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
Is impaired lung function related to spinal deformities in patients with adolescent idiopathic scoliosis? A systematic review and meta-analysis-SOSORT 2019 award paper.
Some teenagers with adolescent idiopathic scoliosis (AIS) display compromised lung function. However, the evidence regarding the relations between pulmonary impairments and various spinal deformity parameters in these patients remains unclear, which affects clinical management. This systematic review and meta-analysis aimed to summarize the associations between various lung function parameters and radiographic features in teenagers with AIS. ⋯ Larger thoracic Cobb angles, greater apical vertebral rotation angle, or hypokyphosis were significantly associated with greater pulmonary impairments in patients with AIS, although the evidence was limited. From a clinical perspective, the results highlight the importance of minimizing the three-dimensional spinal deformity in preserving lung function in these patients. More research is warranted to confirm these results.
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Review Meta Analysis
Radiofrequency ablation is as safe and effective as surgical excision for spinal osteoid osteoma: a systematic review and meta-analysis.
Osteoid osteoma (OO) is a primary benign tumor that affects mainly young patients. Ten percent of all OO are located in the vertebral column. Treatment of spinal OO is challenging and there is no consensus in the literature on the best operative approach. ⋯ This meta-analysis found high global success rates for both surgical and RFA treatments. Both treatments were efficient in pain relief and presented a low rate of recurrences. The complication rate was low for both treatments. Compared to surgical excision, RFA is a less invasive procedure which proved to be a safe and as effective option for the treatment of spinal OO.
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Review Meta Analysis
Bone mineral density in children and young adults with idiopathic scoliosis: a systematic review and meta-analysis.
Osteoporosis is a risk factor for idiopathic scoliosis (IS) progression, but it is still unclear whether IS patients have bone mineral density (BMD) loss and a higher risk of osteoporosis than asymptomatic people. This systematic review aims to explore the differences in BMD and prevalence of osteoporosis between the IS group and the control group. ⋯ Both the male and female IS patients had a generalized lower BMD and an increased prevalence of osteopenia and osteoporosis than the control group. Future research should focus on the validity of quantitative ultrasound in BMD screening. To control the risk of progression in IS patients, regular BMD scans and targeted intervention are necessary for IS patients during clinical practice.
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Review Meta Analysis
Does kyphoplasty affect the global sagittal alignment in patients with osteoporotic vertebral fractures? A systematic review and meta-analysis.
Osteoporotic vertebral compression fractures (OVCF) are common in elderly patients and may cause local kyphosis due to the vertebral collapse and wedging. Balloon kyphoplasty (BKP) with polymethyl methacrylate is widely used to relieve back pain and restore the height and kyphosis of the destroyed vertebra Johnell (Osteoporos Int 17(12):1726-33, 2006); Wasnich (Bone 18: 179S-183S, 1996); Finnern (Osteoporos Int 14:429-436, 2003). However, the influence of BKP on global sagittal alignment (GSA) in patients with OVCF remains unclear. ⋯ Performing BKP procedures does not significantly affect the global sagittal alignment in patients with osteoporotic vertebral compression fractures. There was however, a significant improvement in pain scores in patients undergoing BKP at 1 or more levels.
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Patients undergoing spinal fusion are prone to develop persisting spinal pain that may be related to pre-existent psychological factors. The aim of this review was to summarize the existing evidence about perioperative psychological interventions and to analyze their effect on postoperative pain, disability, and quality of life in adult patients undergoing complex surgery for spinal disorders. Studies investigating any kind of psychological intervention explicitly targeting patients undergoing a surgical fusion on the spine were included. ⋯ The existing evidence suggests that a reduction in pain and disability in the short-term, starting from immediately after surgery to 3 months, is likely to be obtained when a CBT approach is used. However, there is inconclusive evidence regarding the long-term effect of a perioperative psychological intervention after spinal fusion surgery. Further research is necessary to better define the frequency, intensity, and timing of such an approach in relation to the surgical intervention, to be able to maximize its effect and be beneficial to patients.