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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Conventional lumbar arthrodesis for the treatment of degenerative spondylolisthesis (DS) is associated with high complication rates and variable clinical efficacy. Modern minimally invasive (MIS) approaches may reduce the morbidity and produce greater clinical improvement compared to traditional surgical techniques. The objective of this study is to report radiographic outcomes and evaluate clinical improvements in the context of substantial clinical benefit for DS patients treated with a MIS 90° lateral, transpsoas approach for lumbar interbody fusion. ⋯ MIS lateral interbody fusion in the treatment of DS resulted in significant improvements in clinical and radiographic outcomes, with a low complication rate and a high proportion of patients achieving substantial clinical benefit.
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Congenital craniocervical segmentation anomaly associated with malalignment of the odontoid process causes progressive spinal cord compression with myelopathy. Recent literatures have reported that ventral decompression could be achieved with posterior craniocervical realignment through posterior instrumented reduction. The purpose of the present study is to show the efficacy of intraoperative electrophysiological monitoring during craniocervical realignment through screws and rod system for congenital craniocervical segmentation anomaly. ⋯ Craniocervical realignment through screws and rod system may be safe and efficacious surgical technique for the treatment of congenital craniocervical anomaly with the help of intraoperative neuromonitoring. However, distraction should be cautiously monitored, especially when Klippel-Feil syndrome is combined.
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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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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 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.