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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Review Meta Analysis
The efficacy of conservative treatment of osteoporotic compression fractures on acute pain relief: a systematic review with meta-analysis.
The aim of this study is to systematically evaluate the efficacy of commonly used non-surgical treatments in acute care of adults with osteoporotic vertebral compression fractures (VCFs). ⋯ At present, there is insufficient evidence to inform conservative care for acute pain related to VCF. Large, multinational, placebo/sham-controlled trials to address this gap in evidence are needed.
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Posterior decompression by laminoplasty and anterior decompression/fixation have been widely accepted, and they provide sufficient results for cervical spondylotic myelopathy. However, combined procedure of posterior decompression and reconstruction is favorable for some patients accompanying local kyphosis, segmental instability, previously operated conditions on the cervical spine, etc. ⋯ Combined procedure of posterior reconstructive surgery using a pedicle screw fixation provides better clinical outcomes than laminoplasty alone for cervical spondylotic myelopathy accompanying local kyphosis or segmental instability. Further development of supporting tools for cervical pedicle screw insertion including aiming device, navigation system and neuromonitoring procedure are expected for safer screw insertion.
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Review Case Reports
Post-traumatic Collet-Sicard syndrome: personal observation and review of the pertinent literature with clinical, radiologic and anatomic considerations.
The lesion of the lower four cranial nerves, commonly called Collet-Sicard syndrome, can be caused by a blunt head and neck trauma. It may be associated to an isolated fracture of the occipital condyle or of the atlas. ⋯ The p-CSS is caused by force directed through the top of the head. We suppose that the nerve injuries are due to their laceration caused by a displacement of a condyle fragment or to their compression and stretching when they pass between the lateral mass of the atlas and the styloid process. These modalities of trauma explain the better clinical results in patients affected by C1 fractures. Conservative treatment is the option of choice. Surgical option, when choosed, is not considered to fix nerve damages.
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Multicenter Study
Radiographic outcomes of anterior column realignment for adult sagittal plane deformity: a multicenter analysis.
Anterior column reconstruction (ACR) is a minimally invasive technique for the treatment of sagittal plane deformity. ACR uses a lateral transpsoas approach with ALL release and the application of an interbody device to achieve correction. Here, we present 1-year radiographic results from a multicenter study of adult spinal deformity (ASD) patients. ⋯ ACR successfully restores lumbar lordosis in ASD patients with sagittal imbalance. ACR results in greater segmental correction than is achieved with LLIF alone. Supplementing with posterior osteotomies allows for even greater correction. The ability to achieve the desired radiographic goals is expected to improve as technical nuances are refined and patient selection is optimized.