European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Rigid cervical spine following trauma immobilization is recommended to reduce neurological disability and provide spinal stability. Soft collars have been proposed as a good alternative because of the complications related to rigid collars. The purpose of this study was to perform a systematic review on soft and rigid collars in the prehospital management of cervical trauma. ⋯ II, Systematic Review.
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Review
Learning curve for minimally invasive transforaminal lumbar interbody fusion: a systematic review.
Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) is commonly used to treat degenerative lumbar spinal disorders. It facilitates a full-scale spinal decompression and interbody fusion with minimal neural retraction using the tubular retractor system. Despite the benefits of surgical efficiency and minimalism, this technique requires a long learning curve. There is currently no consensus on the learning curve characteristics and proper training methods for MI-TLIF. Thus, this systematic review aimed to discuss the cutoff point at which technical proficiency is achieved and ways to enhance the learning process. ⋯ The plateau point in the learning curve for MI-TLIF may differ according to the outcome measures used. Most studies have demonstrated the learning progress based on simple task efficiency, rather than patient outcomes. Moreover, the learning rate may be affected by the patients' and technical conditions. Therefore, great care is required in interpreting the learning curve and cutoff point for MI-TLIF proficiency.
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Pelvic incidence (PI) is a key morphological parameter that reflects the relation between the sacrum and iliac wings. It is well accepted that PI remains constant after reaching maturity. However, recent studies indicated that PI might be altered after lumbosacral fusion. Additionally, it remains uncertain on the long-term influence of long fusion to pelvis with S2-alar-iliac screw on PI in patients with adult spinal deformity (ASD). ⋯ Our study showed that PI decreased in more than half of ASD patients immediately after spinal surgery using S2AI screws. Approximately 48% of them were able to recover during the 2-year follow-up. Lower pre-op PI, post-op PI and PT were found to be strongly associated with the return of PI. Thus, these current findings indicated that patients with a high PI at pre-operation should not be over-corrected to avoid PI-LL mismatch postoperatively.
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Chordomas and chondrosarcomas are locally destructive tumors with high progression or recurrence rates after initial multimodality treatment. This report examined the role of radiosurgery in patients who were considered inoperable after the recurrence of large chordoma disease having undergone previous surgery and/or radiotherapy. ⋯ Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.
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The aim of this study is to identify risk factors associated with postoperative DJF in long constructs for ASD. ⋯ Recently, DJF has received recognition as its own entity due to a notable postoperative incidence. Few studies to date have evaluated risk factors for DJF. The results of our study highlight that pedicle subtraction osteotomy, poor correction of lumbar lordosis, and sagittal vertical axis are significantly associated with postoperative occurrence of DJF.