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A UK-based pilot study of current surgical practice and implant preferences in lumbar fusion surgery
Lumbar fusion surgery is an established procedure for the treatment of low back pain. Despite the wide set of alternative fusion techniques and existing devices, uniform guidelines are not available yet and common surgical trends are scarcely investigated. The purpose of this UK-based study was to p...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039689/ https://www.ncbi.nlm.nih.gov/pubmed/29952965 http://dx.doi.org/10.1097/MD.0000000000011169 |
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author | Provaggi, Elena Capelli, Claudio Leong, Julian J.H. Kalaskar, Deepak M. |
author_facet | Provaggi, Elena Capelli, Claudio Leong, Julian J.H. Kalaskar, Deepak M. |
author_sort | Provaggi, Elena |
collection | PubMed |
description | Lumbar fusion surgery is an established procedure for the treatment of low back pain. Despite the wide set of alternative fusion techniques and existing devices, uniform guidelines are not available yet and common surgical trends are scarcely investigated. The purpose of this UK-based study was to provide a descriptive portrait of current surgeons’ practice and implant preferences in lumbar fusion surgery. A UK-based in-person survey was designed for this study and submitted to a group of consultant spinal surgeons (n = 32). Fifteeen queries were addressed based on different aspects of surgeons’ practice: lumbar fusion techniques, implant preferences, and bone grafting procedures. Answers were analyzed by means of descriptive statistics. Thirty-two consultant spinal surgeons completed the survey. There was clear consistency on the relevance of a patient-centered management (82.3%), along with a considerable variability of practice on the preferred fusion approach. Fixation surgery was found to be largely adopted (96.0%) and favored over stand-alone cages. With regards to the materials, titanium cages were the most used (54.3%). The geometry of the implants influenced the choice of lumbar cages (81.3%). Specifically, parallel-shape cages were mostly avoided (89.2%) and hyperlordotic cages were preferred at the lower lumbar levels. However, there was no design for lumbar cages which was consistently favored. Autograft bone graft surgeries were the most common (60.0%). Amongst the synthetic options, hydroxyapatite-based bone graft substitutes (76.7%) in injectable paste form (80.8%) were preferred. Current lumbar fusion practice is variable and patient-oriented. Findings from this study highlight the need for large-scale investigative surveys and clinical studies aimed to set specific guidelines for certain pathologies or patient categories. |
format | Online Article Text |
id | pubmed-6039689 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-60396892018-07-16 A UK-based pilot study of current surgical practice and implant preferences in lumbar fusion surgery Provaggi, Elena Capelli, Claudio Leong, Julian J.H. Kalaskar, Deepak M. Medicine (Baltimore) Research Article Lumbar fusion surgery is an established procedure for the treatment of low back pain. Despite the wide set of alternative fusion techniques and existing devices, uniform guidelines are not available yet and common surgical trends are scarcely investigated. The purpose of this UK-based study was to provide a descriptive portrait of current surgeons’ practice and implant preferences in lumbar fusion surgery. A UK-based in-person survey was designed for this study and submitted to a group of consultant spinal surgeons (n = 32). Fifteeen queries were addressed based on different aspects of surgeons’ practice: lumbar fusion techniques, implant preferences, and bone grafting procedures. Answers were analyzed by means of descriptive statistics. Thirty-two consultant spinal surgeons completed the survey. There was clear consistency on the relevance of a patient-centered management (82.3%), along with a considerable variability of practice on the preferred fusion approach. Fixation surgery was found to be largely adopted (96.0%) and favored over stand-alone cages. With regards to the materials, titanium cages were the most used (54.3%). The geometry of the implants influenced the choice of lumbar cages (81.3%). Specifically, parallel-shape cages were mostly avoided (89.2%) and hyperlordotic cages were preferred at the lower lumbar levels. However, there was no design for lumbar cages which was consistently favored. Autograft bone graft surgeries were the most common (60.0%). Amongst the synthetic options, hydroxyapatite-based bone graft substitutes (76.7%) in injectable paste form (80.8%) were preferred. Current lumbar fusion practice is variable and patient-oriented. Findings from this study highlight the need for large-scale investigative surveys and clinical studies aimed to set specific guidelines for certain pathologies or patient categories. Wolters Kluwer Health 2018-06-29 /pmc/articles/PMC6039689/ /pubmed/29952965 http://dx.doi.org/10.1097/MD.0000000000011169 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 |
spellingShingle | Research Article Provaggi, Elena Capelli, Claudio Leong, Julian J.H. Kalaskar, Deepak M. A UK-based pilot study of current surgical practice and implant preferences in lumbar fusion surgery |
title | A UK-based pilot study of current surgical practice and implant preferences in lumbar fusion surgery |
title_full | A UK-based pilot study of current surgical practice and implant preferences in lumbar fusion surgery |
title_fullStr | A UK-based pilot study of current surgical practice and implant preferences in lumbar fusion surgery |
title_full_unstemmed | A UK-based pilot study of current surgical practice and implant preferences in lumbar fusion surgery |
title_short | A UK-based pilot study of current surgical practice and implant preferences in lumbar fusion surgery |
title_sort | uk-based pilot study of current surgical practice and implant preferences in lumbar fusion surgery |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039689/ https://www.ncbi.nlm.nih.gov/pubmed/29952965 http://dx.doi.org/10.1097/MD.0000000000011169 |
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