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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Elucidate whether it is preferable to use the reference frame (RF) middle attachment (RFMA) method over the edge of the planned pedicle screw (PS) insertion area for RF placement in the surgery for adolescent idiopathic scoliosis (AIS) with intraoperative computed tomography (CT) navigation. ⋯ The RFMA method in thoracic scoliosis surgery for AIS with intraoperative CT navigation could significantly decrease the number of CT scans and blood loss while maintaining a comparable PS perforation rate to RF placement at the distal end of the planned PS insertion range.
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Review Meta Analysis
Transforaminal lumbar interbody fusion using banana-shaped and straight cages: meta-analysis of clinical and radiological outcomes.
Transforaminal lumbar interbody fusion (TLIF) surgery rate increased over the last decade. There is no consensus about the better shape of cage to use in TLIF. This meta-analysis was conducted to compare the shape focusing on bony union, lordosis restoration as well as perioperative complications. ⋯ Straight-shaped cages had a better restoration of lumbar lordosis, disc height, and a lower subsidence rate when compared to banana-shaped cages. This may be explained by the absence of the optimal placement of the curved cages, which is at the most anterior part of the disc space. Better conducted randomized controlled trial could strengthen these findings.
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Patients with spinal deformities undergoing corrective surgery are at risk for iatrogenic spinal cord injury (SCI) and subsequent neurological deficit. Intraoperative neurophysiological monitoring (IONM) allows early detection of SCI which enables early intervention resulting in a better prognosis. The primary aim of this literature review was to search if there are threshold values of TcMEP and SSEP in the literature that are widely accepted as alert during IONM. The secondary aim was to update knowledge concerning IONM during scoliosis surgery. ⋯ Concerning SSEP, a loss of 50% in amplitude and/or an increase of 10% of latency is widely accepted as an alert. For TcMEP, it seems that the use of highest threshold values can avoid unnecessary surgical procedure for the patient without increasing risk of neurological deficit.