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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In elderly patients with reduced bone quality, insufficiency fractures of the sacrum are relatively common and are typically accompanied by severe, disabling pain. The objective of this study was to evaluate the feasibility of cement augmentation by RFS, as well as to determine postinterventional leakages and present the patients' outcomes. ⋯ As a minimally invasive procedure, RFS is an effective and safe method of treatment for rapid, significant and sustained pain reduction.
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To evaluate long-term clinical and radiological results of cervical laminectomy without adjuvant-instrumented fusion for degenerative spinal cord compression. ⋯ Cervical laminectomy without adjuvant-instrumented fusion should be considered as a treatment for compressive degenerative cervical myelopathy in patients with a lordotic cervical spine without congenital deformities. Additional reconstructive correction of the cervical spine is only proven appropriate in selected cases.
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Several techniques have been introduced to manage irreducible atlantoaxial dislocation (IAAD). However, no study has reported the surgical method for the management of IAAD caused by odontoid fracture malunion. This study aimed to introduce a surgical method of transoral anterior release, odontoid partial resection, and reduction with sequential posterior fusion for the treatment of IAAD caused by odontoid fracture malunion. We also evaluated the clinical efficacy of this surgery. ⋯ Transoral anterior release, odontoid partial resection, and reduction combined with posterior fusion are effective, reliable, and safe procedures for the treatment of IAAD caused by odontoid fracture malunion.
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The LLIF procedure is a useful stand-alone and adjunct surgical approach for many spinal conditions. One complication of LLIF is subsidence of the interbody graft into the vertebral bodies, resulting in severe pain, impaired arthrodesis and potentially fracture of the body. Low bone density, as measured by T score on DEXA scanning, has also been postulated to increase the risk of subsidence. ⋯ Patients with DEXA T scores less than -1.0 who undergo stand-alone LLIF are at a much higher risk of developing graft subsidence. Further, they are at an increased risk of requiring additional surgery. In patients with poor bone quality, consideration could be made to supplement the LLIF cage with posterior instrumentation.
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Restoring sagittal alignment is an important factor in the treatment of spinal deformities. Recent investigations have determined that releasing the anterior longitudinal ligament (ALL) and placing hyperlordotic cages can increase lordosis, while minimizing need for 3 column osteotomies. The influences of parameters such as cage height and angle have not been determined. Finite element analysis was employed to assess the extent of lordosis achievable after placement of different sized lordotic cages. ⋯ Increased segmental lumbar lordosis is achievable with hyperlordotic cages after ALL resection. Increased cage height tended to increase the amount of lordosis achieved, although in some cases additional posterior bone resection was required to maximize lordosis. Further studies are needed to evaluate the impact on regional lumbar lordosis.