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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To determine the efficacy and safety of transforaminal lumbar interbody fusion (TLIF) for revision lumbar spine surgery in patients with previous laminectomy. The secondary objective was to evaluate the clinical and radiological outcome after such a procedure. ⋯ The current study confirmed that TLIF approach in patients with previous laminectomy is effective and safe with good outcomes.
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Indication for surgery in spine trauma patients depends on the extent of destruction of the spine. Computer-assisted tomography scan (CAT scan) is not suitable to diagnose type B-injuries. Aim of the study was to investigate whether ultrasound is able to detect destruction of the posterior ligament complex (PLC). ⋯ Ultrasound may indicate rupture or integrity of PLC in cases where MRI is missing.
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A retrospective review ⋯ TLIF may induce uneven changes in foraminal morphometry. Cage position may be the major determinant of this result.
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Minimally invasive techniques have become increasing popular and are expanding into deformity surgery. The lateral retroperitoneal transpsoas anterior column release (ACR) is a newer minimally invasive alternative to posterior osteotomy techniques for correcting and promoting global spinal alignment. This procedure attempts to avoid the potential complications associated with conventional osteotomies, but has its own subset of unique complications to be discussed in depth. ⋯ The MIS-ACR is one of the most technically demanding procedures performed from the lateral transpsoas approach. This procedure has the advantage of maintaining and improving spinal global alignment while minimizing blood loss and excessive tissue dissection. It comes with its own unique set of potentially catastrophic complications and should only be performed by surgeons proficient in both deformity correction and the lateral approach.
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Adult deformity combined with sagittal malalignment is a pathology that decreases patient's quality of life and that requires surgical correction to achieve clinical improvement. Spine osteotomies are usually performed to restore alignment of the spine, even if these techniques are associated with high intraoperative risks, revision rates and relevant mortality rates. Anterior column realignment (ACR) is a new technique that allows large corrections through a minimally invasive lateral approach to the spine after release of the anterior longitudinal ligament. ⋯ Preliminary data show that ACR allows corrections similar to those obtained with a Pedicle Subtraction Osteotomy, avoiding risks related to this technique.