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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Randomized Controlled Trial
An analysis of fusion cage migration in unilateral and bilateral fixation with transforaminal lumbar interbody fusion.
To investigate if instrumentation (unilateral vs. bilateral fixation) has an effect on the rate of fusion cage migration. ⋯ We conclude that unilateral fixation is not stable enough to prevent fusion cage migration in some patients who undergo TLIF.
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Randomized Controlled Trial
Pain from donor site after anterior cervical fusion with bone graft: a prospective randomized study with 12 months of follow-up.
Harvesting bone graft from the iliac crest in spinal fusion surgery is a widely used technique. However, complications can occur and there are also reports of patients with persistent graft site pain after surgery. The aim of this study was to evaluate pain from the donor site (DS) over time, and register associated complications and if it affected health-related quality of life (HRQoL). ⋯ Harvesting of iliac crest bone graft is associated with significant pain. However, at 3 months postoperatively, the negative effect of clinical importance seemed to have disappeared compared to when no bone graft was harvested. The pain from bone graft harvesting does not seem to affect the quality of life at 4 weeks postoperatively and onward.
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Randomized Controlled Trial
No difference in 9-year outcome in CLBP patients randomized to lumbar fusion versus cognitive intervention and exercises.
To compare the 9-year outcome in patients with chronic low back pain treated by instrumented lumbar fusion versus cognitive intervention and exercises. ⋯ The outcome at 9 years was not different between instrumented lumbar fusion and cognitive intervention and exercises.
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Randomized Controlled Trial
Spine surgeon's kinematics during discectomy according to operating table height and the methods to visualize the surgical field.
The ergonomic problems for surgeons during spine surgery are an awkward body posture, repetitive movements, increased muscle activity, an overflexed spine, and a protracted time in a standing posture. The authors analyzed whole spine angles during discectomy. The objective of this study is to assess differences in surgeon whole spines angles according to operating table height and the methods used to visualize surgical field. ⋯ This study suggests that loupe use and a table height midpoint between the umbilicus and sternum are optimal for reducing surgeon musculoskeletal fatigue.
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Randomized Controlled Trial
Development of a per-operative procedure for concentrated bone marrow adjunction in postero-lateral lumbar fusion: radiological, biological and clinical assessment.
Addition of bone marrow to the bone graft in the postero-lateral lumbar arthrodesis is a widely used technique. Bone marrow brings stem cells and growth factors contained in the platelets, favorable for bone growth. Adjunction of concentrated bone marrow should create better conditions and may increase bone growth. ⋯ Despite the concentration obtained, there was no increase of bone growth by adding concentrated bone marrow. However, the number of stem cells in bone marrow was low and maybe a stronger concentration is needed to obtain a difference. The 3D reconstruction of the graft and the analysis of the graft's volume using a novel software was efficient according to the similarity of the graft's volume post-operatively in all patients.