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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Review Meta Analysis Comparative Study
Comparison of MIS vs. open PLIF/TLIF with regard to clinical improvement, fusion rate, and incidence of major complication: a meta-analysis.
Meta-analysis was conducted to estimate whether MiTLIF could reduce the complication rate while maintaining the similar clinical result to that of open procedures. ⋯ Fusion rate and complication rate for both open and MiTLIF were similar. Moreover, the MiTLIF group tended to have a higher revision/readmission rate, which might be associated with the deep learning curve. Therefore, to achieve the level of surgical skill required of an MiTLIF surgeon, many years of training and experience are necessary. Otherwise, MiTLIF may yield unsatisfactory result upon patients.
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Septic cervical facet joints arthritis is a rare pathology, usually revealed by fever and neck pain. As symptoms may be indolent, a high index of suspicion needs to be maintained. Magnetic resonance imaging (MRI) is effective for early diagnostic, looking for local spread and guiding potential preoperative planning. We present a case exhibiting an uncommon pathology with possible significant morbidity if misdiagnosed. ⋯ Atlantoaxial septic arthritis is an under reported and severe infection. Early use of MRI should avoid delayed diagnosis and would guide the practitioner in choosing an appropriate therapy. Early surgical treatment for uncontrolled sepsis is also a critical element of the prognosis.
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Comparative Study
Fusion in degenerative spondylolisthesis: comparison of osteoconductive and osteoinductive bone graft substitutes.
The emergent widespread options of bone graft substitutes for spinal fusion procedures vary in their osteobiologic activity. A majority of current literature focuses on the comparison of osteoinductive (OI) or osteoconductive (OC) bone graft substitutes individually against ICBG. These studies have demonstrated the legitimacy of bone graft substitutes, but despite the widespread use in spinal fusion procedures there is a dearth in the current literature in the direct comparison of OC and OI substitutes. This retrospective comparative analysis compares the efficacy of OI vs. solely OC agents in producing radiographic fusion on patients with DS. ⋯ With the vastly growing market for OI and OC materials commonly used in lumbar spinal fusions, the options for surgical treatment for degenerative spondylolisthesis are ever expanding. No significant difference was found when comparing fusion rates between the two types of materials in this retrospective analysis. Interestingly, TLIF procedures provided lower fusion rates than posterolateral fusion procedures. This may be due to a small sample size but the association with a minimally invasive technique warrants investigation. Due to the substantial difference in price between the OI and OC materials and the lack of evidence supporting higher fusion rates with more expensive OI agents, it is incumbent on the spine community to consider and reassess the products that are routinely used.
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Review Meta Analysis
Effects of transplantation of olfactory ensheathing cells in chronic spinal cord injury: a systematic review and meta-analysis.
The debate on the effects and outcome of olfactory ensheathing cell (OEC) transplantation for the treatment of spinal cord injury (SCI) has remained unresolved for nearly 20 years. This study aimed to evaluate the safety and efficacy of OEC transplantation in chronic SCI patients. ⋯ Given the results from our study, we conclude that OEC transplantation appears to be safe, although the evidence for efficacy is modest and requires the support of prospective, randomized trials in larger cohorts of patients. Further randomized controlled trials utilizing strict therapy programs and implanted cell selections are needed to confirm these findings.
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Multicenter Study
Surgical treatment of sacral chordoma: prognostic variables for local recurrence and overall survival.
Sacral chordomas (SC) are rare, locally invasive, malignant neoplasms. Despite surgical resection and adjuvant therapies, local recurrence (LR) is common and overall survival (OS) is poor. The objective of this study was to identify prognostic factors that have an impact on the local recurrence-free survival (LRFS) and OS of patients with SC. ⋯ This study identified two predictive variables for LRFS (previous tumor surgery and type of surgical resection) and two for OS (age and impaired motor function) in surgically treated SC patients. Our results indicate that en bloc resection reduces LR but does not influence OS. However, this was likely due to short follow-up (3.2 years).