Spine
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Review
Nonoperative treatment of lumbar spinal stenosis with neurogenic claudication: a systematic review.
Systematic review. ⋯ Moderate- and high-GRADE evidence for nonoperative treatment is lacking and thus prohibiting recommendations to guide clinical practice. Given the expected exponential rise in the prevalence of lumbar spinal stenosis with neurogenic claudication, large high-quality trials are urgently needed.
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A retrospective analysis of patients undergoing spinal deformity correction surgery by the assistance of intraoperative computed tomography (iCT) with or without navigation system. ⋯ The iCT navigation system provides desirable accuracy of posterior spinal instrumentation for patients during surgical correction of spinal deformity without radiation exposure to the medical staff, especially in thoracic spine instrumentation. Meanwhile, the iCT in itself is an effective means of assessing complex instrumentation of the spinal deformity.
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Review Case Reports
Cervical myelopathy after cervical total disc arthroplasty: case report and literature review.
Case report and literature review. ⋯ On the basis of presented cases and other reports, the surgical goals in these patients were prioritized as follows: (1) safe and adequate neurological decompression and (2) establishment and maintenance of cervical sagittal balance. Moreover, a criterion for selecting patients undergoing CTDA needs to be established in order to reduce the occurrence of neurological complications associated with the procedure.
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Randomized Controlled Trial Comparative Study
Direct lateral approach to lumbar fusion is a biomechanically equivalent alternative to the anterior approach: an in vitro study.
A human cadaveric biomechanical study of lumbar mobility before and after fusion and with or without supplemental instrumentation for 5 instrumentation configurations. ⋯ Our data support that the direct lateral approach, when supplemented with bilateral PSF, is a minimally invasive and biomechanically stable alternative to the open, anterior approach to lumbar spine fusion.
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Multicenter Study
Postoperative segmental motion of the unfused spine distal to the fusion in 100 patients with adolescent idiopathic scoliosis.
A cross-sectional study. ⋯ In a group of postoperative patients with adolescent idiopathic scoliosis, evaluation of the distal unfused intervertebral motion showed that preservation of vertebral motion segments allowed greater distribution of functional motion across more levels. With each distal fusion level, motion was significantly increased at the L2-L3, L3-L4, and L4-L5 segmental levels in lateral bending. The relationship between the increased motion and subsequent disc degeneration with a more distal fusion is unknown, but suspected.