Summary of Background Data. Older patients have increased complication rates after spinal fusion surgery. Treatments which have the possibility of enhancing functional outcome and fusion
rates without lengthening the procedure could prove Selleck LY3023414 beneficial. DC-stimulation of spinal fusion has proven effective in increasing fusion rates in younger and “”high risk”" patients, but little information exist on the effect in older patients.
Methods. A randomized clinical trial comprising 5 orthopedic centers. The study included a total of 107 patients randomized to uninstrumented posterolateral lumbar spinal fusion with or without DC-stimulation. Fusion rate was assessed at 2 year follow-up using thin slice CT. Functional outcome was assessed using Dallas Pain Questionnaire and Low Back Pain Rating Scale pain index.
Results. Available follow-up after 2 years was 89% (84 of 95 patients). Fusion rates were surprisingly low. DC-stimulation had no effect on fusion rate: 35% versus 36% in controls. Other factors associated with low fusion rates were female gender (32% vs. 42% in males, P = 0.050) and smoking (21% vs. 42% in nonsmokers, P = 0.079). Patients who achieved a solid Selleckchem FHPI fusion as determined by CT had superior functional outcome and pain scores at their latest follow-up.
Conclusion.
Thin slice CT revealed very high nonunion rates after uninstrumented spinal fusion in older patients. DC-stimulation was not effective in increasing fusion rates in this BAY 63-2521 inhibitor patient population. The achievement of a solid fusion was associated with superior functional outcome.”
“Objective. The objective of this study was to investigate the relationship between the ankle brachial index (ABI) and the severity of atherosclerotic renal artery stenosis (ARAS).
Material and methods. In total, 138 patients with a complete clinical record were enrolled in this study. The severity of ARAS was judged by renal artery angiography and the ABI was measured according to the method recommended by the American Heart Association. Results. Hypertension, coronary artery disease, chronic renal dysfunction and hyperlipidaemia were significantly increased in the ARAS group (p < 0.05 or 0.01), and the ARAS patients were significantly older than the non-ARAS patients (p < 0.05). There were 31 cases of mild renal artery stenosis, 26 of midrange stenosis, 14 of severe stenosis and 16 of bilateral stenosis. In total, 104 cases had a normal ABI, while 34 cases had an abnormal ABI (<= 0.9). Abnormal ABI values were not significantly correlated with mild ARAS, but the abnormal ABI value in patients with midrange and severe ARAS was approximately four times the normal ABI in these patients. Conclusion. ABI is a valuable predictive index of midrange to severe ARAS.