506:
727:
29:
514:
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224:
390:, approximately 488,000 spinal fusions were performed during U.S. hospital stays in 2011 (a rate of 15.7 stays per 10,000 population), which accounted for 3.1% of all operating room procedures. This was a 70 percent growth in procedures from 2001. Lumbar fusions are the most common type of fusion performed ~ 210,000 per year. 24,000 thoracic fusions and 157,000 cervical fusions are performed each year.
779:
risk of infection, which themselves are underreported given the long time frame (0–7 years) and reportedly lack follow up data on the patients undergoing spine surgery. A petition was filed by the lead investigator, Aakash
Agarwal, to rectify this global public health hazard of implanting contaminated spinal devices in patients.
567:
Spinal fusion is a high risk surgery and complications can be serious, including death. In general, there is a higher risk of complications in older people with elevated body mass index (BMI), other medical problems, poor nutrition and nerve symptoms (numbness, weakness, bowel/bladder issues) before
675:
Recovery following spinal fusion is extremely variable, depending on individual surgeon's preference and the type of procedure performed. The average length of hospital stay for spinal fusions is 3.7 days. Some patients can go home the same day if they undergo a simple cervical spinal fusion at an
214:
Like any surgery, complications may include infection, blood loss, and nerve damage. Fusion also changes the normal motion of the spine and results in more stress on the vertebrae above and below the fused segments. As a result, long-term complications include degeneration at these adjacent spine
778:
broadcast an investigation, "Surgical implants raising contamination concerns", uncovering a dossier of scientific evidences that current methods of processing and handling spinal implants are extremely unhygienic and lacks quality control. This lack of quality control is exposing patients to high
680:
are also significantly reducing the amount of time spent in the hospital. Recovery typically involves both restriction of certain activities and rehabilitation training. Restrictions following surgery largely depend on surgeon preference. A typical timeline for common restrictions after a lumbar
640:
Infection – sources of bacterial bioburden that infiltrate the wound site are several, but the latest research highlights repeated reprocessing of implants before surgery and exposure of implants (such as pedicle screws) to bacterial contaminants in the "sterile-field" during surgery as major risk
451:
techniques are also becoming more popular. These techniques use advanced image guidance systems to insert rods/screws into the spine through smaller incisions, allowing for less muscle damage, blood loss, infections, pain, and length of stay in the hospital. The following list gives examples of
446:
or artificial bone substitute is packed between the vertebrae to help them heal together. In general, fusions are done either on the anterior (stomach), posterior (back), or both sides of the spine. Today, most fusions are supplemented with hardware (screws, plates, rods) because they have been
430:, in comparison to decompression surgery alone. This Swedish study, including 247 patients enrolled from 2006 to 2012, further found increased medical costs for those who received the fusion surgery, as a result of increased surgery time, hospital stay duration, and cost of the implant.
270:
Lumbar and cervical spinal fusions are more commonly performed than thoracic fusions. Degeneration happens more frequently at these levels due to increased motion and stress. The thoracic spine is more immobile, so most fusions are performed due to trauma or deformities like
712:
According to a report by the Agency for
Healthcare Research and Quality (AHRQ), approximately 488,000 spinal fusions were performed during U.S. hospital stays in 2011, a rate of 15.7 stays per 10,000 population, which accounted for 3.1% of all operating room procedures.
267:) causes pain in the area where the nerves originated (leg for lumbar pathology, arm for cervical pathology). In severe cases, this pressure can cause neurologic deficits, like numbness, tingling, bowel/bladder dysfunction, and paralysis.
1575:
495:
Posterior instrumentation and fusion – many different types of hardware can be used to help fuse the thoracic spine including sublaminar wiring, pedicle and transverse process hooks, pedicle screw-rod systems, vertebral body plate
144:. This procedure can be performed at any level in the spine (cervical, thoracic, lumbar, or sacral) and prevents any movement between the fused vertebrae. There are many types of spinal fusion and each technique involves using
254:
The most common cause of pressure on the spinal cord/nerves is degenerative disc disease. Other common causes include disc herniation, spinal stenosis, trauma, and spinal tumors. Spinal stenosis results from bony growths
1317:
Phan, Kevin; Rao, Prashanth J.; Mobbs, Ralph J. (2015-08-01). "Percutaneous versus open pedicle screw fixation for treatment of thoracolumbar fractures: Systematic review and meta-analysis of comparative studies".
1786:
McGregor, Alison H.; Probyn, Katrin; Cro, Suzie; Doré, Caroline J.; Burton, A. Kim; Balagué, Federico; Pincus, Tamar; Fairbank, Jeremy (2013-12-09). "Rehabilitation following surgery for lumbar spinal stenosis".
1855:
1475:
1125:"Public Health Notifications (Medical Devices)—FDA Public Health Notification: Life-threatening Complications Associated with Recombinant Human Bone Morphogenetic Protein in Cervical Spine Fusion"
397:
Average age for someone undergoing a spinal fusion was 54.2 years – 53.3 years for primary cervical fusions, 42.7 years for primary thoracic fusions, and 56.3 years for primary lumbar fusions
657:
Adjacent segment disease – degeneration of vertebrae above/below the fused segments due altered biomechanical stresses or patient propensity to develop progressive degenerative change.
438:
There are many types of spinal fusion techniques. Each technique varies depending on the level of the spine and the location of the compressed spinal cord/nerves. After the spine is
1369:
Yang, Michael M. H.; Riva-Cambrin, Jay; Cunningham, Jonathan; Jetté, Nathalie; Sajobi, Tolulope T.; Soroceanu, Alex; Lewkonia, Peter; Jacobs, W. Bradley; Casha, Steven (2020-09-15).
2187:
1254:
Försth, Peter; Ólafsson, Gylfi; Carlsson, Thomas; Frost, Anders; Borgström, Fredrik; Fritzell, Peter; Öhagen, Patrik; Michaëlsson, Karl; Sandén, Bengt (2016-04-14).
704:
Rehabilitation after spinal fusion is not mandatory. There is some evidence that it improves functional status and low back pain so some surgeons may recommend it.
568:
surgery. Complications also depend on the type/extent of spinal fusion surgery performed. There are three main time periods where complications typically occur:
1217:
406:
Average length of hospital stay was 3.7 days – 2.7 days for primary cervical fusion, 8.5 days for primary thoracic fusion, and 3.9 days for primary lumbar fusion
1904:
418:
Although spinal fusion surgery is widely performed, there is limited evidence for its effectiveness for several common medical conditions. For example, in a
987:
Yavin, D; Casha, S; Wiebe, S; Feasby, TE; Clark, C; Isaacs, A; Holroyd-Leduc, J; Hurlbert, RJ; Quan, H; Nataraj, A; Sutherland, GR; Jette, N (1 May 2017).
1954:
175:
Spinal fusion is most commonly performed to relieve the pain and pressure from mechanical pain of the vertebrae or on the spinal cord that results when a
2180:
541:. A plastic or titanium device may be placed between the vertebra to maintain spine alignment and disc height. The types of interbody fusion are:
1714:"Decreasing hospital length of stay following lumbar fusion utilizing multidisciplinary committee meetings involving surgeons and other caretakers"
2173:
1600:
259:) or thickened ligaments that cause narrowing of the spinal canal over time. This causes leg pain with increased activity, a condition called
78:
187:), in case patient anatomy prevents replacement of the disc. Other common pathological conditions that are treated by spinal fusion include
1147:"Recombinant human bone morphogenetic protein-2: adverse events reported to the Manufacturer and User Facility Device Experience database"
1550:
160:) is often used to hold the bones in place while the graft fuses the two vertebrae together. The placement of hardware can be guided by
387:
2049:
Williams, K. D. and A. L. Park. Chapter 39: Lower Back Pain and
Disorders of Intervertebral Discs. In: Canale, S. T. and J. H. Beaty.
2580:
1190:
1124:
677:
553:
Transpsoas interbody fusion (DLIF or XLIF) – the disc is accessed from an incision through the psoas muscle on one side of the spine
2532:
746:
Please help improve this article by looking for better, more reliable sources. Unreliable citations may be challenged and removed.
2697:
2017:
469:
363:
1576:"Current use of contaminated pedicle screws & required practice for asepsis in spine surgery — 2 Qs with Dr. Aakash Agarwal"
1371:"Development and validation of a clinical prediction score for poor postoperative pain control following elective spine surgery"
1418:
Pumberger, Matthias; Chiu, Ya Lin; Ma, Yan; Girardi, Federico P.; Vougioukas, Vassilios; Memtsoudis, Stavros G. (August 2012).
2117:
2073:
2058:
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2010:
971:
2153:
829:
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Oblique lateral lumbar interbody fusion (OLLIF) – the disc is accessed from an incision through the psoas muscle obliquely
2438:
2124:
Oblique
Lateral Lumbar Interbody Fusion (OLLIF): Technical Notes and Early Results of a Single Surgeon Comparative Study.
1255:
651:
448:
1233:
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2433:
550:
Transforaminal lumbar interbody fusion (TLIF) – the disc is accessed from a posterior incision on one side of the spine
243:. In general, spinal fusion is performed to decompress and stabilize the spine. The greatest benefit appears to be in
2692:
2029:
807:
761:
1929:
1047:
Rajaee, Sean S.; Bae, Hyun W.; Kanim, Linda E.A.; Delamarter, Rick B. (2012). "Spinal Fusion in the United States".
797:
2492:
2487:
1097:
184:
2384:
63:
1525:
666:– inflammation of the thin membrane surrounding the spinal cord, usually caused by infection or contrast dye.
156:), or artificial bone substitutes—to help the bones heal together. Additional hardware (screws, plates, or
1129:
1093:
1830:
1420:"Perioperative mortality after lumbar spinal fusion surgery: an analysis of epidemiology and risk factors"
419:
1987:
2421:
1993:
Boatright, K. C. and S. D. Boden. Chapter 12: Biology of Spine Fusion. In: Lieberman, J., et al., Eds.
740:
426:, after 2 and 5 years there was no significant clinical benefits of lumbar fusion in combination with
359:
2525:
527:
505:
290:
180:
165:
2547:
2338:
735:
544:
Anterior lumbar interbody fusion (ALIF) – the disc is accessed from an anterior abdominal incision
526:
in the back of the spine. These vertebrae are then fixed in place with screws or wire through the
321:
85:
403:
83.8% were white, 7.5% black, 5.1% Hispanic, 1.6% Asian or
Pacific Islander, 0.4% Native American
427:
362:(rhBMP) should not be routinely used in any type of anterior cervical spine fusion, such as with
342:
260:
1905:"UT researcher calls on FDA to change rules to address spine screw contamination | UToledo News"
137:
2457:
2328:
2296:
393:
A 2008 analysis of spinal fusions in the United States reported the following characteristics:
169:
2159:
2426:
1712:
Shields, Lisa B. E.; Clark, Lisa; Glassman, Steven D.; Shields, Christopher B. (2017-01-19).
371:
157:
2604:
231:
Spinal fusion can be used to treat a variety of conditions affecting any level of the spine—
2515:
2235:
605:
439:
2137:
602:
Wound infections - risk factors include old age, obesity, diabetes, smoking, prior surgery
8:
2667:
2477:
2399:
547:
Posterior lumbar interbody fusion (PLIF) – the disc is accessed from a posterior incision
534:
176:
149:
2165:
2034:
Camillo, F. X. Chapter 36: Arthrodesis of the Spine. In: Canale, S. T. and J. H. Beaty.
1981:
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1998:
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523:
240:
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28:
16:
Immobilization or ankylosis of two or more vertebrae by fusion of the vertebral bodies
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2394:
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2240:
2113:
2097:
2069:
2054:
2039:
2025:
2006:
1930:"The Hardest Decision Any Spine Surgeon Has to Make | Orthopedics This Week - Part 2"
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73:
47:
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879:
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2112:(2nd Ed.). Rolling Meadows, Illinois: American Association of Neurosurgeons. 2008.
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1526:"Banned in the USA: Petition calls for FDA to prohibit reprocessed pedicle screws"
105:
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between vertebrae is removed and a bone graft is placed in the space between the
423:
248:
200:
188:
91:
1617:
2660:
2575:
2520:
2379:
2333:
2093:
989:"Lumbar Fusion for Degenerative Disease: A Systematic Review and Meta-Analysis"
647:
295:
2016:
Holmes, C. F., et al. Chapter 9: Cervical Spine
Injuries. In: Schenck, R. F.,
1435:
1387:
1370:
513:
183:). It is also used as a backup procedure for total disc replacement surgery (
2686:
2369:
2312:
2230:
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1808:
1739:
1730:
1677:
1500:
1443:
1396:
1339:
1292:
1256:"A Randomized, Controlled Trial of Fusion Surgery for Lumbar Spinal Stenosis"
663:
443:
264:
145:
1955:"Implant-Related Management of Surgical Site Infections After Spine Surgery"
1005:
988:
2630:
2594:
2537:
2286:
2271:
2256:
2101:
2002:
1816:
1757:
1695:
1668:
1636:
1461:
1404:
1347:
1300:
1229:
1202:
1170:
1068:
1014:
871:
650:– nonunion between fused bone segments. Risk factors include tobacco use,
622:
2149:
American
Academy of Orthopaedic Surgeons. June 2010. Accessed 1 June 2013.
1275:
2640:
2635:
2465:
2281:
2266:
660:
Epidural fibrosis – scarring of the tissue that surrounds the spinal cord
530:
of each vertebra, attaching to a metal rod on each side of the vertebrae.
367:
337:
256:
196:
161:
99:
52:
452:
common types of fusion techniques performed at each level of the spine:
370:
swelling, which in turn can cause life-threatening complications due to
286:
Conditions where spinal fusion may be considered include the following:
2655:
2625:
2482:
2276:
2261:
1831:"Permanent Restrictions after Spinal Fusion – What Do the Doctors Say?"
1284:
476:
455:
1191:"Characteristics of Operating Room Procedures in U.S. Hospitals, 2011"
685:
Walking – most people are out of bed and walking the day after surgery
115:
2413:
2374:
2364:
2068:. trans. B. Herwig. Berlin: Springer-Verlag. 2006. pp. 273–288.
1551:"Pedicle screw handling techniques "lead to contamination of screws""
691:
Lifting – it is generally recommended to avoid lifting until 12 weeks
312:
272:
204:
153:
141:
56:
2080:
Tehranzadehlow J.; et al. (2005). "Advances in spinal fusion".
1184:
1182:
1146:
966:. Philadelphia, PA: Lippincott Williams & Wilkins. p. 343.
1856:"11 Investigates: Surgical implants raising contamination concerns"
1476:"11 Investigates: Surgical implants raising contamination concerns"
538:
327:
317:
280:
276:
208:
1224:(171). Rockville, MD: Agency for Healthcare Research and Quality.
1218:"Trends in Operating Room Procedures in U.S. Hospitals, 2001–2011"
1197:(170). Rockville, MD: Agency for Healthcare Research and Quality.
2143:. Division of Orthopedic Surgery. Duke University Medical Center.
2064:
1650:
McGregor, Alison H.; Dicken, Ben; Jamrozik, Konrad (2006-05-31).
1179:
775:
447:
shown to have higher union rates than non-instrumented fusions.
223:
654:
use, osteoporosis, revision procedures, decreased immune system.
1652:"National audit of post-operative management in spinal surgery"
1368:
232:
2448:
2053:. (11th Ed.). Philadelphia: Mosby. 2007. pp. 2159–2224.
2038:. (11th Ed.). Philadelphia: Mosby. 2007. pp. 1851–1874.
304:
1092:
644:
Deformity – loss of height, alignment, and failure of fusion
583:
Damage to nerves and surrounding structures during procedure
2215:
2197:
1711:
1253:
850:
Rajaee, Sean (2012). "Spinal Fusion in the United States".
1881:"Ban 'Reprocessing' of Spinal Surgery Screws, Experts Say"
1501:"Ban 'Reprocessing' of Spinal Surgery Screws, Experts Say"
2195:
2024:
1046:
830:"Subacute and Chronic Low Back Pain: Surgical Treatment"
263:. Pressure on the nerves as they exit the spinal cord (
1649:
1417:
1188:
509:
1785:
1098:"Five Things Physicians and Patients Should Question"
986:
796:
Meyer, Bernhard; Rauschmann, Michael (4 March 2019).
2156:
SpineUniverse. September 2012. Accessed 1 June 2013.
1189:
Weiss AJ, Elixhauser A, Andrews RM (February 2014).
697:
Return to sedentary work – usually between 3–6 weeks
517:
Stabilization rods used after spinal fusion surgery.
2066:
MRI Atlas: Orthopedics and Neurosurgery – The Spine
634:
1601:"Adjacent segment pathology of the cervical spine"
688:Sitting – can begin at 1–6 weeks following surgery
522:Posterolateral fusion is a bone graft between the
350:Any condition that causes instability of the spine
2154:What is Spinal Instrumentation and Spinal Fusion?
2079:
388:Agency for Healthcare Research and Quality (AHRQ)
2684:
1215:
795:
589:Harvesting of bone graft (if autograft is used)
2162:Encyclopedia of Surgery. Accessed 1 June 2013.
1988:A Patient's Guide to Anterior Cervical Fusion.
2181:
533:Interbody Fusion is a graft where the entire
179:(cartilage between two vertebrae) wears out (
1316:
630:Shock, sepsis and cerebrovascular infarction
366:. There are reports of this therapy causing
1789:The Cochrane Database of Systematic Reviews
1605:Journal of Family Medicine and Primary Care
482:Posterior cervical decompression and fusion
2188:
2174:
1088:
1086:
700:Return to manual work – between 7–12 weeks
27:
2581:Anterior cruciate ligament reconstruction
1747:
1729:
1685:
1667:
1626:
1616:
1451:
1386:
1274:
1004:
762:Learn how and when to remove this message
227:Herniated disc pressing on spinal nerves.
2533:Ulnar collateral ligament reconstruction
1548:
961:
694:Driving – usually can begin at 3–6 weeks
512:
504:
454:
400:45.5% of all spinal fusions were on men
222:
140:or neurosurgeons that joins two or more
1122:
1083:
716:
470:Anterior cervical discectomy and fusion
364:anterior cervical discectomy and fusion
2685:
1990:University of Maryland Medical Center.
1952:
1598:
1523:
849:
577:Patient positioning on operating table
2169:
2022:Athletic Training in Sports Medicine.
1781:
1779:
1777:
1775:
1773:
1771:
1769:
1767:
1707:
1705:
1573:
1312:
1310:
1216:Weiss AJ, Elixhauser A (March 2014).
964:Orthopaedic Surgery Essentials: Spine
957:
955:
953:
951:
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945:
943:
941:
939:
937:
935:
933:
931:
929:
927:
925:
923:
921:
919:
917:
915:
913:
911:
909:
599:Moderate to severe postoperative pain
2110:Surgical Management of Low Back Pain
1599:Chu, ECP; Lee, LYK (February 2022).
1042:
1040:
1038:
1036:
1034:
1032:
1030:
1028:
1026:
1024:
907:
905:
903:
901:
899:
897:
895:
893:
891:
889:
845:
843:
827:
823:
821:
819:
799:Spine Surgery: A Case-Based Approach
720:
593:
459:Anterior approach to cervical spine.
354:
347:Other degenerative spinal conditions
2439:Autologous chondrocyte implantation
2051:Campbell's Operative Orthopaedics 2
2036:Campbell's Operative Orthopaedics 2
1320:Clinical Neurology and Neurosurgery
1144:
1123:Schultz, Daniel G. (July 1, 2008).
652:nonsteroidal anti-inflammatory drug
13:
2590:Unicompartmental knee arthroplasty
2434:Knee cartilage replacement therapy
2141:Wheeless' Textbook of Orthopaedics
2082:Seminars in Ultrasound, CT and MRI
1975:
1764:
1702:
1307:
14:
2709:
2130:
1574:Korol, Shayna (15 October 2018).
1021:
886:
840:
816:
681:fusion surgery are listed below:
571:
492:Anterior decompression and fusion
486:
463:
1718:Surgical Neurology International
725:
635:Weeks to years following surgery
413:
409:In-hospital mortality was 0.25%
185:intervertebral disc arthroplasty
1946:
1922:
1897:
1873:
1848:
1823:
1643:
1592:
1567:
1542:
1517:
1493:
1468:
1411:
1362:
1263:New England Journal of Medicine
1247:
500:
381:
247:, while evidence is weaker for
218:
2698:Orthopedic surgical procedures
2136:Wheeless, C. R., et al., Eds.
1801:10.1002/14651858.CD009644.pub2
1524:Hudson, Jocelyn (2019-01-16).
1375:Journal of Neurosurgery. Spine
1332:10.1016/j.clineuro.2015.05.016
1209:
1110:, North American Spine Society
980:
828:Chou, Roger (March 11, 2016).
789:
1:
1656:BMC Musculoskeletal Disorders
782:
386:According to a report by the
1995:Bone Regeneration and Repair
1163:10.1016/j.spinee.2012.09.052
1094:North American Spine Society
1061:10.1097/brs.0b013e31820cccfb
864:10.1097/brs.0b013e31820cccfb
678:Minimally invasive surgeries
586:Insertion of spinal hardware
433:
136:, is a surgery performed by
7:
2005:. 2005. pp. 225–239.
1618:10.4103/jfmpc.jfmpc_1380_21
676:outpatient surgery center.
670:
420:randomized controlled trial
10:
2714:
2422:Articular cartilage repair
2094:10.1053/j.sult.2005.02.007
774:In 2019, the news channel
360:Bone morphogenetic protein
148:—either from the patient (
2618:
2558:
2503:
2456:
2447:
2412:
2357:
2321:
2305:
2249:
2223:
2214:
2205:
1555:Spinal News International
1530:Spinal News International
1436:10.1007/s00586-012-2298-8
1388:10.3171/2020.5.SPINE20347
291:Degenerative disc disease
181:degenerative disc disease
112:
98:
84:
72:
62:
46:
38:
26:
21:
2693:Neurosurgical procedures
2548:Finger joint replacement
2339:Distraction osteogenesis
1731:10.4103/2152-7806.198732
707:
562:
2108:Resnick, D. K., et al.
1982:Cervical Spinal Fusion.
1549:willdate (2020-06-05).
1105:: an initiative of the
962:Agulnick, Marc (2017).
734:Some of this section's
343:Posterior rami syndrome
261:neurogenic claudication
2329:Femoral head ostectomy
2297:Vertebral augmentation
1953:Agarwal, Aakash; PhD.
1669:10.1186/1471-2474-7-47
1424:European Spine Journal
1222:HCUP Statistical Brief
1195:HCUP Statistical Brief
518:
510:
460:
296:Spinal disc herniation
228:
2526:Weaver–Dunn procedure
2427:Microfracture surgery
2196:Procedures involving
1276:10.1056/nejmoa1513721
1006:10.1093/neuros/nyw162
516:
508:
458:
428:decompression surgery
372:difficulty swallowing
322:Scheuermann's disease
226:
2516:Shoulder replacement
2478:Intervertebral discs
2236:Orthognathic surgery
2138:Fusion of the Spine.
1580:www.beckersspine.com
1145:Woo, EJ (Oct 2012).
717:Public health hazard
606:Deep vein thrombosis
524:transverse processes
374:and pressure on the
138:orthopaedic surgeons
2668:Arthroscopic lavage
2400:Tension band wiring
535:intervertebral disc
33:Fusion of L5 and S1
2610:Triple arthrodesis
2605:Broström procedure
2543:Brunelli procedure
2344:Ilizarov apparatus
2292:Vertebral fixation
2208:Orthopedic surgery
1999:Totowa, New Jersey
627:Neurologic deficit
612:Pulmonary embolism
519:
511:
475:Anterior cervical
461:
449:Minimally invasive
309:Vertebral fracture
229:
166:navigation systems
2680:
2679:
2676:
2675:
2646:Joint replacement
2600:Ankle replacement
2408:
2407:
2395:External fixation
2390:Internal fixation
2241:Chin augmentation
2118:978-1-60406-035-5
2074:978-3-540-33533-7
2059:978-0-323-03329-9
2044:978-0-323-03329-9
2011:978-0-89603-847-9
1911:. 11 January 2019
1835:The Healthy Talks
1269:(15): 1413–1423.
1151:The Spine Journal
1096:(February 2013),
973:978-1-49631-854-1
772:
771:
764:
618:Urinary retention
594:Within a few days
376:respiratory tract
355:Contraindications
333:Spondylolisthesis
245:spondylolisthesis
193:spondylolisthesis
123:
122:
2705:
2586:Knee replacement
2511:Shoulder surgery
2454:
2453:
2221:
2220:
2190:
2183:
2176:
2167:
2166:
2105:
1969:
1968:
1966:
1965:
1950:
1944:
1943:
1941:
1940:
1926:
1920:
1919:
1917:
1916:
1909:news.utoledo.edu
1901:
1895:
1894:
1892:
1891:
1877:
1871:
1870:
1868:
1867:
1852:
1846:
1845:
1843:
1842:
1827:
1821:
1820:
1795:(12): CD009644.
1783:
1762:
1761:
1751:
1733:
1709:
1700:
1699:
1689:
1671:
1647:
1641:
1640:
1630:
1620:
1596:
1590:
1589:
1587:
1586:
1571:
1565:
1564:
1562:
1561:
1546:
1540:
1539:
1537:
1536:
1521:
1515:
1514:
1512:
1511:
1497:
1491:
1490:
1488:
1487:
1472:
1466:
1465:
1455:
1430:(8): 1633–1639.
1415:
1409:
1408:
1390:
1366:
1360:
1359:
1314:
1305:
1304:
1278:
1260:
1251:
1245:
1244:
1242:
1241:
1232:. Archived from
1213:
1207:
1206:
1186:
1177:
1174:
1141:
1139:
1137:
1118:
1117:
1115:
1090:
1081:
1080:
1044:
1019:
1018:
1008:
984:
978:
977:
959:
884:
883:
847:
838:
837:
825:
814:
813:
793:
767:
760:
756:
753:
747:
729:
721:
201:spinal fractures
134:spondylosyndesis
116:edit on Wikidata
108:
94:
42:Spondylosyndesis
31:
19:
18:
2713:
2712:
2708:
2707:
2706:
2704:
2703:
2702:
2683:
2682:
2681:
2672:
2614:
2571:Hip replacement
2566:Hip resurfacing
2554:
2499:
2443:
2404:
2353:
2349:Phemister graft
2317:
2301:
2245:
2210:
2201:
2194:
2152:Spinasanta, S.
2133:
1978:
1976:Further reading
1973:
1972:
1963:
1961:
1951:
1947:
1938:
1936:
1928:
1927:
1923:
1914:
1912:
1903:
1902:
1898:
1889:
1887:
1879:
1878:
1874:
1865:
1863:
1854:
1853:
1849:
1840:
1838:
1829:
1828:
1824:
1784:
1765:
1710:
1703:
1648:
1644:
1597:
1593:
1584:
1582:
1572:
1568:
1559:
1557:
1547:
1543:
1534:
1532:
1522:
1518:
1509:
1507:
1499:
1498:
1494:
1485:
1483:
1474:
1473:
1469:
1416:
1412:
1367:
1363:
1315:
1308:
1258:
1252:
1248:
1239:
1237:
1214:
1210:
1187:
1180:
1135:
1133:
1113:
1111:
1107:ABIM Foundation
1103:Choosing Wisely
1091:
1084:
1045:
1022:
985:
981:
974:
960:
887:
848:
841:
826:
817:
810:
794:
790:
785:
768:
757:
751:
748:
745:
730:
719:
710:
673:
637:
596:
574:
565:
503:
489:
466:
436:
424:spinal stenosis
422:of people with
416:
384:
357:
300:Discogenic pain
249:spinal stenosis
221:
189:spinal stenosis
119:
104:
90:
34:
17:
12:
11:
5:
2711:
2701:
2700:
2695:
2678:
2677:
2674:
2673:
2671:
2670:
2665:
2664:
2663:
2661:Arthrocentesis
2658:
2648:
2643:
2638:
2633:
2628:
2622:
2620:
2616:
2615:
2613:
2612:
2607:
2602:
2597:
2592:
2583:
2578:
2576:Rotationplasty
2573:
2568:
2562:
2560:
2556:
2555:
2553:
2552:
2551:
2550:
2545:
2535:
2530:
2529:
2528:
2523:
2521:Bankart repair
2518:
2507:
2505:
2501:
2500:
2498:
2497:
2496:
2495:
2490:
2485:
2475:
2474:
2473:
2462:
2460:
2451:
2445:
2444:
2442:
2441:
2436:
2431:
2430:
2429:
2418:
2416:
2410:
2409:
2406:
2405:
2403:
2402:
2397:
2392:
2387:
2382:
2380:Epiphysiodesis
2377:
2372:
2367:
2361:
2359:
2355:
2354:
2352:
2351:
2346:
2341:
2336:
2334:Astragalectomy
2331:
2325:
2323:
2319:
2318:
2316:
2315:
2309:
2307:
2303:
2302:
2300:
2299:
2294:
2289:
2284:
2279:
2274:
2269:
2264:
2259:
2253:
2251:
2247:
2246:
2244:
2243:
2238:
2233:
2227:
2225:
2218:
2212:
2211:
2206:
2203:
2202:
2193:
2192:
2185:
2178:
2170:
2164:
2163:
2160:Spinal fusion.
2157:
2150:
2147:Spinal Fusion.
2144:
2132:
2131:External links
2129:
2128:
2127:
2121:
2106:
2088:(2): 103–113.
2077:
2062:
2047:
2032:
2014:
1991:
1985:
1977:
1974:
1971:
1970:
1945:
1921:
1896:
1872:
1847:
1822:
1763:
1701:
1642:
1611:(2): 787–789.
1591:
1566:
1541:
1516:
1492:
1467:
1410:
1361:
1306:
1246:
1208:
1178:
1176:
1175:
1142:
1119:, which cites
1082:
1020:
999:(5): 701–715.
979:
972:
885:
839:
815:
808:
787:
786:
784:
781:
770:
769:
752:September 2023
736:listed sources
733:
731:
724:
718:
715:
709:
706:
702:
701:
698:
695:
692:
689:
686:
672:
669:
668:
667:
661:
658:
655:
648:Pseudarthrosis
645:
642:
636:
633:
632:
631:
628:
625:
620:
615:
609:
603:
600:
595:
592:
591:
590:
587:
584:
581:
578:
573:
572:During surgery
570:
564:
561:
560:
559:
558:
557:
554:
551:
548:
545:
531:
502:
499:
498:
497:
493:
488:
487:Thoracic spine
485:
484:
483:
480:
473:
465:
464:Cervical spine
462:
435:
432:
415:
412:
411:
410:
407:
404:
401:
398:
383:
380:
356:
353:
352:
351:
348:
345:
340:
335:
330:
325:
315:
310:
307:
301:
298:
293:
220:
217:
128:, also called
121:
120:
113:
110:
109:
102:
96:
95:
88:
82:
81:
76:
70:
69:
66:
60:
59:
50:
44:
43:
40:
36:
35:
32:
24:
23:
15:
9:
6:
4:
3:
2:
2710:
2699:
2696:
2694:
2691:
2690:
2688:
2669:
2666:
2662:
2659:
2657:
2654:
2653:
2652:
2649:
2647:
2644:
2642:
2639:
2637:
2634:
2632:
2629:
2627:
2624:
2623:
2621:
2617:
2611:
2608:
2606:
2603:
2601:
2598:
2596:
2593:
2591:
2587:
2584:
2582:
2579:
2577:
2574:
2572:
2569:
2567:
2564:
2563:
2561:
2557:
2549:
2546:
2544:
2541:
2540:
2539:
2536:
2534:
2531:
2527:
2524:
2522:
2519:
2517:
2514:
2513:
2512:
2509:
2508:
2506:
2502:
2494:
2491:
2489:
2486:
2484:
2481:
2480:
2479:
2476:
2472:
2471:Spinal fusion
2469:
2468:
2467:
2464:
2463:
2461:
2459:
2455:
2452:
2450:
2446:
2440:
2437:
2435:
2432:
2428:
2425:
2424:
2423:
2420:
2419:
2417:
2415:
2411:
2401:
2398:
2396:
2393:
2391:
2388:
2386:
2383:
2381:
2378:
2376:
2373:
2371:
2370:Bone grafting
2368:
2366:
2363:
2362:
2360:
2356:
2350:
2347:
2345:
2342:
2340:
2337:
2335:
2332:
2330:
2327:
2326:
2324:
2320:
2314:
2313:Acromioplasty
2311:
2310:
2308:
2304:
2298:
2295:
2293:
2290:
2288:
2285:
2283:
2280:
2278:
2275:
2273:
2270:
2268:
2265:
2263:
2260:
2258:
2255:
2254:
2252:
2248:
2242:
2239:
2237:
2234:
2232:
2231:Jaw reduction
2229:
2228:
2226:
2222:
2219:
2217:
2213:
2209:
2204:
2199:
2191:
2186:
2184:
2179:
2177:
2172:
2171:
2168:
2161:
2158:
2155:
2151:
2148:
2145:
2142:
2139:
2135:
2134:
2125:
2122:
2119:
2115:
2111:
2107:
2103:
2099:
2095:
2091:
2087:
2083:
2078:
2075:
2071:
2067:
2063:
2060:
2056:
2052:
2048:
2045:
2041:
2037:
2033:
2031:
2030:0-89203-172-7
2027:
2023:
2019:
2015:
2012:
2008:
2004:
2000:
1996:
1992:
1989:
1986:
1983:
1980:
1979:
1960:
1959:SpineUniverse
1956:
1949:
1935:
1931:
1925:
1910:
1906:
1900:
1886:
1882:
1876:
1862:. 5 July 2019
1861:
1857:
1851:
1836:
1832:
1826:
1818:
1814:
1810:
1806:
1802:
1798:
1794:
1790:
1782:
1780:
1778:
1776:
1774:
1772:
1770:
1768:
1759:
1755:
1750:
1745:
1741:
1737:
1732:
1727:
1723:
1719:
1715:
1708:
1706:
1697:
1693:
1688:
1683:
1679:
1675:
1670:
1665:
1661:
1657:
1653:
1646:
1638:
1634:
1629:
1624:
1619:
1614:
1610:
1606:
1602:
1595:
1581:
1577:
1570:
1556:
1552:
1545:
1531:
1527:
1520:
1506:
1502:
1496:
1482:. 5 July 2019
1481:
1477:
1471:
1463:
1459:
1454:
1449:
1445:
1441:
1437:
1433:
1429:
1425:
1421:
1414:
1406:
1402:
1398:
1394:
1389:
1384:
1380:
1376:
1372:
1365:
1357:
1353:
1349:
1345:
1341:
1337:
1333:
1329:
1325:
1321:
1313:
1311:
1302:
1298:
1294:
1290:
1286:
1282:
1277:
1272:
1268:
1264:
1257:
1250:
1236:on 2014-03-28
1235:
1231:
1227:
1223:
1219:
1212:
1204:
1200:
1196:
1192:
1185:
1183:
1172:
1168:
1164:
1160:
1157:(10): 894–9.
1156:
1152:
1148:
1143:
1132:
1131:
1126:
1121:
1120:
1109:
1108:
1104:
1099:
1095:
1089:
1087:
1078:
1074:
1070:
1066:
1062:
1058:
1054:
1050:
1043:
1041:
1039:
1037:
1035:
1033:
1031:
1029:
1027:
1025:
1016:
1012:
1007:
1002:
998:
994:
990:
983:
975:
969:
965:
958:
956:
954:
952:
950:
948:
946:
944:
942:
940:
938:
936:
934:
932:
930:
928:
926:
924:
922:
920:
918:
916:
914:
912:
910:
908:
906:
904:
902:
900:
898:
896:
894:
892:
890:
881:
877:
873:
869:
865:
861:
857:
853:
846:
844:
835:
831:
824:
822:
820:
811:
809:9783319988757
805:
801:
800:
792:
788:
780:
777:
766:
763:
755:
743:
742:
737:
732:
728:
723:
722:
714:
705:
699:
696:
693:
690:
687:
684:
683:
682:
679:
665:
664:Arachnoiditis
662:
659:
656:
653:
649:
646:
643:
639:
638:
629:
626:
624:
621:
619:
616:
613:
610:
607:
604:
601:
598:
597:
588:
585:
582:
579:
576:
575:
569:
555:
552:
549:
546:
543:
542:
540:
536:
532:
529:
525:
521:
520:
515:
507:
494:
491:
490:
481:
478:
474:
471:
468:
467:
457:
453:
450:
445:
441:
431:
429:
425:
421:
414:Effectiveness
408:
405:
402:
399:
396:
395:
394:
391:
389:
379:
377:
373:
369:
365:
361:
349:
346:
344:
341:
339:
336:
334:
331:
329:
326:
323:
319:
316:
314:
311:
308:
306:
302:
299:
297:
294:
292:
289:
288:
287:
284:
282:
278:
274:
268:
266:
265:radiculopathy
262:
258:
252:
250:
246:
242:
238:
234:
225:
216:
212:
210:
206:
202:
198:
194:
190:
186:
182:
178:
173:
171:
167:
163:
159:
155:
151:
147:
146:bone grafting
143:
139:
135:
131:
130:spondylodesis
127:
126:Spinal fusion
117:
111:
107:
103:
101:
97:
93:
89:
87:
83:
80:
77:
75:
71:
67:
65:
61:
58:
54:
51:
49:
45:
41:
37:
30:
25:
22:Spinal fusion
20:
2650:
2631:Arthroplasty
2595:Ankle fusion
2538:Hand surgery
2493:Arthroplasty
2488:Annuloplasty
2470:
2287:Foraminotomy
2272:Laminoplasty
2257:Coccygectomy
2140:
2109:
2085:
2081:
2065:
2050:
2035:
2021:
2003:Humana Press
1994:
1962:. Retrieved
1958:
1948:
1937:. Retrieved
1933:
1924:
1913:. Retrieved
1908:
1899:
1888:. Retrieved
1884:
1875:
1864:. Retrieved
1859:
1850:
1839:. Retrieved
1837:. 2021-02-08
1834:
1825:
1792:
1788:
1721:
1717:
1659:
1655:
1645:
1608:
1604:
1594:
1583:. Retrieved
1579:
1569:
1558:. Retrieved
1554:
1544:
1533:. Retrieved
1529:
1519:
1508:. Retrieved
1504:
1495:
1484:. Retrieved
1479:
1470:
1427:
1423:
1413:
1378:
1374:
1364:
1323:
1319:
1266:
1262:
1249:
1238:. Retrieved
1234:the original
1221:
1211:
1194:
1154:
1150:
1134:. Retrieved
1128:
1112:, retrieved
1101:
1055:(1): 67–76.
1052:
1048:
996:
993:Neurosurgery
992:
982:
963:
858:(1): 67–76.
855:
851:
833:
802:. Springer.
798:
791:
773:
758:
749:
738:
711:
703:
674:
623:Malnutrition
566:
501:Lumbar spine
440:decompressed
437:
417:
392:
385:
382:Epidemiology
358:
285:
269:
253:
230:
219:Medical uses
213:
174:
133:
129:
125:
124:
2641:Arthroscopy
2636:Synovectomy
2466:Arthrodesis
2282:Facetectomy
2267:Laminectomy
1934:ryortho.com
1381:(1): 3–12.
1285:10616/46584
739:may not be
368:soft tissue
338:Spondylosis
257:osteophytes
197:spondylosis
162:fluoroscopy
100:MedlinePlus
53:Orthopedics
39:Other names
2687:Categories
2656:Arthrogram
2626:Arthrotomy
2483:Discectomy
2277:Corpectomy
2262:Laminotomy
2200:and joints
1964:2020-07-29
1939:2020-07-29
1915:2020-07-29
1890:2020-07-29
1866:2020-07-29
1841:2021-03-18
1585:2020-07-28
1560:2020-07-28
1535:2020-07-28
1510:2020-07-28
1486:2020-07-28
1240:2014-05-19
783:References
580:Blood loss
479:and fusion
477:corpectomy
444:bone graft
215:segments.
152:), donor (
64:ICD-10-PCS
2414:Cartilage
2385:Reduction
2375:Osteotomy
2365:Ostectomy
1809:1469-493X
1740:2229-5097
1678:1471-2474
1444:0940-6719
1397:1547-5646
1340:1872-6968
1326:: 85–92.
1293:0028-4793
434:Technique
313:Scoliosis
273:scoliosis
205:scoliosis
154:allograft
150:autograft
142:vertebrae
57:Neurology
48:Specialty
2651:imaging:
2102:15856812
1885:Medscape
1860:wtol.com
1817:24323844
1758:28217384
1696:16737522
1637:35360775
1505:Medscape
1480:wtol.com
1462:22526700
1405:32932227
1356:31098673
1348:26051881
1301:27074066
1230:24851286
1203:24716251
1171:23098616
1136:25 March
1114:25 March
1077:22564134
1069:21311399
1015:28327997
880:22564134
872:21311399
834:UpToDate
741:reliable
671:Recovery
641:factors.
539:vertebra
528:pedicles
496:systems.
328:Lordosis
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