Background: Controlling the hemodynamic situation of patients who have Spinal operation is of prime importance, and maintaining the heart rate and blood pressure in normal or low- normal levels in these patients can reduce their bleeding loss. One of the commonly used drugs for this purpose is remifentanil. Another sedative-hypnotic-analgesic drug, with acceptable effects is dexmedetomidine.The aim of this study was to compare the effect of dexmedetomidine with remifentanil in Spinal operation.Methods: In a double blind randomized clinical trial, using random sampling method, 60 patients with the age range of 15-65 years who were candidates for posterior Spinal fusion operation were included. Induction of anesthesia was performed, and both groups received isoflurane 1% during the surgery. Remifentanil was injected via infusion pump in one group. The patients in the trial group received dexmedetomidine. As trial outcomes, heart rate and blood pressure were measured before, after induction and during the operation. Pain score, sedation score and the need to analgesic therapy were recorded in the recovery room and the ward. Independent sample t-test and chi-square were used for statistical analysis.Results: Dexmedetomidine had a significant lowering impact on intraoperative blood pressure and heart rate compared to remifentanil (p<0.001). The mean of sedation scores after extubation in patients who received dexmedetomidine was significantly higher than the sedation scores in patients who received remifentanil (p<0.001). The mean of post-extubation and recovery pain score in patients taking remifentanil was significantly higher than patients taking dexmedetomidine (p<0.05).Conclusion: Dexmedetomidine in patients with Spinal operation is associated with lower postoperative pain score and intraoperative bleeding. Hemodynamic effects are significantly better in patients received dexmedetomidine.

Background: As life expectancy in the society increases, the rate of degenerative diseases of the spine surge dramatically. Therefore, the number of patients undergoing Spinal fusion surgery rises; however, the effectiveness of this operation is still controversial. Objectives: The aim of this study was to investigate disability and quality of life in patients undergoing Spinal fusion and compare the results with a matched general population sample. Methods: In this prospective study, which was conducted during 2015-2016 in Iran, data were collected from 100 patients undergoing Spinal fusion surgery at Baqiyatallah and Shariati Hospitals. We also recruited 100 people from the general population in the hospital matched with the patients with regard to sex, age, and smoking status. The participants filled out the 36-item short form (SF-36) and Oswestry disability index (ODI) questionnaires. The collected data on the quality of life and disability of patients, before and three and six months after the surgery were compared. Results: The patient and general population groups were matched in terms of sex, age, educational level, body mass index (BMI), employment status, and smoking status (P > 0. 05). Preoperative ODI score in the patients was 54. 8 (SD 15. 7), and six months after the surgery, it diminished to 24. 8 (SD 9. 25). ODI score in the general population sample was 17. 5 (SD 8. 3). Although disability improved significantly six months after surgery, it did not reach the level of the general population sample (P < 0. 001). All aspects of the SF-36 improved six months after surgery (P < 0. 05) and the patients reached the general population sample in emotional, mental health, and vitality subscales of SF-36 (P > 0. 05). They did not reach the general population sample in other subscales of SF-36 (P < 0. 05). Conclusions: Despite the significant improvement in disability and all subscales of quality of life in the patients, they did not reach the general population sample in disability index, physical function, general health, physical role, social function, and pain subscales of the SF-36. However, they reached general population sample level in emotional, mental health, and vitality subscales of the SF-36.

Background: Spinal fusion surgery (SFS) is commonly performed as an elective procedure in the United States that employs minimally invasive techniques,however, it possesses potential risks and side effects and is still considered an experimental treatment. As such, patients can often be hesitant when proposed SFS. In that regard, this study aimed to analyze and critique available SFS instructive materials, to account for the procedure’s potential risks for patients. Methods: We have reviewed information concerning surgical procedures and policies (pre-operative to postoperative) on 20 hospitals and medical center websites. All possible keywords regarding SFS were systematically arranged and considered in various ways. The collected data was assessed and compared to identify common themes. Results: Our results indicate that, although some informational sources reaffirm each other’s materials, few provided key SFS details, such as potential candidates, outcomes, risks, and aftercare. Moreover, information was neither delivered systematically nor consistently, leading patients to feel anxious, fearful, or confused when making decisions involving SFS. Conclusion: This paper recommends a comprehensive and interactive information system (IS) with a patient-oriented approach, which will facilitate patient decision-making and help people discern between factual data and false information supplied through social media or word of mouth. This information system could then be used for other elective procedures.