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
-
Degenerative lumbar scoliosis (DLS) is a spinal deformity that typically develops in adults over 50 years old. Although its etiology is unclear, asymmetric degeneration of the spine is the main cause. Individuals with DLS may experience no symptoms of the deformity, mild symptoms, or severe disability. Most patients with DLS receive conservative treatment, while a small number of patients receive surgery for severe DLS with back pain and/or progressive neurological symptoms. A variety of surgical procedures have emerged. However, a systemic comparison of these surgical procedures is currently unavailable. This study reviews the main outcomes and complications of surgical treatments. ⋯ Despite a high rate of complications, this review demonstrates that surgery is an effective and reasonable treatment intervention for severe DLS and ultimately improves spine function and deformity. This review also suggests that large scale, high quality studies with long term follow-up are needed to provide more reliable evidence for future evaluation.
-
Review Meta Analysis Comparative Study
Comparison of anterior approach versus posterior approach for the treatment of multilevel cervical spondylotic myelopathy.
The purpose of this study is to evaluate the clinical outcomes, complications, and surgical trauma between anterior and posterior approaches for the treatment of multilevel cervical spondylotic myelopathy (CSM). ⋯ In summary, our meta-analysis suggested that a definitive conclusion could not be reached regarding which surgical approach is more effective for the treatment of multilevel CSM. Although anterior approach was associated with better postoperative neural function than posterior approach in the treatment of multilevel CSM, there was no apparent difference in the neural function recovery rate between the two approaches. Higher rates of surgery-related complication and reoperation should be taken into consideration when anterior approach is used for patients with multilevel CSM.
-
Meta Analysis Comparative Study
A meta-analysis of the fusion rate from surgical treatment for odontoid factures: anterior odontoid screw versus posterior C1-C2 arthrodesis.
Surgical treatment for odontoid fractures is widely performed in practice. However, the choice of different surgical procedures remains controversial. Regardless of the surgical technique, the fusion situation is one of the important factors that affect the clinical efficacy. A discrepancy in fusion rate between the anterior odontoid screw fixation approach and the posterior C1-C2 arthrodesis approach has been suggested in clinical research, yet no consensus has been reached. This meta-analysis aims to synthesize the currently available evidence on the topic. ⋯ In light of these findings, we concluded that significant higher fusion rates were observed in patients who underwent posterior C1-C2 arthrodesis surgeries compared to those treated with anterior odontoid screw fixation.