The rate of PEEK cage subsidence after MITLIF was relatively low. End-plate manipulation and cage insertion during MITLIF were not influenced by a small operation window.

We retrospectively evaluated 488 percutaneous pedicle screws in 110 consecutive patients that had undergone minimally invasive transforaminal lumbar interbody fusion (MITLIF) to determine the incidence of pedicle screw misplacement and its relevant risk factors. Screw placements were classified based on postoperative computed tomographic findings as ''correct'', ''cortical encroachment'' or as ''frank penetration''. Age, gender, body mass index, bone mineral density, diagnosis, operation time, estimated blood loss (EBL), level of fusion, surgeon's position, spinal alignment, quality/quantity of multifidus muscle, and depth to screw entry point were considered to be demographic and anatomical variables capable of affecting pedicle screw placement. Pedicle dimensions, facet joint arthritis, screw location (ipsilateral or contralateral), screw length, screw diameter, and screw trajectory angle were regarded as screw-related variables. Logistic regression analysis was conducted to examine relations between these variables and the correctness of screw placement. The incidence of cortical encroachment was 12.5% (61 screws), and frank penetration was found for 54 (11.1%) screws. Two patients (0.4%) with medial penetration underwent revision for unbearable radicular pain and foot drop, respectively. The odds ratios of significant risk factors for pedicle screw misplacement were 3.373 (95% CI 1.095-10.391) for obesity, 1.141 (95% CI 1.024-1.271) for pedicle convergent angle, 1.013 (95% CI 1.006-1.065) for EBL [400 cc, and 1.003 (95% CI 1.000-1.006) for cross-sectional area of multifidus muscle. Although percutaneous insertion of pedicle screws was performed safely during MITLIF, several risk factors should be considered to improve placement accuracy.

BackgroundHypertension is a major contributor to the global disease burden of cardiovascular and cerebrovascular disease. The aim of this study was to determine demographic and clinical factors associated with adherence to antihypertensive medication.MethodsFrom August 2012 to February 2015, we recruited 1,523 Korean patients with hypertension who visited family physicians. The study was conducted in 24 facilities located in urban and metropolitan areas. Of these facilities, two were primary care clinics and 22 were level 2 or 3 hospitals. Adherence was assessed using the pill count method; a cut-off value of 80% was used as the criterion for good adherence. Sociodemographic and lifestyle factors were compared between the adherent and nonadherent groups using the chi-square test for categorical variables and t-test for continuous variables. Binary logistic regression analysis was performed with medication adherence as the outcome variable.ResultsOf the 1,523 patients, 1,245 (81.7%) showed good adherence to antihypertensive medication. In the multivariate logistic analysis, age ≥65 years, exercise, treatment in a metropolitan-located hospital, being on ≥2 classes of antihypertensive medication and concomitant medication for diabetes, and a family history of hypertension or cardiovascular diseases were associated with good adherence. Patients who had a habit of high salt intake were less adherent to medication.ConclusionMultiple classes of antihypertensive medications, concomitant medication, and exercise were associated with good adherence to antihypertensive medication, and high salt intake was associated with poor adherence to antihypertensive medication. These factors should be considered to improve hypertension control.