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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Comparative Study
In vitro comparison of endplate preparation between four mini-open interbody fusion approaches.
Discectomy and endplate preparation are important steps in interbody fusion for ensuring sufficient arthrodesis. While modern less-invasive approaches for lumbar interbody fusion have gained in popularity, concerns exist regarding their ability to allow for adequate disc space and endplate preparation. Thus, the purpose of this study was to quantitatively and qualitatively evaluate and compare disc space and endplate preparation achieved with four less-invasive approaches for lumbar interbody fusion in cadaveric spines. ⋯ These results demonstrate that adequate endplate preparation for interbody fusion can be achieved utilizing various minimally invasive approach techniques (mini-ALIF, MAS TLIF, MAS PLIF, XLIF), however, XLIF appears to provide a greater area of and more complete endplate preparation.
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To assess the feasibility of temporary pedicle screw fixation for motion preservation of type II odontoid fractures unsuitable for anterior screw. ⋯ Temporary pedicle screw fixation is a feasible technique for motion preservation of type II odontoid fractures unsuitable for anterior screw.
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To design and investigate a novel technique of percutaneous posterior transdiscal oblique screw fixation with lateral interbody fusion. ⋯ Using specially designed trapezoid shape interbody cages, assisted by intra-operative image intensification and endoscope, it is feasible to perform percutaneous posterior transdiscal oblique screw fixation with lateral interbody fusion technique.
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Adult deformity combined with sagittal malalignment is a pathology that decreases patient's quality of life and that requires surgical correction to achieve clinical improvement. Spine osteotomies are usually performed to restore alignment of the spine, even if these techniques are associated with high intraoperative risks, revision rates and relevant mortality rates. Anterior column realignment (ACR) is a new technique that allows large corrections through a minimally invasive lateral approach to the spine after release of the anterior longitudinal ligament. ⋯ Preliminary data show that ACR allows corrections similar to those obtained with a Pedicle Subtraction Osteotomy, avoiding risks related to this technique.
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Minimally invasive techniques have become increasing popular and are expanding into deformity surgery. The lateral retroperitoneal transpsoas anterior column release (ACR) is a newer minimally invasive alternative to posterior osteotomy techniques for correcting and promoting global spinal alignment. This procedure attempts to avoid the potential complications associated with conventional osteotomies, but has its own subset of unique complications to be discussed in depth. ⋯ The MIS-ACR is one of the most technically demanding procedures performed from the lateral transpsoas approach. This procedure has the advantage of maintaining and improving spinal global alignment while minimizing blood loss and excessive tissue dissection. It comes with its own unique set of potentially catastrophic complications and should only be performed by surgeons proficient in both deformity correction and the lateral approach.