Uninstrumented Posterior Lumbar Interbody Fusion: Have Technological Advances in Stabilizing the Lumbar Spine Truly Improved Outcomes?

Background: Since the 1980s, numerous operations have replaced posterior lumbar interbody fusion (PLIF) with human bone. These operations often involve expensive implants and complex procedures. Escalating expenditures in lumbar fusion surgery warrant re-evaluation of classical PLIF with allogeneic ilium and without instrumentation.

The use of bone grafts and alloplastic materials in cranioplasty.

Trephination dates from prehistoric neolithic times (10,000-7000 B.C.) and is the oldest operation known.

Effects of stimulus intensity on direct recordings of eighth nerve auditory evoked responses.

Effects of auditory stimulus intensity on auditory nerve and brainstem evoked potential patterns recorded simultaneously from the scalp and directly from the eighth nerve were compared for an anesthetized patient undergoing surgery for macrovascular decompression. Replicable robust potentials were readily obtained from a recording electrode on the eighth nerve less than half a second after as few as 15 stimulations. Less robust and less readable evoked potential patterns were obtained from scalp recordings after 30 seconds and about 900 stimulations.