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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Dynamic contrast-enhanced MRI (DCE-MRI) was used to investigate the associations between intervertebral disc degeneration and changes in perfusion and diffusion in the disc endplates. ⋯ Increased enhancement in the endplate regions of degenerating discs might be an indication of ongoing damage in these tissues. Therefore, DCE-MRI could aid in understanding the pathophysiology of disc degeneration. Moreover, it could be used in the planning of novel treatments such as stem cell therapy.
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To assess the cost-utility and perioperative costs of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) versus open-TLIF for degenerative lumbar pathologies. ⋯ From the limited evidence, the available data suggest a trend of significantly reduced perioperative costs, length of stay, and blood loss for minimally invasive compared with open surgical approaches for TLIF. MI-TLIF may represent an opportunity for optimal utilization and allocation of health-care resources from both a hospital and societal perspective.
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Randomized Controlled Trial
The combined use of unilateral pedicle screw and contralateral facet joint screw fixation in transforaminal lumbar interbody fusion.
This paper is to evaluate the efficacy and safety of transforaminal lumbar interbody fusion (TLIF) using unilateral pedicle screws along with contralateral translaminar facet joint screw (UPS+TFS) fixation in comparison with the method using bilateral pedicle screws fixation (BPS) in degenerative lumbar diseases. ⋯ The clinical efficacy and safety of TLIF with UPS+TFS fixation were comparable to BPS fixation; however, the soft tissue injury and the corresponding operation cost were reduced with unilateral pedicle screw plus translaminar facet screw fixation.
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Comparative Study
Long vs. short fusions for adult lumbar degenerative scoliosis: does balance matters?
Surgery of adult scoliosis was based upon coronal plane radiographical analysis using Cobb angle measurements, but recently it has been demonstrated that sagittal spinopelvic alignment plays a critical role in determining the final outcome. The aim of this paper is to compare the clinical and radiological results of 81 patients affected by adult scoliosis, treated with short or long fusions, and followed for 2-5 year follow-up. ⋯ Surgical treatment of degenerative lumbar scoliosis improved balance and alignment of the spine, and also the coronal plane in terms of Cobb angle. These results were associated to a consistent clinical improvement and an acceptable rate of complications.
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Comparative Study Clinical Trial
Clinical and radiological features of hybrid surgery in multilevel cervical degenerative disc disease.
Although several studies have established the safety and efficacy of cervical disc arthroplasty (CDA) as compared to anterior cervical discectomy and fusion (ACDF), few studies have investigated the role of hybrid surgery (HS) that incorporates ACDF and CDA techniques in multilevel cervical degenerative disc disease (MLCDDD). ⋯ HS is an effective, reliable, and safe procedure for the treatment MLCDDD. Such a surgical construct is comparable to ACDF and CDA in terms of safety and feasibility. However, large, randomized controlled trials are warranted.