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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Multicenter Study Clinical Trial
Lumbar total disc replacement by less invasive lateral approach: a report of results from two centers in the US IDE clinical trial of the XL TDR® device.
To evaluate the clinical and radiographic outcomes following total disc arthroplasty using the XL TDR(®) Lumbar Disc in the treatment of patients with symptomatic degenerative disc disease at one level between L1-2 and L4-5. ⋯ The results following XL TDR show good clinical and radiographic outcomes out to 3 years postoperative, with clinically significant improvements in pain, function, and general health, few complications, and high patient satisfaction.
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Review
Risk factors for development of myelopathy in patients with cervical spondylotic cord compression.
To clarify risk factors for the development of myelopathy in patients with cervical spondylotic cord compression. ⋯ Several predictable risk factors for the development of myelopathy have been proposed in CSM or OPLL studies, but they were not definitive. Further prospective population-based study is needed to clarify the mechanism.
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Cervical laminectomy is a reliable tool for posterior decompression in various cervical spine pathologies. Although there is increasing evidence of superior clinical, neurological and radiological outcomes when using anterior cervical decompression, laminectomy can be a valuable tool when combined with instrumented lateral mass fusion for carefully selected indications. ⋯ This review article will provide decision-making guidance, technical advice and pitfalls. The technical advice for laminectomy and instrumented lateral mass fusion is illustrated. The authors review the literature on outcomes and complications and suggest indications for the safe and successful application of cervical laminectomy and lateral mass fusion.
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Patients with signs and/or symptoms of cervical spondylotic myelopathy are frequently encountered in spinal practice. Exact numbers of prevalence or incidence are not known. ⋯ Surprisingly, an extensive search of the literature did not reveal exact data about the incidence or prevalence of cervical spondylotic myelopathy. The prevalence of surgically treated cervical spondylotic myelopathy was estimated as 1.6 per 100,000 inhabitants. Although the population adherence to the surgical practice is reasonably fixed and referral patterns are known, this estimate will still be too low for various reasons. At best, this estimate is the minimal prevalence of cervical spondylotic myelopathy that has been operated upon. To address the exact incidence or prevalence of cervical spondylotic myelopathy in general or needing surgical treatment, other investigations are warranted.
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Clinical Trial
Anterior stand-alone fusion revisited: a prospective clinical, X-ray and CT investigation.
The purpose of this study was to assess the mid-term clinical and radiological results as well as patient safety in terms of complication and reoperation rates in patients treated with a novel anterior stand-alone fusion (ASAF) device (Synfix-LR, DePuy Synthes, West Chester, PA, USA) in a cohort of patients with predominant and intractable low back pain originating from monosegmental degenerative disc disease at the lumbosacral junction. ⋯ The current study delineates satisfactory clinical results following ASAF at the lumbosacral junction. Patient safety was demonstrated with acceptable complication and low reoperation rates. Radiological data demonstrated a significant reconstruction of lordosis at the lumbosacral junction. Solid interbody fusion was achieved in 97.3 % of all cases in a highly selected cohort with optimal predisposition for fusion. ASAF may serve to avoid a variety of negative side effects for a considerable number of patients which, otherwise, would have been candidates for posterior instrumented fusion techniques.