scholarly journals Evaluation of the reduction, tightening and gripping performance of an innovative set screw technology for instrumented posterior lumbar fusion: a biomechanical study

2021 ◽  
pp. 102918
Author(s):  
Francisco Ardura ◽  
David Chenaux ◽  
Hugues Pascal-Moussellard ◽  
Martin Hessmann
Keyword(s):  
Lumbar Fusion ◽  
Biomechanical Study ◽  
Posterior Lumbar Fusion

Rheumatoid Arthritis Increases Risk of Medical Complications Following Posterior Lumbar Fusion

2021 ◽  
Author(s):  
Joshua Bell ◽  
Sean Sequeira ◽  
Pramod Kamalapathy ◽  
Varun Puvanesarajah ◽  
Hamid Hassanzadeh
Keyword(s):  
Rheumatoid Arthritis ◽  
Lumbar Fusion ◽  
Medical Complications ◽  
Posterior Lumbar Fusion

scholarly journals Using Predictive Modeling and Supervised Machine Learning to Identify Patients at Risk for Venous Thromboembolism Following Posterior Lumbar Fusion

2021 ◽  
pp. 219256822110193
Author(s):  
Kevin Y. Wang ◽  
Ijezie Ikwuezunma ◽  
Varun Puvanesarajah ◽  
Jacob Babu ◽  
Adam Margalit ◽  
...  
Keyword(s):  
Machine Learning ◽  
At Risk ◽  
Venous Thromboembolism ◽  
Risk Stratification ◽  
Predictive Model ◽  
Predictive Modeling ◽  
Lumbar Fusion ◽  
Posterior Lumbar Fusion ◽  
Single Level ◽  
Patients At Risk

Study Design: Retrospective review. Objective: To use predictive modeling and machine learning to identify patients at risk for venous thromboembolism (VTE) following posterior lumbar fusion (PLF) for degenerative spinal pathology. Methods: Patients undergoing single-level PLF in the inpatient setting were identified in the National Surgical Quality Improvement Program database. Our outcome measure of VTE included all patients who experienced a pulmonary embolism and/or deep venous thrombosis within 30-days of surgery. Two different methodologies were used to identify VTE risk: 1) a novel predictive model derived from multivariable logistic regression of significant risk factors, and 2) a tree-based extreme gradient boosting (XGBoost) algorithm using preoperative variables. The methods were compared against legacy risk-stratification measures: ASA and Charlson Comorbidity Index (CCI) using area-under-the-curve (AUC) statistic. Results: 13, 500 patients who underwent single-level PLF met the study criteria. Of these, 0.95% had a VTE within 30-days of surgery. The 5 clinical variables found to be significant in the multivariable predictive model were: age > 65, obesity grade II or above, coronary artery disease, functional status, and prolonged operative time. The predictive model exhibited an AUC of 0.716, which was significantly higher than the AUCs of ASA and CCI (all, P < 0.001), and comparable to that of the XGBoost algorithm ( P > 0.05). Conclusion: Predictive analytics and machine learning can be leveraged to aid in identification of patients at risk of VTE following PLF. Surgeons and perioperative teams may find these tools useful to augment clinical decision making risk stratification tool.

Three-Dimensional Computed Tomography and Multiplanar Reformations in the Assessment of Pseudarthrosis in Posterior Lumbar Fusion Patients

Spine ◽  
1988 ◽  
Vol 13 (1) ◽  
pp. 69-75 ◽  
Author(s):  
PHILIPP LANG ◽  
HARRY K. GENANT ◽  
NEIL CHAFETZ ◽  
PETER STEIGER ◽  
JAMES M. MORRIS
Keyword(s):  
Computed Tomography ◽  
Lumbar Fusion ◽  
Three Dimensional ◽  
Posterior Lumbar Fusion ◽  
Multiplanar Reformations

scholarly journals The Effects of Chronic Preoperative Steroid Therapy on Perioperative Complications Following Elective Posterior Lumbar Fusion

2018 ◽  
Vol 8 (8) ◽  
pp. 834-841 ◽  
Author(s):  
William A. Ranson ◽  
Samuel J. W. White ◽  
Zoe B. Cheung ◽  
Christopher Mikhail ◽  
Ivan Ye ◽  
...  
Keyword(s):  
Steroid Therapy ◽  
Lumbar Fusion ◽  
Perioperative Complications ◽  
Posterior Lumbar Fusion

scholarly journals A comparative study of functional outcome between posterior lumbar fusion and posterior lumbar interbody fusion in spondylolisthesis

2021 ◽  
Vol 7 (3) ◽  
pp. 544
Author(s):  
Harpreet Singh ◽  
Dhruv Patel ◽  
Sangam Tyagi ◽  
Krushna Saoji ◽  
Tilak Patel ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Interbody Fusion ◽  
Operative Time ◽  
Lumbar Fusion ◽  
Tertiary Care ◽  
Posterior Lumbar Interbody Fusion ◽  
Invasive Technique ◽  
Lumbar Interbody Fusion ◽  
Tertiary Care Centre ◽  
Posterior Lumbar Fusion

<p class="abstract"><strong>Background:</strong> Spondylolisthesis is condition in which one vertebra slips over other vertebra. This study has been done to compare the functional outcome and complications of two techniques: posterior lumbar fusion (intertransverse fusion) and posterior lumbar interbody fusion.</p><p class="abstract"><strong>Methods:</strong> Total 20 patients with spondylolisthesis admitted in a tertiary care centre in Rajasthan were allotted alternatively in posterior lumbar fusion (PLF) group and posterior lumbar interbody fusion (PLIF) group. In PLF, fusion was done by placing bone graft between transverse processes and around facets. In PLIF, fusion was bone by placing cage in between vertebral bodies.</p><p class="abstract"><strong>Results:</strong> 20 patients were included in our study with female predominance (65%). Mean age was 54.2 years (PLF=58.4 and PLIF=50.2). 70% patients have L4-L5 level spondylolisthesis. Average operative time was less in PLF group, which is statistically significant. Functional outcome was measured by using visual analogue scale (VAS) score and Japanese orthopedics association score (JOAS) at 3 weeks, 3 months and 6 months. There is a significant decrease between preoperative VAS and at 6 months, in both PLF and PLIF group. JOAS was significantly increased at 6 months in both PLF and PLIF group as compared to preoperative score. But difference in JOAS at 6 months is not significant between PLF and PLIF.</p><p class="abstract"><strong>Conclusions:</strong> Both PLF and PLIF are equally effective for spondylolisthesis. Both techniques have same satisfactory results. As PLIF is more invasive technique, more operative time and more complications are seen.</p>

scholarly journals The incidence of stroke among patients undergoing elective posterior lumbar fusion: a retrospective cohort study

2019 ◽  
Author(s):  
Patrick Arena ◽  
Jingping Mo ◽  
Charu Sabharwal ◽  
Elizabeth Begier ◽  
Xiaofeng Zhou ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Lumbar Fusion ◽  
Index Hospitalization ◽  
Loss To Follow Up ◽  
Posterior Lumbar Fusion ◽  
Electronic Healthcare Record ◽  
Post Operation

Abstract Background: Although stroke is an uncommon but life-threatening complication among spinal surgery patients, the recognition of this adverse event is critical given the aging population undergoing surgical procedures. The objective of this study was to estimate the incidence of stroke among adults undergoing elective posterior lumbar fusion (PLF) during post-operative risk windows and among different subgroups. Methods: A retrospective cohort study using a longitudinal electronic healthcare record (EHR) database was conducted from January 1, 2007 to June 30, 2018. Elective PLF, stroke, and select clinical characteristics were defined based on International Classification of Disease codes. Patients aged 18 to 85 years with ≥ 183 days of enrollment in the database prior to undergoing elective PLF were followed from the index date until the occurrence of stroke, death, loss to follow-up, or end of study period, whichever occurred first. Incidence proportions (IPs) and rates (IRs) of stroke were estimated in the following risk windows: index hospitalization, ≤ 30 days, ≤ 90 days, ≤ 180 days, and ≤ 365 days post-operation Results: A total of 43,063 patients were eligible for the study. The IP of stroke following elective PLF ranged from 0.29% (95% confidence interval [CI]: 0.25%, 0.35%) during index hospitalization to 1.12% (95% CI: 1.03%, 1.23%) ≤ 365 days post-operation; the IR of stroke following elective PLF per 1000 person-years decreased consistently from 229.08 (95% CI: 192.38, 272.78) during index hospitalization to 13.68 (95% CI: 12.51, 14.96) ≤ 365 days post-operation. Stratified analyses revealed that older patients had a higher incidence of stroke. Additionally, black patients had higher stroke incidences than white, Asian, or other patients. Furthermore, the incidence of post-operative stroke was higher among patients with a history of type 2 diabetes than among patients without such history. Conclusions: The incidence of stroke following elective PLF found here using an EHR database is slightly higher than that reported in the literature; however, the discrepancy is due to differences in the variable definitions, study populations, follow-up periods, and data sources between our study and those in the literature.

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