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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Meta Analysis Comparative Study
Comparison of unilateral versus bilateral pedicle screw fixation in lumbar interbody fusion: a meta-analysis.
This is a meta-analysis to compare the clinical results between unilateral and bilateral pedicle screw (PS) fixation in lumbar interbody fusion. ⋯ In our meta-analysis, we found that unilateral PS fixation in lumbar fusion was as effective as bilateral PS fixation for lumbar degenerative diseases without major instability, no significant difference was found in hospital time, fusion rate and screw complications. In terms of operative time and blood loss, unilateral PS fixation even produced better results.
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Human cadaveric study measuring the morphology of C2 vertebra, description of anterior placement of pedicle screw with post-fixation computed tomography (CT) analysis. ⋯ Quantitative data regarding C2 pedicle shape and location with respect to the anterior placement of pedicle screws have not been previously reported. This study indicates that anterior placement of 3.5 mm C2 pedicle screws through a transoral approach may be both feasible and safe and also provides an important anatomic analysis that may guide clinical application.
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Review Meta Analysis
Anterior corpectomy versus posterior laminoplasty for multilevel cervical myelopathy: a systematic review and meta-analysis.
Surgical strategy for multilevel cervical myelopathy resulting from cervical spondylotic myelopathy (CSM) or ossification of posterior longitudinal ligament (OPLL) still remains controversial. There are still questions about the relative benefit and safety of direct decompression by anterior corpectomy (CORP) versus indirect decompression by posterior laminoplasty (LAMP). ⋯ Based on the results above, anterior CORP and fusion is recommended for the treatment of multilevel cervical myelopathy when the involved surgical segments were <3. Given the higher rates of surgical complications and complication-related reoperation and the higher surgical trauma associated with multilevel CORP, however, it is suggested that posterior LAMP may be the preferred method of treatment for multilevel cervical myelopathy when the involved surgical segments were equal to 3 or more. In addition, taking the limitations of this study into consideration, it was still not appropriate to draw a strong conclusion claiming superiority for CORP or LAMP. A well-designed, prospective, randomized controlled trial is necessary to provide objective data on the clinical results of both procedures.
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Randomized Controlled Trial
Treatment of cervical disc herniation through percutaneous minimally invasive techniques.
The goal of this study is to compare the therapeutic effectiveness of percutaneous cervical discectomy, percutaneous cervical disc nucleoplasty, and a combination of the two for the treatment of cervical disc herniation and the effective stabilization of the cervical vertebral column. ⋯ Each group achieved good clinical outcomes with this safe, minimally invasive spinal surgery for the treatment of cervical disc herniation. In addition, no postoperative risk of cervical instability was found.
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Haemangiomas are very frequent benign spinal tumours. However, pure epidural location is extremely rare. At present, only 52 cases have been reported in the literature during the last 10 years. We proposed to analyse clinical and radiological features of this rare entity treated in a tertiary care centre over the last 10 years. ⋯ Epidural haemangiomas are extremely rare spinal lesions. They may mimic more common spinal tumours clinically and radiologically. The usual treatment is gross total resection confirming the diagnosis histologically.