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Failure of reconstitution of open-section, posterior iliac-wing bone graft donor sites after lumbar spinal fusion. Observations with implications for the etiology of donor site pain.

https://arctichealth.org/en/permalink/ahliterature178413
Source
Eur Spine J. 2005 Feb;14(1):95-8
Publication Type
Article
Date
Feb-2005
Author
Drew A Bednar
Waleed Al-Tunaib
Author Affiliation
Division of Orthopedic Surgery, Department of Surgery, McMaster University, c/o 414 Victoria Avenue North #M-9, Hamilton, Ontario, L8L 5G8, Canada. spinopod@allstream.net
Source
Eur Spine J. 2005 Feb;14(1):95-8
Date
Feb-2005
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Bone Regeneration - physiology
Bone Remodeling - physiology
Bone Transplantation - adverse effects - methods - statistics & numerical data
Cohort Studies
Female
Humans
Ilium - pathology - radiography - surgery
Low Back Pain - surgery
Lumbar Vertebrae - surgery
Male
Middle Aged
Ontario
Pain, Postoperative - etiology - mortality - pathology
Spinal Fusion - adverse effects - methods
Tomography, X-Ray Computed
Wound Healing - physiology
Abstract
The objective of this cohort study--conducted at a regional trauma unit in southern Ontario, Canada--was to review the imaging history of open-section, iliac-wing bone graft donor sites in lumbar fusion patients. Intervention entailed review of available X-ray and CT scan images for all patients undergoing lumbar fusion with iliac autograft in the senior author's practice over a 4-year period. Outcome was radiographic confirmation of the absence of bony reconstitution at the iliac harvest site. Of 239 primary fusions performed, 209 complete imaging records were available for review. The images of a further 20 patients who had surgery with the senior author prior to the study period and who presented at the office in the first half of 2000 were also assessed. All cases showed persistence of the iliac donor harvest site defect. Only minimal marginal sclerosis to suggest attempted remodeling was observed. We conclude that iliac-wing bone graft donor sites do not remodel. Given that iliac harvesting is known to increase strain in the pelvis, and that lumbosacral stabilization increases stress in the pelvis, permanent deficiency of iliac bone stock at donor harvest site may be a factor in both primary donor site pain and the observed high frequency of this problem in lumbosacral fusion patients.
Notes
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PubMed ID
15365797 View in PubMed
Less detail

The long-term outcome of lumbar fusion in the Swedish lumbar spine study.

https://arctichealth.org/en/permalink/ahliterature282366
Source
Spine J. 2016 05;16(5):579-87
Publication Type
Article
Date
05-2016
Author
Rune Hedlund
Christer Johansson
Olle Hägg
Peter Fritzell
Tycho Tullberg
Source
Spine J. 2016 05;16(5):579-87
Date
05-2016
Language
English
Publication Type
Article
Keywords
Adult
Female
Humans
Low Back Pain - surgery
Lumbar Vertebrae - surgery
Male
Middle Aged
Physical Therapy Modalities - adverse effects
Postoperative Complications
Prospective Studies
Randomized Controlled Trials as Topic
Spinal Fusion - adverse effects
Surveys and Questionnaires
Sweden
Treatment Outcome
Abstract
Current literature suggests that in the long-term, fusion of the lumbar spine in chronic low back pain (CLBP) does not result in an outcome clearly better than structured conservative treatment modes.
This study aimed to assess the long-term outcome of lumbar fusion in CLBP, and also to assess methodological problems in long-term randomized controlled trials (RCTs).
A prospective randomized study was carried out.
A total of 294 patients (144 women and 150 men) with CLBP of at least 2 years' duration were randomized to lumbar fusion or non-specific physiotherapy. The mean follow-up time was 12.8 years (range 9-22). The follow up rate was 85%; exclusion of deceased patients resulted in a follow-up rate of 92%.
Global Assessment (GA) of back pain, Oswestry Disability Index (ODI), visual analogue scale (VAS) for back and leg pain, Zung depression scale were determined. Work status, pain medication, and pain frequency were also documented.
Standardized outcome questionnaires were obtained before treatment and at long-term follow-up. To optimize control for group changers, four models of data analysis were used according to (1) intention to treat (ITT), (2) "as treated" (AT), (3) per protocol (PP), and (4) if the conservative group automatically classify group changers as unchanged or worse in GA (GCAC). The initial study was sponsored by Acromed (US$50,000-US$100,000).
Except for the ITT model, the GA, the primary outcome measure, was significantly better for fusion. The proportion of patients much better or better in the fusion group was 66%, 65%, and 65% in the AT, PP, and GCAC models, respectively. In the conservative group, the same proportions were 31%, 37%, and 22%, respectively. However, the ODI, VAS back pain, work status, pain medication, and pain frequency were similar between the two groups.
One can conclude that from the patient's perspective, reflected by the GA, lumbar fusion surgery is a valid treatment option in CLBP. On the other hand, secondary outcome measures such as ODI and work status, best analyzed by the PP model, indicated that substantial disability remained at long-term after fusion as well as after conservative treatment. The lack of objective outcome measures in CLBP and the cross-over problem transforms an RCT to an observational study, that is, Level 2 evidence. The discrepancy between the primary and secondary outcome measures prevents a strong conclusion on whether to recommend fusion in non-specific low back pain.
Notes
Comment In: Spine J. 2016 May;16(5):588-9027261844
PubMed ID
26363250 View in PubMed
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Prospective clinical and radiographic results of CHARITÉ III artificial total disc arthroplasty at 2- to 7-year follow-up: a Canadian experience.

https://arctichealth.org/en/permalink/ahliterature139151
Source
Can J Surg. 2010 Dec;53(6):408-4145
Publication Type
Article
Date
Dec-2010
Author
Michael Katsimihas
Christopher S Bailey
Khalil Issa
Jennifer Fleming
Patricia Rosas-Arellano
Stewart I Bailey
Kevin R Gurr
Author Affiliation
The Division of Orthopaedics, Department of Surgery, University of Western Ontario, London, ON.
Source
Can J Surg. 2010 Dec;53(6):408-4145
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Adult
Arthroplasty, Replacement - instrumentation
Canada
Disability Evaluation
Female
Follow-Up Studies
Humans
Intervertebral Disc - radiography - surgery
Intervertebral Disc Degeneration - surgery
Joint Prosthesis
Low Back Pain - surgery
Lumbar Vertebrae - radiography - surgery
Male
Middle Aged
Pain Measurement
Prospective Studies
Abstract
Early and intermediate results have shown that the SB CHARITÉ III total disc arthroplasty (TDA) favourably compares to spinal fusion, but is associated with fewer complications and higher levels of satisfaction. We sought to prospectively report the clinical and radiographic results of the CHARITÉ III TDA after an average of 55 months follow-up.
We conducted a prospective study of patients receiving the CHARITÉ TDA at either L4-5 or L5-S1 between April 2001 and November 2006. The primary indication for surgery was discogenic low-back pain confirmed by provocative discography. Assessment included pre- and postoperative (3, 6 and 12 mo and yearly thereafter) validated patient outcome measures and radiographic review.
Fifty-seven of the potential 64 (89%) patients were available for complete follow-up. Their mean age was 39 (range 21-59) years. A statistically significant improvement was demonstrated between all the mean pre- and postoperative intervals for the Oswestry Disability Index, visual analogue scale for back and leg pain, and Short Form-36 health survey (p
Notes
Cites: Spine (Phila Pa 1976). 2000 Jul 1;25(13):1711-510870148
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Cites: J Spinal Disord Tech. 2003 Feb;16(1):96-912571491
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Cites: Spine (Phila Pa 1976). 2001 Dec 1;26(23):2521-32; discussion 2532-411725230
PubMed ID
21092434 View in PubMed
Less detail

Radiofrequency neurotomy for lumbar pain.

https://arctichealth.org/en/permalink/ahliterature169145
Source
Issues Emerg Health Technol. 2006 May;(83):1-4
Publication Type
Article
Date
May-2006
Author
J. Murtagh
V. Foerster
Source
Issues Emerg Health Technol. 2006 May;(83):1-4
Date
May-2006
Language
English
Publication Type
Article
Keywords
Canada
Denervation - methods
Humans
Insurance Coverage
Low Back Pain - surgery
Lumbar Vertebrae - innervation - surgery
Radio Waves - therapeutic use
Radiosurgery - adverse effects - economics
Spinal Nerves - surgery
Treatment Outcome
Zygapophyseal Joint - innervation - surgery
Abstract
(1) Chronic lumbar (lower back) pain, which affects many Canadians, imposes a large economic burden. (2) Symptoms may occur in the vertebral facet joints of 15% to 40% of patients with lower back pain. (3) Medial branch radiofrequency neurotomy is a minimally invasive outpatient procedure that reduces pain by interrupting the nerve supply to painful facet joints. (4) Four systematic reviews of this procedure offer disparate conclusions. (5) One small well designed observational study has shown positive results, but no equally rigorous randomized controlled trial has been conducted.
PubMed ID
16724429 View in PubMed
Less detail

[Unbiased neutral handling is wanted for the inspection of hospital departments].

https://arctichealth.org/en/permalink/ahliterature205185
Source
Lakartidningen. 1998 Jun 10;95(24):2795-6
Publication Type
Article
Date
Jun-10-1998
Author
B. Nyström
Source
Lakartidningen. 1998 Jun 10;95(24):2795-6
Date
Jun-10-1998
Language
Swedish
Publication Type
Article
Keywords
Hospital Departments - economics - standards
Humans
Low Back Pain - surgery - therapy
Orthopedics - economics - standards
Quality Assurance, Health Care
Surgery Department, Hospital - economics - standards
Sweden
Treatment Outcome
Notes
Comment On: Lakartidningen. 1998 Mar 25;95(13):1435-89560973
PubMed ID
9656632 View in PubMed
Less detail

Women do not fare worse than men after lumbar fusion surgery: Two-year follow-up results from 4,780 prospectively collected patients in the Swedish National Spine Register with lumbar degenerative disc disease and chronic low back pain.

https://arctichealth.org/en/permalink/ahliterature282975
Source
Spine J. 2017 May;17(5):656-662
Publication Type
Article
Date
May-2017
Author
Jan Triebel
Greta Snellman
Bengt Sandén
Fredrik Strömqvist
Yohan Robinson
Source
Spine J. 2017 May;17(5):656-662
Date
May-2017
Language
English
Publication Type
Article
Keywords
Adult
Aged
Female
Humans
Intervertebral Disc Degeneration - surgery
Low Back Pain - surgery
Lumbar Vertebrae - surgery
Male
Middle Aged
Postoperative Complications - epidemiology
Sex Factors
Spinal Fusion - adverse effects - methods
Sweden
Abstract
Proper patient selection is of utmost importance in the surgical treatment of degenerative disc disease (DDD) with chronic low back pain (CLBP). Among other factors, gender was previously found to influence lumbar fusion surgery outcome.
This study investigates whether gender affects clinical outcome after lumbar fusion.
This is a national registry cohort study.
Between 2001 and 2011, 2,251 men and 2,521 women were followed prospectively within the Swedish National Spine Register (SWESPINE) after lumbar fusion surgery for DDD and CLBP.
Patient-reported outcome measures (PROMs), visual analog scale (VAS) for leg and back pain, Oswestry Disability Index (ODI), quality of life (QoL) parameter EQ5D, and labor status and pain medication were collected preoperatively, 1 and 2 years after surgery.
Gender differences of baseline data and PROM improvement from baseline were analyzed. The effect of gender on clinically important improvement of PROM was determined in a multivariate logistic regression model. Furthermore, gender-related differences in return-to-work were investigated.
Preoperatively, women had worse leg pain (p
PubMed ID
27845232 View in PubMed
Less detail

6 records – page 1 of 1.