Journal of neurosurgery. Spine
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Review Multicenter Study Meta Analysis Comparative Study
Pedicle screw navigation: a systematic review and meta-analysis of perforation risk for computer-navigated versus freehand insertion.
In this paper the authors' goal was to compare the accuracy of computer-navigated pedicle screw insertion with nonnavigated techniques in the published literature. ⋯ There is a significantly lower risk of pedicle perforation for navigated screw insertion compared with nonnavigated insertion for all spinal regions.
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Review Case Reports
High prevalence of heterotopic ossification after cervical disc arthroplasty: outcome and intraoperative findings following explantation of 22 cervical disc prostheses.
Cervical disc arthroplasty (CDA) has been increasingly used for the treatment of cervical disc herniations. However, the impact of CDA on adjacent-segment degeneration and the degree of heterotopic ossification (HO) of the treated segment remain a subject of controversy. Due to a product failure of the Galileo-type disc prosthesis, 22 of these devices were explanted. The radiological and clinical course in each case was investigated in detail with an emphasis on the incidence of HO and facet joint degeneration 18 months following the operation. Intraoperative findings regarding ossification and implant fixation were documented. Thus, the authors were able to describe the true rate of adjacent-segment degeneration and HO following CDA and the clinical relevance thereof. ⋯ In this study, a higher incidence of HO after CDA could be demonstrated using CT, compared with studies using fluoroscopy only. However, patient selection and/or the operative technique might have contributed to the high prevalence of osteophyte formation. Thus, the exact indication for CDA has to be reconsidered. Because implant migration was detected, using fixation in the present CDA model appears suboptimal.