533:
754:
29:
541:
483:
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.
449:, there was no benefit in health outcomes (improvement in pain or function) of performing fusion surgery in comparison to intensive rehabilitation including cognitive-behavioral treatment. Similarly, researchers in Washington State viewed lumbar fusion surgery to have questionable medical benefit, increased costs and increased risks, in comparison to intensive pain programs for chronic
806:
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.
594:
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
702:
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
805:
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
707:
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
667:
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
478:
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
473:
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
739:
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.
1696:
522:
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
1438:
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".
1907:
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".
1976:
1596:
1392:
Franklin, Gary M.; Wickizer, Thomas M.; Coe, Norma B.; Fulton-Kehoe, Deborah (2014-10-20). "Workers' compensation: Poor quality health care and the growing disability problem in the United States".
1152:"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
684:
Adjacent segment disease – degeneration of vertebrae above/below the fused segments due altered biomechanical stresses or patient propensity to develop progressive degenerative change.
465:
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
1490:
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).
2308:
1281:
Försth, Peter; Ólafsson, Gylfi; Carlsson, Thomas; Frost, Anders; Borgström, Fredrik; Fritzell, Peter; Öhagen, Patrik; Michaëlsson, Karl; Sandén, Bengt (2016-04-14).
731:
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.
595:
surgery. Complications also depend on the type/extent of spinal fusion surgery performed. There are three main time periods where complications typically occur:
1244:
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
2025:
418:
Although spinal fusion surgery is widely performed, there is limited evidence for its effectiveness for several common medical conditions. For example, in a
1014:
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).
2075:
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
2301:
1341:
Chou, Roger; Baisden, Jamie; Carragee, Eugene J.; Resnick, Daniel K.; Shaffer, William O.; Loeser, John D. (May 2009). "Surgery for Low Back Pain".
568:. A plastic or titanium device may be placed between the vertebra to maintain spine alignment and disc height. The types of interbody fusion are:
1835:"Decreasing hospital length of stay following lumbar fusion utilizing multidisciplinary committee meetings involving surgeons and other caretakers"
2294:
1721:
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
1174:"Recombinant human bone morphogenetic protein-2: adverse events reported to the Manufacturer and User Facility Device Experience database"
1671:
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:
2170:
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.
2701:
1217:
1151:
704:
580:
Transpsoas interbody fusion (DLIF or XLIF) – the disc is accessed from an incision through the psoas muscle on one side of the spine
2653:
773:
Please help improve this article by looking for better, more reliable sources. Unreliable citations may be challenged and removed.
2818:
2138:
496:
363:
1697:"Current use of contaminated pedicle screws & required practice for asepsis in spine surgery — 2 Qs with Dr. Aakash Agarwal"
1492:"Development and validation of a clinical prediction score for poor postoperative pain control following elective spine surgery"
1539:
Pumberger, Matthias; Chiu, Ya Lin; Ma, Yan; Girardi, Federico P.; Vougioukas, Vassilios; Memtsoudis, Stavros G. (August 2012).
2238:
2194:
2179:
2164:
2131:
998:
2274:
856:
583:
Oblique lateral lumbar interbody fusion (OLLIF) – the disc is accessed from an incision through the psoas muscle obliquely
2559:
2245:
Oblique
Lateral Lumbar Interbody Fusion (OLLIF): Technical Notes and Early Results of a Single Surgeon Comparative Study.
1282:
678:
475:
1260:
2710:
2554:
577:
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
2813:
2150:
834:
788:
2050:
1074:
Rajaee, Sean S.; Bae, Hyun W.; Kanim, Linda E.A.; Delamarter, Rick B. (2012). "Spinal Fusion in the United States".
824:
2613:
2608:
1124:
184:
2505:
63:
1646:
693:– 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
1156:
1120:
1951:
1541:"Perioperative mortality after lumbar spinal fusion surgery: an analysis of epidemiology and risk factors"
419:
2108:
2542:
2114:
Boatright, K. C. and S. D. Boden. Chapter 12: Biology of Spine Fusion. In: Lieberman, J., et al., Eds.
767:
426:, after 2 and 5 years there was no significant clinical benefits of lumbar fusion in combination with
359:
2646:
554:
532:
454:
446:
290:
180:
165:
2668:
2459:
762:
571:
Anterior lumbar interbody fusion (ALIF) – the disc is accessed from an anterior abdominal incision
553:
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:
2026:"UT researcher calls on FDA to change rules to address spine screw contamination | UToledo News"
137:
2578:
2449:
2417:
393:
A 2008 analysis of spinal fusions in the United States reported the following characteristics:
169:
2280:
2547:
1833:
Shields, Lisa B. E.; Clark, Lisa; Glassman, Steven D.; Shields, Christopher B. (2017-01-19).
371:
157:
2725:
231:
Spinal fusion can be used to treat a variety of conditions affecting any level of the spine—
2636:
2356:
632:
466:
2258:
629:
Wound infections - risk factors include old age, obesity, diabetes, smoking, prior surgery
8:
2788:
2598:
2520:
574:
Posterior lumbar interbody fusion (PLIF) – the disc is accessed from a posterior incision
561:
176:
149:
2286:
2155:
Camillo, F. X. Chapter 36: Arthrodesis of the Spine. In: Canale, S. T. and J. H. Beaty.
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28:
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Immobilization or ankylosis of two or more vertebrae by fusion of the vertebral bodies
2766:
2720:
2515:
2510:
2361:
2234:
2218:
2190:
2175:
2160:
2146:
2127:
2051:"The Hardest Decision Any Spine Surgeon Has to Make | Orthopedics This Week - Part 2"
1933:
1925:
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192:
73:
47:
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1103:
906:
2706:
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2267:
2233:(2nd Ed.). Rolling Meadows, Illinois: American Association of Neurosurgeons. 2008.
2210:
1921:
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1378:
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1185:
1083:
1027:
886:
1647:"Banned in the USA: Petition calls for FDA to prohibit reprocessed pedicle screws"
105:
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1354:
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1087:
890:
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between vertebrae is removed and a bone graft is placed in the space between the
423:
248:
200:
188:
91:
1738:
2781:
2696:
2641:
2500:
2454:
2214:
1016:"Lumbar Fusion for Degenerative Disease: A Systematic Review and Meta-Analysis"
674:
295:
2137:
Holmes, C. F., et al. Chapter 9: Cervical Spine
Injuries. In: Schenck, R. F.,
1556:
1508:
1491:
540:
183:). It is also used as a backup procedure for total disc replacement surgery (
2807:
2490:
2433:
2351:
2001:
1929:
1860:
1851:
1798:
1621:
1564:
1517:
1460:
1413:
1362:
1319:
1283:"A Randomized, Controlled Trial of Fusion Surgery for Lumbar Spinal Stenosis"
690:
470:
450:
442:
438:
264:
145:
2076:"Implant-Related Management of Surgical Site Infections After Spine Surgery"
1032:
1015:
2751:
2715:
2658:
2407:
2392:
2377:
2222:
2123:
1937:
1878:
1816:
1789:
1757:
1582:
1525:
1468:
1421:
1370:
1327:
1256:
1229:
1197:
1095:
1041:
898:
677:– nonunion between fused bone segments. Risk factors include tobacco use,
649:
2270:
American
Academy of Orthopaedic Surgeons. June 2010. Accessed 1 June 2013.
1302:
2761:
2756:
2586:
2402:
2387:
687:
Epidural fibrosis – scarring of the tissue that surrounds the spinal cord
557:
of each vertebra, attaching to a metal rod on each side of the vertebrae.
367:
337:
256:
196:
161:
99:
52:
479:
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:
2776:
2746:
2603:
2397:
2382:
1952:"Permanent Restrictions after Spinal Fusion – What Do the Doctors Say?"
1405:
1311:
503:
482:
1218:"Characteristics of Operating Room Procedures in U.S. Hospitals, 2011"
712:
Walking – most people are out of bed and walking the day after surgery
115:
2534:
2495:
2485:
2189:. trans. B. Herwig. Berlin: Springer-Verlag. 2006. pp. 273–288.
1672:"Pedicle screw handling techniques "lead to contamination of screws""
718:
Lifting – it is generally recommended to avoid lifting until 12 weeks
312:
272:
204:
153:
141:
56:
2201:
Tehranzadehlow J.; et al. (2005). "Advances in spinal fusion".
1211:
1209:
1173:
993:. Philadelphia, PA: Lippincott Williams & Wilkins. p. 343.
1977:"11 Investigates: Surgical implants raising contamination concerns"
1597:"11 Investigates: Surgical implants raising contamination concerns"
565:
327:
317:
280:
276:
208:
1251:(171). Rockville, MD: Agency for Healthcare Research and Quality.
1245:"Trends in Operating Room Procedures in U.S. Hospitals, 2001–2011"
1224:(170). Rockville, MD: Agency for Healthcare Research and Quality.
2264:. Division of Orthopedic Surgery. Duke University Medical Center.
2185:
1771:
McGregor, Alison H.; Dicken, Ben; Jamrozik, Konrad (2006-05-31).
1206:
802:
474:
shown to have higher union rates than non-instrumented fusions.
223:
681:
use, osteoporosis, revision procedures, decreased immune system.
1773:"National audit of post-operative management in spinal surgery"
1489:
1391:
232:
2569:
2174:. (11th Ed.). Philadelphia: Mosby. 2007. pp. 2159–2224.
2159:. (11th Ed.). Philadelphia: Mosby. 2007. pp. 1851–1874.
304:
1119:
671:
Deformity – loss of height, alignment, and failure of fusion
610:
Damage to nerves and surrounding structures during procedure
2336:
2318:
1832:
1280:
877:
Rajaee, Sean (2012). "Spinal Fusion in the United States".
2002:"Ban 'Reprocessing' of Spinal Surgery Screws, Experts Say"
1622:"Ban 'Reprocessing' of Spinal Surgery Screws, Experts Say"
1340:
2316:
2145:
1073:
857:"Subacute and Chronic Low Back Pain: Surgical Treatment"
263:. Pressure on the nerves as they exit the spinal cord (
1770:
1538:
1215:
536:
1906:
1125:"Five Things Physicians and Patients Should Question"
1013:
823:
Meyer, Bernhard; Rauschmann, Michael (4 March 2019).
2277:
SpineUniverse. September 2012. Accessed 1 June 2013.
1216:
Weiss AJ, Elixhauser A, Andrews RM (February 2014).
724:
Return to sedentary work – usually between 3–6 weeks
544:
Stabilization rods used after spinal fusion surgery.
2187:
MRI Atlas: Orthopedics and Neurosurgery – The Spine
661:
1722:"Adjacent segment pathology of the cervical spine"
715:Sitting – can begin at 1–6 weeks following surgery
549:Posterolateral fusion is a bone graft between the
350:Any condition that causes instability of the spine
2275:What is Spinal Instrumentation and Spinal Fusion?
2200:
388:Agency for Healthcare Research and Quality (AHRQ)
2805:
1242:
822:
616:Harvesting of bone graft (if autograft is used)
2283:Encyclopedia of Surgery. Accessed 1 June 2013.
2109:A Patient's Guide to Anterior Cervical Fusion.
2302:
560:Interbody Fusion is a graft where the entire
179:(cartilage between two vertebrae) wears out (
1437:
657:Shock, sepsis and cerebrovascular infarction
366:. There are reports of this therapy causing
1910:The Cochrane Database of Systematic Reviews
1726:Journal of Family Medicine and Primary Care
509:Posterior cervical decompression and fusion
2309:
2295:
1115:
1113:
727:Return to manual work – between 7–12 weeks
27:
2702:Anterior cruciate ligament reconstruction
1868:
1850:
1806:
1788:
1747:
1737:
1572:
1507:
1301:
1031:
789:Learn how and when to remove this message
227:Herniated disc pressing on spinal nerves.
2654:Ulnar collateral ligament reconstruction
1669:
988:
721:Driving – usually can begin at 3–6 weeks
539:
531:
481:
400:45.5% of all spinal fusions were on men
222:
140:or neurosurgeons that joins two or more
1394:American Journal of Industrial Medicine
1149:
1110:
743:
497:Anterior cervical discectomy and fusion
364:anterior cervical discectomy and fusion
2806:
2111:University of Maryland Medical Center.
2073:
1719:
1644:
876:
604:Patient positioning on operating table
2290:
2143:Athletic Training in Sports Medicine.
1902:
1900:
1898:
1896:
1894:
1892:
1890:
1888:
1828:
1826:
1694:
1433:
1431:
1243:Weiss AJ, Elixhauser A (March 2014).
991:Orthopaedic Surgery Essentials: Spine
984:
982:
980:
978:
976:
974:
972:
970:
968:
966:
964:
962:
960:
958:
956:
954:
952:
950:
948:
946:
944:
942:
940:
938:
936:
626:Moderate to severe postoperative pain
2231:Surgical Management of Low Back Pain
1720:Chu, ECP; Lee, LYK (February 2022).
1069:
1067:
1065:
1063:
1061:
1059:
1057:
1055:
1053:
1051:
934:
932:
930:
928:
926:
924:
922:
920:
918:
916:
872:
870:
854:
850:
848:
846:
826:Spine Surgery: A Case-Based Approach
747:
620:
486:Anterior approach to cervical spine.
354:
347:Other degenerative spinal conditions
2560:Autologous chondrocyte implantation
2172:Campbell's Operative Orthopaedics 2
2157:Campbell's Operative Orthopaedics 2
1441:Clinical Neurology and Neurosurgery
1171:
1150:Schultz, Daniel G. (July 1, 2008).
679:nonsteroidal anti-inflammatory drug
13:
2711:Unicompartmental knee arthroplasty
2555:Knee cartilage replacement therapy
2262:Wheeless' Textbook of Orthopaedics
2203:Seminars in Ultrasound, CT and MRI
2096:
1885:
1823:
1428:
14:
2830:
2251:
1695:Korol, Shayna (15 October 2018).
1048:
913:
867:
843:
708:fusion surgery are listed below:
598:
519:Anterior decompression and fusion
513:
490:
1839:Surgical Neurology International
752:
662:Weeks to years following surgery
413:
409:In-hospital mortality was 0.25%
185:intervertebral disc arthroplasty
2067:
2043:
2018:
1994:
1969:
1944:
1764:
1713:
1688:
1663:
1638:
1614:
1589:
1532:
1483:
1385:
1334:
1290:New England Journal of Medicine
1274:
527:
381:
247:, while evidence is weaker for
218:
2819:Orthopedic surgical procedures
2257:Wheeless, C. R., et al., Eds.
1922:10.1002/14651858.CD009644.pub2
1645:Hudson, Jocelyn (2019-01-16).
1496:Journal of Neurosurgery. Spine
1453:10.1016/j.clineuro.2015.05.016
1236:
1137:, North American Spine Society
1007:
855:Chou, Roger (March 11, 2016).
816:
1:
1777:BMC Musculoskeletal Disorders
809:
386:According to a report by the
2116:Bone Regeneration and Repair
1355:10.1097/BRS.0b013e3181a105fc
1190:10.1016/j.spinee.2012.09.052
1121:North American Spine Society
1088:10.1097/brs.0b013e31820cccfb
891:10.1097/brs.0b013e31820cccfb
705:Minimally invasive surgeries
613:Insertion of spinal hardware
460:
441:found that for nonradicular
136:, is a surgery performed by
7:
2126:. 2005. pp. 225–239.
1739:10.4103/jfmpc.jfmpc_1380_21
703:outpatient surgery center.
697:
420:randomized controlled trial
10:
2835:
2543:Articular cartilage repair
2215:10.1053/j.sult.2005.02.007
801:In 2019, the news channel
360:Bone morphogenetic protein
148:—either from the patient (
2739:
2679:
2624:
2577:
2568:
2533:
2478:
2442:
2426:
2370:
2344:
2335:
2326:
1676:Spinal News International
1651:Spinal News International
1557:10.1007/s00586-012-2298-8
1509:10.3171/2020.5.SPINE20347
455:degenerative disk disease
447:degenerative disk disease
291:Degenerative disc disease
181:degenerative disc disease
112:
98:
84:
72:
62:
46:
38:
26:
21:
2814:Neurosurgical procedures
2669:Finger joint replacement
2460:Distraction osteogenesis
1852:10.4103/2152-7806.198732
734:
589:
2229:Resnick, D. K., et al.
2103:Cervical Spinal Fusion.
1670:willdate (2020-06-05).
1132:: an initiative of the
989:Agulnick, Marc (2017).
761:Some of this section's
343:Posterior rami syndrome
261:neurogenic claudication
2450:Femoral head ostectomy
2418:Vertebral augmentation
2074:Agarwal, Aakash; PhD.
1790:10.1186/1471-2474-7-47
1545:European Spine Journal
1249:HCUP Statistical Brief
1222:HCUP Statistical Brief
545:
537:
487:
296:Spinal disc herniation
228:
2647:Weaver–Dunn procedure
2548:Microfracture surgery
2317:Procedures involving
1303:10.1056/nejmoa1513721
1033:10.1093/neuros/nyw162
543:
535:
485:
433:Additionally, a 2009
428:decompression surgery
372:difficulty swallowing
322:Scheuermann's disease
226:
2637:Shoulder replacement
2599:Intervertebral discs
2357:Orthognathic surgery
2259:Fusion of the Spine.
1701:www.beckersspine.com
1172:Woo, EJ (Oct 2012).
744:Public health hazard
633:Deep vein thrombosis
551:transverse processes
374:and pressure on the
138:orthopaedic surgeons
2789:Arthroscopic lavage
2521:Tension band wiring
562:intervertebral disc
33:Fusion of L5 and S1
2731:Triple arthrodesis
2726:Broström procedure
2664:Brunelli procedure
2465:Ilizarov apparatus
2413:Vertebral fixation
2329:Orthopedic surgery
2120:Totowa, New Jersey
1406:10.1002/ajim.22399
654:Neurologic deficit
639:Pulmonary embolism
546:
538:
502:Anterior cervical
488:
476:Minimally invasive
309:Vertebral fracture
229:
166:navigation systems
2801:
2800:
2797:
2796:
2767:Joint replacement
2721:Ankle replacement
2529:
2528:
2516:External fixation
2511:Internal fixation
2362:Chin augmentation
2239:978-1-60406-035-5
2195:978-3-540-33533-7
2180:978-0-323-03329-9
2165:978-0-323-03329-9
2132:978-0-89603-847-9
2032:. 11 January 2019
1956:The Healthy Talks
1349:(10): 1094–1109.
1296:(15): 1413–1423.
1178:The Spine Journal
1123:(February 2013),
1000:978-1-49631-854-1
799:
798:
791:
645:Urinary retention
621:Within a few days
435:systematic review
376:respiratory tract
355:Contraindications
333:Spondylolisthesis
245:spondylolisthesis
193:spondylolisthesis
123:
122:
2826:
2707:Knee replacement
2632:Shoulder surgery
2575:
2574:
2342:
2341:
2311:
2304:
2297:
2288:
2287:
2226:
2090:
2089:
2087:
2086:
2071:
2065:
2064:
2062:
2061:
2047:
2041:
2040:
2038:
2037:
2030:news.utoledo.edu
2022:
2016:
2015:
2013:
2012:
1998:
1992:
1991:
1989:
1988:
1973:
1967:
1966:
1964:
1963:
1948:
1942:
1941:
1916:(12): CD009644.
1904:
1883:
1882:
1872:
1854:
1830:
1821:
1820:
1810:
1792:
1768:
1762:
1761:
1751:
1741:
1717:
1711:
1710:
1708:
1707:
1692:
1686:
1685:
1683:
1682:
1667:
1661:
1660:
1658:
1657:
1642:
1636:
1635:
1633:
1632:
1618:
1612:
1611:
1609:
1608:
1593:
1587:
1586:
1576:
1551:(8): 1633–1639.
1536:
1530:
1529:
1511:
1487:
1481:
1480:
1435:
1426:
1425:
1389:
1383:
1382:
1338:
1332:
1331:
1305:
1287:
1278:
1272:
1271:
1269:
1268:
1259:. Archived from
1240:
1234:
1233:
1213:
1204:
1201:
1168:
1166:
1164:
1145:
1144:
1142:
1117:
1108:
1107:
1071:
1046:
1045:
1035:
1011:
1005:
1004:
986:
911:
910:
874:
865:
864:
852:
841:
840:
820:
794:
787:
783:
780:
774:
756:
748:
201:spinal fractures
134:spondylosyndesis
116:edit on Wikidata
108:
94:
42:Spondylosyndesis
31:
19:
18:
2834:
2833:
2829:
2828:
2827:
2825:
2824:
2823:
2804:
2803:
2802:
2793:
2735:
2692:Hip replacement
2687:Hip resurfacing
2675:
2620:
2564:
2525:
2474:
2470:Phemister graft
2438:
2422:
2366:
2331:
2322:
2315:
2273:Spinasanta, S.
2254:
2099:
2097:Further reading
2094:
2093:
2084:
2082:
2072:
2068:
2059:
2057:
2049:
2048:
2044:
2035:
2033:
2024:
2023:
2019:
2010:
2008:
2000:
1999:
1995:
1986:
1984:
1975:
1974:
1970:
1961:
1959:
1950:
1949:
1945:
1905:
1886:
1831:
1824:
1769:
1765:
1718:
1714:
1705:
1703:
1693:
1689:
1680:
1678:
1668:
1664:
1655:
1653:
1643:
1639:
1630:
1628:
1620:
1619:
1615:
1606:
1604:
1595:
1594:
1590:
1537:
1533:
1488:
1484:
1436:
1429:
1390:
1386:
1339:
1335:
1285:
1279:
1275:
1266:
1264:
1241:
1237:
1214:
1207:
1162:
1160:
1140:
1138:
1134:ABIM Foundation
1130:Choosing Wisely
1118:
1111:
1072:
1049:
1012:
1008:
1001:
987:
914:
875:
868:
853:
844:
837:
821:
817:
812:
795:
784:
778:
775:
772:
757:
746:
737:
700:
664:
623:
601:
592:
530:
516:
493:
463:
439:lower back pain
437:on surgery for
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:
2832:
2822:
2821:
2816:
2799:
2798:
2795:
2794:
2792:
2791:
2786:
2785:
2784:
2782:Arthrocentesis
2779:
2769:
2764:
2759:
2754:
2749:
2743:
2741:
2737:
2736:
2734:
2733:
2728:
2723:
2718:
2713:
2704:
2699:
2697:Rotationplasty
2694:
2689:
2683:
2681:
2677:
2676:
2674:
2673:
2672:
2671:
2666:
2656:
2651:
2650:
2649:
2644:
2642:Bankart repair
2639:
2628:
2626:
2622:
2621:
2619:
2618:
2617:
2616:
2611:
2606:
2596:
2595:
2594:
2583:
2581:
2572:
2566:
2565:
2563:
2562:
2557:
2552:
2551:
2550:
2539:
2537:
2531:
2530:
2527:
2526:
2524:
2523:
2518:
2513:
2508:
2503:
2501:Epiphysiodesis
2498:
2493:
2488:
2482:
2480:
2476:
2475:
2473:
2472:
2467:
2462:
2457:
2455:Astragalectomy
2452:
2446:
2444:
2440:
2439:
2437:
2436:
2430:
2428:
2424:
2423:
2421:
2420:
2415:
2410:
2405:
2400:
2395:
2390:
2385:
2380:
2374:
2372:
2368:
2367:
2365:
2364:
2359:
2354:
2348:
2346:
2339:
2333:
2332:
2327:
2324:
2323:
2314:
2313:
2306:
2299:
2291:
2285:
2284:
2281:Spinal fusion.
2278:
2271:
2268:Spinal Fusion.
2265:
2253:
2252:External links
2250:
2249:
2248:
2242:
2227:
2209:(2): 103–113.
2198:
2183:
2168:
2153:
2135:
2112:
2106:
2098:
2095:
2092:
2091:
2066:
2042:
2017:
1993:
1968:
1943:
1884:
1822:
1763:
1732:(2): 787–789.
1712:
1687:
1662:
1637:
1613:
1588:
1531:
1482:
1427:
1400:(3): 245–251.
1384:
1333:
1273:
1235:
1205:
1203:
1202:
1169:
1146:, which cites
1109:
1047:
1026:(5): 701–715.
1006:
999:
912:
866:
842:
835:
814:
813:
811:
808:
797:
796:
779:September 2023
763:listed sources
760:
758:
751:
745:
742:
736:
733:
729:
728:
725:
722:
719:
716:
713:
699:
696:
695:
694:
688:
685:
682:
675:Pseudarthrosis
672:
669:
663:
660:
659:
658:
655:
652:
647:
642:
636:
630:
627:
622:
619:
618:
617:
614:
611:
608:
605:
600:
599:During surgery
597:
591:
588:
587:
586:
585:
584:
581:
578:
575:
572:
558:
529:
526:
525:
524:
520:
515:
514:Thoracic spine
512:
511:
510:
507:
500:
492:
491:Cervical spine
489:
462:
459:
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:
2831:
2820:
2817:
2815:
2812:
2811:
2809:
2790:
2787:
2783:
2780:
2778:
2775:
2774:
2773:
2770:
2768:
2765:
2763:
2760:
2758:
2755:
2753:
2750:
2748:
2745:
2744:
2742:
2738:
2732:
2729:
2727:
2724:
2722:
2719:
2717:
2714:
2712:
2708:
2705:
2703:
2700:
2698:
2695:
2693:
2690:
2688:
2685:
2684:
2682:
2678:
2670:
2667:
2665:
2662:
2661:
2660:
2657:
2655:
2652:
2648:
2645:
2643:
2640:
2638:
2635:
2634:
2633:
2630:
2629:
2627:
2623:
2615:
2612:
2610:
2607:
2605:
2602:
2601:
2600:
2597:
2593:
2592:Spinal fusion
2590:
2589:
2588:
2585:
2584:
2582:
2580:
2576:
2573:
2571:
2567:
2561:
2558:
2556:
2553:
2549:
2546:
2545:
2544:
2541:
2540:
2538:
2536:
2532:
2522:
2519:
2517:
2514:
2512:
2509:
2507:
2504:
2502:
2499:
2497:
2494:
2492:
2491:Bone grafting
2489:
2487:
2484:
2483:
2481:
2477:
2471:
2468:
2466:
2463:
2461:
2458:
2456:
2453:
2451:
2448:
2447:
2445:
2441:
2435:
2434:Acromioplasty
2432:
2431:
2429:
2425:
2419:
2416:
2414:
2411:
2409:
2406:
2404:
2401:
2399:
2396:
2394:
2391:
2389:
2386:
2384:
2381:
2379:
2376:
2375:
2373:
2369:
2363:
2360:
2358:
2355:
2353:
2352:Jaw reduction
2350:
2349:
2347:
2343:
2340:
2338:
2334:
2330:
2325:
2320:
2312:
2307:
2305:
2300:
2298:
2293:
2292:
2289:
2282:
2279:
2276:
2272:
2269:
2266:
2263:
2260:
2256:
2255:
2246:
2243:
2240:
2236:
2232:
2228:
2224:
2220:
2216:
2212:
2208:
2204:
2199:
2196:
2192:
2188:
2184:
2181:
2177:
2173:
2169:
2166:
2162:
2158:
2154:
2152:
2151:0-89203-172-7
2148:
2144:
2140:
2136:
2133:
2129:
2125:
2121:
2117:
2113:
2110:
2107:
2104:
2101:
2100:
2081:
2080:SpineUniverse
2077:
2070:
2056:
2052:
2046:
2031:
2027:
2021:
2007:
2003:
1997:
1983:. 5 July 2019
1982:
1978:
1972:
1957:
1953:
1947:
1939:
1935:
1931:
1927:
1923:
1919:
1915:
1911:
1903:
1901:
1899:
1897:
1895:
1893:
1891:
1889:
1880:
1876:
1871:
1866:
1862:
1858:
1853:
1848:
1844:
1840:
1836:
1829:
1827:
1818:
1814:
1809:
1804:
1800:
1796:
1791:
1786:
1782:
1778:
1774:
1767:
1759:
1755:
1750:
1745:
1740:
1735:
1731:
1727:
1723:
1716:
1702:
1698:
1691:
1677:
1673:
1666:
1652:
1648:
1641:
1627:
1623:
1617:
1603:. 5 July 2019
1602:
1598:
1592:
1584:
1580:
1575:
1570:
1566:
1562:
1558:
1554:
1550:
1546:
1542:
1535:
1527:
1523:
1519:
1515:
1510:
1505:
1501:
1497:
1493:
1486:
1478:
1474:
1470:
1466:
1462:
1458:
1454:
1450:
1446:
1442:
1434:
1432:
1423:
1419:
1415:
1411:
1407:
1403:
1399:
1395:
1388:
1380:
1376:
1372:
1368:
1364:
1360:
1356:
1352:
1348:
1344:
1337:
1329:
1325:
1321:
1317:
1313:
1309:
1304:
1299:
1295:
1291:
1284:
1277:
1263:on 2014-03-28
1262:
1258:
1254:
1250:
1246:
1239:
1231:
1227:
1223:
1219:
1212:
1210:
1199:
1195:
1191:
1187:
1184:(10): 894–9.
1183:
1179:
1175:
1170:
1159:
1158:
1153:
1148:
1147:
1136:
1135:
1131:
1126:
1122:
1116:
1114:
1105:
1101:
1097:
1093:
1089:
1085:
1081:
1077:
1070:
1068:
1066:
1064:
1062:
1060:
1058:
1056:
1054:
1052:
1043:
1039:
1034:
1029:
1025:
1021:
1017:
1010:
1002:
996:
992:
985:
983:
981:
979:
977:
975:
973:
971:
969:
967:
965:
963:
961:
959:
957:
955:
953:
951:
949:
947:
945:
943:
941:
939:
937:
935:
933:
931:
929:
927:
925:
923:
921:
919:
917:
908:
904:
900:
896:
892:
888:
884:
880:
873:
871:
862:
858:
851:
849:
847:
838:
836:9783319988757
832:
828:
827:
819:
815:
807:
804:
793:
790:
782:
770:
769:
764:
759:
755:
750:
749:
741:
732:
726:
723:
720:
717:
714:
711:
710:
709:
706:
692:
691:Arachnoiditis
689:
686:
683:
680:
676:
673:
670:
666:
665:
656:
653:
651:
648:
646:
643:
640:
637:
634:
631:
628:
625:
624:
615:
612:
609:
606:
603:
602:
596:
582:
579:
576:
573:
570:
569:
567:
563:
559:
556:
552:
548:
547:
542:
534:
521:
518:
517:
508:
505:
501:
498:
495:
494:
484:
480:
477:
472:
468:
458:
456:
452:
451:low back pain
448:
444:
443:low back pain
440:
436:
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:
2771:
2752:Arthroplasty
2716:Ankle fusion
2659:Hand surgery
2614:Arthroplasty
2609:Annuloplasty
2591:
2408:Foraminotomy
2393:Laminoplasty
2378:Coccygectomy
2261:
2230:
2206:
2202:
2186:
2171:
2156:
2142:
2124:Humana Press
2115:
2083:. Retrieved
2079:
2069:
2058:. Retrieved
2054:
2045:
2034:. Retrieved
2029:
2020:
2009:. Retrieved
2005:
1996:
1985:. Retrieved
1980:
1971:
1960:. Retrieved
1958:. 2021-02-08
1955:
1946:
1913:
1909:
1842:
1838:
1780:
1776:
1766:
1729:
1725:
1715:
1704:. Retrieved
1700:
1690:
1679:. Retrieved
1675:
1665:
1654:. Retrieved
1650:
1640:
1629:. Retrieved
1625:
1616:
1605:. Retrieved
1600:
1591:
1548:
1544:
1534:
1499:
1495:
1485:
1444:
1440:
1397:
1393:
1387:
1346:
1342:
1336:
1293:
1289:
1276:
1265:. Retrieved
1261:the original
1248:
1238:
1221:
1181:
1177:
1161:. Retrieved
1155:
1139:, retrieved
1128:
1082:(1): 67–76.
1079:
1075:
1023:
1020:Neurosurgery
1019:
1009:
990:
885:(1): 67–76.
882:
878:
860:
829:. Springer.
825:
818:
800:
785:
776:
765:
738:
730:
701:
650:Malnutrition
593:
528:Lumbar spine
467:decompressed
464:
432:
417:
392:
385:
382:Epidemiology
358:
285:
269:
253:
230:
219:Medical uses
213:
174:
133:
129:
125:
124:
2762:Arthroscopy
2757:Synovectomy
2587:Arthrodesis
2403:Facetectomy
2388:Laminectomy
2055:ryortho.com
1502:(1): 3–12.
1312:10616/46584
766:may not be
368:soft tissue
338:Spondylosis
257:osteophytes
197:spondylosis
162:fluoroscopy
100:MedlinePlus
53:Orthopedics
39:Other names
2808:Categories
2777:Arthrogram
2747:Arthrotomy
2604:Discectomy
2398:Corpectomy
2383:Laminotomy
2321:and joints
2085:2020-07-29
2060:2020-07-29
2036:2020-07-29
2011:2020-07-29
1987:2020-07-29
1962:2021-03-18
1706:2020-07-28
1681:2020-07-28
1656:2020-07-28
1631:2020-07-28
1607:2020-07-28
1267:2014-05-19
810:References
607:Blood loss
506:and fusion
504:corpectomy
471:bone graft
215:segments.
152:), donor (
64:ICD-10-PCS
2535:Cartilage
2506:Reduction
2496:Osteotomy
2486:Ostectomy
1930:1469-493X
1861:2229-5097
1799:1471-2474
1565:0940-6719
1518:1547-5646
1461:1872-6968
1447:: 85–92.
1414:0271-3586
1363:0362-2436
1320:0028-4793
461:Technique
313:Scoliosis
273:scoliosis
205:scoliosis
154:allograft
150:autograft
142:vertebrae
57:Neurology
48:Specialty
2772:imaging:
2223:15856812
2006:Medscape
1981:wtol.com
1938:24323844
1879:28217384
1817:16737522
1758:35360775
1626:Medscape
1601:wtol.com
1583:22526700
1526:32932227
1477:31098673
1469:26051881
1422:25331746
1371:19363455
1328:27074066
1257:24851286
1230:24716251
1198:23098616
1163:25 March
1141:25 March
1104:22564134
1096:21311399
1042:28327997
907:22564134
899:21311399
861:UpToDate
768:reliable
698:Recovery
668:factors.
566:vertebra
555:pedicles
523:systems.
328:Lordosis
320:(e. g.,
318:Kyphosis
281:lordosis
277:kyphosis
241:thoracic
237:cervical
209:kyphosis
170:robotics
74:ICD-9-CM
2740:General
2479:General
1870:5288986
1808:1481518
1749:8963601
1574:3535239
1379:1504909
1157:fda.gov
803:WTOL-TV
303:Spinal
92:D013123
2570:Joints
2237:
2221:
2193:
2178:
2163:
2149:
2130:
2105:WebMD.
1936:
1928:
1877:
1867:
1859:
1815:
1805:
1797:
1783:: 47.
1756:
1746:
1581:
1571:
1563:
1524:
1516:
1475:
1467:
1459:
1420:
1412:
1377:
1369:
1361:
1326:
1318:
1255:
1228:
1196:
1102:
1094:
1040:
997:
905:
897:
833:
499:(ACDF)
279:, and
233:lumbar
207:, and
106:002968
68:M43.26
2579:Spine
2371:Spine
2337:Bones
2319:bones
1845:: 5.
1473:S2CID
1375:S2CID
1343:Spine
1286:(PDF)
1100:S2CID
1076:Spine
903:S2CID
879:Spine
735:Usage
635:(DVT)
590:Risks
453:with
445:with
305:tumor
168:, or
158:cages
114:[
2345:Face
2247:NIH.
2235:ISBN
2219:PMID
2191:ISBN
2176:ISBN
2161:ISBN
2147:ISBN
2139:AAOS
2128:ISBN
1934:PMID
1926:ISSN
1875:PMID
1857:ISSN
1813:PMID
1795:ISSN
1754:PMID
1579:PMID
1561:ISSN
1522:PMID
1514:ISSN
1465:PMID
1457:ISSN
1418:PMID
1410:ISSN
1367:PMID
1359:ISSN
1324:PMID
1316:ISSN
1253:PMID
1226:PMID
1194:PMID
1165:2014
1143:2013
1092:PMID
1038:PMID
995:ISBN
895:PMID
831:ISBN
641:(PE)
239:and
177:disc
86:MeSH
79:81.0
2680:Leg
2625:Arm
2443:Leg
2427:Arm
2211:doi
1918:doi
1865:PMC
1847:doi
1803:PMC
1785:doi
1744:PMC
1734:doi
1569:PMC
1553:doi
1504:doi
1449:doi
1445:135
1402:doi
1351:doi
1308:hdl
1298:doi
1294:374
1186:doi
1084:doi
1028:doi
887:doi
132:or
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2207:26
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