PURPOSE A 48-hour trial of dexamethasone coanalgesia became our standard practice in May 2008. This is our research Ethics Board-approved review of this experience to date with attention to perioperative narcotics use and pain scores for the first 48 hours after surgery as well as length of stay (LOS), wound healing complications, and infections in the first 6 months, compared with the historic...

BACKGROUND Although some investigators believe that the rate of postoperative instability is low after lumbar spinal stenosis surgery, the majority believe that postoperative instability usually develops. Decompression alone and decompression with fusion have been widely used for years in the surgical treatment of lumbar spinal stenosis. Nevertheless, in recent years several biomechanical studi...

Intraoperative pulmonary fat and bone-marrow embolism is a serious complication of bone and joint surgery. We have investigated the occurrence and incidence of intraoperative embolism in patients undergoing elective lumbar spinal surgery with or without instrumentation. Sixty adult patients with lumbar degenerative disease were examined by intraoperative transoesophageal echocardiography while ...

The question in the title of this paper practically answers itself. Can the anxiety domain of EQ‐5D and mental health items from SF‐36 help predict outcomes after surgery for lumbar degenerative disorders? Yes, paper and pencil questionnaires (however brief) purporting to assess patients’ emotional status may contribute some small incremental value for predicting lumbar fusion outcomes. However...

OBJECTIVES Multiple different approaches are used to treat lumbar degenerative disc disease and spinal instability. Both anterior-posterior (AP) reconstructive surgery and transforaminal lumbar interbody fusion (TLIF) provide a circumferential fusion and are considered reasonable surgical options. The purpose of this study was to quantitatively assess clinical parameters such as surgical blood ...

The aim of the study was to investigate the changes of the lumbar intervertebral disc degeneration by magnetic resonance imaging (MRI) after the implantation of interspinous device and the fusion of the adjacent segment. A total of 62 consecutive patients suffering L5/S1 lumbar disc herniation (LDH) with concomitant disc space narrowing or low-grade instability up to 5 mm translational slip in ...

Background: Interbody cage stabilization as a stand-alone procedure in lumbar spine fusion is questioned due to inconsistent mechanical effects registered in human cadaveric studies. Even segmental mobility exceeding the normal range of motion is described after cage implantation. For the anterior interbody cage fusion, this potential, undesired destabilization is explained by the resection of ...

Adult degenerative scoliosis associated with lumbar stenosis has become a common issue in the elderly population. But its surgical management is on debating. The main issue condenses on the management priority of scoliosis or stenosis. This study is to investigate surgical management strategy and outcome of adult degenerative scoliosis associated with lumbar stenosis. Between January 2003 and D...

BACKGROUND Failed fusion surgery remains difficult to treat. Few published data on disc replacement surgery after failed fusion procedures exist. Our objective was to evaluate outcomes of junctional lumbar disc replacement after previous fusion surgery and to correlate outcome with radiological changes to parameters of sagittal balance. METHODS Out of a single-center prospective registry of 2...

The many unanswered questions surrounding ADR beget the question of whether patients would ultimately be better managed with lumbar fusion surgery or even no surgery at all. Lumbar fusion technology has made advances in recent years with the advent of transforaminal lumbar interbody fusion (TLIF) and the use of bone morphogenetic proteins. With a TLIF procedure, spine surgeons are able to obtai...