Spine
-
Review Comparative Study
Do lumbar motion preserving devices reduce the risk of adjacent segment pathology compared with fusion surgery? A systematic review.
A systematic review of the literature. ⋯ 1. Evidence demonstrates that the risk of clinical ASP requiring surgery is likely greater after fusion but the risk is still quite rare. The increased risk compared to TDR could be as small as less than 1% or as great as 10%. Strength of Statement: Weak. 2. There is insufficient evidence to make a definitive statement regarding fusion versus other motion-sparing devices with respect to the risk of ASP.
-
Systematic review. ⋯ 1. Operative management for lumbar ASP should be considered after failure of nonoperative management of ASP. Strength of Statement: Weak. 2. When considering the type of operative treatment for the treatment of lumbar ASP, clinical judgment, radiographical appearance, and patient preference should guide operative intervention. Strength of Statement: Weak. 3. Although the level of evidence for the outcomes of the treatment of lumbar ASP is weak, there does seem to be some benefit from the surgical treatment of lumbar ASP. Thus, if the patient's disability secondary to lumbar ASP is high enough, consideration should be given to operative treatment. Strength of Statement: Weak.
-
Comparative Study
Real-time and spatial quantification using contrast-enhanced ultrasonography of spinal cord perfusion during experimental spinal cord injury.
Experimental study in male Wistar rats. ⋯ CEU seems reliable for quantifying temporal and spatial changes in spinal cord blood flow. After SCI, bleeding occurs in the spinal cord parenchyma and increases significantly throughout the first hour.
-
Systematic review. ⋯ 1. The risk of developing new symptoms secondary to adjacent segment pathology causing radiculopathy and/or myelopathy after cervical fusion surgery ranges from a cumulative rate of 1.6% to 4.2% per year. Strength of Statement: Strong. 2. The risk of developing adjacent-level symptoms may be increased if disc protrusion, disc degeneration, or cord effacement is present at C5–C6 and/or C6–C7 and if those levels are adjacent to the planned surgical level. Strength of Statement: Strong.
-
A systematic review. ⋯ Systematic reviews were undertaken to understand the classification, risks, risk factors, and treatment of RASP and CASP and to provide consensus statements and clinical recommendations. This article reports the methods used in the reviews.