Articles: spinal-fusion-adverse-effects.
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Retrospective cohort study. ⋯ The incidence of lumbar curve adding-on was 6.2%. Patients who were hypokyphotic and skeletally immature are nine times and six times more likely to have lumbar adding-on, respectively. This article examines adding-on in patients who had either anterior or posterior approach scoliosis surgeries, with follow-up stretching up to 10 years. This offers the rare opportunity to examine the natural history of the adding-on phenomenon.Level of Evidence: 3.
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The study is designed as a retrospective cohort study. ⋯ Glycopyrrolate use, benign prostate hyperplasia, and postoperative urinary tract infection were independent risk factors for postoperative urinary retention. The use of glycopyrrolate is a potentially modifiable risk factor for postoperative urinary retention.Level of Evidence: 3.
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This is a multicenter retrospective review of 257 surgically treated consecutive ASD patients who had a minimum of five fused segments, completed a 2-year follow-up (53 ± 19 yrs, females: 236 [92%]). ⋯ In this multicenter study, in an Asian ASD patient cohort, the GAP score was not associated with the incidence of MF or revision surgery. Additional studies on the predictive ability of the GAP score in different patient cohorts are warranted.Level of Evidence: 3.
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Anesthesia and analgesia · Jan 2021
Randomized Controlled TrialAnalgesic Effect of Intraoperative Intravenous S-Ketamine in Opioid-Naïve Patients After Major Lumbar Fusion Surgery Is Temporary and Not Dose-Dependent: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.
Severe pain often accompanies major spine surgery. Opioids are the cornerstone of postoperative pain management but their use can be limited by numerous side effects. Several studies claim that adjuvant treatment with intravenous (IV) ketamine reduces opioid consumption and pain after back surgery. However, the exact role of ketamine for this indication is yet to be elucidated. We compared 2 different doses of S-ketamine with placebo on postoperative analgesic consumption, pain, and adverse events in adult, opioid-naïve patients after lumbar fusion surgery. ⋯ Neither a 0.12 nor a 0.6 mg/kg/h infusion of intraoperative IV S-ketamine was superior to the placebo in reducing oxycodone consumption at 48 hours after lumbar fusion surgery in an opioid-naïve adult study population. Future studies should assess ketamine's feasibility in specific study populations who most benefit from reduced opioid consumption.