life expectancy after spinal fusion

For a complete background on Dr. Siddiqi, his practice locations or to learn more about Texas Spine Center, go to, 19255 Park Row, Suite 205, Houston, Texas 77084, Common Cervical & Lumbar Spinal Conditions. [5,6] Although medication, physical therapy and epidural steroid injections are used to manage those patients, some of such patients complain of debilitating persistent pain and functional disability. Anterior cervical discectomy and fusion with plate versus posterior screw fixation after traumatic subaxial fractures in octogenarians: complications and outcomes with a 2-year follow-up. Bookshelf FOIA If using a brace or trying physical therapy hasn't improved your condition, surgery is likely the next step. No mortality occurred. Reduction of surgical time, mainly due to the use of a IGS, in our experience, represents a crucial point to reach better results and to reduce the co-morbidity due to anaesthesia and blood loss. In the non-fused group maximal coronal curve measured 76, in the fused group, pre-operative maximal coronal curve measured 69, post-operative curve measured 34(ns). Surgery was performed on patients who reported severe persisting radiating pain to a lower extremity, neurogenic claudication no more than 100 meters, and/or low back pain despite conservative treatment lasting at least 3 months, and /or who had a neurologic deficit. Epub 2021 Aug 25. In the present series, the authors used cannulated screws for a cement augmentation with PMMA only for the revision surgery. Unauthorized use of these marks is strictly prohibited. However, there were significant differences in details. Becker P, Bretschneider W, Tuschel A, Ogon M. Life quality after instrumented lumbar fusion in the elderly. Your message has been successfully sent to your colleague. The incidence of co-morbidity was of 70.6% and is summarized in Table1. Wolters Kluwer Health Statistical analysis was performed using SPSS 18.0 (SPSS Inc., Chicago, IL). The researchers constructed five "distinct health states" with projected neck disability index intervals onto visual analogue scale. Demographic, medical, and surgical data, and change between preoperative and >500 days postoperative health survey scores were collected. National Library of Medicine Fusing one part of the spine shifts additional mechanical stress to the next mobile level above or below the fusion. eCollection 2022. official website and that any information you provide is encrypted Ger Med Sci 9. In addition, percent changes of VAS-BP and VAS-LP were also not different. The rate of medical and post-operative complications (35.8%) is higher if compared with the rate of the overall population operated on for the same pathologies (17.4%) in our department, resulting in a higher mean hospitalization (7.8 vs. 5.9days). Percent change were calculated as (postoperative value-preoperative value) / preoperative value100 (%). [17,19] There is still controversy over which treatment is more appropriate for improving the quality of life of SE patients. 2. The aim of this study was to evaluate the clinical and radiological outcomes of elderly patients who have undergone spinal instrumented fusion surgery. More often than not, this becomes necessary when a condition or injury such as a herniated disc, tumor, or spinal fracture causes unbearable pain in everyday movements. Spinal fixation and fusion in patients older than 75years old grants good results in terms of quality of life but the rate of morbidity is higher than standard spine surgery. Martin BI, Mirza SK, Comstock BA, Gray DT, Kreuter W, Deyo RA. Epub 2015 May 23. Anyone interested in vigorous exercising or playing sports may need additional time. Phone: +39-02-82245940, Fax: +39-02-82244693, Spine surgery, Elderly, Complication, Navigation system, Outcome. In these patients, appropriate surgical treatment should be considered. Having scoliosis is no way to live when it impedes your daily functions. Received 2013 Aug 15; Revised 2013 Sep 8; Accepted 2013 Sep 8. Data published in January 2012 in the journal "Spine" indicate that the annual number of spinal fusions performed in the United States increased 2.4 times from 1998 to 2008 1. Complications were classified as early or late according to time of occurrence based on findings at postoperative 3 months. Patients who underwent spinal fusion surgery for DLSS between January 2011 and November 2019 and had at least 1 year of follow-up were eligible for inclusion. Damage in the area of L5-S1 may result in some degree of weakness or numbness in the legs. The proper diameter of the screw was selected according to information provided by the CT scan images using the navigation system. That being said, many studies have been done to examine the outcomes of artificial disc replacement at five and 10 years post-surgery, and the results are very encouraging. Spinal fusion surgery is considerable treatment to improve the quality of life of SE patients with DLSS, however careful perioperative management is needed to prevent postoperative delirium. Abbreviations: ASA = American society of anesthesiologists, BSF = The Brantigan, Steffee and Fraser, DLSS = degenerative lumbar spinal stenosis, K-ODI = Korean Oswestry disability index, SE = super-elderly, VAS-BP = visual analog scales for back pain, VAS-LP = visual analog scales for leg pain. 3K-ODI = Korean Oswestry disability index. The rising life expectancy of cancer patients has led to a greater need for treatment of spinal metastases. The mean operating time was 79.413 (range 5598) min: between the two types of data set acquisition of CT scans, for the IGS there is a difference of mean surgical time: 86.7 vs. 73.6min without statistical difference. You might need to stay longer if you're at risk of an infection or other complications. Recovery time for spinal fusion surgery varies significantly from patient to patient, but the average spans between three and six months before the patient is back to their daily routine; working, traveling, and even exercising with more freedom and less pain than they could before the surgery. J Neurosurg Spine. The following information explains scoliosis and its effect on life expectancy: Preoperative and postoperative K-ODI were higher in group SE than group E (all P<.05). Surg Neurol Int. Medical records were reviewed. Even in Japan, life expectancy at birth was 84.7 years in 2015 and is expected to reach 91.6 years in 2050. United States Census Bureau. There wasn't a significant difference between preoperative utility when the researchers compared ACDF and cervical disc replacement at two levels. Similar results were also referred by Fischgrund et al. This demonstrated statistically significant predictability for decreased life expectancy after spinal fusion in children with CP. bDepartment of Orthopedic Surgery, Hanyang University, College of Medicine, Guri Hospital, Gyeonggi, Korea. Despite selection bias for elective surgery, there would be other possible mechanisms to explain the positive effects of surgery. The overall mortality rate of this cohort was 51%. sharing sensitive information, make sure youre on a federal Potential failure could include a screw coming loose, a rod snapping, or natural wear and tear that accompanies aging. All implant failures were defined as a radiolucent line over 2mm between bone and implant or a disruption of the continuity of implant in the plain radiographs or computed tomography. Major complications were death, neurologic deficit, leakage of cerebrospinal fluid, deep wound infection, congestive heart failure, deep vein thrombosis, pulmonary thromboembolism, acute myocardial infarction/ischemia, pneumonia, atelectasis, acute kidney injury and stroke. Copyright 2023 Leaf Group Ltd., all rights reserved. Medicine. Spinal fusions, including those at L5-S1, often are performed to treat chronic pain related to spinal degeneration or arthritis. and transmitted securely. [19,21,23] However, there is no consensus about whether age by itself is a risk factor for postoperative complications after spinal surgery in elderly patients. Get new journal Tables of Contents sent right to your email inbox, Articles in PubMed by Stuart V. Braun, MD, Articles in Google Scholar by Stuart V. Braun, MD, Other articles in this journal by Stuart V. Braun, MD. Most patients see a drastic increase in their quality of life and pain levels within as little as a year after the surgery, and those statistics only improve as time goes on. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily unavailable. Acknowledgment date: March 26, 2008. These include excessive bleeding, reactions to drugs or anesthesia or formation of blood clots in vessels that might break free and damage organs, including the lungs. To evaluate the clinical and radiological outcomes of elderly (>75years old) patients who underwent spinal instrumented fusion surgery. Dr. John Sherman is an orthopedic surgeon at Twin City Orthopedics. Get new journal Tables of Contents sent right to your email inbox, Life Expectancy After Lumbar Spine Surgery: One- to Eleven-Year Follow-up of 1015 Patients, Articles in Google Scholar by Ho-Joong Kim, MD, Other articles in this journal by Ho-Joong Kim, MD. For more information, please refer to our Privacy Policy. Objective: To describe mortality after lumbar fusion surgery in Washington State workers' compensation claimants in the perioperative period and beyond. Adolescents with thoracic idiopathic scoliosis should expect little if any change in their health . Koo AB, Elsamadicy AA, Sarkozy M, David WB, Reeves BC, Hong CS, Boylan A, Laurans M, Kolb L. World Neurosurg. Recovery time for spinal fusion surgery varies significantly from patient to patient, but the average spans between three and six months before the patient is back to their daily routine; working, traveling, and even exercising with more freedom and less pain than they could before the surgery. The choice of treatment for elderly patients, as for all other cases, must depend on the balance of risks and benefits in the treatment itself. Although in the literature there are no conclusive studies conducted on elderly patients, good clinical results are described with improvements both in VAS and ODI of 45 and 27%, respectively [2, 3, 6, 15, 16]. 2003. Surgeries always carry a risk for infection, which can vary by institution. Mean age of the population was 77.8years (range 7582); 31 (58.4%) female and 22 (41.6%) male. 1VAS-BP = visual analogue scale for back pain. The 10-year survival rate of female patients and patients who underwent fusion surgery were higher than those of male patients and patients with nonfusion surgery. Therefore, surgery for spinal stenosis is a justifiable procedure even in elderly patients. Otherwise, postoperative delirium was significantly more frequent in the SE group. Unauthorized use of these marks is strictly prohibited. All rights reserved. but little is known about the long-term survival after surgery. 2019 May 3;8(5):606. doi: 10.3390/jcm8050606. Nerve damage - While also very rare, nerves can be damaged during the procedure. Puvanesarajah V, Jain A, Kebaish K, et al.. Poor nutrition status and lumbar spine fusion surgery in the elderly: readmissions, complications, and mortality. Accessibility Elective admissions were associated with much lower rates of mortality (OR, 0.28), complication (OR, 0.68), and adverse outcome (OR, 0.26). Ravindra VM, Senglaub SS, Rattani A, et al.. Degenerative lumbar spine disease: estimating global incidence and worldwide volume, Increasing incidence of degenerative spinal diseases in Japan during 25years: the registration system of spinal surgery in Tohoku University spine society, Outcomes and health care resource utilization in super-elderly trauma patients. In our experience, the use of neuronavigation and intraoperative CT allows a reduction of surgical time in spinal arthrodesis with a mean time of almost 73min [11]. This stark statistic includes patients who underwent surgery due to severe trauma or instability caused by cancer. Once home, the patient will continue to rest and recover for about four weeks, during which time someone will be expected to help with wound care. Additionally, the more dedicated you are to your physical therapy and following your surgeons directions, the more quickly youll get back to the life you want to have and the healthier youll feel. government site. Careers, Unable to load your collection due to an error. Among the minor complications, only postoperative delirium was significantly higher in group SE than group E (26.7% vs 9.2%, P=.027) (Table (Table4).4). This is a rare occurrence, though. Not only is there the lifespan of the hardware that's a concern; the hardware can also fail. In fact, the rate of lumbar fusion in elderly patients (defined as age >75years) has doubled in the 80s and tripled in the 90s and is still increasing as the life expectancy of the population on the rise (up to 86.6years for women and 81.1 for men in 2,050) [1]. Using Kaplan-Meier curves, the overall 10-year survival was 87.8% in patients 60 to 70 years old at surgery, and 83.8% in patients 70 to 85 years old at surgery. Raffo CS, Lauerman WC. Resnick, D., Choudhri, T., Daily, A., Groff, M. Khoo, L., Matz, P., Mummaneni, P., Watters, W., Wang, J., Walters, B., Hadley, M. Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. p 142The Effect of Spinal Fusion on Life Expectancy for Patients With Profound Cerebral PalsyE-POSTER #251ELECTRONIC POSTER ABSTRACTSBraun, Stuart V. MD; Goldberg, Michael J. MDUSASummary: In this long term follow-up case controlled study, patients with scoliosis and cerebral palsy who underwent instrumented spinal fusion had improved life expectancy over those treated non-operatively.Introduction: For decades spine surgeons and others who care for patients with cerebral palsy and scoliosis have been trying to obtain evidence that spine fusion helps these children. 2003 Nov;89(7):621-31. Bone mineral density was examined by dual-energy X-ray absorptiometry. Accessibility Epub 2021 Jan 23. Artificial disc replacement was approved for use in the United States in the early 2000s, so we still don't have any data on the full "life expectancy" of artificial discs. 4. Clinical and functional outcomes were evaluated using preoperative and postoperative visual analog scales for back pain (VAS-BP) and leg pain (VAS-LP) and the Korean Oswestry disability index (K-ODI). Compared to the adjusted corresponding portion in general population, the standardized mortality ratios were 0.21, 0.53, and 0.45 in patients aged 50 to 59, 60 to 69, and 70 to 85, respectively. Ice, electrical stimulation, massage, and other treatments may be used to make the patient more comfortable. How to cite this article: Son HJ, Jo YH, Ahn HS, You J, Kang CN. All rights reserved. Specific to spine surgery, cigarette smoking significantly increases the odds that an attempted fusion will fail. Morbidity and mortality after spinal deformity surgery in patients 75 years and older: complications and predictive factors. Spinal fusion can help correct problems with the way the spine is formed. Predicting morbidity and mortality of lumbar spine arthrodesis in patients in their ninth decade. To date, there are little data on the clinical and radiological outcome following spinal fixation and fusion in elderly patients and the studies present some limitations, . Please enable scripts and reload this page. 2018 Feb 14;19(1):57. doi: 10.1186/s12891-018-1967-0. Recently, the authors use cement-augmented cannulated pedicle screws to prevent implant failure.[15]. Arch Orthop Trauma Surg. may email you for journal alerts and information, but is committed Furthermore, bone mineral density, operative time, estimated blood loss, blood transfusion, hospital days, hospitalization in intensive care unit and postoperative complications were compared. Objectives: The median blood loss was 320ml (range 210490ml). However, proper wound care and regular redressing of the surgical site will minimize that risk. Medical records were reviewed to investigate postoperative complications. Patients older than 84 years had a 40-fold increase in adverse outcomes and a 5-fold likelihood of medical complications. There is little information about in-hospital complication rates, adverse outcomes, and mortality after spinal fusion for cervical spondylotic myelopathy (CSM). However, there was no difference was observed in percent change of VAS-BP, VAS-LP or K-ODI. Address correspondence and reprint requests to Seong-Hwan Moon, MD, Department of Orthopaedic Surgery, Yonsei University College of Medicine, 134 Shinchondong, Seodaemunku, Seoul, Korea; E-mail: [emailprotected]. An official website of the United States government. If you are experiencing serious medical symptoms, seek emergency treatment immediately. An MOR. Eur Spine J. Spinal fusions, including those at L5-S1, often are performed to treat chronic pain related to spinal degeneration or arthritis. [29,30] Rates of implant failure in the present study were 36.7% and 40.8% in group SE and group E, respectively. 14 patients (26.4%) referred some discomfort (i.e., nausea, vomiting, stipsis) due to post-operative analgesic drugs (morphine) and the drugs were stopped and changed. Intraoperative spinal navigation. A total of 58,115 patients with CSM underwent spinal fusion with an average mortality rate of 0.6%, a complication rate of 13.4%, and a mean length of stay of 4 days. FOIA From the Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea. Predicting complications in elderly patients undergoing lumbar decompression. Of the more than 1 million people in the United States who underwent a lumbar spinal fusion between 1998 and 2008, approximately 1 in 500 died 1. A second surgery due to screw mobilization was necessary in seven patients: one before the first follow-up and six patients (12.4%) after this end-point. It will require general anesthesia and often takes several hours for the procedure itself, which will involve taking bone from one part of your body (usually the hip) and placing it in between two vertebrae along your spine. The .gov means its official. [Long-term results of surgical treatment of lumbar spinal stenosis]. Some L5-S1 fusions also fail to accomplish the objective of reducing instability or pain, although rates vary depending on patient characteristics and surgical techniques. Please try after some time. The influence of comorbidities on the treatment outcome in symptomatic lumbar spinal stenosis: A systematic review and meta-analysis. Specific to spine surgery, cigarette smoking significantly increases the odds that an attempted fusion will fail. PMC The fusion was achieved using autologous bone deriving from the decompressive laminectomy for lateral fusion. See Multilevel Fusion Risks. Spine fusion shares some risks common to all major surgeries. 2012. It is generally believed that a more conservative treatment should be chosen for elderly patients due to the higher risks of surgery and lower surgical outcomes, compared with younger patients. Please enable it to take advantage of the complete set of features! Data curation: Hyung Seob Ahn, Jooyoung You. Independent Association of Obesity and Nonroutine Discharge Disposition After Elective Anterior Cervical Discectomy and Fusion for Cervical Spondylotic Myelopathy. Conceptualization: Hee Jung Son, Chang-Nam Kang. As a library, NLM provides access to scientific literature. It is rare for an activity during the day to require more than 30% to 50% of a healthy cervical . Volvo award winner in clinical studies. Abdu WA, Lurie JD, Spratt KF, Tosteson AN, Zhao W, Tosteson TD, Herkowitz H, Longely M, Boden SD, Emery S, Weinstein JN. Acceptance date: April 8, 2008. However, to date there are few series which properly evaluate this aspect of surgery in the elderly. Int J Spine Surg. [19] found an overall fusion rate of 90.1%. [17,18] Late complications included adjacent segment disease, revision surgery and implant failure. The last follow-up performed at 18.4months (range 1520) was completed for 49 patients of the initial 53: one had died and the other three were lost at the follow-up time. Lad SP, Patil CG, Berta S, Santarelli JG, Ho C, Boakye M. Surg Neurol. 8600 Rockville Pike Bethesda, MD 20894, Web Policies Moreover, the use of an IGS based on a CT scan intraoperatively allowed a defining of the bone quality of the pedicle and vertebral body, granting a proper choice of the type of screws, as well as the suitable diameter and length to adopt. HHS Vulnerability Disclosure, Help Infection - Any surgery carries a risk of infection with it. Relationship of Success Rate for Balloon Adhesiolysis with Clinical Outcomes in Chronic Intractable Lumbar Radicular Pain: A Multicenter Prospective Study. What to Expect after Spinal Fusion Surgery. Nasser R, Yadla S, Maltenfort MG, et al.. Campbell PG, Yadla S, Nasser R, Malone J, Maltenfort MG, Ratliff JK. Costa F, Cardia A, Ortolina A, Fabio G, Zerbi A, Fornari M. Spinal navigation: standard preoperative versus intraoperative computed tomography data set acquisition for computer-guidance system: radiological and clinical study in 100 consecutive patients. The researchers constructed five "distinct health states" with projected neck disability index intervals onto visual analogue scale. This is what the patient can typically expect at physical therapy: Pain relief and inflammation are the key concerns at first. Several surgical options are available at present, depending on the severity and extent of the cases, however, one of the most crucial points to consider for the elderly is the length of surgery and general anaesthesia. Spine Surgery. Despite the increasing prevalence of spinal surgery in super-elderly (SE) patients, the outcomes and complication rates have not been fully elucidated. Acosta FL, Jr, McClendon J, Jr, OShaughnessy BA, Koller H, Neal CJ, Meier O, Ames CP, Koski TR, Ondra SL. Outcomes of posterior cervical fusion and decompression: a systematic review and meta-analysis. Life expectancy of persons with developmental disabilities (e.g., cerebral palsy, vegetative state, traumatic brain injury, spinal cord injury, autism, downs, down syndrome). 53 patients were studied. Epub 2023 Mar 30. According to the review, in spite of the high rates of adjacent degeneration, only about 36 percent become symptomatic and fewer than half of these require further surgical intervention. More often than not, this becomes necessary when a condition or injury such as a herniated disc, tumor, or spinal fracture causes unbearable pain in everyday movements. However, even patients with more than 1 comorbidity have relatively good clinical outcomes after spinal fusion. All radiographic assessment was performed independently by a spine fellow (HJS) and chief orthopedic resident (HSA), who did not participate in the surgery. Although blood transfusion was a risk factor for early major complications, the odds ratio of 1.001 was too low to justify application to clinical situations. Deyo et al[21] reported that the rates of complications after lumbar spinal surgery in patients aged 75years or older reached 18%. Summary of Background Data. Spinal fusion surgery for DLSS in SE patients resulted in more minor complications, especially postoperative delirium, than in elderly patients, however similar rates of early major complications, late complications, improvements of clinical and functional outcomes, and fusion rates. While you're at. Differences were considered statistically significant at P<.05. No patients died from surgery-related complications during either hospital stays or follow-up. Four-year results of the spine patient outcomes research trial. 2019 Oct;19(10):1714-1729. doi: 10.1016/j.spinee.2019.04.019. The aim of this study was to report inpatient mortality, complications, and outcomes on a national level. In that study, 21 of the patients were older than 80 and no 1 died either in hospital or soon after surgery. [16] BSF-1 and 2 were classified as nonunion, BSF-3 as union. Your doctor will often recommend strengthening the parts of your body that will be affected by the surgery, such as your back, shoulder, and hip muscles. Chan AY, Himstead AS, Choi EH, Hsu Z, Kurtz JS, Yang C, Lee YP, Bhatia NN, Lefteris CT, Wilson WC, Hsu FPK, Oh MY. The https:// ensures that you are connecting to the Endres S (2011) Instrumented posterolateral fusionclinical and functional outcome in elderly patients. 2022 Jul 15;13:300. doi: 10.25259/SNI_497_2022. 29th Annual Meeting - The Business & Operations of ASCs, Digital Innovation + Patient Experience and Marketing Virtual Event, 4 surgeons who have performed spine procedures on professional athletes this year, From awards to efficiency efforts: What spine surgeons are most proud of so far in 2023, Pain Management Pay Trends and Ancillary Opportunities, The Next Move for Orthopedic and Spine Supergroups, Corewell Health opens Michigan spine center, Technology Revolutionizing Orthopedics and Spine: Key Concepts, Strategic transactions in the spine, orthopedic & pain space: 5 takeaways, Orthopedic surgeon among 2 convicted in $31M Medicare fraud scheme, Orthopedic surgeon sentenced in $31M fraud scheme, Ohio State Medical board permanently revokes license of orthopedic surgeon accused of abuse, Good news, bad news for spine and orthopedic surgeons in 2023, Connecticut orthopedic surgeon fined, reprimanded for operating on wrong hip, Surgeries halted at Florida spine practice, Wisconsin orthopedic surgeon sanctioned in patient's death, Former Philadelphia Eagles player wins $43.5M verdict in knee injury case, 7 best hospitals in Florida for outpatient hip, knee replacements, Person of interest identified in neurosurgeon's death released from custody, 2 orthopedic surgeons file whistleblower suit against Erlanger for alleged Medicaid fraud, Aetna revises lumbar disc replacement policy, The most dangerous trends in orthopedics and spine from 25 leaders, Spine surgeon convicted for accepting $300K+ in kickbacks, 12 best hospitals in North Carolina for outpatient hip, knee replacements, Indiana orthopedic surgeon settles Medicaid fraud allegations for $700K, 4 orthopedic surgeons suing former practice move to Trinity Health, The 14 best hospitals in California for spine surgery, 17 best hospitals in California for outpatient hip, knee replacements, 7 spine, orthopedic surgeons honored in Q1, Hospital system argues orthopedic surgeons' whistleblower suit should be dismissed, Stryker to lay off 500+ Florida employees, 'This system is unsustainable': Why orthopedic surgeons do not feel fairly compensated, Orthopedic surgeon sues Vanderbilt over alleged discrimination, Orthopedic surgeon sues health system for $24.7M over termination, Rothman Orthopaedics lays off 18 corporate employees, Top 12 hospitals in California for orthopedic surgery, Orthopedic groups band together to form 400+ physician platform, New Hampshire orthopedic surgeon arrested for alleged patient abuse, Who is the best spine surgeon in the US? The proportion of patients with 1 or more comorbidities was similar and mean preoperative ASA scores were not different in the 2 groups, indicating that the groups were of much the same preoperative physical status (Table (Table22). spinal stenosis, spine surgery, 10-year survival rate. Fusion was defined as the absence of segmental instability on flexionextension radiography and Bridwell grade I or II on CT scans [13]. Pain from the bone graft - The bone graft, if one is taken, usually comes from the patients hip bone. This site needs JavaScript to work properly. Risk difference assessment noted an 18.8% improvement in survival following spinal fusion, with and Odds ratio of 2.1. Hear from your peers about the better TLIF by Medtronic, Interested in increasing awareness of your research? Thirty patients in the SE group (group SE, 80years) and 130 patients in the elderly group (group E, 65years and <80years) were enrolled. Youssef JA, Heiner AD, Montgomery JR, Tender GC, Lorio MP, Morreale JM, Phillips FM. Lange T, Schulte TL, Gosheger G, Schulze Boevingloh A, Mayr R, Schmoelz W. BMC Musculoskelet Disord. After March 2009, in 24 cases (45.3%), the navigation system adopted images obtained intraoperatively by the O-arm system. A total of 160 patients were enrolled with 30 and 130 patients assigned to group SE and group E, respectively. Complications with L5-S1 fusions are more likely to occur in the presence of certain known risk factors. Cement-augmented cannulated pedicle screws were placed in the case of patients with 2 or more risk factors for implant failure among osteoporosis, >65years of age, autoimmune disease and stage 3 to 5 chronic kidney disease, while solid pedicle screws were used for those without risk factors. HHS Vulnerability Disclosure, Help 2021 Jul;151:e950-e960. Anterior fusions were associated with a greater incidence of dysphagia (3%) and hoarseness (0.21%). Comparison with patients aged 65 years and over, and under 80 years. 2016;1175. Inclusion in an NLM database does not imply endorsement of, or agreement with,

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