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The article details the results of a comparison between lumbar floating fusion (LFF) and lumbosacral fusion. The patients involved in this study are those with degenerative spondylolisthesis and preexisting degenerative L5-S1 disc treated with LFF and LSF. Results exhibited high percentage of satisfactory clinical results with posterior instrumentation with posterolateral LFF for treatment of degenerative spondylolisthesis.

Abstract  Identifying offending pathogens is crucial for appropriate antibiotic administration for infectious spondylitis. Although computed tomography (CT)-guided biopsy for bacteriologic diagnosis is a standard procedure, it has a variable success rate. Some reports claim percutaneous endoscopic discectomy and drainage offer a sufficient amount of tissue for microbiologic examination and easy application. We therefore compared the diagnostic value of CT guidance with that of endoscope guidance in 52 patients with suspected infectious spondylitis. Twenty patients underwent percutaneous endoscopic discectomy and drainage by an orthopaedic surgeon and the other 32 patients underwent CT-guided biopsies by a radiologist. Patients were followed a minimum of 12 months after treatment. Culture results of the biopsy specimens were recorded. Causative bacteria were identified more frequently with percutaneous endoscopy than in CT-guided biopsy (18 of 20 [90%] versus 15 of 32 [47%]). We observed no biopsy-related complications or side effects in either group. The data suggest percutaneous endoscopic discectomy and drainage yield higher bacterial recovery rates than CT-guided spinal biopsy. Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: A prospective study.OBJECTIVES.: To compare the efficacy of calcium sulfate pellets plus laminectomy bone chips with a fresh autologous iliac bone graft for short-segment lumbar fusion.SUMMARY OF BACKGROUND DATA.: Bone graft substitute material can be used to expand an existing quantity of available laminectomy bone chips.METHODS.: Seventy-four patients underwent surgery for instrumented one- or two-segment fusion with decompression. Autologous iliac crest bone graft was placed in one posterolateral gutter, while on the other side, an equal quantity of autogenous laminectomy bone supplemented with calcium sulfate was placed. Radiographic assessment included radiographs alone; this was performed every 3 months (3 months to 12 months), then annually. The status of fusion and the relative size of the fusion bone mass on either side of the vertebra were compared.RESULTS.: Using iliac crest bone graft (control side) versus autograft laminectomy bone with calcium sulfate (test side), there was no significant difference between the fusion rate and sizes of the fusion bone mass (P > 0.05). Follow-up periods ranged from 30 months to 34 months, averaging 32.5 months. For the 39 patients who received single-segment fusion, 34 patients (87.2%) exhibited bone fusion on the test side, and 35 patients (89.7%) had evidence of fusion on the control side. For the 35 patients who received two-segment fusion, 29 patients (82.9%) exhibited bone fusion on the test side and 30 patients (85.7%) demonstrated complete fusion on the control side.CONCLUSIONS.: The fusion rate and fusion size between the two groups are similar. Calcium sulfate pellets may play a role as a bone graft extender in short-segment spinal fusion. [ABSTRACT FROM AUTHOR]

SUMMARY: STUDY DESIGN A case report is presented.OBJECTIVES To report a rare complication of delayed cement displacement following percutaneous vertebroplasty.SUMMARY OF BACKGROUND DATA Although percutaneous vertebroplasty is considered a minimally invasive procedure, it may result in several complications. To our knowledge, this is the first report of delayed cement displacement after percutaneous vertebroplasty.METHODS A 69-year-old man with T12 osteoporotic compression fracture received percutaneous vertebroplasty. One month after surgery, the patient complained of progressive severe back pain, and roentgenographic image revealed a breakdown of the anterior cortex of the T12 vertebral body with anterior displacement of the bone cement.RESULTS The complication was solved by one stage anterior and posterior operation: thoracoabdominal approach with removal of the displaced cement and posterior instrumentation from T11 to L1. The severe back pain with associated weakness improved after surgery.CONCLUSIONS This complication is rare and likely to occur in treatment of osteoporotic vertebral fracture with avascular necrosis and anterior cortical defect. [ABSTRACT FROM AUTHOR]