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
Radiographic outcomes of anterior column realignment for adult sagittal plane deformity: a multicenter analysis.
Anterior column reconstruction (ACR) is a minimally invasive technique for the treatment of sagittal plane deformity. ACR uses a lateral transpsoas approach with ALL release and the application of an interbody device to achieve correction. Here, we present 1-year radiographic results from a multicenter study of adult spinal deformity (ASD) patients. ⋯ ACR successfully restores lumbar lordosis in ASD patients with sagittal imbalance. ACR results in greater segmental correction than is achieved with LLIF alone. Supplementing with posterior osteotomies allows for even greater correction. The ability to achieve the desired radiographic goals is expected to improve as technical nuances are refined and patient selection is optimized.
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To conduct a systematic review of the literature to determine important clinical predictors of surgical outcome in patients with cervical spondylotic myelopathy (CSM). ⋯ The most important predictors of outcome were preoperative severity and duration of symptoms. This review also identified many other valuable predictors including signs, symptoms, comorbidities and smoking status.
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Minimally invasive lateral interbody fusion (MIS-LIF) has become a popular less invasive treatment option for degenerative spinal disease, deformity, and trauma. While MIS-LIF offers several advantages over traditional anterior and posterior approaches, the procedure is not without risk. The purpose of this study was to evaluate the incidence of visceral, vascular, and wound complications following MIS-LIF performed by experienced surgeons. ⋯ The incidence of surgical site infections and vascular and visceral complications following MIS-LIF in this large series was low and compared favorably with rates for alternative interbody fusion approaches. Although technically demanding, MIS-LIF is a reproducible approach for interbody fusion with a low risk of vascular and visceral complications and infections.
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To investigate the relationship between sagittal spinal alignment and the incidence of vertebral fracture in patients with osteoporosis. ⋯ Osteoporosis patients with low LL, LLI, and PI could be at high risk of lumbar vertebral fracture. In addition to BMD, the abnormal sagittal spinal profile should also be taken into consideration when predicting the incidence of vertebral fracture in such patients.
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Minimal-invasive cement augmentation techniques gained popularity recently. Long-term studies, however, are still not available focusing on the effect of possible acceleration of intervertebral disc degeneration. ⋯ Despite several limitations regarding patients' age and lack of performed perfusion MRI scans, this study suggests that vertebral cement augmentation through kyphoplasty has no significant influence on disc degeneration even after a long period. The absence of severe disc degeneration after vertebral augmentation supports further clinical trials, which should incorporate endplate perfusion studies for detailed information regarding disc perfusion.