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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It is well established that the perioperative course in terms of patient satisfaction, neurological function and quality of life, is assessed by monitoring the walking capacity. This examination method is affected by several primary and secondary influences. Therefore, we performed a feasibility study to investigate the possibility of assessing the perioperative walking capacity using a global positioning system (GPS) in neurosurgical spine patients. A step was undertaken to generate objective and reliable data for monitoring control with a cost-effective and easy-to-use measurement tool. ⋯ In this feasibility study, we demonstrated that this tool is able to measure the perioperative mobility and walking-capability. The certainty of data is dependent on the patients' compliance. The measuring method is used as a low cost, easily accessible, and easy-to-use technique, which seems to be superior to common methods like a treadmill-tests or walking tests. Nevertheless, these results are still to prove in upcoming analysis.
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Multicenter Study
Major perioperative complications after spine surgery in patients with cerebral palsy: assessment of risk factors.
A prospective, longitudinal cohort was studied to determine the incidence, consequences, and risk factors of major perioperative complications in patients with cerebral palsy (CP) treated with spinal fusion. There is a wide variety of data available on the complications of spine surgery; however, little exists on the perioperative complications in patients with CP. ⋯ 2.
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Review Multicenter Study
A multicentre retrospective review of muscle necrosis of the leg following spinal surgery with motor evoked potential monitoring: a cause for concern?
There are very few reported cases of compartment syndrome of the leg following spinal surgery via a posterior approach. An association between compartment syndrome and muscle over-activity via nerve stimulation during evoked potential monitoring was first suggested in 2003. No further reports have suggested this link. We present a multicentre retrospective review of a series of five patients who developed compartment syndrome of the leg following spinal surgery via a posterior approach, whilst un-paralysed and with combined sensory (SSEP)/motor evoked potential (MEP) monitoring with an aim of highlighting this possible causative factor. ⋯ Previous cases in the literature have related to mal-positioning on the Jackson table or use of the knee-chest position for surgery. This was not the case for our patients; therefore, we suspect an association between overactive muscle stimulation and muscle necrosis. Further experimental studies investigating this link are required.
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Accurate survival estimation is prerequisite to determine the most appropriate treatment for patients with metastatic spine disease. Several authors have proposed classification systems analyzing clinical and radiological parameters, such as, performance status, metastasis localization, and primary tumor histotype, but the modified Tokuhashi score (mTS) is the most widely used. Although it is regarded as one of the most complete and accurate systems, it does not take the effectiveness of new therapeutic strategies into consideration, contributing to a progressive loss of accuracy. The purpose of this review is to verify the ability of the mTS to accurately estimate metastatic spine patient survival, nearly 10 years after it was introduced. ⋯ The mTS is suggestive of actual survival for patients with a good prognosis. It is less accurate for patients with an estimated survival of less than 12 months. The decreasing trend in mTS accuracy over time will likely further reduce mTS utility. An important opportunity exists to develop new instruments to assist spine surgeons and oncologists to choose appropriate surgical or non-surgical treatment modalities for patients with metastatic spine disease.