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
-
To evaluate the results of a novel rigid-dynamic stabilization technique in lumbar degenerative segment diseases (DSD), expressly pointing out the preservation of postoperative lumbar lordosis (LL). ⋯ When properly selected, this technique leads to good results. A proper LL should be achieved after any hybrid stabilization to preserve the segment above the fusion.
-
Multicenter Study Observational Study
Maverick total disc replacement in a real-world patient population: a prospective, multicentre, observational study.
Controlled trials have shown that total disc replacement (TDR) can provide pain and disability relief to patients with degenerative disc disease; however, whether these outcomes can also be achieved for patients treated in normal surgical practice has not been well documented. ⋯ This is the first international observational study to report outcomes of TDR in real-world clinical settings. We showed statistically significant improvements in disability and pain scores at 6 months following Maverick TDR, which were maintained for 2 years alongside an acceptable rate of perioperative complications. The safety and tolerability shown in this observational study were comparable to those from controlled trials.
-
Multicenter Study
Sagittal spinopelvic alignment in 654 degenerative spondylolisthesis.
Degenerative spondylolisthesis (DS) is common degenerative spinal disease. Recent studies highlighted relationship between DS and high pelvic incidence (PI). Moreover, impact of spinopelvic alignment on clinical outcomes has been emphasized. We aimed at describing epidemiologic and sagittal spinopelvic parameters in patients with DS, comparing them with asymptomatic volunteers, and determining a classification of DS patients. ⋯ Predominance of high PI and female gender was emphasized in DS population. Moreover, these findings highlighted the importance of sagittal alignment analysis in DS with 24 % of patients with anterior malalignment and in the remaining 76 % (normal C7Tilt), more than 50 % had pelvic retroversion. Consequently, DS sagittal malalignment should lead to specific surgical correction adapted to each subgroup of patients.
-
Multicenter Study
Surgical treatment of sacral chordoma: prognostic variables for local recurrence and overall survival.
Sacral chordomas (SC) are rare, locally invasive, malignant neoplasms. Despite surgical resection and adjuvant therapies, local recurrence (LR) is common and overall survival (OS) is poor. The objective of this study was to identify prognostic factors that have an impact on the local recurrence-free survival (LRFS) and OS of patients with SC. ⋯ This study identified two predictive variables for LRFS (previous tumor surgery and type of surgical resection) and two for OS (age and impaired motor function) in surgically treated SC patients. Our results indicate that en bloc resection reduces LR but does not influence OS. However, this was likely due to short follow-up (3.2 years).
-
Multicenter Study
Sacropelvic fixation in adult spinal deformity (ASD); a very high rate of mechanical failure.
Sacropelvic fixation (SPF) is an integral part of ASD surgery. Literature suggests that combination of S1 and iliac screws may be associated with lowest rate of complications. ⋯ Pelvic fixation is still associated with a very high rate of mechanical failure. Major risk factors appear to be age and type of fixation. Although could not be shown to be statistically significant, failure to restore the optimal sagittal balance may be a contributing factor as well. So in conclusion, in cases with suboptimal sagittal plane correction, S2AI with polyaxial screws seem to have higher risk of short-term acute failure compared to IwL.