The spine journal : official journal of the North American Spine Society
-
Although stand-alone cages were advocated to be superior to plate-cage construct (PCC) because of comparable clinical outcomes and fewer plate-related complications, cage dislocation and subsidence were frequently mentioned in multilevel fusion. There are some concerns about whether these issues can be effectively prevented in multilevel anterior cervical discectomy and fusion (ACDF) by stand-alone anchored spacer (SAAS). ⋯ In the surgical treatment of three-level CSM, PCC is superior to SAAS in correction and maintenance of SA and avoiding cage subsidence, although the technique of ACDF with SAAS yielded encouraging clinical outcomes and high fusion rate.
-
Revision adult spinal deformity surgery (RASDS) is a particularly high-risk intervention. ⋯ Perioperative complication rate associated with RASDS is lower when patients are treated by high-volume surgeons at high-volume centers. As complex cases requiring osteotomy and combined approaches are more frequent at high-volume centers, an operative complexity index helps predict the likelihood of volume-dependent complication rates. Future interhospital and intersurgeon comparisons should account for these case characteristics so that similar case complexity is compared in these analyses.
-
Although there have been several reports describing the radiologic and clinical outcomes of pedicle subtraction osteotomy (PSO) in ankylosing spondylitis (AS) with spinal kyphotic deformity, little is known about the digestive function improvement in AS kyphosis after PSO. ⋯ The single-level or two-level PSO is an effective and safe technique to correct AS kyphosis. And the conditions of extrusion of viscera by trunk flexion decreased volume of the abdominal cavity, and abnormal visceral positions were improved by the osteotomy, followed with digestive function improvement.
-
Lumbar degenerative spondylolisthesis (LDS) is often diagnosed by conventional supine magnetic resonance imaging (MRI). Numerous studies have shown, however, that the degree of spondylolisthesis can be reduced or disappears when the patient is supine as compared with standing lateral and flexion-extension (SLFE) radiographs. ⋯ This study found that MRI had a sensitivity of 78% for detecting L4-L5 LDS compared with 98% for lateral standing films. We also identified facet effusion size as a marker to predict mobile LDS. These findings suggest that, particularly in the setting of facet effusions, the complete workup of patients in whom LDS is possible should include standing radiographs.
-
Pedicle subtraction osteotomy (PSO) is the most commonly recommended technique for the correction of local post-traumatic thoracolumbar deformity; however, the surgical results are not always satisfactory because the possibly damaged upper disc is preserved, and all the posterior elements are resected. ⋯ The modified PSO provides an alternative method with which to correct kyphotic deformity in patients with post-traumatic thoracolumbar kyphosis.