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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To report the use of a posterior based 'fusion mass screw' (FMS) as a primary or salvage fixation point in a revision spinal deformity following a previous posterior spinal fusion (PSF). Our experience of this technique in a case report and the clinical and radiological results are reported. ⋯ In this report, we present a novel method of using posterior FMSs to achieve fixation and correction in cases of revision deformity surgery with difficult anatomy. While we feel pedicle screws are the gold standard in deformity correction, knowledge of alternatives such as the FMS can allow surgeons to achieve stable constructs when faced with challenging situations.
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Review Meta Analysis
Mid- to long-term outcomes after cervical disc arthroplasty compared with anterior discectomy and fusion: a systematic review and meta-analysis of randomized controlled trials.
To evaluate the mid- to long-term clinical outcomes after cervical disc arthroplasty (CDA) as compared with anterior cervical discectomy and fusion (ACDF) for the treatment of symptomatic cervical disc disease. ⋯ CDA may result in better mid- to long-term functional recovery and a lower rate of subsequent surgical procedures than ACDF would. A review of the literature showed that only an insufficient number of studies had investigated adjacent segment disease; therefore, it is mandatory that adequate future research should focus in this direction.
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Review Case Reports
A novel case of "ambulatory" cervical spondyloptosis: case report with literature review.
Cervical spondyloptosis is an extreme variant of cervical spinal injury where patients usually present with disabling neurological deficits. Presentation of these patients without significant morbidity is very rare and we could only find sporadic case reports in literature involving traumatic cervical spondyloptosis without neurological deficits. Usually such patients get spared due to expansion of spinal canal after fracture of posterior vertebral elements. We report a case of traumatic C5/C6 spondyloptosis in an ambulatory patient despite having an intact posterior vertebral arch. This patient was managed successfully with anterior cervical fusion. ⋯ To the best of our knowledge, this is the first case report of its kind as it exemplifies the rarity of such an occurrence and underlines the importance of timely management to maintain such preserved neurological status.
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Randomized Controlled Trial
Transforaminal lumbar interbody fusion vs. posterolateral instrumented fusion: cost-utility evaluation along side an RCT with a 2-year follow-up.
Long-lasting low back pain is an increasing problem, and for some patients surgery is the final option for improvement. Several techniques for spinal fusion are available and the optimal technique remains uncertain. The objective of this study was to assess the cost-effectiveness and cost-utility of transforaminal lumbar interbody fusion (TLIF) compared to posterolateral instrumented fusion (PLF) from the societal perspective. ⋯ TLIF does not seem to be a relevant alternative to PLF from a socioeconomic, societal point of view.