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Darryl Lau, Dean Chou, John E. Ziewacz and Praveen V. Mummaneni

, hyperlipidemia, presence of cancer, kidney disease, liver disease, COPD, history of cerebrovascular accident (CVA)/transient ischemic attack (TIA), and alcohol use. Body mass index was calculated using the following formula: (weight in kg)/(height in meters). 2 Diagnosis-related and surgically related covariates (number of corpectomies performed) were also recorded. Diagnosis was categorized into 4 groups for statistical purposes: degenerative disease, trauma, tumor/metastasis, and osteomyelitis/infection. Preoperative neurological functional status was collected and measured

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Michael Y. Wang and Praveen V. Mummaneni

D ue to advances in medical care, the life expectancy of Americans has increased significantly over the past half century. However, with this lengthening of the human lifespan has come an increase in the prevalence of disorders associated with aging, including adult spinal deformity. Adult thoracolumbar scoliosis and kyphosis can be the consequence of numerous etiologies, including progression of a preexisting deformity, delayed posttraumatic sequelae, infection, progressive disc and facet joint degeneration, iatrogenic spinal destabilization, and

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Adam S. Kanter and Praveen V. Mummaneni

S ince its inception, minimally invasive spine surgery has been a field in evolution. The modernization of tools and techniques for minimally invasive surgery (MIS) has recently enabled spine surgeons to expand patient selection and candidacy to include a growing array of spinal disorders such as degenerative disc disease and herniation, fractures, tumors, infections, instability, and deformity. Despite an expanding literature database, many traditional spine surgeons remain skeptical of the role for MIS in the spine. This skepticism is in part due to the

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The future in the care of the cervical spine: interbody fusion and arthroplasty

Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004

Praveen V. Mummaneni and Regis W. Haid

as the interbody spacer. Although an excellent material to promote interbody fusion, it is associated with harvest site—related morbidity in up to 25% of patients. The potential for donor site infection and pain are limitations of its use. 2, 14 Consequently, allograft eventually replaced iliac crest autograft as the most typical choice for an interbody spacer. When allograft is used for ACDF without anterior plate fixation, successful fusion has been reported in 90% of single-level surgeries; however, in cases requiring two-level surgeries, the fusion rate

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Praveen V. Mummaneni, David H. Walker, Junichi Mizuno and Gerald E. Rodts

T ranspedicular vertebroplasty is a well-established treatment for compression fractures of the thoracic and lumbar spine. The reported complication rates are low. We present two cases in which patients had been treated with vertebroplasty despite a history of infection. Osteomyelitis and abscesses developed in both patients and were subsequently treated by corpectomy, anterior reconstruction, and posterior stabilization. Great care should be taken in performing vertebroplasty in patients with a history of infection, as osteomyelitis may develop. To

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Scott A. Meyer and Praveen V. Mummaneni

evaluate complications from AxiaLIF. All patients underwent pedicle screw fixation in addition to AxiaLIF. Most of these patients had bone morphogenetic protein placed within the implant. The reported fusion rate was more than 91%. Sixteen patients had 18 complications (26.5%). The complications reported by the authors included pseudarthrosis (8.8%), superficial infection (5.9%), sacral fracture (2.9%), rectal injury (2.9%), pelvic hematoma (2.9%), wound leakage (1.5%), and temporary S-1 radiculopathy (1.5%). Infections in 2 patients were managed with empiric antibiotics

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Junichi Mizuno, Praveen V. Mummaneni, Gerald E. Rodts and Daniel L. Barrow

N ontraumatic SDH is often found in the elderly population. Risk factors for developing spontaneous SDH include hypertension, vascular abnormality, neoplasm, infection, alcoholism, or coagulopathy. Subdural hematomas may also form after CSF overdrainage following a shunt placement procedure, lumbar puncture, external ventricular drainage, and administration of epidural anesthesia. 4 , 5 , 7 , 10 We report a rare case of recurrent SDH caused by a spontaneous CSF fistula located at L-1 to L-2. Case Report Presentation and Examination. This 34

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Adam S. Kanter, Michael Y. Wang and Praveen V. Mummaneni

patients in the latter category with anterior bone apposition received an anterior approach for spinal realignment if the anatomical access permitted, otherwise a posterior approach was performed followed by either anterior wedge osteotomy or osteoclasis and PSF. Patients were monitored for neurological outcome, radiographic fusion, and complications. Complications were categorized into general (such as infection, dysphagia, or death) and surgical (such as instrumentation failure) subtypes. Postoperative follow-up examinations were performed at intervals of 6 weeks, 6

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Scott A. Meyer, Jau-Ching Wu and Praveen V. Mummaneni

. Preoperative and postoperative dynamic x-rays were available in 83% of patients. Perioperative Data The mean number of levels treated for the degenerative group was 3.9, and the mean EBL was 206 ml. The mean LOS was 3.7 days. There were 2 patients with complications requiring repeat operation in the degenerative group: 1 with a wound infection and 1 with a collapsed laminoplasty segment that caused restenosis. Both of these complications led to revision surgery. The patient with the infection was treated with a wound debridement, and all hardware was left in place

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Praveen V. Mummaneni, Jeff Pan, Regis W. Haid and Gerald E. Rodts

fusion, is associated with harvest site morbidity in up to 25% of patients. The potential for donor site infection and donor site pain limit the use of iliac crest bone graft. 1, 14 New osteobiological materials, such as rhBMP-2, offer the benefit of osteoinduction while avoiding iliac crest donor site morbidity. In this article, we compare the results of iliac crest autograft and the preliminary results of rhBMP-2 (In-Fuse; Medtronic Sofamor Danek, Memphis, TN) when placed in the interbody space during TLIF. Clinical Material and Methods Patient Population