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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Comparative Study
The use of surgical sealants in the repair of dural tears during non-instrumented spinal surgery.
To compare the success in repair of dural tears (DTs) using two different surgical sealants in non-instrumented lumbar spinal surgery and evaluate the incidence of associated short- and long-term complications. ⋯ Intraoperative DTs can be easily repaired by many effective techniques. However, in our experience, the use of BioGlue is an effective adjunct to immediate dural repair, being comparable in terms of efficacy and safety to the use of fibrin glue, potentially decreasing the incidence of associated short- and long-term complications.
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To report the surgical technique and preliminary clinical results for the treatment of basilar invagination (BI) with atlantoaxial dislocation (AAD) by posterior C1-C2 pedicle screw and rod instrument. ⋯ This C1-C2 pedicle screw and rod instrument is a promising technique for the treatment of BI with AAD.
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The optimal surgical technique for multilevel cervical degenerative disc diseases (DDD) remains controversial. Hybrid surgery (HS) incorporating anterior cervical discectomy and fusion (ACDF) and cervical disc replacement (CDR) is increasingly performed for cervical DDD. This study aims to evaluate the biomechanical and clinical evidence available for HS and to provide a systematic review of current understanding of HS. ⋯ There is a paucity of high quality evidence for HS. HS may be a safe and efficacious technique to benefit a select group of multilevel cervical DDD, which is needed to be confirmed by further prospective, randomized controlled trials.
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Little data are available regarding the influence of psychiatric factors on chronic dysphagia after anterior cervical spine surgery. The purpose of this study was to identify associations between psychiatric factors and the development of chronic dysphagia in patients after anterior cervical spine surgery. ⋯ The presence of a psychiatric problem seems to be an important risk factor of chronic dysphagia in patients with cervical disc herniation. The study shows that psychiatric factors should be evaluated prior to surgery to determine the risk of chronic dysphagia.
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To investigate the quality of life outcomes following surgical treatment of patients with coexisting multiple sclerosis (MS) and cervical stenosis with associated myelopathy (CS). ⋯ Patients in the control cohort had clinically and statistically significant improvements in QALY outcomes. Those in the MS cohort averaged no change in QALY. However, only a minority of MS/CS patients had worsening QALY following surgery, and as such surgery may still be considered for these patients. It is imperative that there are preoperative discussions with the MS/CS patient regarding the likelihood that surgery will only provide limited, if any, improvements in QOL.