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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To develop a decision-making pathway for primary SA-LLIF. Furthermore, we analyzed the agreement of this pathway and compared outcomes of patients undergoing either SA-LLIF or 360-LLIF. ⋯ Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.
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This study exploits a novel musculoskeletal finite element (MS-FE) spine model to evaluate the post-fusion (L4-L5) alterations in adjacent segment kinetics. ⋯ Alterations in segmental rotations mainly affected adjacent disc shear forces, facet/ligament forces, and annulus/collagen fibers stresses/strains. An altered lumbopelvic rhythm (increased pelvis rotation) tends to mitigate some of these surgically induced changes.
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Posterior and transforaminal lumbar interbody fusion (PLIF, TLIF) are among the most popular surgical options for lumbar interbody fusion. If non-union occurs with consequent pain and reduced quality of life, revision surgery should correct any previous technical errors, avoiding further complications. The aim of this study was to analyze technical advantages, radiological and clinical outcomes of anterior approaches (ALIF) in case of failed PLIF or TLIF. ⋯ Salvage ALIF is a safe option that can significantly ameliorate residual pain achieving primary interbody stability with an ideal segmental lordosis according to pelvic parameters. The advantages of a naive anterior approach fulfils the main objectives of a revision surgery in order to significantly increase the chances of definitive fusion.
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To assess whether saphenous somatosensory-evoked potentials (saphSSEP) monitoring may provide predictive information of femoral nerve health during prone lateral interbody fusion (LIF) procedures. ⋯ Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.
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Retrospective Cohort Study. ⋯ Frailty was associated with higher odds of all perioperative complications, LOS, and all-payer costs following multi-level lumbar fusion. Frail patients had significantly higher rates of 90 and 180-day readmission and higher rates of wound disruption at 90-days. On subgroup analysis, MIS was associated with significantly reduced rates of surgical complications specifically in frail patients. Our results suggest frailty status to be an important predictor of perioperative complications and long-term readmissions in geriatric patients receiving multi-level lumbar fusions. Frail patients should undergo surgery utilizing minimally invasive techniques to minimize risk of surgical complications. Future studies should explore the utility of implementing frailty in risk stratification assessments for patients undergoing spine surgery.