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Donepezil treatment does not improve postoperative delirium, medical, or surgical outcomes following lumbar spine surgery: a propensity-matched analysis.

BACKGROUND CONTEXT: Patients with preoperative cognitive impairment, defined as a diagnosis of dementia or mild cognitive impairment (MCI), … ts diagnosed with either dementia or MCI who underwent lumbar spine surgery for treatment of lumbar spondylolisthesis or stenosis. Propensity score matching was performed to adjust for age, race, gender, and comorbidities, thereby controlling for potential confounders. Postoperative outcomes were identified utilizing corresponding diagnostic and procedural codes. …

[Clinical outcomes of allograft Cages in transforaminal lumbar interbody fusion].

OBJECTIVE: To explore the fusion effect of allograft Cages on transforaminal lumbar interbody fusion (TLIF). METHODS: The clinical data of 30 patients (38 vertebral segments) who underwent TLIF with allograft interbody fusion Cages between January 2015 and January 2017 were retrospectively analysed. There were 25 males and 5 females with an average age of 56.9 years (range, 44-72 years). The lesions included 20 cases of lumbar disc herniation, 7 cases of lumbar spondylolisthesis, and 3 cases of lumbar spinal stenosis. The operation section included 4 cases of L 3, 4, 13 cases of L 4, 5, 5 cas…

Diagnostic imaging for spinal disorders in the elderly: a narrative review.

The high prevalence of neck and low back pain in the rapidly aging population is associated with significant increases in health care expenditure. While spinal imaging can be useful to identify less common causes of neck and back pain, overuse and misuse of imaging services has been widely reported. This narrative review aims to provide primary care providers with an overview of available imaging studies with associated potential benefits, adverse effects, and costs for the evaluation of neck and back pain disorders in the elderly population. While the prevalence of arthritis and degenerative

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… Additionally, lumbar spine radiographs are indicated in patients over 65 or those who have progressive neurologic deficits with suspected degenerative spondylolisthesis, lateral stenosis, or central stenosis. … An evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spondylolisthesis. Spine J. 2009;9:609–614. doi: 10.1016/j.spinee.2009.03.016. Endean A, Palmer KT, Coggon D. …

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… Hybrid surgery was used predominantly in cases with mixed pathology - typically DDD at one level and low-grade spondylolisthesis at another. ALIF was performed in both DDD and spondylolisthesis cases. Clinical outcomes were assessed using VAS (back and leg), ODI, and RMDQ scores up to 24 months. … ALIF, TDR, and hybrid approaches all led to meaningful clinical improvement in patients with lumbar DDD and/or low-grade spondylolisthesis. …

Worker's Compensation Status and Outcomes Following Anterior Lumbar Interbody Fusion: Prospective Observational Study.

BACKGROUND: Anterior lumbar-interbody fusion (ALIF) is a commonly performed procedure for degenerative spinal disorders with reasonable clinical and safety outcomes, although there is limited evidence regarding the impact of ALIF in patients receiving worker's compensation (WC) compared with those without. The aim of our study is to identify whether WC status affects the clinical outcome and rates of complication following ALIF surgery in a prospective cohort. METHODS: We followed prospectively 114 consecutive patients undergoing ALIF surgery from 2012-2014. Patients were categorized into 2 g

Does Navigation Improve Pedicle Screw Placement Accuracy? Comparison Between Navigated and Non-navigated Percutaneous and Open Fixations.

BACKGROUND: The aim of our study was to assess how a preoperative computed tomography (CT)-based navigation system affected the correctness and safety of transpedicular screw insertion, compared with standard techniques. METHOD: Between January 2012 and February 2014, 203 patients underwent thoracic and lumbar fixation, with open and percutaneous techniques; 218 screws were implanted through an open navigated technique (1.0 Spine & Trauma 3d ver. 2.0 BrainLab, Feldkirchen Germany) in 43 patients; 220 screws were inserted with an open free-hand technique in 45 patients; 230 screws were implant

Indirect foraminal decompression after lateral transpsoas interbody fusion.

OBJECT: Lateral transpsoas interbody fusion (LTIF) permits anterior column lumbar interbody fusion via a direct lateral approach. The authors sought to answer 3 questions. First, what is the effect of LTIF on lumbar foraminal area? Second, how does interbody cage placement affect intervertebral height? And third, how does the change in foraminal area and cage position correlate with changes in Oswestry Disability Index (ODI) and 12-Item Short Form Health Survey (SF-12) scores? METHODS: Included patients underwent LTIF with or without posterior instrumentation and received preoperative and pos

[Posterior and transforaminal lumbar interbody fusion (PLIF/TLIF) for the treatment of localised segment degeneration of lumbar spine].

BACKGROUND: Chronic intractable low back pain is one of the most common orthopaedic diagnoses, with an enormous socioeconomic impact. The surgical treatment by posterior transpedicular instrumentation and interbody fusion of the affected segments is an established procedure after exhaustion of conservative therapies. Due to different study data on the clinical and functional results after posterior (PLIF) and transforaminal (TLIF) interbody fusion, our own patient population was analysed retrospectively. PATIENTS AND METHODS: Included were 143 patients who had been treated surgically at our i

Unilateral lateral mass-facet fractures with rotational instability: new classification and a review of 39 cases treated conservatively and with single segment anterior fusion.

OBJECTIVE: This study examined the clinical and radiologic results of cervical spine injuries associated with a unilateral lateral mass-facet fracture (ULMFF) in an attempt to clarify the fracture pattern and treatment strategies using single-level anterior fusion. METHODS: From July 2003 to June 2006, adult patients, who had sustained ULMFFs of the middle cervical spine, were reviewed retrospectively. The fractures were classified into six subtypes using roentgenogram and computed tomography imaging with three-dimensional analysis. Initially, 15 patients without severe translation and kyphos

The positive effect of posterolateral lumbar spinal fusion is preserved at long-term follow-up: a RCT with 11-13 year follow-up.

INTRODUCTION: Few studies have investigated the long-term effect of posterolateral lumbar spinal fusion on functional outcome. AIM: To investigate the long-term result after posterolateral lumbar spinal fusion with and without pedicle screw instrumentation. METHODS: Questionnaire survey of 129 patients originally randomised to posterolateral lumbar spinal fusion with or without pedicle screw instrumentation. Follow-up included Dallas Pain Questionnaire (DPQ), Oswestry Disability Index (ODI), SF-36 and a question regarding willingness to undergo the procedure again knowing the result as globa

Mediastinal migration of distal occipito-thoracic instrumentation.

We present the occurrence and management of mediastinal migration of the distal aspect of a posterior occipito-thoracic screw-rod construct. No similar occurrence was found in the literature. This event occurred following an emergency tracheotomy (requiring neck hyperextension) in a patient with severe rheumatoid arthritis, who had previously undergone decompression and an Occiput-T2 instrumented fusion for cranio-cervical and sub-axial cervical spine instability. Imaging showed fracture-subluxation of T1/2 and T2/3 with the bilateral C7, T1 and T2 screws in the mediastinum causing tracheal an

Lumbar disc degeneration in Thai elderly: a population-based study.

OBJECTIVE: Determine the prevalence and related factors of lumbar disc degeneration in the Thai elderly. MATERIAL AND METHOD: A population-based study was done at Rom Klao community, Bangkok. Seven hundred and ninety-two cases (306 males, and 486 females) out of 1166 elderly people aged > or =50 (mean age of 61.07 +/- 7.8 years) were assessed. The lateral spinal radiographs were interpreted as spondylosis grade 0-3 according to the degree of severity. RESULTS: Males had more prevalence of grade 2-3 spondylosis than females (58.8% vs. 52.9%), but females had higher prevalence of spinal listhe

Surgical outcome of drop foot caused by degenerative lumbar diseases.

STUDY DESIGN: A total of 46 patients undergoing lumbar spine surgery for degenerative lumbar disease and presenting with drop foot were included in this retrospective study. OBJECTIVE: To determine which preoperative patients' symptoms were of statistical significance in their effect on surgical outcome. SUMMARY OF BACKGROUND DATA: Drop foot is a neuromuscular condition that results in palsy of the ankle dorsiflexion and is a major problem in Japanese daily life. Few studies have described the effect of a surgical intervention on drop foot associated with degenerative lumbar disorders and th

Thoracolumbar deformity arthrodesis to L5 in adults: the fate of the L5-S1 disc.

STUDY DESIGN: A retrospective clinical and radiographic analysis of long adult deformity fusions terminating at L5. OBJECTIVES: To define the results of thoracolumbar fusions to L5 in adult deformity patients with critical evaluation for potential subsequent L5-S1 disc degeneration and L5 implant loosening. SUMMARY OF BACKGROUND DATA: Few studies have reported the results of long adult fusions to L5 and the potential for subsequent advanced L5-S1 disc degeneration is unknown. MATERIALS AND METHODS: Thirty-four consecutive patients fused from the thoracic spine to L5 at a single institution

Correction of adult scoliosis via a posterior-only approach.

OBJECT: Adult scoliosis is a pathologically different entity from adolescent idiopathic scoliosis. The curves are more rigid, and rotational deformity and multilevel sagittal vertebral slippages compound the coronal malalignment. To correct these deformities, a surgical anterior release procedure is usually required, as well as posterior instrumentation-assisted fusion. This exposes the patient to the risks of a second procedure and of a thoracotomy or laparotomy. To decrease these risks, the authors have performed an anterior release, posterior release, and reduction via a posterior-only appr

Paraspinal musculature and adjacent segment disease after lumbar fusion: a systematic review and meta-analysis of fusion with and without posterior instrumentation.

BACKGROUND CONTEXT: Adjacent segment disease (ASD) is the principal long-term complication following lumbar fusion, contributing to pain, di … PATIENT SAMPLE: Adults (≥18 years) undergoing lumbar fusion for degenerative pathologies including spondylolisthesis, stenosis, and degenerative disc disease. OUTCOME MEASURES: Primary outcomes were diagnosis of rASD, reoperation due to ASD and all cause reoperations. Secondary outcomes included fusion success, cage subsidence, perioperative complications, and pa …

The association between teaching hospital status and postoperative outcomes among adults undergoing long-segment posterior lumbar instrumentation.

BACKGROUND CONTEXT: Long-segment lumbar spine fusions (LSLF) are widely performed in the United States to address degenerative conditions, i … nt posterior lumbar instrumentation spanning 3 to 12 vertebral segments for lumbar spinal stenosis, spondylolisthesis, or scoliosis. OUTCOME MEASURES: Primary outcomes included surgical complications (wound dehiscence, infection, reoperation) at 30 and 90 days postoperatively. Secondary outcomes assessed medical complications at 30 and 90 days, and pseudoarthrosis …

Robot-assisted versus navigated spinal fusion surgery: a comparative multicenter study on transpedicular screw placement accuracy and patient outcomes.

The transpedicular screw placement has been the gold standard for over a decade in treating degenerative diseases of the lumbo-sacral spine … ed diagnoses were degenerative disc disease (RS: 56%, NS: 52%), spinal stenosis (RS: 28%, NS: 31%), spondylolisthesis (RS: 12%, NS: 14%), and traumatic pathology (RS: 4%, NS: 3%). While there was a trend towards greater precision in screw placement with robotic technology, no significant difference was observed compared to neuronavigation with the O-arm. Both techn …

Hysterectomy-a possible risk factor for operative intervention in female patients for degenerative lumbar spine conditions: a case control and cohort study.

BACKGROUND CONTEXT: Researchers have recently linked hysterectomy, which alters sex hormone levels, to diseases like osteoporosis, lumbar spondylolisthesis, hypertension and diabetes etc. However, the association between hysterectomy and lumbar disc herniation (LDH)/lumbar spinal stenosis (LSS) remains unclarified. PURPOSE: To determine whether there is a correlation between hysterectomy and surgical intervention for LDH/LSS in women, further substantiated through imaging and clinical research. STUDY DESIGN: A case control and cohort study. PATIENT SAMPLE: The study group comprised 1202 fem…

Development and Validation of a Prediction Model for Pain and Functional Outcomes After Lumbar Spine Surgery.

IMPORTANCE: Functional impairment and pain are common indications for the initiation of lumbar spine surgery, but information about expected … 80.6%) underwent elective lumbar fusion procedures; 1223 (77.3%) had stenosis, and 1033 (65.3%) had spondylolisthesis. Twelve-month follow-up participation rates for each outcome were between 66% and 70%. Improvements were reported in function, back pain, and leg pain at 12 months by 306 of 528 surgical patients (58.0%), 616 of 899 patients (68.5%), and 355 of 464 …