bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complications from the use of intrawound vancomycin in lumbar spinal surgery: a systematic review
Authors: Ghobrial George M. , Cadotte David W. , Williams Kim , Fehlings Michael G. , Harrop James S. 
Published: October 2015

OBJECT
The use of intrawound vancomycin is rapidly being adopted for the prevention of surgical site infection (SSI) in spinal surgery. At operative closure, the placement of vancomycin powder in the wound bed—in addition to standard infection prophylaxis—can provide high concentrations of antibiotics with minimal systemic absorption. However, despite its popularity, to date the majority of studies on intrawound vancomycin are retrospective, and there are no prior reports highlighting the risks of routine treatment.

METHODS
A MEDLINE search for pertinent literature was conducted for studies published between 1966 and May 2015 using the following MeSH search terms: “intrawound vancomycin,” “operative lumbar spine complications,” and “nonoperative lumbar spine complications.” This was supplemented with references and known literature on the topic.

RESULTS
An advanced MEDLINE search conducted on May 6, 2015, using the search string “intrawound vancomycin” found 22 results. After a review of all abstracts for relevance to intrawound vancomycin use in spinal surgery, 10 studies were reviewed in detail. Three meta-analyses were evaluated from the initial search, and 2 clinical studies were identified. After an analysis of all of the identified manuscripts, 3 additional studies were included for a total of 16 studies. Fourteen retrospective studies and 2 prospective studies were identified, resulting in a total of 9721 patients. A total of 6701 (68.9%) patients underwent treatment with intrawound vancomycin. The mean SSI rate among the control and vancomycin-treated patients was 7.47% and 1.36%, respectively. There were a total of 23 adverse events: nephropathy (1 patient), ototoxicity resulting in transient hearing loss (2 patients), systemic absorption resulting in supratherapeutic vancomycin exposure (1 patient), and culture-negative seroma formation (19 patients). The overall adverse event rate for the total number of treated patients was 0.3%.

CONCLUSIONS
Intrawound vancomycin use appears to be safe and effective for reducing postoperative SSIs with a low rate of morbidity. Study disparities and limitations in size, patient populations, designs, and outcomes measures contribute significant bias that could not be fully rectified by this systematic review. Moreover, care should be exercised in the use of intrawound vancomycin due to the lack of well-designed, prospective studies that evaluate the efficacy of vancomycin and include the appropriate systems to capture drug-related complications.
Iatrogenic spondylolisthesis following laminectomy for degenerative lumbar stenosis: systematic review and current concepts
Authors: Guha Daipayan , Heary Robert F. , Shamji Mohammed F. 
Published: October 2015

OBJECT
Decompression without fusion for degenerative lumbar stenosis is an effective treatment for both the pain and disability of neurogenic claudication. Iatrogenic instability following decompression may require further intervention to stabilize the spine. The authors review the incidence of postsurgical instability following lumbar decompression, and assess the impact of surgical technique as well as study design on the incidence of instability.

METHODS
A comprehensive literature search was performed to identify surgical cohorts of patients with degenerative lumbar stenosis, with and without preexisting spondylolisthesis, who were treated with laminectomy or minimally invasive decompression without fusion. Data on patient characteristics, surgical indications and techniques, clinical and radiographic outcomes, and reoperation rates were collected and analyzed.

RESULTS
A systematic review of 24 studies involving 2496 patients was performed, assessing both open laminectomy and minimally invasive bilateral canal enlargement. Postoperative pain and functional outcomes were similar across the various studies, and postoperative radiographie instability was seen in 5.5% of patients. Instability was seen more frequently in patients with preexisting spondylolisthesis (12.6%) and in those treated with open laminectomy (12%). Reoperation for instability was required in 1.8% of all patients, and was higher for patients with preoperative spondylolisthesis (9.3%) and for those treated with open laminectomy (4.1%).

CONCLUSIONS
Instability following lumbar decompression is a common occurrence. This is particularly true if decompression alone is selected as a surgical approach in patients with established spondylolisthesis. This complication may occur less commonly with the use of minimally invasive techniques; however, larger prospective cohort studies are necessary to more thoroughly explore these findings.
Complications related to the use of spinal cord stimulation for managing persistent postoperative neuropathic pain after lumbar spinal surgery
Authors: Shamji Mohammed F. , Westwick Harrison J. , Heary Robert F. 
Published: October 2015

OBJECT
Structural spinal surgery yields improvement in pain and disability for selected patients with spinal stenosis, spondylolisthesis, or a herniated intervertebral disc. A significant fraction of patients exhibit persistent postoperative neuropathic pain (PPNP) despite technically appropriate intervention, and such patients can benefit from spinal cord stimulation (SCS) to alleviate suffering. The complication profile of this therapy has not been systematically assessed and, thus, was the goal of this review.

METHODS
A comprehensive literature search was performed to identify prospective cohorts of patients who had PPNP following structurally corrective lumbar spinal surgery and who underwent SCS device implantation. Data about study design, technique of SCS lead introduction, and complications encountered were collected and analyzed. Comparisons of complication incidence were performed between percutaneously and surgically implanted systems, with the level of significance set at 0.05.

RESULTS
Review of 11 studies involving 542 patients formed the basis of this work: 2 randomized controlled trials and 9 prospective cohorts. Percutaneous implants were used in 4 studies and surgical implants were used in 4 studies; in the remainder, the types were undefined. Lead migration occurred in 12% of cases, pain at the site of the implantable pulse generator occurred in 9% of cases, and wound-related complications occurred in 5% of cases; the latter 2 occurred more frequently among surgically implanted devices.

CONCLUSIONS
Spinal cord stimulation can provide for improved pain and suffering and for decreased narcotic medication use among patients with PPNP after lumbar spinal surgery. This study reviewed the prospective studies forming the evidence base for this therapy, to summarize the complications encountered and, thus, best inform patients and clinicians considering its use. There is a significant rate of minor complications, many of which require further surgical intervention to manage, including lead migration or implant infection, although such complications do not directly threaten patient life or function.
Perioperative morbidity and mortality after lumbar trauma in the elderly
Authors: Winkler Ethan A. , Yue John K. , Birk Harjus , Robinson Caitlin K. , Manley Geoffrey T. , Dhall Sanjay S. , Tarapore Phiroz E. 
Published: October 2015

OBJECT
Traumatic fractures of the thoracolumbar spine are common injuries, accounting for approximately 90% of all spinal trauma. Lumbar spine trauma in the elderly is a growing public health problem with relatively little evidence to guide clinical management. The authors sought to characterize the complications, morbidity, and mortality associated with surgical and nonsurgical management in elderly patients with traumatic fractures of the lumbar spine.

METHODS
Using the National Sample Program of the National Trauma Data Bank, the authors performed a retrospective analysis of patients ≥ 55 years of age who had traumatic fracture to the lumbar spine. This group was divided into middle-aged (55–69 years) and elderly (≥ 70 years) cohorts. Cohorts were subdivided into nonoperative, vertebroplasty or kyphoplasty, noninstrumented surgery, and instrumented surgery. Univariate and multivariable analyses were used to characterize and identify predictors of medical and surgical complications, mortality, hospital length of stay, ICU length of stay, number of days on ventilator, and hospital discharge in each subgroup. Adjusted odds ratios, mean differences, and associated 95% CIs were reported. Statistical significance was assessed at p < 0.05, and the Bonferroni correction for multiple comparisons was applied for each outcome analysis.

RESULTS
Between 2003 and 2012, 22,835 people met the inclusion criteria, which represents 94,103 incidents nationally. Analyses revealed a similar medical and surgical complication profile between age groups. The most prevalent medical complications were pneumonia (7.0%), acute respiratory distress syndrome (3.6%), and deep venous thrombosis (3%). Surgical site infections occurred in 6.3% of cases. Instrumented surgery was associated with the highest odds of each complication (p < 0.001). The inpatient mortality rate was 6.8% for all subjects. Multivariable analyses demonstrated that age ≥ 70 years was an independent predictor of mortality (OR 3.16, 95% CI 2.77–3.60), whereas instrumented surgery (multivariable OR 0.38, 95% CI 0.28–0.52) and vertebroplasty or kyphoplasty (OR 0.27, 95% CI 0.17–0.45) were associated with decreased odds of death. In surviving patients, both older age (OR 0.32, 95% CI 0.30–0.34) and instrumented fusion (OR 0.37, 95% CI 0.33–0.41) were associated with decreased odds of discharge to home.

CONCLUSIONS
The present study confirms that lumbar surgery in the elderly is associated with increased morbidity. In particular, instrumented fusion is associated with periprocedural complications, prolonged hospitalization, and a decreased likelihood of being discharged home. However, fusion surgery is also associated with reduced mortality. Age alone should not be an exclusionary factor in identifying surgical candidates for instrumented lumbar spinal fusion. Future studies are needed to confirm these findings.
Comparison of complication rates of minimally invasive transforaminal lumbar interbody fusion and lateral lumbar interbody fusion: a systematic review of the literature
Authors: Joseph Jacob R. , Smith Brandon W. , La Marca Frank , Park Paul 
Published: October 2015

OBJECT
Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) and lateral lumbar interbody fusion (LLIF) are 2 currently popular techniques for lumbar arthrodesis. The authors compare the total risk of each procedure, along with other important complication outcomes.

METHODS
This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant studies (up to May 2015) that reported complications of either MI-TLIF or LLIF were identified from a search in the PubMed database. The primary outcome was overall risk of complication per patient. Secondary outcomes included risks of sensory deficits, temporary neurological deficit, permanent neurological deficit, intraoperative complications, medical complications, wound complications, hardware failure, subsidence, and reoperation.

RESULTS
Fifty-four studies were included for analysis of MI-TLIF, and 42 studies were included for analysis of LLIF. Overall, there were 9714 patients (5454 in the MI-TLIF group and 4260 in the LLIF group) with 13,230 levels fused (6040 in the MI-TLIF group and 7190 in the LLIF group). A total of 1045 complications in the MI-TLIF group and 1339 complications in the LLIF group were reported. The total complication rate per patient was 19.2% in the MI-TLIF group and 31.4% in the LLIF group (p < 0.0001). The rate of sensory deficits and temporary neurological deficits, and permanent neurological deficits was 20.16%, 2.22%, and 1.01% for MI-TLIF versus 27.08%, 9.40%, and 2.46% for LLIF, respectively (p < 0.0001, p < 0.0001, p = 0.002, respectively). Rates of intraoperative and wound complications were 3.57% and 1.63% for MI-TLIF compared with 1.93% and 0.80% for LLIF, respectively (p = 0.0003 and p = 0.034, respectively). No significant differences were noted for medical complications or reoperation.

CONCLUSIONS
While there was a higher overall complication rate with LLIF, MI-TLIF and LLIF both have acceptable complication profiles. LLIF had higher rates of sensory as well as temporary and permanent neurological symptoms, although rates of intraoperative and wound complications were less than MI-TLIF. Larger, prospective comparative studies are needed to confirm these findings as the current literature is of relative poor quality.
Lumbar pseudarthrosis: a review of current diagnosis and treatment
Authors: Chun Danielle S. , Baker Kevin C. , Hsu Wellington K. 
Published: October 2015

OBJECT
Failed solid bony fusion, or pseudarthrosis, is a well-known complication of lumbar arthrodesis. Recent advances in radiographic technology, biologics, instrumentation, surgical technique, and understanding of the local biology have all aided in the prevention and treatment of pseudarthrosis. Here, the current literature on the diagnosis and management of lumbar pseudarthroses is reviewed.

METHODS
A systematic literature review was conducted using the MEDLINE and Embase databases in order to search for the current radiographie diagnosis and surgical treatment methods published in the literature (1985 to present). Inclusion criteria included: 1) published in English; 2) level of evidence I–III; 3) diagnosis of degenerative lumbar spine conditions and/or history of lumbar spine fusion surgery; and 4) comparative studies of 2 different surgical techniques or comparative studies of imaging modality versus surgical exploration.

RESULTS
Seven studies met the inclusion criteria for current radiographie imaging used to diagnose lumbar pseudarthrosis. Plain radiographs and thin-cut CT scans were the most common method for radiographie diagnosis. PET has been shown to be a valid imaging modality for monitoring in vivo active bone formation. Eight studies compared the surgical techniques for managing and preventing failed lumbar fusion. The success rates for the treatment of pseudarthrosis are enhanced with the use of rigid instrumentation.

CONCLUSIONS
Spinal fusion rates have improved secondary to advances in biologies, instrumentation, surgical techniques, and understanding of local biology. Treatment of lumbar pseudarthrosis includes a variety of surgical options such as replacing loose instrumentation, use of more potent biologies, and interbody fusion techniques. Prevention and recognition are important tenets in the algorithm for the management of spinal pseudarthrosis.
Céramiques de l'Antiquité tardive à Marseille (corne du port antique, sondages D II 11 et D II 15).
Authors: Cavailles-Llopis Maria-Teresa 
Published: October 2015

A partir d'une analyse fine de la stratigraphie de deux sondages pratiqués en 1979 dans les sédiments de la corne du port antique de Marseille, l'auteur met en évidence l'évolution du mobilier exhumé (presque exclusivement céramique) durant les cinq phases individualisées au cours de l'Antiquité tardive.
L'étude, bien illustrée, est faite par grandes catégories de matériel selon un processus précis de présentation diachronique des formes, des décors et des techniques. Diagrammes et tableaux comparatifs ou récapitulatifs facilitent la compréhension de l'évolution générale.
Le dépôt de bronzes launacien de Roque-Courbe (Saint-Saturnin, Hérault)
Authors: Garcia Dominique 
Published: October 2015

Des travaux agricoles ont permis la découverte en 1974 d'un très important lot d'objets en bronze qui a pu être recueilli dans sa totalité. Il s'agit d'un dépôt de 428 pièces contenu dans une situle en tôle de bronze.
L'auteur présente et analyse l'intégralité du mobilier qui comporte des pièces d'armement, d'outillage, de parure, de harnachement, des lingots et des résidus de fonderie. Les objets sont décrits, remarquablement illustrés, et comparés à ceux provenant d'autres dépôts similaires ou d'habitats d'Europe occidentale.
Cet ensemble s'intègre dans la série des dépôts de type "launacien" dont il est le plus important par le nombre des objets avec celui du site éponyme. Les recoupements chronologiques permettent de proposer une date d'enfouissement dans la seconde moitié du VIème s. av. J.-C.
Un habitat du Bronze final II aux Esquérades (Tresques, Gard)
Authors: Goury Dominic 
Published: October 2015

La découverte récente de vestiges datables, entre autres, du Bronze final II dans la vallée de la Tave à Tresques, relance la question des modes de l'habitat à cette époque. C'est la première fois qu'une implantation en plaine est attestée avec certitude dans la partie nord du département du Gard. La superficie reconnue du gisement suggère la présence à ce moment du Bronze final de groupements d'habitations tout à fait comparables à ceux des régions lagunaires. La cartographie générale du département publiée par l'auteur souligne bien l'originalité de ce nouveau site dans son contexte régional.
Le gisement n'a malheureusement pu être fouillé d'une manière extensive. L'auteur en a pourtant déterminé les limites. Il présente le faciès et la composition morphologique du mobilier recueilli, exclusivement céramique.
Amphores importées durant le IIe s. av. J.-C. dans trois habitats de Provence occidentale : Entremont, le Baou-Roux et Saint-Blaise.
Authors: Gateau Fabienne 
Published: October 2015

Entremont, le Baou-Roux and Saint-Blaise are among the earliest excavated protohistorical sites of the hinterland of Marseille. The relative vastness of the excavated areas and a common occupation during the IInd century B.C. were the reasons to choose these sites for an analytical and comparative study of the amphorae imported during this era.
Data analysis is based on the whole of the sufficiently large fragments that have been preserved and on the establishment of metric correlations between the morphological components. Containers of Italic origin are by the most numerous. Greco-Italic amphorae dominate, but the percentage of type Dressel I differs according to site. Hence the idea of integrating the results of this study with those already supplied by other categories of objects in order to give a better support to the present hypotheses about the termini ante quos of these habitats, all destroyed by enemy action between the years 130 and 90 B.C.
Espaces publics, espaces religieux protohistoriques en Gaule méridionale
Authors: Arcelin Patrice , Dedet Bernard , Schwaller Martine 
Published: October 2015

Ce dossier constitue les actes de la table ronde de Lattes du 4 décembre 1991 sur les "Monuments et bâtiments publics protohistoriques de Gaule méridionale". Il rassemble des documents souvent méconnus et parfois inédits qui bénéficient d'une présentation analytique et forment la base d'une première synthèse sur le sujet.
Les salles monumentales et les lieux de culte recouvrent essentiellement trois formes : les salles hypostyles ou portiques (Nîmes, Saint-Blaise, Entremont, Ensérune), les fanums au plan proche de celui des temples celtiques (Nages et Roque-de-Viou) et de grandes salles de réunion comme celle de Mouriès. Une présentation synthétique des monuments publics tardo-hellénistiques de Glanon permet de les situer dans leur contexte urbain, chronologique et culturel.
Les découvertes récentes effectuées à Nîmes près de la source de la Fontaine constituent un ensemble cultuel remarquable qui bénéficie d'études diversifiées et d'un article de synthèse.
Les tours monumentales de la région nîmoise représentent un type original de l'expression monumentale qui a certainement une signification plus large que la seule fonction défensive.
La citerne collective de l'oppidum de la Cloche, avec un réservoir de 600 hl, un système de captation et d'épuration par décantation, est un document particulier en milieu indigène aux nettes influences méditerranéennes.
Ce dossier est également l'occasion de faire le point sur les stèles anépigraphes mises au jour sur plusieurs sites préromains méridionaux ; des documents, souvent inédits, provenant du Marduel, de Martigues, de Lattes, de Vié-Cioutat, des Caisses, de la Ramasse ou d' Entremont, permettent de conclure à la présence d'anciens sanctuaires indigènes ou de tombes.
Deux études synthétiques closent ce dossier : la première est une analyse des modes de constructions des bâtiments publics protohistoriques qui mêlent très tôt les emprunts au monde méditerranéen aux techniques traditionnelles ; la seconde est une nouvelle approche synthétique des espaces publics et des espaces religieux du Midi gaulois.
A Jacksonian view of American English
Authors: Miller Michael I. 
Published: October 2015

Une vision jacksonienne de l'anglais américain.
Les Virginia Museum papers sont ici étudiés pour montrer l'état de l'anglais américain à l'époque de la Présidence d'Andrew Jackson, la méthodologie linguistique alors employée, et pour donner une théorie nouvelle quant à son auteur.
Le stoïcisme de Firmin Laferrière (1798-1861)
Authors: Durelle-Marc Yann-Arzel 
Published: October 2015

À travers son important Cours de droit public et administratif (1839), F. Laferrière (1798-1861) est l’un des fondateurs de la science et de la pensée du droit administratif français ; mais, plus historien du droit que véritablement administrativiste , il nourrit toute son œuvre du retour au droit romain dans une perspective constamment savignicienne. Au-delà de la méthode cependant, cet auteur bâtit une vision providentialiste qui mêle idéalement stoïcisme et christianisme au service d’une conception eschatologique de la science juridique conçue comme facteur et instrument actifs.
Implementation of a Progressive Mobilization Program in a Medical-Surgical Intensive Care Unit
Authors: Messer April , Comer Linda , Forst Steve 
Published: October 2015

BackgroundCurrent literature supports implementation of progressive mobility protocols in intensive care units. Education can help nurses overcome barriers to mobility and increase knowledge about the positive effects of mobility.ObjectiveTo evaluate the effect of education for a progressive mobilization program for intensive care nurses on knowledge and performance.MethodsA pretest-posttest evaluation was conducted for 41 nurses, and a chart review was performed before and after implementation of the educational intervention to evaluate changes in knowledge and mobilization.ResultsScores after the educational intervention were significantly higher than scores before the intervention (t = 2.02; P &lt; .001). Overall mobilization (P = .04) and dangling (P = .01) increased significantly after the education. No significant increases occurred in ambulating or getting patients up to a chair.ConclusionsMobilization education was effective and increased nurses’ knowledge about the benefits of mobility for critically ill patients. The educational program also affected how nurses performed mobility interventions. Although provision of education had positive effects on patients’ mobility, leadership and coaching are still important components in implementing change.