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
Minimally invasive surgery for lumbar disc herniation: a systematic review and meta-analysis.
Assessing the benefits of surgical treatments for sciatica is critical for clinical and policy decision-making. To compare minimally invasive (MI) and conventional microdiscectomy (MD) for patients with sciatica due to lumbar disc herniation. ⋯ There is moderate to low quality evidence of no differences in clinical outcomes between MI surgery and conventional microdiscectomy for patients with sciatica due to lumbar disc herniation. Studies comparing transforaminal MI with conventional surgery with sufficient sample size and methodological robustness are lacking.
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Meta Analysis
Comparison of unilateral versus bilateral pedicle screw fixation in degenerative lumbar diseases: a meta-analysis.
Traditionally, lumbar spinal surgery is performed with bilateral pedicle screw fixation to provide stability as the fusion heals. However, many studies have reported that unilateral pedicle screw fixation is as effective as bilateral constructs. To compare the clinical outcomes, complications, and surgical trauma between the two techniques for treatment of degenerative lumbar diseases, we conducted a meta-analysis. ⋯ This meta-analysis shows that there was significantly less blood loss in unilateral group and less operating time; however, the fusion rate was significantly higher in the bilateral group. The outcomes of hospital stay, ODI, JOA, VAS, SF-36 score, and complications are similar in the two groups.
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Spondylotic vertebral artery (VA) compression is a rare cause of vertebrobasilar insufficiency and stroke. ⋯ Spondylotic VA stenosis can cause hemodynamic TIAs and watershed strokes, especially when contralateral VA insufficiency is combined to specific neck movements. Low-amplitude neck movement may suffice in severe cases. Embolic vertebrobasilar events are less frequent. VA decompression from spondylosis may prevent recurrent ischemic episodes.
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Case Reports
Combined traumatic atlantooccipital and atlantoaxial articulation instability: a case report with survival.
Traumatic atlantooccipital dislocation is a rare injury in survivors with 15 % share in deaths due to spinal injury. The authors present a case of a patient with concurrent atlantooccipital and atlantoaxial instability of the upper cervical spine, which he suffered after a fall from height. ⋯ We performed realignment of the dislocation and posterior occipitocervical (C0-C3) fusion. After the surgery, the patient manifested neurological improvement almost to a normal neurological outcome with persistent residual finding after subarachnoid hemorrhage.