Evaluation of a single-dose, extended-release epidural morphine formulation for pain control after lumbar spine surgery.

DepoDur, an extended-release epidural morphine, has been used effectively for postoperative pain control following many orthopaedic and general surgery procedures and has provided prolonged analgesia when compared with Duramorph. The goal of this article was to compare the safety and analgesic efficacy of DepoDur versus Duramorph after lumbar spine surgery. A prospective, randomized, double-blind clinical study was completed at a single extended-stay ambulatory surgery center.

Outcomes of posterior lumbar interbody fusion with the 9-mm width lumbar I/F cage and the variable screw placement system.

Posterior lumbar interbody fusion (PLIF) using interbody cages and posterior pedicle screw fixation has increased the successful fusion rate to nearly 100% in the lumbar spine. In the design of the cage, only the surface area of the opening for bone graft contact with the endplates varied with the width of the cage. When space is limited, the 9-mm width cages may be the largest size that can be used.

Repair of pars interarticularis defect with a modified cable-screw construct.

Operative treatment of symptomatic spondylolysis is not common. Multiple surgical techniques have been described for direct repairs of the pars defects. Reported success rates are high, although few reports describe successful return to sports in athletes.

Fusion assessment of posterior lumbar interbody fusion using radiolucent cages: X-ray films and helical computed tomography scans compared with surgical exploration of fusion.

Background: Plain radiographic assessment of posterolateral fusion has been reported as accurate in only two thirds of patients who were found to be healed at surgical exploration. Plain radiographic techniques for fusion assessment of interbody fusion with radiolucent cages are reported to be accurate. A helical computed tomography (CT) scan shows a high sensitivity for pseudarthrosis compared with plain radiography.

Treatment of cervical pseudarthrosis after Smith-Robinson procedure with Halifax clamp fixation.

Treatment of pseudarthrosis of the cervical spine has been debated extensively with various solutions being proposed. This article reviews 18 cases of pseudarthrosis after attempted anterior cervical discectomy and fusion with tricortical iliac crest autograft using the Smith-Robinson method. All cases were subsequently treated with posterior fusion using cancellous iliac autograft and fixation with Halifax clamps.

Is one cage enough in posterior lumbar interbody fusion: a comparison of unilateral single cage interbody fusion to bilateral cages.

Posterior lumbar interbody fusion (PLIF), as recommended with bilateral lumbar interbody cages and pedicle screw fixation, has increased the successful fusion rate to nearly 100%. Presently, a unilateral approach to the disc space with a variant of PLIF, the trans-foraminal interbody fusion is often used. There are few clinical studies of unilateral interbody fusion.

Outcomes of L1-L2 posterior lumbar interbody fusion with the Lumbar I/F cage and the variable screw placement system: reporting unexpected poor fusion results at L1-L2.

Background Context: Posterior lumbar interbody fusion (PLIF) was introduced 50 years ago. The Lumbar I/F cage (DePuy Spine, Raynham, MA) was designed to enhance PLIF results. PLIF with the Lumbar I/F cage and posterior Variable Screw Placement System (VSP) has increased the success of fusion to nearly 100% at the four lowest lumbar levels, L2-L3 through L5-S1.

The Lumbar I/F Cage for posterior lumbar interbody fusion with the variable screw placement system: 10-year results of a Food and Drug Administration clinical trial.

Background Context: The Lumbar I/F Cage is a carbon fiber reinforced polymer (CFRP) device designed to separate the mechanical and device functions of interbody fusion. A Investigational Device Exemption (IDE) clinical study of the CFRP cage was conducted during an enrollment period from 1991 to 1993. Based on the 2-year results of this study, the cage was approved by the US Food and Drug Administration (FDA) in February 1999.

Complications and surgical considerations in posterior lumbar interbody fusion with carbon fiber interbody cages and Steffee pedicle screws and plates.

Sixty consecutive patients undergoing posterior lumbar interbody fusion with a carbon fiber cage and posterolateral fusion using Steffee VSP (Depuy, Raynham, Mass) pedicle screw and plate instrumentation were reviewed. Perioperative complications, operative blood loss, and operative time were evaluated. Six dural tears, three transient sensory deficits, and two cases of deep venous thrombosis were reported.

Coccygodynia: treatment.

This article presents a retrospective review of the treatment of coccygodynia. The past 5 years of conservative treatment for coccygodynia were reviewed, including local injection. The results were evaluated.