Patient Satisfaction After Circumferential Lumbar Fusion

Slosar, Paul; Reynolds, James B.; Schofferman, Jerome; Goldthwaite, Noel; White, Arthur H.; Keaney, Diane

doi:10.1097/00007632-200003150-00012

Cited by 96 publications

(60 citation statements)

References 22 publications

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“…By combining the anterior lumbar interbody fusion with posterior instrumentation, the pseudoarthrosis rate decreases substantially [3,7]. Many reports have documented high fusion rates (88-100%) and low pseudoarthrosis rates using anteroposterior fusion [13,20,23,24,35]. A fusion rate of 92% in group 1 (conventional approach) of this study is similar to that in other series with anteriorposterior fusion.…”

Section: Discussionsupporting

confidence: 82%

“…The incidence of a postoperative ileus after ALIF has been cited between 0-11% [9,27,29,32,35,38,39]. The ileus incidence in our collective was in the same range, with spontaneous appearance of peristalsis on the third to fourth postoperative day in all cases.…”

Section: Discussionsupporting

confidence: 62%

“…The danger of injuring the hypogastric plexus, which in men may result in retrograde ejaculation, is small when operating by the retroperitoneal approach but cannot be completely excluded. Reported incidence of retrograde ejaculation in men who had undergone fusion by retroperitoneal approach is 1-10% [29,32,35,36,39]. This takes place especially when monopolar diathermy or microdiathermy is used instead of endoclips [32].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of conventional versus minimally invasive extraperitoneal approach for anterior lumbar interbody fusion

et al. 2004

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

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Comparison of conventional versus minimally invasive extraperitoneal approach for anterior lumbar interbody fusion

et al. 2004

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“…For example, studies have compared satisfaction with pharmacological vs nonpharmacological treatments for hypertension, oral vs topical vs implantation treatments for erectile dysfunction, inhalers for treatment of asthma, medical care received from health care providers, and surgical outcomes. [11][12][13][14][15][16][17][18][19][20] None of the studies compared patient satisfaction achieved with different classes of medications for a chronic condition that requires long-term medication therapy.…”

Section: Introductionmentioning

confidence: 99%

Patient satisfaction with antihypertensive therapy

et al. 2005

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The objective of the study was to assess factors associated with treatment satisfaction among patients receiving antihypertensive therapy. A weighted crosssectional online survey was conducted with hypertensive patients participating in a chronic disease panel in the US. Patients on monotherapy with medications from the following classes were identified: ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), beta blockers (BBs), calcium channel blockers (CCBs), and diuretics. The control group included patients without treatment. Pairwise comparisons between groups were conducted for factors that may affect patients' satisfaction. The study population had a mean age of 54.7714.2 years and was 56.7% female. Participants with blood pressure (BP) controlled to JNC 7 guidelines were more satisfied with their medication than those with uncontrolled BP (90.3 vs 71.5%, Po0.05). Patients who had not experienced adverse events had higher satisfaction than patients experiencing adverse events (90.9 vs 75.8%, Po0.05). The most frequently self-reported adverse events were frequent urination, sexual dysfunction, and fatigue ranging from 7.0 to 9.6% across classes. The adverse event rates differed by class and were lowest among the ARBs. Patients on ARBs were the most likely to have switched from a previous antihypertensive class as compared to other classes (57.1% ARBs vs 49.8% ACEIs, 38.7% diuretics, 36.3% CCBs, and 31.7% BBs). Physician recommendation was the most common reason for switching. In conclusion, the ability to effectively treat hypertension depends upon a patient's satisfaction with antihypertensive therapy, which may be improved by achieving BP control and minimizing the occurrence of adverse events.

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“…One needs to consider that revision surgery in these patients has a high failure rate as far as patient satisfaction is concerned. [22][23][24][25] Salvage surgery usually includes combined anterior and posterior spinal surgery [23][24][25] or posterior extension osteotomies with extension of the fusion. 23 In our opinion, an isolated single-level disc replacement after previous fusion surgery can only correct a limited degree of lumbar Á at-back deformity.…”

Section: Discussionmentioning

confidence: 99%

Kineflex (Centurion) Lumbar Disc Prosthesis: Insertion Technique and 2-Year Clinical Results in 100 Patients

Hähnle¹,

Weinberg²,

Sliwa³

et al. 2007

SAS Journal

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Adjacent-level degeneration is a major concern in lumbar fusion operations. [1][2][3][4] Lumbar artiÀ cial discs are an alternative to arthrodesis (fusion). The purpose of total disc replacement is to restore the intervertebral segment and protect the adjacent levels against abnormal loading conditions. A description of the surgical insertions of a lumbar prosthetic nucleus replacement, ABSTRACT BackgroundThe KineÁ ex lumbar disc is a mechanical, unconstrained, re-centering disc prosthesis developed in South Africa. The À rst implantation took place in October 2002. We present a single-center, prospective, longitudinal study of the À rst 100 patients treated with the KineÁ ex lumbar disc. Our objective was to evaluate the insertion technique, clinical outcomes, and patient satisfaction at 2 years postimplantation in 100 consecutive patients with 132 (68 single-and 32 2-level) KineÁ ex lumbar disc replacements. MethodsWe determined the exact central placement of all disc implants in the coronal and midsagittal planes. We measured clinical outcome with the Oswestry disability index (ODI), our own questionnaire, and the time needed to return to work. All patients received radiological and clinical follow-up assessments for 2 years after the index procedure. ResultsForty-three patients were female. The mean age of the patients at operation was 44.9 years (range, 23-63 years). Postoperative hospitalization averaged 2.8 days (range, 2 to 8 days). All patients who were employed before surgery returned to work 31 ± 16.8 days after the operation. Fifty-six percent of operated disc levels had intervertebral disc heights of less than 5 mm. A 2-year clinical outcome was available for 98 of the 100 patients (58 excellent, 30 good, 7 fair, 3 poor). The ODI score improved from 47.8 ± 16.0 preoperatively to 14.2 ± 14.0 (P < .01) at 2 years. At 2 years, 95% of disc implants were radiologically in the ideal position. The insertion technique, with a released prosthetic mechanism for À nal placement, allowed ideal placement in the sagittal plane in 98% of discs. The radiographic placement accuracy achieved was equal in patients with preoperative intervertebral disc height below and above 5 mm. ConclusionsGood short-term clinical results were achieved with the KineÁ ex disc in a heterogeneous patient group with a high number of patients with advanced disc degeneration, severe disc space narrowing, and lumbar Á at-back deformity. In this cohort, accurate implant placement could be achieved in our À rst 100 patients. Clinical RelevenceThis is the À rst report on the KineÁ ex mechanical lumbar disc prosthesis.Key Words KineÁ ex disc, degenerative disc disease, lumbar disc prosthesis, insertion technique, unconstrained disc prosthesis, Oswestry disability index.

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Patient Satisfaction After Circumferential Lumbar Fusion

Cited by 96 publications

References 22 publications

Comparison of conventional versus minimally invasive extraperitoneal approach for anterior lumbar interbody fusion

Comparison of conventional versus minimally invasive extraperitoneal approach for anterior lumbar interbody fusion

Patient satisfaction with antihypertensive therapy

Kineflex (Centurion) Lumbar Disc Prosthesis: Insertion Technique and 2-Year Clinical Results in 100 Patients

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