Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

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Articles

Minimally Invasive Surgical Techniques in Adult Degenerative Spinal Deformity: A Systematic Review

Konrad Bach MD, Amir Ahmadian MD, Armen Deukmedjian MD, Juan S. Uribe MD

Minimally invasive surgery (MIS) approaches have the potential to reduce procedure-related morbidity when compared with traditional approaches. However, the magnitude of radiographic correction and degree of clinical improvement with MIS techniques for adult spinal deformity remain undefined.

How Does Accounting for Worker Productivity Affect the Measured Cost-Effectiveness of Lumbar Discectomy?

Lane Koenig PhD, Timothy M. Dall MS, Qian Gu PhD, Josh Saavoss BA, Michael F. Schafer MD

Back pain attributable to lumbar disc herniation is a substantial cause of reduced workplace productivity. Disc herniation surgery is effective in reducing pain and improving function. However, few studies have examined the effects of surgery on worker productivity.

Can Internet Information on Vertebroplasty be a Reliable Means of Patient Self-education?

T. Barrett Sullivan BSE, Joshua T. Anderson BS, Uri M. Ahn MD, Nicholas U. Ahn MD

Studies of the quality and accuracy of health and medical information available on the Internet have shown that many sources provide inadequate information. However, to our knowledge, there are no published studies analyzing the quality of information available online regarding vertebroplasty. Because this has been a high-volume procedure with highly debated efficacy, it is critical that patients receive complete, accurate, and well-balanced information before deciding a treatment course. Additionally, few studies have evaluated the merit of academic site authorship or site certification on information quality, but some studies have used measurements of quality that are based primarily on subjective criteria or information accuracy rather than information completeness.

Elderly Patients Have Similar Outcomes Compared to Younger Patients After Minimally Invasive Surgery for Spinal Stenosis

Ilyas S. Aleem MD, Y. Raja Rampersaud MD, FRCS(C)

Older patients undergo surgery for lumbar spinal stenosis in great numbers, but as a result of substantial diagnostic and surgical heterogeneity, the impact of age on results after surgery is poorly defined.

Same-day Discharge After Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Series of 808 Cases

Walter W. Eckman MD, Lynda Hester PT, Michelle McMillen RN

The versatility of transforaminal lumbar interbody fusion (TLIF) allows fusion at any level along with any necessary canal decompression. Unilateral TLIF with a single interbody device and unilateral pedicle fixation has proven effective, and minimally invasive techniques have shortened hospital stays. Reasonable questions have been raised, though, about whether same-day discharge is feasible and safe after TLIF surgery.

Does Obesity Affect the Surgical Outcome and Complication Rates of Spinal Surgery? A Meta-analysis

Jin Jiang MD, Yuanjun Teng MD, Zhenzhen Fan MD, Shahidur Khan MD, Yayi Xia MD, PhD

As obesity becomes more prevalent, it becomes more common among patients considering orthopaedic surgery, including spinal surgery. However, there is some controversy regarding whether obesity is associated with complications, failed reconstructions, or reoperations after spinal surgery.

Does Minimally Invasive Transsacral Fixation Provide Anterior Column Support in Adult Scoliosis?

Neel Anand MD, MchOrth, Eli M. Baron MD, Babak Khandehroo MD

Spinal fusion to the sacrum, especially in the setting of deformity and long constructs, is associated with high complication and pseudarthrosis rates. Transsacral discectomy, fusion, and fixation is a minimally invasive spine surgery technique that provides very rigid fixation. To date, this has been minimally studied in the setting of spinal deformity correction.

What Is the Learning Curve for Robotic-assisted Pedicle Screw Placement in Spine Surgery?

Xiaobang Hu MD, PhD, Isador H. Lieberman MD, MBA, FRCSC

Some early studies with robotic-assisted pedicle screw implantation have suggested these systems increase accuracy of screw placement. However, the relationship between the success rate of screw placement and the learning curve of this new technique has not been evaluated.

Do Abdominal Cutouts in Thoracolumbosacral Orthoses Increase Pulmonary Function?

Donna Frownfelter PT, DPT, MA, CCS, RRT, FCCP, Karen Stevens PT, DPT, MS, OCS, Mary Massery PT, DPT, DSc, Gene Bernardoni RPh, CO

Thoracolumbosacral orthoses (TLSOs) are effective in their intended purpose of limiting spinal movement but tend to restrict rib cage and abdominal motion. Incorporating an abdominal cutout, allowing abdominal excursion, may reduce the restraint on abdominal expansion associated with inhalation and thereby reduce pulmonary compromise.

Is the Lateral Transpsoas Approach Feasible for the Treatment of Adult Degenerative Scoliosis?

Carlos Castro MD, Leonardo Oliveira BS, Rodrigo Amaral MD, Luis Marchi MS, Luiz Pimenta MD, PhD

Lumbar degenerative scoliosis is a common condition in the elderly. Open traditional surgical approaches are associated with high-morbidity complication rates. Less invasive options may carry fewer risks in this patient population. A minimally disruptive lateral transpsoas retroperitoneal technique to accomplish interbody fusion was developed to avoid the morbidity of traditional open surgery, but this approach as an anterior stand-alone construction has not been reported yet for the treatment of adult degenerative scoliosis.