Spine
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Systematic analysis. ⋯ Based on the summary of criteria results, future research evaluating complications following surgery for odontoid fractures in elderly patients is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate currently available in the literature.
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Systematic review. ⋯ We define a complication as an unintended and undesirable diagnostic or therapeutic event that may impact the patient's care. Complications should be recorded and analyzed relative to disease severity, patient comorbidities, and ultimately their effect on patient outcomes. Further work needs to be done to develop a complication risk impact index that has the ability to help us assess and communicate the interaction of patient comorbidities and complication severity on patient centered outcomes.
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Systematic review. ⋯ A better understanding of dysphagia will require the development of better outcome measures.
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The objective of this article was to undertake a systematic review of the literature to determine whether IOM is able to sensitively and specifically detect intraoperative neurologic injury during spine surgery and to assess whether IOM results in improved outcomes for patients during these procedures. ⋯ Based on strong evidence that multimodality intraoperative neuromonitoring (MIOM) is sensitive and specific for detecting intraoperative neurologic injury during spine surgery, it is recommended that the use of MIOM be considered in spine surgery where the spinal cord or nerve roots are deemed to be at risk, including procedures involving deformity correction and procedures that require the placement of instrumentation. There is a need to develop evidence-based protocols to deal with intraoperative changes in MIOM and to validate these prospectively.
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Prospective cohort study. ⋯ After adjusting for the number of years since surgery, metal implant exposure is positively associated with elevated serum chromium levels in adolescent idiopathic scoliosis patients with stainless steel posterior spinal implants. This is the first study to identify statistically significant positive associations between specific spinal implant characteristics (other than corrosion identified by radiographs) and serum chromium levels.