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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Surgical approaches to pathologies of the L5 vertebra constitute a significant challenge. Our aim was to review the efficacy and safety of the surgical approaches to L5 corpectomy and reconstruction across the range of presenting pathology. ⋯ Where there is clinical and circumstantial equipoise regarding the choice of surgical approaches for a L5 corpectomy, this review indicates a reported mean blood loss of 2265 ml (400-4700 ml), high fusion rates (94%) and relatively low complication rates (11.7%). It is difficult to make direct comparisons between approaches due to small case series, the variability in primary pathology, clinical intent and surgeon experience.
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Surgical approaches to pathologies of the L5 vertebra constitute a significant challenge. Our aim was to review the efficacy and safety of the surgical approaches to L5 corpectomy and reconstruction across the range of presenting pathology. ⋯ Where there is clinical and circumstantial equipoise regarding the choice of surgical approaches for a L5 corpectomy, this review indicates a reported mean blood loss of 2265 ml (400-4700 ml), high fusion rates (94%) and relatively low complication rates (11.7%). It is difficult to make direct comparisons between approaches due to small case series, the variability in primary pathology, clinical intent and surgeon experience.
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Surgery with radiation therapy (RT) is more effective in treating spinal metastases, than RT alone. However, RT when administered in close proximity to surgery may predispose to wound complications. There exist limited guidelines on the optimal timing between RT and surgery. The purpose of this systematic review is to: (1) address whether pre-operative RT (preop-RT) and/or post-operative RT (postop-RT) is associated with wound complications and (2) define the safe interval between RT and surgery or vice versa. ⋯ Evidence is insufficient to draw definitive conclusion about optimal RT-surgery interval. However, based on published literature and expert opinions, we conclude that an interval of 2 weeks, the minimum being 7 days, is optimum between RT-surgery or vice versa; this can be reduced further by postop-stereotactic body RT. If RT-surgery window is > 12 months, wound-complications rise. Postop-RT has fewer wound complications versus preop-RT.
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Surgery with radiation therapy (RT) is more effective in treating spinal metastases, than RT alone. However, RT when administered in close proximity to surgery may predispose to wound complications. There exist limited guidelines on the optimal timing between RT and surgery. The purpose of this systematic review is to: (1) address whether pre-operative RT (preop-RT) and/or post-operative RT (postop-RT) is associated with wound complications and (2) define the safe interval between RT and surgery or vice versa. ⋯ Evidence is insufficient to draw definitive conclusion about optimal RT-surgery interval. However, based on published literature and expert opinions, we conclude that an interval of 2 weeks, the minimum being 7 days, is optimum between RT-surgery or vice versa; this can be reduced further by postop-stereotactic body RT. If RT-surgery window is > 12 months, wound-complications rise. Postop-RT has fewer wound complications versus preop-RT.
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With the population aging, there is an associated rise in the prevalence of adult degenerative scoliosis (ADS). However, limited data were found to elaborate the trend of ADS research. Our study aims to investigate the global trend of ADS research in this decade. ⋯ Literature growth in ADS was rapidly expanding in this decade. The USA was the most productive country and also had a largest quantity of top authors and institutes, so that scholars can keep following and cooperated with. Radiological parameter was an emerging topic and might also be a hot spot in the near future.