Articles: spinal-fusion-adverse-effects.
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Multicenter Study
Neural complications in the surgical treatment of adolescent idiopathic scoliosis.
Multicenter, prospective, consecutive clinical series. ⋯ The neural complication rate was 0.69%. Two thecal penetrations were due to medial placement of pedicle screws, and 1 was due to dissection during spine exposure. If these are eliminated, as they imply intraspinal entry but not direct neural injury, together with 1 positional neurapraxia, which is remote from the surgical field, our complication rate is 0.38%. This is consistent with other studies in the North American Literature, including multiple reports from the Scoliosis Research Society. Common themes are significant curve correction producing neural stretch and the use of sublaminar wires. None of the neural injuries was permanent. These results reaffirm that surgical treatment of adolescent idiopathic scoliosis has a low but real neural complication rate.
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Multicenter Study
Diabetes and early postoperative outcomes following lumbar fusion.
Retrospective cohort study using data from the Nationwide Inpatient Sample administrative data from 1988 through 2003. ⋯ This nationally representative study of inpatients in the United States provides evidence that diabetes is associated with increased risk for postoperative complications, nonroutine discharge, increased total hospital charges, and length of stay following lumbar fusion. Prospective studies to determine causality as well as the potential impact of diabetes control on these variables have not yet been done.
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Multicenter Study
Complications in posterior fusion and instrumentation for degenerative lumbar scoliosis.
Radiographic analysis was performed retrospectively. Outcomes and complications were collected prospectively. ⋯ The complication rate after posterior fusion and instrumentation for degenerative lumbar scoliosis was 68%. Abundant blood loss was a significant risk factor for early perioperative complications. The improvement of Oswestry disability index was less in patients with late complications.
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Multicenter Study
Dysphagia after anterior cervical decompression and fusion: prevalence and risk factors from a longitudinal cohort study.
Retrospective analysis of the incidence and prevalence of dysphagia after anterior cervical decompression and fusion (ACDF). ⋯ Duration of preexisting pain and the number of vertebral levels involved in the surgical procedure appear to influence the likelihood of dysphagia after ACDF.
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Multicenter Study Clinical Trial
Perioperative changes in pulmonary function after anterior scoliosis instrumentation: thoracoscopic versus open approaches.
A prospective evaluation of pulmonary function in patients with adolescent idiopathic scoliosis undergoing surgical correction. ⋯ The thoracoscopic approach causes a smaller decline in pulmonary function 3 months and 1 year after surgery as compared to the more invasive technique of open thoracotomy for anterior spinal instrumentation for correction of adolescent idiopathic scoliosis.