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Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_I | Pages 237 - 237
1 Mar 2010
Rashid M Harland N Allerton K
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Purpose of study: Non-fusion stabilisation of degenerative lumbar spine with hinged pedicle screws provides an alternative to spinal fusion in preventing junctional breakdown.

Methods and Results: In this prospective cohort study, clinical, functional (Roland-Morris Disability Scale 18 question version) and radiological assessment of patients was performed pre-operatively and postoperatively at predetermined intervals. 36 patients were reviewed with a mean follow-up of 18 months (12 – 28 months). The indications of operation were symptomatic spinal stenosis, discogenic mechanical back pain, post discectomy syndrome and revision spinal surgery. Average age was 57 years (35 – 78 years). Average pre-operative duration of back pain was 6 years (2 – 25 years). 18 patients had stabilisation of single motion segment, 12 had two adjacent motion segments stabilised and six had three segments stabilised. 28 patients had spinal decompression along with stabilisation. On excluding one patient with wound infection average hospital stay was 5 days. There were 78 rods and 192 pedicle screws used with in-situ breakage of two screws and loosening of one screw.

Functional score (Roland-Morris Disability Scale 18 question version) improved from 11.33 to 4.44. Visual analogue score (VAS 0 – 100) improved from 79.29 to 13.29. Subjective outcome, measured with descriptive analogue scale, showed marked improvement in 76% of patients.

Conclusion: The posterior dynamic stabilisation eliminates the risks and complications of fusion surgery. Although long term results are not available yet but considering early results, this technique can be used safely as a first line surgical treatment for degenerate lumbar spine.


The Journal of Bone & Joint Surgery British Volume
Vol. 83-B, Issue 5 | Pages 739 - 740
1 Jul 2001
Pacheco RJ Buckley S Oxborrow NJ Weeber AC Allerton K

We describe two patients who developed gluteal compartment syndrome after total knee arthroplasty (TKA) carried out under epidural analgesic infusion and light sedation. To our knowledge, this occurrence has not been described previously after TKA.