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Margaret A. Olsen, Jennie Mayfield, Carl Lauryssen, Louis B. Polish, Marilyn Jones, Joshua Vest and Victoria J. Fraser

–24 A wide variety of risk factors for SSI in spinal surgery have been reported. Patient characteristics reported to be associated with increased risk of SSI include older age, 13, 22 obesity, 2, 24 diabetes, 21, 24 smoking, 24 preoperative malnutrition, 13, 16 bowel and bladder incontinence, 18 and previous or repeated spinal surgery. 2, 20, 24 Surgery-related risk factors reported to increase the risk of SSI following spinal surgery are longer preoperative hospital LOS, 24 increased duration 22, 24 and increased complexity of surgery, 4, 24 placement of

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Masahiko Watanabe, Daisuke Sakai, Daisuke Matsuyama, Yukihiro Yamamoto, Masato Sato and Joji Mochida

ranged from 0 to 15%, depending on the reason for the operation, the site, the approach, and the use of instrumentation. 1 , 2 , 10 , 13 , 27 , 32 , 40 , 42 , 44 Known risk factors for infection after spine surgery include advanced age, drug and alcohol abuse, smoking history, diabetes, obesity, malnutrition, immunological insufficiency, an operation for traumatized spine, prolonged surgical time, high blood loss, posterior approach, use of instrumentation, and a high volume of personnel moving through the operating rooms. 2 , 5 , 10 , 20 , 21 , 26–28 Awareness of

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Noboru Hosono, Masato Namekata, Takahiro Makino, Toshitada Miwa, Takashi Kaito, Noriyoshi Kaneko and Takeshi Fuji

to the t-test (Surgeon A vs B, p = 0.832; Surgeon A vs C, p = 0.958; Surgeon A vs D, p = 0.210; Surgeon B vs C, p = 0.8529; Surgeon B vs D, p = 0.061; and Surgeon C vs D, p = 0.223) Multivariate analysis concerning the relationship between complications and risk factors (operation time, estimated intraoperative blood loss, and surgeon's experience) revealed that the operation time was the only significant risk factor for complications (operation time, p = 0.035; blood loss, p = 0.1351; surgeon's experience, p = 0.2432 [all chi-square analyses]). Discussion In

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Jianxiong Shen, Jinqian Liang, Haiquan Yu, Guixing Qiu, Xuhong Xue and Zheng Li

T he identification and quantification of risk factors for delayed infections after spine surgery are of paramount importance to the patient and the clinician. In addition to its obvious importance for patient safety, risk factor information becomes critical as health care policy makers implement and enforce “quality” metrics. Numerous authors have reported potential risk factors for postoperative infections after pediatric spinal deformity surgery. Certain patient-related risk factors, such as underlying medical conditions and previous surgeries, are

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Yasuchika Aoki, Masatsune Yamagata, Fumitake Nakajima, Yoshikazu Ikeda, Koh Shimizu, Masakazu Yoshihara, Junichi Iwasaki, Tomoaki Toyone, Koichi Nakagawa, Arata Nakajima, Kazuhisa Takahashi and Seiji Ohtori

procedures, there are no published reports describing specific risk factors that need to be taken into account to avoid this undesirable event. After we experienced 4 cases of posterior migration of fusion cages following TLIF, a retrospective study was conducted to identify risk factors for this complication. Methods Patient Population Between April 2006 and January 2008, 144 discs in 125 patients with lumbar degenerative disc disease (78 women and 47 men; mean age 64 ± 11.7 years) were treated using TLIF. Patients were followed up for 12–33 months

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Morio Matsumoto, Kota Watanabe, Takashi Tsuji, Ken Ishii, Hironari Takaishi, Masaya Nakamura, Yoshiaki Toyama and Kazuhiro Chiba

additional procedures may increase surgical time, medical costs, risk of dislodgement and infection, and should be reserved for use in specific patients in whom these additional procedures are absolutely necessary. The purposes of this study were to evaluate the prevalence and clinical consequences of postoperative lamina closure after opendoor laminoplasty and to identify its risk factors. Methods Eighty-two consecutive patients who underwent open-door laminoplasty for cervical myelopathy in the period between 2004 and 2005 were enrolled in this study. The patients

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David Christopher Kieser, Derek Thomas Cawley, Takashi Fujishiro, Simon Mazas, Louis Boissière, Ibrahim Obeid, Vincent Pointillart, Jean-Marc Vital and Olivier Gille

deposition, or micromotion, and therefore an alternative cause is likely. Controversy remains as to whether the surgical approach or the implant is the cause of ABL, especially considering the lack of recognition of this phenomenon in anterior cervical discectomy and fusion (ACDF). This study therefore aimed to examine the risk factors associated with ABL in CDA, specifically patient age and sex, as well as the potentially modifiable risk factors of implant type, alignment, number of levels operated, and motion. In addition, we aimed to determine the clinical affect of

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John A. Boockvar, Matthew F. Philips, Albert E. Telfeian, Donald M. O'Rourke and Paul J. Marcotte

smoking, and host bone density. 3, 12, 22, 26 Because of the unique biomechanics and anatomy of the CTJ, our goal in this study was to identify risk factors for graft failure, including pseudarthrosis, specific to this area of the spine. Additionally, in this retrospective review of 14 patients in whom anterior CTJ surgery was performed, we describe the clinical data and potential complications found in the subset of patients for whom the anterior approach alone may not be sufficient for stabilization. Clinical Material and Methods Patient Population From

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Jennifer A. Moliterno, Jared Knopman, Karishma Parikh, Jessica N. Cohan, Q. Daisy Huang, Grant D. Aaker, Anastasia D. Grivoyannis, Ashwin R. Patel, Roger Härtl and John A. Boockvar

our experience to provide further insight into the rate of LDH recurrence following tLMD. Moreover, we sought to identify specific risk factors associated with recurrence and to determine whether such factors differ from those of open discectomy. 24 , 25 Methods Patient Population A consecutive cohort of 217 patients with single-level LDH who underwent tLMD that entailed using the tubular retractor system (METRx System, Medtronic Sofamor Danek, or Insight System, Synthes) between 2004 and 2008 were initially included in this retrospective study. Patients

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Shota Takenaka, Kosuke Tateishi, Noboru Hosono, Yoshihiro Mukai and Takeshi Fuji

, postdecompression lumbar disc herniation (PDLDH) at the same level is the first or second most common reason for reoperations. 8 , 11 , 17 , 19 , 21 , 36 , 38 By identifying PDLDH risk factors, it is possible to avoid reoperations at the same level, which are often complicated and even risky. 35 However, previous reports have included patient cohorts that were too heterogeneous to appropriately elucidate significant PDLDH risk factors. In the present study, we aimed to identify the preoperative and intraoperative risk factors for PDLDH in homogeneous patient cohorts