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
-
To (1) clarify the role of various risk factors in the development of ASD, (2) compare instrumentation configuration with the development of ASD, (3) correlate the radiological incidence of ASD and its clinical outcome and (4) compare the clinical outcome between patients with radiological evidence of ASD and without ASD. ⋯ Patients with preoperative disc degeneration at an adjacent segment were more at risk for the development of ASD. Other risk factors including instrumentation configuration were not significantly associated with ASD. There was no correlation between both the radiological development of ASD and its clinical outcome and the clinical outcome of patients with and without ASD.
-
To investigate: (1) the risk factors for radiologic cranial adjacent segment degeneration (ASD) after single-segment PLIF at the same level, and (2) the impact of the ASD on the clinical outcomes. ⋯ Radiologic degeneration of the cranial adjacent segment after single-segment PLIF did not significantly correlate with clinical outcomes. Age was a risk factor for radiologic degeneration, however, there was no significant correlation between degeneration and preoperative radiologic factors and bone mineral density (BMD).
-
There are few prospective studies on surgical outcomes and survival in patients with metastatic disease to the spine. The magnitude and duration of effect of surgery on pain relief and quality of life remains uncertain. Therefore, the aim of this clinical study was to prospectively evaluate clinical, functional, quality of life and survival outcomes after palliative surgery for vertebral metastases. ⋯ The potential for immediate and prolonged improvement in pain, function and quality of life in patients with symptomatic vertebral metastases should be considered during the decision-making process when selecting and counselling patients for surgery.
-
Novel and better vertebral body replacement constructs are always desired by surgeons. Endplate geometry is crucial for the design of those implants, but current literature on that topic is very scarce. The authors present a morphometric study of thoracolumbar vertebral endplates, the goal of which was to analyze the geometry of endplates from T10 inferior to L3 superior by employing data from CT scans, as well as to verify the reliability of data derived from the CT measurement. ⋯ The mean difference between CT and cadaveric measurements was small (Cronbach alpha > 0.8). Those morphologic parameters, especially the concavity of endplates, should be taken into consideration when designing novel vertebral body replacement constructs. CT measurement data could be used to calculate most suitable geometric parameters of those implants.
-
Odontoid diameter in some individuals may not be large enough to accommodate two 3.5-mm cortical screws for anterior odontoid fracture fixation. The study was performed to evaluate, in a Brazilian population, the diameter of the odontoid process and the feasibility of using two 3.5-mm cortical screws for anterior odontoid fracture fixation. ⋯ The insertion of two 3.5-mm cortical screws was possible for anterior fixation of odontoid fracture in 57 (65%) individuals of our study, and there was no statistical difference between males and females.