A New Surgical Strategy for Infective Spondylodiscitis: Comparison Between the Combined Antero-Posterior and Posterior-Only Approaches

Conclusion. Interbody fusion with long-level pedicle screws fixation through a posterior-only approach was shown to be as effective as a combined antero-posterior approach for the surgical treatment of infective spondylodiscitis. A posterior-only approach is recommended when the regional wedge angle of the collapsed vertebra is less than 8.2°. Level of Evidence: 4
Source: Spine - Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

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Instrumented posterolateral lumbar fusion (PLF) surgery is commonly used to alleviate pain and other symptoms associated with degenerative conditions of the lumbosacral spine.  Although autologous iliac crest bone graft (ICBG) remains the gold standard graft material for PLF, surgeons have sought alternatives to avoid morbidities associated with ICBG harvest. OSTEOAMP® is a novel allograft bone graft substitute (BGS) that retains multiple endogenous growth factors. Evid ence concerning effectiveness of PLF in multi-level fusion is scarce.
Source: The Spine Journal - Category: Orthopaedics Authors: Source Type: research
Abstract Diffuse idiopathic skeletal hyperostosis (DISH) is a systematic disease of unknown etiology characterized by ossification at the site of spine and major joints entheses, including the hip. Ossified connective tissue may cause pain and joint stiffness, which may require surgical intervention. The purpose of this study was to investigate the clinical, radiographic, and arthroscopic presentation and surgical outcomes of patients with DISH involving the hips. Fourteen hips in 9 patients (mean±SD age, 63±14 years; range, 35-76 years) with overcoverage of the femoral head by DISH were retrospectiv...
Source: Orthopedics - Category: Orthopaedics Authors: Tags: Orthopedics Source Type: research
Conclusion. While the radiographic nonunion rate at 24 months was 13%, PROs show that many of the radiographic nonunions were asymptomatic. Although the majority of patients with radiographic nonunion did not undergo additional surgery, the rate of secondary surgeries at the index level was significantly higher in the radiographic nonunion group. Level of Evidence: 2
Source: Spine - Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research
This study focused on the optimal dose for each segment and the efficacy of E.BMP-2 as a substitute for autogenous iliac bone graft. Ten patients were enrolled from January 2015 to December 2015, and underwent an additional posterolateral fusion procedure, with 2.5 mg of E.BMP-2 followed by decompression, transpedicular fixation, and interbody fusion. The mean follow-up period was 13.9 months, and regular radiological examinations were performed in every case. Clinical outcomes were measured with a visual analog scale for back pain (VAS-BP), and leg pain (VAS-LP) and the Korean Oswestry Disability Index (K-ODI). All par...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Abstract OBJECTIVE: A consequence of anterior cervical discectomy and fusion (ACDF) is graft subsidence, potentially leading to kyphosis, nonunion, foraminal stenosis, and recurrent pain. Bone density, as measured in Hounsfield units (HUs) on CT, may be associated with subsidence. The authors evaluated the association between HUs and subsidence rates after ACDF. METHODS: A retrospective study of patients treated with single-level ACDF at the University of California, San Francisco, from 2008 to 2017 was performed. HU values were measured according to previously published methods. Only patients with preoperati...
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
ConclusionThe results of this retrospective study suggest that the 45S5 BAG may be an interesting alternative option to autologous graft, in terms of safety and bone fusion efficiency.Level of evidenceIV Retrospective study
Source: European Journal of Orthopaedic Surgery and Traumatology - Category: Orthopaedics Source Type: research
Instrumented posterolateral lumbar fusion (PLF) surgery is commonly used to alleviate pain and other symptoms associated with degenerative conditions of the lumbosacral spine. Although autologous iliac crest bone graft (ICBG) remains the “gold standard” grafting material for these procedures, surgeons have sought alternatives to avoid the potential morbidity associated with ICBG harvest. OSTEOAMP is a novel allograft bone graft substitute (BGS) that has been processed to retain multiple endogenous growth factors.
Source: The Spine Journal - Category: Orthopaedics Authors: Source Type: research
Conclusion. Minimally invasive intervention with intradiscal injection of ASA was successful in reducing IDD in a reproducible rabbit model, with significant improvement in disc height and morphology when compared with vehicle and untreated control groups on radiographic and MRI analyses. Level of Evidence: N/A
Source: Spine - Category: Orthopaedics Tags: BASIC SCIENCE Source Type: research
ConclusionsEnhanced strut porosity SiCaP EP provided high (month 12: 86.3%) spinal fusion success rates in PLF surgery. Fusion success was associated with improved clinical outcomes in patients within 12  months, relative to baseline.ClinicalTrials.gov identifierNCT01452022Graphical abstractThese slides can be retrieved under Electronic Supplementary Material.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
CONCLUSIONS PPS fixation alone was a valid and less invasive surgery for the treatment of early spinal TB. Furthermore, the recovery process of spinal TB can be facilitated using a "simple" internal fixation procedure, and bone fusion can be achieved without aggressive debridement and bone graft surgery. PMID: 30811378 [PubMed - in process]
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
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