Spine
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Reliability analysis based on expert panel case series review and grading per the Enneking and Weinstein-Boriani-Biagini classification systems. ⋯ Results indicate moderate interobserver reliability and substantial and near-perfect intraobserver reliability for both the Enneking and WBB classification in terms of staging and guidance for treatment, despite a less than moderate interobserver reliability in interpreting the Enneking local tumor extension and WBB sector. Before incorporating the classifications in the clinical practice and research studies, further work is required to investigate the validity of the classifications.
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Case Reports
Vascular complications from anterior spine surgery in three patients with Ehlers-Danlos syndrome.
A case report of vascular complications arising from anterior spine surgery in 3 patients with Ehlers-Danlos syndrome (EDS). ⋯ These complications may be explained by the fragility of blood vessels secondary to the collagen defect in EDS. Though methods exist to decrease these complications, they may not be enough to prevent catastrophic bleeding. For EDS patients, risk of vascular complications during anterior surgery of the spine is high and surgeons should be aware of this when developing a surgical plan.
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Comparative Study
Four-year incidence of sick leave because of neck and shoulder pain and its association with work and lifestyle.
Four-year prospective cohort study. ⋯ The incidence of NSP based on sick leave is definitely very low compared with previous studies in high-income countries. This incidence varies between participants and nonparticipants. Risk factors for sick leave differ from risk factors for self-reported pain. A young population, job security, the insurance system, different health behaviors, and healthy worker bias, are all factors that may affect the results, and sick-leave as an outcome must be interpreted with more caution in middle- and low-income countries.
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A prospective analysis. ⋯ In our study the first clinical assessment of a new bone mounted robot system guiding percutaneous pedicle screw placement was done. A deviation <2 mm to the surgeon 's plan in 91.0% to 98.5% verifies the system's accuracy.
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In vitro human cadaveric biomechanical study. ⋯ Our results suggest that C2 intralaminar fixation provides a viable alternative to pedicle screws and is superior to pars instrumentation in cases with preserved atlantoaxial ligamentous attachments. In the presence of a traumatic dens fracture, however, intralaminar fixation may not be the optimal choice.