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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Multicenter Study
Is MAGEC X better than earlier designs of magnetically controlled growing rod: an explant study.
Determine the performance of MAGEC X rods through retrieval analysis and comparison with clinical data. ⋯ Despite the substantial design changes with MAGEC X tissue metallosis was seen in most cases; most explanted MAGEC X rods had lengthened only partially and produced no force output. While the previous issue of locking pin fracture appears to have been mitigated with MAGEC X, there are multiple other and new failure modes, such as endcap separation. Overall MAGEC X appears to give little improvement over earlier iterations of the rod.
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Comparative Study
Comparison of clinical and radiographic outcomes in unilateral transforaminal lumbar interbody fusion: a retrospective analysis of three surgical approaches.
The primary objective of this study is to evaluate and compare the clinical and radiographic outcomes of the combined spinous process-splitting approach with a Wiltse (SPSW) approach, the combined conventional approach with a Wiltse (CW) approach, and the conventional open (CO) approach in unilateral transforaminal lumbar interbody fusion (TLIF). ⋯ All the SPSW, CW, and CO approach TLIF procedures achieved overall satisfactory effects of decompression and fusion for lumbar degenerative diseases. The SPSW approach procedure appears to be associated with the smallest surgical trauma and highest satisfaction because of reducing iatrogenic injury of the paraspinal muscles.
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Degenerative spine disease (DSD) is increasingly prevalent due to aging populations, leading to higher surgical interventions and associated complications. This necessitates a comprehensive preoperative assessment, evaluating frailty through tools such as the modified Frailty Index 5 and modified Frailty Index 11 (mFI-5 and mFI-11). Despite the utility of mFI-5 and mFI-11 in predicting postoperative complications, these indices do not account for sarcopenia, a syndrome related to but distinct from frailty, which is associated with higher complication rates. This paper aims to retrospectively evaluate the influence of sarcopenia and frailty on postoperative adverse events in a cohort of patients who underwent posterior spine fusion for degenerative disease of the lumbar spine. ⋯ Frailty is a robust predictor of postoperative complications in DSD surgeries, while sarcopenia, appears to play a lesser role. The findings suggest that frailty alone provide a more comprehensive assessment of risk than sarcopenia.
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The demand for SIJ fusion among obese patients has grown substantially. However, the clinical relevance of obesity in the context of SI joint fusion has not been well investigated specifically, whether there is a BMI cutoff above which the benefit-risk ratio is low. ⋯ This study demonstrates similar benefits across all BMI categories. This data suggests that obese patients do benefit from minimally invasive SIJ fusion, specifically the 35-40 BMI cohort of patients, and should not be denied this procedure based on arbitrary healthcare organizations BMI criteria.
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In the present study, we aimed to analyze whether the Charlson Comorbidity Index (CCI) score was predictive for pseudoarthrosis in patients who underwent with short-segment lumbar decompression and fusion for degenerative lumbar spine disorders (DSD). ⋯ A combined effect of comorbidities might yield higher pseudoarthrosis rates following short-segment decompression and fusion for DSD. Each one-point increment in CCI score and SFI score yielded a 26% increment and a 73% decrement in risk for pseudoarthrosis in those subjects. A cut-off value of 2.5 points for the CCI score could distinguish the subjects who might have pseudoarthrosis following short-segment surgery for DSD.