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Anterior fusion of the lumbar spine. End-result study with long-term follow-up

The Journal of Bone & Joint Surgery.  1979; 61:1143-1150 
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Abstract

We reviewed the cases of fifty patients who underwent anterior lumbar-spine fusion with autogenous fibular and iliac-bone grafts and were followed for two to fifteen years. Their diagnoses were instability of the spine, degenerative disc disease, pseudarthrosis, and spondylolisthesis. Fifty-six per cent had union and 44 per cent, non-union. Those who had iliac grafts healed in an average of 2.5 years and those who had fibular grafts, in 5.2 years. The clinical result was successful in twenty-six patients (52 per cent) and unsuccessful in twenty-four patients (48 per cent). Paradoxically, about one-half of the patients with clinical successes had a non-union and one-half of the failures had union. Retrograde ejaculation (sterility) did not develop in any of the men, and a survey of world authorities on anterior spine fusion revealed only sixteen patients with the sequela of retrograde ejaculation. The incidence of that complication has been exaggerated.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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