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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Multicenter Study Clinical Trial
Stand-alone ALIF with integrated intracorporeal anchoring plates in the treatment of degenerative lumbar disc disease: a prospective study on 65 cases.
ALIF with cages is expected to restore disc height and stabilize the spine promoting fusion, while avoiding damage attributed to rod-pedicle screw fixation. However, it may be related to an increased risk of fusion failure and subsidence. A prospective study was conducted by five investigators across three centers to confirm performance of a PEEK cage for stand-alone ALIF in the treatment of lumbar degenerative disc disease (DDD). ⋯ Safety and efficacy of this stand-alone cage with integrated intracorporeal plates was confirmed through 12 months for treatment of degenerative conditions. The design of the cage and plates may contribute to the decreased subsidence rate observed.
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To conduct a retrospective multicenter study to investigate the accuracy of pedicle screw (PS) placement in the cervical spine by freehand technique and the related complications in various pathological conditions including trauma, rheumatoid arthritis, degenerative conditions and others. ⋯ Malposition rate of PS placement in the cervical spine by freehand technique was high in rheumatoid patients even when being performed by experienced spine surgeons. Any guidance tools including navigation systems are recommended for placement of cervical PSs in patients with RA.
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The Swiss Federal Office of Public Health demanded a nationwide HTA registry for lumbar total disc arthroplasty (TDA), to decide about its reimbursement. The goal of the SWISS spine registry is to generate evidence about the safety and efficiency of lumbar TDA. ⋯ Lumbar TDA appeared as efficient in long-term pain alleviation, consequent reduction of pain medication consumption and improvement of quality of life. The procedure also appeared sufficiently safe, but surgeons have to be aware of a list of potential adverse events. The outcome is stable over the 5-year postoperative period. The vast majority of treated segments remained mobile after 5 years, although almost half of patients showed osteophytes.
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Comparative Study Clinical Trial
Prospective comparative study between straight and curved probe for pedicle screw insertion.
To evaluate difference in accuracy of pedicle screw insertion in thoracic and lumbosacral spine using a straight pedicle probe vis-à-vis a curved one. ⋯ No significant difference in outcome of pedicle screw insertion with either a straight or a curved pedicle probe.
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Comparative Study
Comparison between pain at discography and morphological disc changes at axial loaded MRI in patients with low back pain.
Discogenic pain is induced by axial load, but there are no studies evaluating the influence of dynamic MRI in relation to provoked pain at discography. The aim of this study was to investigate the relationship between discography-induced pain and morphological disc changes, occurring during axial loaded MRI (alMRI). A secondary aim was to compare and register the frequency of provoked concordant pain at alMRI and discography. ⋯ In the majority of patients with low back pain, discography as well as alMRI provoked concordant pain. Loading of the spine, alMRI, revealed however no clinically useful morphological characteristics in the discs with concordant discograms. Alternative or more sensitive diagnostic methods are needed to understand load-induced discogenic pain.