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Query: UNIPROT:Q9NRP7 (fused)
 58,367 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eighty patients were treated by radical arch resection, i.e., removal of the loose lamina and the fibrous tissue in and around the pseudarthrosis and resection of the caudal portion of the ventral part of the pedicle. In 17 patients an additional spinal fusion was performed. The mean observation time was 4.7 years. The forward dislocation increased by 25 per cent in the group without fusion compared with 16 per cent in the fused group. The symptoms of nerve root affection for the most part improved, but the back pain persisted in 28 patients. Fifty per cent of the patients were in full-time employment at the time of the follow-up. A total of 75 per cent were improved and 25 per cent unchanged or worse.
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PMID:Spondylolisthesis. Treatment by excision of the loose lamina and resection of the pedicle. 14 85

Prior experience with the rare combination of horseshoe kidney and significant atherosclerotic vascular disease suggests difficulty in intraoperative management, often requiring division of the renal isthmus or sacrifice of some renal tissue. Seven patients have been managed successfully over the past ten years at The Ohio State University Hospital. There were six men and one woman, ranging in age from 39 to 66 years. Of the five patients with abdominal aortic aneurysm, four had a pulsatile abdominal mass, three had abdominal pain, and one had back pain. The other two patients had progressively symptomatic aortoiliac disease. All seven patients had hypertension, easily controlled by medication. Critical diagnostic procedures are preoperative intravenous pyelogram (IVP) and abdominal aortic arteriogram. The IVP detected the previously unsuspected diagnosis in 100% of the cases. The arteriogram accurately located the aneurysm in relation to the renal vascular supply, and disclosed aberrant blood supply in three of four patients with aberrant vessels. All seven horseshoe kidneys were fused at the lower pole. The operative approach involves meticulous dissection of the aberrant blood supply to the kidneys, and mobilization of the isthmus for adequate retrorenal aortic exposure. In six of the seven patients, the grafts were placed posterior to the isthmus. There were no deaths, and there were no complications related to the presence of the horseshoe kidney. In three of the seven patients, hypertension improved. Patients with horseshoe kidney and aortic disease may be safely operated upon without damage to the kidney. IVP and selective angiography are essential to provide preoperative information.
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PMID:Abdominal aortic surgery in the presence of a horseshoe kidney. 66 80

Back pain questionnaires were completed by a study group of 103 idiopathic scoliosis patients fused with Harrington rods from L3 or lower and a control group of 29 patients fused to L2 or above. Minimum time to follow-up examination was 2 years. The study group had a higher rate of secondary surgeries for complications or late disc disease below the fusion, a higher back pain score, more difficulties with normal daily activities, needed more regular pain medications, and had more episodes of back pain. Patients older than 30 years at surgery had more of these problems if fused to L3 or more caudally. The amount of remaining lumbar lordosis correlated significantly with the difficulty of normal daily activities.
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PMID:Back pain and disability after Harrington rod fusion to the lumbar spine for scoliosis. 138 79

From June, 1989 to March, 1991, 24 cases with various spinal disorders were treated in our department using the Dick technique. The results were as follows: In the fresh fracture group (7 cases), all the spine fractures were reduced anatomically: the 2 cases without neurological defects returned to work 3 months after operation; the 3 cases with incomplete paraplegia had rapid neurological recovery; and the 2 cases with complete paraplegia showed no recovery after operation. In the late fracture group (10 cases), traumatic kyphotic curves were partially reduced and back pain was decreased markedly in all: Muscle power was increased significantly in 3 cases; spasticity was remarkably improved in 2 cases; 3 cases obtained complete cure of incontinence; and 4 cases had no significant improvement. In 3 cases with ankylosing spondylitis, the initial average kyphotic curve was 73.3 degrees, while the postoperative average curve was 28.3 degrees. The result of treatment of spinal stenosis due to degenerative spondylolisthesis (1 case) was good; slipping vertebrae were stabilized and fused with the Dick system after thorough decompression. In 1 tumor and 2 Tb-spine cases, the patients recovered and were ambulatory soon after operation.
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PMID:The application of Dick instrumentation in spine surgery. 142 57

A total of 104 patients underwent transpedicular spinal instrumentation using the Cotrel-Dubousset (71 cases) or the Texas Scottish Rite Hospital (33) screw-rod system. Surgery was performed for lumbar vertebral column instability secondary to fractures (28 cases), spondylolisthesis (29), tumors (four), vertebral osteomyelitis (two), or postoperative causes (41). Pseudoarthrodesis due to failure of a prior fusion was present in 37 cases. The 55 men and 49 women (mean age 47 years, range 18 to 87 years) all presented with severe back pain. Signs or symptoms of neural compression were noted in 96 patients. Surgery consisted of neural decompression, internal fixation, and autogenous iliac bone grafting. Spondylolistheses were fused in situ, without reduction; otherwise, major spinal deformities were corrected. A total of 516 pedicle screws were placed. The mean extent of fusion was 2.7 motion segments (range one to six motion segments). A 96% fusion rate was obtained with a mean follow-up period of 20 months. There were no operative deaths. Major complications included one spinal epidural hematoma, three isolated nerve root deficits (two transient, one permanent), and three wound infections (two deep, one superficial). Instrument failure eventually developed in 18 patients; nine were asymptomatic with a solid fusion and did not require further treatment and the other nine were symptomatic or had a pseudoarthrosis and required operative revision. Pedicle screw-rod fixation offers biomechanical advantages compared to other forms of internal fixation for the lumbar spine. It enables short-segment fixation with preservation of lumbar lordosis and adjacent normal motion segments. This technique provides a highly successful method to obtain arthrodesis, even with prior pseudoarthrosis.
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PMID:Transpedicular screw-rod fixation of the lumbar spine: operative technique and outcome in 104 cases. 831 59

Fifty-three adult idiopathic scoliosis patients whose fusions ended caudally between L2 and S1 were reviewed relative to criteria for selection of the lowest fused vertebra and their outcome. The Harrington stable zone, central sacral line, and the presence of rotary subluxation, arthritis, spondylolisthesis, vertebral body and disc space wedging were studied. Preoperative and postoperative pain, quality of life, and decisions for surgery were surveyed with a 94% response. Results showed the older the patient, the lower the fusion. The Harrington stable zone was useful, whereas the central sacral line frequently indicated longer fusions by as much as three segments. The presence of pathoanatomic features also dictated lower fusions. Patients in whom the lowest level of fusion was consistent with selection criteria had reduced frequency and intensity of low-back pain.
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PMID:Selection of lumbar fusion levels in adult idiopathic scoliosis patients. 175 35

During a 47-month period, 68 patients were studied prospectively to compare single-level lumbar fusion with and without adjunctive pedicular fixation. Fusion indications were disabling back pain for a minimum of 6 months, inability to work, and failed conservative care. Twenty-nine patients fused without hardware and 39 fused with VSP fixation in identical procedures. All patients were evaluated according to fusion success, perceived pain, and return to work. Pseudarthrosis was demonstrated in 58.6% of the noninstrumented group. No pseudarthroses were noted in instrumented patients. Pain improvement in the nonhardware group was 41.4%, and in the hardware group, 76.9%. Return to work was 31% and 72% in each group, respectively. The fusion rate for patients exhibiting single-level disc disease improves with spinal fixation.
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PMID:A comparison of single-level fusions with and without hardware. 183 49

Reports in the literature have questioned the practice of using Harrington distraction rods spanning unfused spinal segments for internal fixation of the fractured thoracolumbar spine. However, the long-term incidence of facet joint osteoarthritis has not been reported. This is the report on a retrospective analysis of 20 of these patients with an average follow-up period of 8.0 years. Eighty-five percent of the patients received a classification of good to excellent regarding back pain and 90% returned to their preinjury occupation. Of significance, of 75 lumbar facets traversed by rods but not fused, only two were classified as "closed" or autofused. It remains to be seen if some pedicular systems are superior to this technique in trained hands. However, multisegmental instrumentation with unisegmental fusion is possible without obtaining the severe osteoarthritic changes that animal studies have demonstrated.
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PMID:Long-term lumbar facet joint changes in spinal fracture patients treated with Harrington rods. 240 87

Persistent back pain in the presence of an intact posterior fusion is commonly seen and is often regarded as being psychogenic in origin. This paper discusses five patients, all of whom were chronically disabled by such pain; all five had a confirmed posterior and/or lateral fusion. In each case lateral discography identified the disc within the fused segment as the source of symptoms and pain relief was obtained with an anterior interbody fusion. This source of pain should be considered as a possibility in similar cases of failed back surgery.
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PMID:Discogenic pain persisting despite solid posterior fusion. 293 99

Seventy-eight unfused patients with idiopathic scoliosis were followed from skeletal maturity over a mean period of 17 years (range 10 to 27 years) with a mean age at follow up of 33.7 years. The following aspects were investigated: curve deterioration, back pain incidence, and psychosocial details. There was considerable variation in the progression rate of similar deformities but on average significant deterioration occurred when the Cobb angle was over 55 degrees with a maximum deterioration approaching 1.5 degrees per year in the thoracic curves between 90 degrees and 100 degrees mature Cobb angle. Thoracolumbar and lumbar curves were slightly more benign with a maximum progression rate of about 1 degree when the mature angle was 80 degrees to 90 degrees. The thoracic component of double curves progressed least. Rotation increased in proportion to the Cobb angle progression except in some lumbar curves where lateral subluxation occurred with a disproportionate amount of rotation. The incidence of back pain in relation to pain in the general population and in fused patients remains uncertain. Eighty-two percent of patients had married and 87% had job satisfaction; 10% received treatment for depression.
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PMID:The natural history of unfused scoliosis. 295 82


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