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- 저자 : Augustus J. Rush III (검색결과 2 건)
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Endoscopic Lumbar Surgery: The State of the Art in 2019
Alexander J. Butler,Milad Alam,Kevin Wiley,Alexander Ghasem,Augustus J. Rush III,Jeffrey Wang 대한척추신경외과학회 2019 Neurospine Vol.16 No.1
This study was aimed to provide a brief historical perspective to facilitate appreciation of current techniques, describe outcomes of endoscopic lumbar surgery relative to those of existing techniques, and identify topics in need of study and future directions for the field of endoscopic lumbar surgery. Using the PubMed database, a comprehensive search was conducted to identify peer-reviewed English language articles pertaining to endoscopic lumbar surgery. Lack of focus on pertinent techniques or lack of outcome measures constituted exclusion criteria. A majority of included articles were published from 2015–2019. A context with which to appreciate the application of endoscopic lumbar techniques is established. An abundance of case series and several recent comparison studies have documented the benefits and potential pitfalls of these methods in the past two decades. The advantages of endoscopic lumbar spine surgery are widely touted to include reduced perioperative morbidity, including blood loss, operative time and immediate postoperative recovery, minimal structural trauma resulting from surgery, generally positive patient report outcome scores and the potential to contain costs. Additional high-quality research assessing outcomes of endoscopic lumbar surgery are certainly needed and currently expected given the rapid expansion of the field in recent years.
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Outcomes of Transforaminal Lumbar Interbody Fusion Using Unilateral Versus Bilateral Interbody Cages
Conor P. Lynch,Elliot D.K. Cha,Augustus J. Rush III,Caroline N. Jadczak,Shruthi Mohan,Cara E. Geoghegan,Kern Singh 대한척추신경외과학회 2021 Neurospine Vol.18 No.4
Objective: To assess the impact of bilateral versus unilateral interbody cages on outcomes for minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) procedures. Methods: A retrospective review for primary, elective, single-level MIS TLIF procedures with bilateral posterior instrumentation from 2008–2020 was performed. Patients were grouped according to unilateral or bilateral interbody cage use. Procedures performed without static interbody cages or indicated for trauma, infection, malignancy were excluded. Patient-reported outcomes (PROs) included visual analogue scale (VAS), Oswestry Disability Index, 12-item Short Form health survey physical composite score (SF-12 PCS), Patient-Reported Outcome Measurement Information System physical function (PROMIS-PF). PROs were collected preoperatively and postoperatively. Change in PROs (Δ) was calculated and compared between groups. Achievement of minimum clinically important difference (MCID) was calculated using established values from the literature. Achievement rates were compared between groups using logistic regression. Results: The study included 151 patients, with 111 unilateral and 40 bilateral cage placements. Charlson Comorbidity Index, diabetes, and insurance status differed between groups (p<0.050). Prevalence of degenerative and isthmic spondylolisthesis (both p≤0.002), operative level (p=0.003), and postoperative length of stay (p=0.022) significantly differed between groups. The unilateral group had lower 1-year arthrodesis rates (p=0.035). Preoperative VAS leg (p=0.017) and SF-12 PCS (p=0.045) were worse for the unilateral group. ΔPROMIS-PF was greater for the bilateral group at 2 years (p=0.001). Majority of patients achieved an overall MCID for all PROs, except VAS leg (bilateral group). Conclusion: While preoperative status and postoperative arthrodesis rates differed, patients achieved an MCID at similar rates regardless of use of unilateral or bilateral cages.
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