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At least 19 recordsLinked to original sources
PubMed1989

Functional activities in spinal muscular atrophy patients after spinal fusion.

Spinal muscular atrophy patients present with weakness, greater in the proximal muscles, leading to scoliosis and limited upper extremity function. The purpose of this study is to identify unique aspects of these patients and to understand how spinal fusion affects their function. Forty patients underwent Harrington or Luque rod instrumentation with functional evaluations preoperatively and 2 and 5 years postoperatively. Biomechanical assessment of function is important. Flexibility of the spine is functionally advantageous because distal strength is used to align weaker proximal segments. Postoperatively, lack of spinal flexibility resulted in a decline in gross motor function and increased use of UE aids due to a change in the trunk position in the weaker patients. The stronger patients' activities were maintained. Earlier mobilization in patients with Luque procedures did not improve postoperative function.

Activities of Daily Living↗
PubMedDate not supplied

Effect of posterior spinal fusion on spinal balance in idiopathic scoliosis.

We analyzed the influence of posterior spinal fusion with Harrington rod instrumentation on spinal balance in 85 patients with primary thoracic curve patterns. Utilizing roentgenographic techniques of measurement, spinal decompensation was improved measurably in 64% of the patients, and lateral trunk shift improved in 82% of the patients with preoperative alterations of spinal balance.

Adolescent↗
PubMed1989

Spinal bone density following spinal fusion.

Spinal bone densities were assessed in 25 patients following lumbar fusion and bracing, in an attempt to study bone remodeling by noninvasive methods. Dual-photon densitometry was used to study specific areas of autologous bone grafts and adjacent vertebrae above the fusion mass. Measurements were made preoperatively and at 6-week intervals postoperatively. The data for the first 12 months postoperatively are reported here. In all patients there was at first a consistent loss in density in the vertebrae above the fusion mass, averaging 15.7%. This was followed by a gradual density increase such that by 1 year postoperatively, in 60% of the subjects, the density of these vertebrae was higher than the preoperative level. In the grafted areas, bone changes were cyclical, demonstrating a remodeling pattern consistent with that described in animal literature for graft healing and also consistent with modern bone remodeling theory. There was a general tendency toward a gradual increase in the density of the fusion mass.

Adult↗
PubMed1986

Long-term follow-up of spinal fusion in spinal muscular atrophy.

From 1966 to 1983, 11 females and eight males with spinal muscular atrophy were treated by arthrodesis. Seventeen of 19 patients were evaluated by follow-up physical examination, roentgenograms, and questionnaires. In order to compare long-term versus short-term results, changes in management, and factors contributing to morbidity and mortality, three groups were identified for study. Group I consisted of 11 patients operated between 1966 and 1983 and alive at follow-up evaluation. Group II consisted of five patients operated between 1980 and 1983. Group III consisted of three patients, all deceased at follow-up evaluation and operated before 1980. In Group I, the preoperative curve averaged 119 degrees and at final follow-up examination, 99 degrees. The average preoperative curve in Group II was 80 degrees and at follow-up examination, 49 degrees. Long-term follow-up vital capacities were obtained in nine patients. The average preoperative vital capacity was 1033 cm3, and the average vital capacity seven years postoperation was 860 cm3. Most patients reported improvement in sitting, balance, and comfort. All patients are wheelchair-bound, as they were before surgery. Few long-term respiratory problems were reported.

Adolescent↗
PubMed1989

Rationale for spinal fusion in lumbar spinal stenosis.

In order to define the indications for spinal fusion in patients undergoing decompression for lumbar spinal stenosis, 114 patients surgically treated were reviewed. Follow-up was 24 to 108 months. Patients were grouped into four categories: 15 with lateral recess stenosis, 45 with central-mixed stenosis, 43 with stenosis following prior lumbar surgery(s), and 11 with scoliosis and spinal stenosis. Only two patients with lateral recess stenosis underwent fusion with fair results. Approximately one-third of those with central-mixed stenosis required a fusion. Results were good in 70%. In those with stenosis following prior lumbar surgeries, although not statistically significant, those who had concomitant decompression and arthrodesis had a better outcome than those in whom decompression only was done. Patients with scoliosis and stenosis had decompression for significant motor and reflex deficits and fusion over the length of their major curves. Patients having decompression for lumbar stenosis with degenerative spondylolisthesis, isolated disc resorption with degenerative facet joints, intervertebral disc disease with instability, and those with scoliosis with multidirectional instabilities benefit from concomitant spinal fusion.

Female↗
PubMed1990

Unstable lumbar spine without hypermobility in postlaminectomy cases. Mechanism of symptoms and effect of spinal fusion with and without spinal instrumentation.

The morbid conditions of unstable lumbar spine that are not associated with hypermobility in postlaminectomy cases were studied. The dura and the nerve roots with adhesion could be affected by minimal movement of the spine, which seemed to be the mechanism of symptoms of instability without hypermobility. The effects of spinal instrumentation on this particular instability were studied. The spinal instrumentation provides instantaneous rigid fixation, and maintains it until fusion is obtained, which might prevent adhesion, new bone formation, and re-stenosis. Spinal instrumentation seemed to be the effective treatment for this particular instability.

Aged↗
PubMed1987

Removal of sublaminar wires after spinal fusion.

Eighteen patients who had had spinal fusion using Harrington rods with sublaminar wires underwent removal of the implants because of tenderness over the implants. There were no important complications. At final follow-up, no patient had a change in neurological function as compared with the preoperative assessment, and all reported relief of the preoperative tenderness. We concluded that the removal of rods and sublaminar wires from patients who have had a spinal fusion is clinically safe and effective.

Adolescent↗
PubMed1986

Aortic laceration after anterior spinal fusion.

Six weeks after anterior spinal fusion and instrumentation for a burst fracture of the second lumbar vertebra, a patient developed a nearly fatal retroperitoneal hemorrhage from a laceration of the aorta produced by the metallic implant. This experience suggests that placement of fusion hardware in close proximity to large arteries should be avoided if possible or, if such placement is necessary, the device should be removed as soon as fusion has taken place.

Adult↗
PubMed1990

Posterior spinal fusion: allograft versus autograft bone.

The effectiveness of allograft bone for posterior spinal fusion in neuromuscular scoliosis is controversial. Thirty patients with cerebral palsy, treated with posterior spinal fusion, were divided into two groups. Group 1 consisted of 18 patients treated by posterior spinal fusion using autogenous bone graft. Group 2 consisted of 12 patients treated by posterior spinal fusion using freeze-dried allograft bone. The average preoperative curve of 70 degrees in Group 1 was corrected to 35 degrees (50% correction). At 3.2 years average follow-up, the curves averaged 51 degrees (46% loss of correction). The average preoperative curve of 80 degrees in Group 2 was corrected to 39 degrees (51% correction). At 3.5 years average follow-up, the curves averaged 54 degrees (38% loss of correction). Anesthesia time decreased from 344 to 281 minutes (p less than 0.05), and intraoperative blood loss decreased from 2730 to 1740 ml (p less than 0.025) when allograft bone was used as a substitute for autograft bone. Freeze-dried allograft bone is a readily available, safe, and effective substitute for autogenous bone graft in patients with cerebral palsy undergoing posterior spinal fusion.

Adolescent↗
PubMed1991

Anterior and posterior spinal fusion. Staged versus same-day surgery.

Seventy-five patients who underwent combined anterior and posterior spinal fusion were compared to evaluate the results and safety of staged vs. continuous anterior and posterior spinal fusion. Thirty-five patients underwent two-stage anterior and posterior spinal fusion. The first stage consisted of anterior release; the second stage, which took place 7-10 days later, consisted of posterior spinal fusion and instrumentation. Forty patients underwent continuous anterior and posterior spinal fusion. This procedure consisted of anterior release followed by immediate posterior spinal fusion and instrumentation. The results show that 1) a continuous procedure is faster than the staged procedure; 2) there is less blood loss; 3) fewer days are spent in the hospital; and 4) better correction of the spinal deformity is achieved. Also, the complications were less frequent and less severe with the continuous procedure. It was concluded that the continuous procedure is safe and efficacious and has several advantages over the staged procedure.

Adult↗
PubMed1986

Subtotal vertebrectomy and spinal fusion for cervical spondylotic myelopathy.

To perform decompression of the spinal cord and stabilization of the cervical spine in the patients with cervical spondylotic myelopathy, subtotal vertebrectomy and spinal fusion of the cervical spine were carried out in 30 patients. In 18 patients, three vertebrectomies and a spinal fusion were carried out, and in 12 patients, four vertebrectomies and a spinal fusion were carried out. Neurologic symptoms that were present before the operations ranged from transverse lesion type myelopathy to motor system syndrome. The patients' symptoms improved significantly after the operations. By the final consultation, the cervical spine motion reduced by about half in the four level vertebrectomy patients and about one third in the three level vertebrectomy patients. No patients reported cervical pain or pain in the arms.

Adult↗
PubMed1988

Treatment of symptomatic flatback after spinal fusion.

Fifty-five patients who had loss of lumbar lordosis after spinal fusion and subsequently had corrective osteotomies were studied. When they were first seen, fifty-two patients (95 per cent) were unable to stand erect and forty-nine (89 per cent) had back pain. The previous use of distraction instrumentation with a hook placed at the level of the lower lumbar spine or the sacrum was the factor that was most frequently identified as leading to the development of the flatback syndrome. Sixty-six extension osteotomies were performed in these fifty-five patients. Nineteen patients (35 per cent) had an associated anterior spinal fusion. Thirty-three patients (60 per cent) had one or more complications, including pseudarthrosis, a dural tear, failure of hardware, neurapraxia, and urinary tract infection. The results of the operation were evaluated at follow-up by review of clinical records, radiographs, and questionnaires. At an average follow-up of six years (range, two to fourteen years), most patients felt that they had benefited from the corrective osteotomies. However, twenty-six patients (47 per cent) continued to lean forward and twenty patients (36 per cent) continued to have moderate or severe back pain. The failure to restore sagittal plane balance led to a higher rate of pseudarthrosis, which was associated with recurrent deformity. Anterior spinal fusion combined with posterior osteotomy resulted in greater maintenance of correction. The prevention of flatback syndrome is important, since its treatment is difficult. When a spinal fusion must be extended to the level of the lower lumbar spine or the sacrum, the use of distraction instrumentation should be avoided in order to prevent this deformity.

Adolescent↗
PubMed1988

Use of cortical cancellous allograft for posterior spinal fusion.

Fifty consecutive patients had posterior spinal fusion using only graft from bone banks. They were studied retrospectively in order to determine the pseudarthrosis rate, the quality of fusion mass obtained, the rate of infection, volume of blood lost, and operative time. The results showed that it is likely that the graft material used is not as important as the fusion technique. Strict adherence to facet obliteration, posterior element decortication, thorough removal of all soft tissue, and stable, well-planned instrumentation are probably the most important factors in preventing pseudarthrosis. With the complications associated with iliac crest graft and the potential benefits of reduced operative time and blood loss, use of allogeneic bone appears justified.

Bone Transplantation↗
PubMed2026

Comparison of Ketamine and Pregabalin on Postoperative Opioid Usage and Pain Management in Spinal Fusion: Systematic Review and Network Meta-analysis.

BACKGROUND CONTEXT: Spinal fusion is associated with substantial early postoperative pain and opioid exposure. Both ketamine and pregabalin are widely incorporated into Enhanced Recovery After Surgery (ERAS) protocols as opioid-sparing adjuncts. However, their comparative efficacy and safety in this specific setting remain uncertain. Our objective was to compare ketamine and pregabalin indirectly for early postoperative opioid consumption, pain, and adverse events in adults undergoing spinal fusion. METHODS: Pubmed, Embase, and Cochrane Trials were searched from inception through October 2025. Eligible studies were randomized trials enrolling adults undergoing instrumented spinal fusion, randomized to perioperative ketamine, pregabalin, or control, and reported extractable 24-hour opioid consumption or pain outcomes. Continuous outcomes were pooled as mean differences in MME or VAS units, and adverse events were reported descriptively. A connected treatment network was analyzed using random-effects models. Risk of bias (RoB) was assessed with the Cochrane RoB 2 tool. RESULTS: Thirteen trials (n=879) were included: ketamine (n=210), pregabalin (n=271), and control (n=398). Six trials contributed opioid data (3 ketamine, 3 pregabalin). Using pregabalin 150 mg as reference, ketamine was associated with lower 0-24-hour opioid use (MD -56.99 mg MME; 95% CI -99.56 to -14.43). Control (MD +21.31; 95% CI -1.05 to +43.66) and pregabalin 300 mg (MD -13.22; 95% CI -40.41 to +13.96) did not significantly differ from pregabalin 150 mg. Seven trials contributed 24-hour VAS data, with control being associated with higher pain versus pregabalin 150 mg (MD +0.84; 95% CI +0.01 to +1.66), while ketamine and pregabalin 300 mg were not k significantly different. Adverse events were generally infrequent and similar to control. CONCLUSIONS: Both ketamine and pregabalin provide early opioid sparing with comparable 24-hour analgesia. Ketamine showed a larger opioid-sparing point estimate, but indirect comparisons are imprecise. Adequately powered head-to-head trials with standardized protocols and adverse event reporting are needed.

Humans↗