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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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.
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Lateral access lumbar interbody fusion (LLIF) is a minimally invasive technique that has an increasing popularity. It offers unique advantages and circumvents risk of certain serious complications encountered in other conventional spinal approaches. This study provides a statistical analysis defining the lateral access learning curve in the Asian population. ⋯ During the learning process, there was no compromise of perioperative or clinical outcomes. It should be feasibly incorporated into a spine surgeon's repertoire of procedures for the lumbar spine.
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This study evaluated the risk factors of new vertebral compression fractures (VCFs) following percutaneous vertebroplasty (PVP). ⋯ The incidence of new symptomatic VCFs after PVP was higher in osteoporotic patients with initial multiple-level fractures.
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Conventional lumbar arthrodesis for the treatment of degenerative spondylolisthesis (DS) is associated with high complication rates and variable clinical efficacy. Modern minimally invasive (MIS) approaches may reduce the morbidity and produce greater clinical improvement compared to traditional surgical techniques. The objective of this study is to report radiographic outcomes and evaluate clinical improvements in the context of substantial clinical benefit for DS patients treated with a MIS 90° lateral, transpsoas approach for lumbar interbody fusion. ⋯ MIS lateral interbody fusion in the treatment of DS resulted in significant improvements in clinical and radiographic outcomes, with a low complication rate and a high proportion of patients achieving substantial clinical benefit.
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Comparative Study
In vitro comparison of endplate preparation between four mini-open interbody fusion approaches.
Discectomy and endplate preparation are important steps in interbody fusion for ensuring sufficient arthrodesis. While modern less-invasive approaches for lumbar interbody fusion have gained in popularity, concerns exist regarding their ability to allow for adequate disc space and endplate preparation. Thus, the purpose of this study was to quantitatively and qualitatively evaluate and compare disc space and endplate preparation achieved with four less-invasive approaches for lumbar interbody fusion in cadaveric spines. ⋯ These results demonstrate that adequate endplate preparation for interbody fusion can be achieved utilizing various minimally invasive approach techniques (mini-ALIF, MAS TLIF, MAS PLIF, XLIF), however, XLIF appears to provide a greater area of and more complete endplate preparation.