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
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This study aimed at determining the variables that may prove useful in predicting clinical outcomes following lumbar disc arthroplasty. ⋯ Several variables may prove effective at optimizing clinical outcomes including a preoperative disc height <8 mm, Modic type 2 changes adjacent to the target disc, a low amount of lordosis present at the treatment level, low levels of fatty replacement of the paraspinal musculature, a prominent amount of facet joint or disc degeneration, and the presence of flat or convex vertebral endplates. There were also post-operative findings associated with better patient outcomes including a larger percent of the endplate covered with the implant, larger implant heights, greater increases in disc space heights, and a larger increase in index level lumbar lordosis. These variables could be explored in other clinical studies to facilitate meta-analyses that could identify effective strategies to optimize clinical outcomes with lumbar disc arthroplasty.
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Review Meta Analysis
Low back pain in children and adolescents: a systematic review and meta-analysis evaluating the effectiveness of conservative interventions.
To identify and evaluate the effectiveness of conservative treatment approaches used in children and adolescents to manage and prevent low back pain (LBP). ⋯ While exercise interventions appear to be promising to treat LBP in children and adolescents, there is a dearth of research data relevant to paediatric populations. Future studies conducted in children and adolescents with LBP should incorporate what has been learnt from adult LBP research and be of rigorous methodological quality.
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Multicenter Study Clinical Trial
Stand-alone ALIF with integrated intracorporeal anchoring plates in the treatment of degenerative lumbar disc disease: a prospective study on 65 cases.
ALIF with cages is expected to restore disc height and stabilize the spine promoting fusion, while avoiding damage attributed to rod-pedicle screw fixation. However, it may be related to an increased risk of fusion failure and subsidence. A prospective study was conducted by five investigators across three centers to confirm performance of a PEEK cage for stand-alone ALIF in the treatment of lumbar degenerative disc disease (DDD). ⋯ Safety and efficacy of this stand-alone cage with integrated intracorporeal plates was confirmed through 12 months for treatment of degenerative conditions. The design of the cage and plates may contribute to the decreased subsidence rate observed.
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Review Case Reports
Pedicle subtraction osteotomy for the treatment of chin-on-chest deformity in a post-radiotherapy dropped head syndrome: a case report and review of literature.
Chin-on-chest deformity is a rare and severe condition mostly related with ankylosing spondylitis, traumas and/or cervical spine surgery. We present a case of 69 years old woman with a rare form of chin-on-chest secondary to dropped head syndrome (DHS), developed after radiotherapy for Hodgkin disease. In addition, we reviewed the few publications about this specific condition; management and surgical treatment of DHS are discussed. ⋯ DHS is a very rare post-radiotherapy complication; there is lack of evidences in literature about its management. The only definitive treatment seems to be surgical intervention. PSO is a valid therapeutic option when fixed chin-on-chest deformity occurs; although it is a demanding technique and it presents high rate of complications, the actual neurological monitoring methods provide more intraoperative safety.
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Review Comparative Study
Revision surgery after PSO failure with rod breakage: a comparison of different techniques.
Author experience and literature review. ⋯ The efficacy of PSO should be balanced with the high risk of the procedure reported in the literature. Management of revision surgery after PSO may require the addition of anterior column support to maintain correction and reduce complications.