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 Historical Article
The relevance of the Hippocratic Oath to the ethical and moral values of contemporary medicine. Part I: The Hippocratic Oath from antiquity to modern times.
The present paper discusses the relevance and significance of the Hippocratic Oath to contemporary medical ethical and moral values. It attempts to answer the questions about some controversial issues related to the Oath. The text is divided in two parts. ⋯ Finally, it discusses the endurance of the ethical values of the Hippocratic Oath over the centuries until today with respect to the physicians' commitment to the practice of patient-oriented medicine. Part I concludes with the Oath's historic input in the Judgment delivered at the close of the Nuremberg "Doctors' Trial"; this Judgement has become legally binding for the discipline in the Western World and was the basis of the Nuremberg Code. The ethical code of the Oath turned out to be a fundamental part of western law not only on medical ethics but also on patients' rights regarding research.
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Review Case Reports
Denosumab: a potential treatment option for aneurysmal bone cyst of the atlas.
Aneurysmal bone cysts (ABCs) of spine are conventionally treated with en-bloc resection or intralesional excision/curettage and reconstruction or filling of defects with bone cement. For the treatment of upper cervical ABCs, en-bloc resections are often not desirable considering the risk/benefit ratio while the risk of recurrence after intralesional excision is high. Hence, alternative management options are often necessary. We describe our clinical experience with one such treatment alternative-denosumab for the treatment of ABC of Atlas. ⋯ Our case report contributes to the accruing evidence on the effectiveness of denosumab for the treatment of spinal ABCs. However, long-term safety, risk of recurrence, optimal duration of treatment and consistency of denosumab are yet to be determined.
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The primary objective of this systematic review is to compare the outcome after decompression with and without concomitant instrumented fusion in patients with lumbar stenosis and degenerative spondylolisthesis. Does adding fusion to simple decompression lead to better results? ⋯ Currently there is not enough evidence that adding instrumented fusion to a decompression leads to superior outcomes compared to decompression only in patients with lumbar stenosis and degenerative spondylolisthesis. The most important clinical outcome measures, including the ODI, show comparable results. Therefore, the least invasive and least costly procedure, being decompression alone, is preferred in patients with low-grade spondylolisthesis with predominant leg pain. These slides can be retrieved under Electronic Supplementary Material.
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Review Case Reports
The etiology of congenital scoliosis: genetic vs. environmental-a report of three monozygotic twin cases.
To describe the presence of congenital scoliosis in a genetically identical population as it relates to the possible genetic vs. environmental etiologic factors. ⋯ The variable presentation of congenital scoliosis in a genetically unique population serves as testament to the complexity associated with its development, likely involving both environmental factors and a genetic predisposition.
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Bilateral hypoglossal palsy is a rare complication during airway management in surgery. ⋯ We aim to create awareness about this complication which has a significant morbidity and negative effect on patient outcomes.