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
-
Review Meta Analysis
The impact of odontoid screw fixation techniques on screw-related complications and fusion rates: a systematic review and meta-analysis.
The primary goal of this study was to conduct a systematic review and meta-analysis of articles focused on odontoid screw fixation (OSF) and screw-related complications or non-union rates. ⋯ The initial selection consisted of 683 abstracts. A total of 150 full texts were chosen for detailed study, and 83 articles were included in the analysis. The point estimates for screw-related complications were as follows: 1. screw malposition frequency-4.8%; 2. screw cut-out rate-5.0%; 3. screw loosening/pull-out-3.8%; and 4. screw fracture rate-3.1%. The point estimate for the non-union rate was 9.7%. Statistical analysis of the screw-related complications rate based on surgical technique details was also performed CONCLUSIONS: Double-screw OSF performance in elder patients resulted in a higher risk of post-operative screw cut-out. In other cases, the development of screw-related complications did not depend on the method of intraoperative head fixation, selection of the implant entry point for OSF, type of the used screws, or cannulated instruments application. The outcomes of single-screw fixation through the anterior lip of the C2 vertebra were comparable to other techniques of OSF. Further, statistically reliable studies should be carried out to identify the optimal technique of OSF.
-
Review Meta Analysis
3D-printed navigation template in cervical spine fusion: a systematic review and meta-analysis.
To explore the effectiveness and advantage of three-dimensional (3D)-printed navigation templates (3DPN-template) assisted in cervical spine fusion (CSF) surgery as compared to conventional surgery. ⋯ The 3D-printed navigation template in the cervical surgery can improve accuracy of pedicle screw placement and consequently improve outcomes. In future, multi-center efforts are needed to validate the relationships found in this review.
-
Separation of C2 growth plates and dens fractures are the most common types of injuries to the axis (C2) in children. Operative treatment of these injuries with the use of direct osteosynthesis requires a profound knowledge of detailed anatomy and dimensions of the axis. The main issue addressed by the study was the age at which the size of the dens is adequate at all levels to accommodate two screws, and the size of the posterior dens angulation angle (PDAA) in a healthy child in individual age periods. ⋯ During growth, there occur changes in PDAA that should be respected in evaluation of transformation of anterior into posterior angulation, as shown by imaging methods. Dens dimensions theoretically allow insertion of two 3.5 mm screws as early as from the age of 1 year.
-
The management of cervical facet dislocation injuries remains controversial. The main purpose of this investigation was to identify whether a surgeon's geographic location or years in practice influences their preferred management of traumatic cervical facet dislocation injuries. ⋯ More than half of responders, regardless of geographical location or practice experience, identified MRI as a screening imaging modality when managing cervical facet dislocation injuries, regardless of the status of the spinal cord and prior to any additional intervention. Additionally, a majority of surgeons would elect an anterior approach for the surgical management of these injuries. The study found overall agreement in management preferences of cervical facet dislocation injuries around the globe.
-
To compare transoral and endoscopic transnasal anterior release without odontoidectomy and posterior reduction and fixation to treat irreducible atlantoaxial dislocation (IAAD). ⋯ The transoral and endoscopic transnasal approaches can achieve equivalent release and reduction effects when treating IAAD. Compared to the transoral approach, the endoscopic transnasal route is less invasive with earlier extubation and oral intake, shorter hospital/ICU stays and lower medical costs, which is conducive to enhanced recovery after surgery.