The spine journal : official journal of the North American Spine Society
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Randomized Controlled Trial
Psychometric properties of selected tests in patients with lumbar spinal stenosis.
The psychometric properties of many outcome tools commonly used with patients with lumbar spinal stenosis have yet to be examined. ⋯ The results of our study indicate that the Oswestry Disability Index, SSS, and Patient Specific Functional Scale possess adequate psychometric properties to be used in the outcome assessment of patients with lumbar spinal stenosis. However, further investigation is needed to validate these findings in other samples of patients with lumbar spinal stenosis and nonspecific low back pain.
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Comparative Study
Retrograde ejaculation after anterior lumbar interbody fusion with and without bone morphogenetic protein-2 augmentation: a 10-year cohort controlled study.
Retrograde ejaculation (RE) is a complication of anterior lumbar interbody fusion (ALIF) techniques. Most commonly, this results from mechanical or inflammatory injury to the superior hypogastric plexus near the aortic bifurcation. Bone morphogenetic protein-2 (BMP-2) has been used in spinal fusions and has been associated with inflammatory and neuroinflammatory adverse reactions, which may contribute to RE development after anterior lumbar surgery. ⋯ This study confirms previous reports of a higher rate of RE in ALIF procedures using rhBMP-2 and an open anterior approach to the spine. This effect may be associated with an increased risk of postoperative urinary retention after BMP-2 exposure. The magnitude of the RE effect may be increased with concomitant prostatic disease treatments.
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Readmissions within 30 days of hospital discharge are undesirable and costly. Little is known about reasons for and predictors of readmissions after elective spine surgery to help plan preventative strategies. ⋯ Among Medicare beneficiaries, 30-day readmissions after elective spine surgery for degenerative conditions represent a target for improvement. Both patient factors and operative techniques are associated with readmissions. Interventions to minimize readmissions should be specific to surgical site and focus on high-risk subgroups where clinical trials of interventions may be of greatest benefit.