋯ IUS is safe and easy to use after a short learning curve. When used in indicated cases, it can replace cumbersome fluoroscopy, reduce the incision dimension and laminectomy levels, and demonstrate the extent of decompression. Incorporating IUS in spinal surgery education programs is warranted.