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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To investigate the effectiveness and safety of separation surgery for Epidural Spinal Cord Compression (ESCC) graded ≥ 2 in patients with Multiple Myeloma (MM), analyze factors influencing surgical outcomes, and develop a preliminary treatment decision framework for these patients. ⋯ Separation surgery effectively alleviates pain, improves neurological function, and enhances the quality of life in patients with ESCC graded ≥ 2 due to MM.
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Comparative Study Observational Study
Fusion versus decompression alone for lumbar degenerative spondylolisthesis and spinal stenosis: a target trial emulation with index trial benchmarking.
The value of adding fusion to decompression surgery for lumbar degenerative spondylolisthesis and spinal canal stenosis remains debated. Therefore, the comparative effectiveness and selected healthcare resource utilization of patients undergoing decompression with or without fusion surgery at 3 years follow-up was assessed. ⋯ Decompression alone should be considered the primary option for patients with lumbar degenerative spondylolisthesis and spinal stenosis.
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Radiation-free systems based on dorsal surface topography can potentially represent an alternative to radiographic examination for early screening of scoliosis, based on the ability of recognizing the presence of deformity or classifying its severity. This study aims to assess the effectiveness of a deep learning model based on convolutional neural networks in directly predicting the Cobb angle from rasterstereographic images of the back surface in subjects with adolescent idiopathic scoliosis. ⋯ Despite some improvement over previous approaches that relied on spine shape reconstruction, the performance of the present fully automatic application is below that of radiographic evaluation performed by human operators. The study confirms that rasterstereography cannot be considered a valid non-invasive alternative to radiographic examination for clinical purposes.
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Deep learning (DL) algorithms can be used for automated analysis of medical imaging. The aim of this study was to assess the accuracy of an innovative, fully automated DL algorithm for analysis of sagittal balance in adult spinal deformity (ASD). ⋯ This is the first study evaluating a complete automated DL algorithm for analysis of sagittal balance with high accuracy for all evaluated parameters. The excellent accuracy in the challenging pathology of ASD with long construct instrumentation demonstrates the eligibility and possibility for implementation in clinical routine.
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Recently, enhanced recovery after surgery (ERAS) protocols have attracted attention; they emphasize on avoiding intraoperative hypothermia while performing lumbar fusion surgery. However, none of the studies have reported the protocol for determining the temperature of saline irrigation during biportal endoscopic spine surgery (BESS) procedure. This study evaluated the effectiveness of warm saline irrigation during BESS in acute postoperative pain and inflammatory reactions. ⋯ Using warm saline irrigation during BESS is beneficial for early recovery after surgery, as it is associated with reduced postoperative pain and complication rates.