Articles: spinal-fusion-adverse-effects.
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Case-report and literature review. ⋯ Instrumentation removal and metallosis debridement seems to be useful for symptomatic patients, but remains controversial on fixed asymptomatic patients. If solid fusion has not been achieved, extension, and reinforcement of the failed fixation could be required.Level of Evidence: 4.
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Patients undergoing spine surgery often inaccurately estimate their pain tolerance and postoperative analgesic requirement. We sought to identify an association between patients' self-perceived pain tolerance and postoperative opioid consumption (POC). ⋯ Self-perceived pain tolerance does not appear to predict POC, while younger age and higher preoperative VAS pain scores are related to increased POC. Younger patients who report high pain tolerance appear to consume higher levels of opioids compared with older patients.
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Retrospective case series. ⋯ Patient factors, whether a procedure is staged, and choice of antibiotic irrigation affect the risk of SSI and ensuing management required.Level of Evidence: 4.
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Cross-sectional study. ⋯ Both AA and AW are associated with adverse outcomes in patients undergoing spinal fusion surgery with more pronounced risks for AW. Aggressive management in perioperative period is required to improve outcomes in these patients.Level of Evidence: 3.
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Comparative Study Observational Study
In-Hospital Course and Complications of Laminectomy alone Versus Laminectomy plus Instrumented Posterolateral Fusion for Lumbar Degenerative Spondylolisthesis: A Retrospective Analysis of 1,804 Patients from the NSQIP Database.
Retrospective analysis of data from the National Surgical Quality Improvement Program (NSQIP). ⋯ We found single-level laminectomy plus fusion for lumbar DS to have a comparable short-term safety profile to laminectomy alone. However, fusion was associated with longer operative time and LOS, higher risk of blood transfusion, and greater need for inpatient rehabilitation. These factors should be recognized by clinicians and discussed with patients in the context of their values when weighing surgical treatment of lumbar DS.Level of Evidence: 3.