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
-
Previous studies have shown that the posterior elements/facet joints provide strength to the overall functional spine unit (FSU) by taking 3-25% of vertical compressive load off the intervertebral disc (IVD). However, little is known regarding whether this offloading has a protective effect against endplate fracture. Therefore, the purpose of this study was to investigate if the posterior elements provide a protective role to the endplate in porcine cervical spines under fracture-inducing conditions. ⋯ In contrast, significantly, more cut FSUs sustained an endplate fracture (11/11) compared to intact FSUs (5/11); p = 0.012. Further, cut FSUs resulted in a fracture area 1.91 times greater in size compared to the fractures seen in the intact FSUs (p = 0.011). Therefore, posterior elements appear to decrease the risk and severity of endplate fracture.
-
Randomized Controlled Trial Multicenter Study
ProDisc-C versus anterior cervical discectomy and fusion for the surgical treatment of symptomatic cervical disc disease: two-year outcomes of Asian prospective randomized controlled multicentre study.
Our study aimed to evaluate non-inferiority of ProDisc-C to anterior cervical discectomy and fusion (ACDF) in terms of clinical outcomes and incidence of adjacent segment disease (ASD) at 24-months post-surgery in Asian patients with symptomatic cervical disc disease (SCDD). ⋯ Cervical TDR with ProDisc-C is feasible, safe, and effective for treatment of SCDD in Asians. No clear non-inferiority was demonstrated between ProDisc-C and ACDF. However, patients treated with ProDisc-C demonstrated significant improvement in NDI, neurologic success, pain scores, and 36-item-short-form survey, along with ROM preservation at 24-months. Enrolment difficulties resulted in inability to achieve pre-planned sample size to prove non-inferiority. Future Asian-focused, large-scale studies are needed to establish unbiased efficacy of ProDisc-C to ACDF.
-
Randomized Controlled Trial
Local vancomycin therapy to reduce surgical site infection in adult spine surgery: a randomized prospective study.
This prospective randomized controlled trial hypothesizes that intra wound vancomycin reduces postoperative infection. ⋯ Intra-wound vancomycin has no effect on SSI; in addition, it can increase the rate of gram-negative infections.
-
Randomized Controlled Trial
Efficacy of erector spinae plane block on postoperative pain in patients undergoing lumbar spine surgery.
Major lumbar spine surgery causes severe pain in the postoperative period. There are few studies regarding the effect of erector spinae plane block (ESPB) effect on lumbar surgery and its effect is still controversial. Therefore, the study aimed to investigate the effect of ultrasound-guided low thoracic ESPB on opioid consumption and postoperative pain score. ⋯ ESPB is adequate for postoperative analgesia in patients undergoing lumbar spine surgery and can reduce opioid consumption compared with standard analgesia.
-
Randomized Controlled Trial
The influence of topical use of tranexamic acid in reducing blood loss on early operation for thoracolumbar burst fracture: a randomized double-blinded controlled study.
To investigate the safety and efficacy of topical use of tranexamic acid (TXA) on early operation for thoracolumbar burst fracture (TBF). ⋯ This RCT first demonstrated that topical TXA usage after wound incision could effectively reduce IBL without increasing risk of complications, beneficial to enhanced recovery after early operation for TBF.