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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It has been shown that pedicle screw instrumentation in the cervical spine has superior biomechanical pullout strength and stability. However, due to the complex and variable anatomy of the cervical pedicles and the risk of catastrophic complications, cervical pedicle screw placement is not widely utilized. ⋯ This study indicates that robotic-guided cervical pedicle screw placement is feasible and safe. The medial breaches did not result in any clinical consequences.
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Intradiscal vacuum phenomenon (IDVP), despite being ubiquitous, is poorly understood. The dynamic passage of peri-discal gases into the degenerated disc is a commonly accepted theory. But the reasons behind its selective appearance in some discs are unevaluated. ⋯ Modic disc-endplate contacts, ALL disruption and coronal translation could be pathways for the passage of peri-discal gases into the degenerated disc. In the pathogenesis of IDVP, advanced disc degeneration, the presence of pathways of gas transfer and angular/coronal instability seem to play complementary roles.
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The aim of this study was to assess the validity and objectivity of a new quantitative radiographic grading system for thoracic intervertebral disc degeneration. ⋯ The new quantitative radiographic grading scheme represents a valid, reliable, and almost objective method for assessing the degree of degeneration of individual thoracic intervertebral discs. Potential effects of interindividual variations and the radiographic superimposition of anatomical structures represent a limitation of this method should be taken into account when using the grading system for clinical and experimental purposes, especially with regard to specific morphological as well as patient- and donor-specific characteristics.
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This retrospective matched case-control study was conducted to compare two CT based surgery techniques for navigated screw placement in spinal surgery, whether a reduction of radiation exposure and surgery time could be achieved. ⋯ The results show that spinal navigation using an intraoperative CT with automatic registration compared to a preoperative CT and intraoperative manual surface registration, allows a significant reduction of radiation exposure, without prolonged surgery time. A significant benefit regarding cut-to-suture-time can be gained with surgeries of a larger scale.