Spine
-
Multicenter Study
Treatment of spondylodiscitis in human immunodeficiency virus-infected patients: a comparison of conservative and operative therapy.
Multicenter retrospective case series. ⋯ The occurrence of spondylodiscitis in HIV-positive patients is associated with a low CD4 T-cell count. The probability of mixed infections rises with a CD4 T-cell count <100/microL. The occurrence of spondylodiscitis in HIV-positive patients is accompanied by high mortality. Operative therapy of spondylodiscitis in HIV-positive patients is not associated with an increased surgical complication rate. HIV infection or AIDS should not have an influence on decision-making regarding conservative or operative therapy of spondylodiscitis.
-
Multicenter Study
Functional and radiological outcomes of 360 degrees fusion of three or more motion levels in the lumbar spine for degenerative disc disease.
This is a single-center, multisurgeon, retrospective study of radiologic and functional outcome measures at a minimum 2-year follow-up. ⋯ The surgical treatment of lumbar degenerative disc disease by 360 degrees fusion should be considered for properly selected patients. The goal of surgery is reduction, not elimination of disability.
-
Multicenter Study
Treatment of thoracic scoliosis: are monoaxial thoracic pedicle screws the best form of fixation for correction?
Multicenter retrospective cohort study of 100 consecutive patients. ⋯ Similar coronal and sagittal plane correction was achieved in thoracic adolescent idiopathic scoliosis with 3 different constructs. There was a trend toward improved correction of clinical rib hump deformity with MONO screw constructs compared with POLY screw constructs.
-
Randomized Controlled Trial Multicenter Study Comparative Study
Implant complications, fusion, loss of lordosis, and outcome after anterior cervical plating with dynamic or rigid plates: two-year results of a multi-centric, randomized, controlled study.
Prospective, controlled, randomized, multicenter study. ⋯ Dynamic cervical plate designs provide less implant complications (no patient) compared with rigid plate designs (4 patients). Speed of fusion was faster in the presence of a dynamic plate. However, loss of segmental lordosis is significantly higher if dynamic plates are used, which did not result in differences regarding clinical outcome between dynamic and constrained plates after 2 years. Thus, dynamic plates should be considered to be the preferred treatment option because of the lower risk for implant failure-related revision surgery.
-
Reliability analysis based on expert panel case series review and grading per the Enneking and Weinstein-Boriani-Biagini classification systems. ⋯ Results indicate moderate interobserver reliability and substantial and near-perfect intraobserver reliability for both the Enneking and WBB classification in terms of staging and guidance for treatment, despite a less than moderate interobserver reliability in interpreting the Enneking local tumor extension and WBB sector. Before incorporating the classifications in the clinical practice and research studies, further work is required to investigate the validity of the classifications.