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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This study was conducted to characterise the O-arm® surgical imaging system in terms of patient organ doses and medical staff occupational exposure during three-dimensional thoracic spine and pelvic examinations. ⋯ Doses delivered to the patient during a three-dimensional thoracic spine image acquisition were found to be significant with the O-arm®, but lower than those observed with a standard computed tomography examination. The detailed dose cartography allows for the optimisation of medical staff positioning within the operating theatre while imaging with the O-arm®.
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Extreme lateral interbody fusion provides minimally invasive treatment of spinal deformity, but complications including nerve and psoas muscle injury have been noted. To avoid nerve injury, mini-open anterior retroperitoneal lumbar interbody fusion methods using an approach between the aorta and psoas, such as oblique lumbar interbody fusion (OLIF) have been applied. OLIF with percutaneous pedicle screws without posterior decompression can indirectly decompress the spinal canal in lumbar degenerated spondylolisthesis. In the current study, we examined the radiographic and clinical efficacy of OLIF for lumbar degenerated spondylolisthesis. ⋯ Significant improvements in disk height and spinal canal area were found after surgery. Bulging of disks was reduced through correction, and stretching the yellow ligament may have decompressed the spinal canal. Lumbar anterolateral fusion without laminectomy may be useful for lumbar spondylolisthesis with back and leg symptoms.
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Review Meta Analysis
Total disc replacement versus fusion for lumbar degenerative disc disease: a systematic review of overlapping meta-analyses.
Although many meta-analyses have been performed to compare total disc replacement (TDR) and fusion for treating lumbar degenerative disc disease (LDDD), their findings are inconsistent. This study aimed to conduct a systematic review of overlapping meta-analyses comparing TDR with fusion for treating LDDD, to assist decision makers in selection among conflicting meta-analyses, and to provide treatment recommendations based on the best available evidence. ⋯ There is discord in results from meta-analyses that assessed TDR and fusion for LDDD. According to this systematic review of overlapping meta-analyses comparing TDR and fusion for LDDD, the current best available evidence suggests that TDR may be an effective technique for the treatment of selected patients with LDDD, and is at least equal to lumbar fusion in the short term. However, considering that disadvantages may appear after years, spine surgeons should be cautions about performing TDR on a large scale.
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Review Meta Analysis
Anterior release for Scheuermann's disease: a systematic literature review and meta-analysis.
Anterior release for Scheuermann's disease was considered an important technique for decades. However, posterior-only surgery for Scheuermann's disease has shown a promising potential to manage this deformity, as well. Correction loss could happen post-operatively, especially when posterior-only surgery is performed in the early days. Therefore, a dispute regarding anterior release for Scheuermann's disease exists. ⋯ A systematic review of the outcomes of Scheuermann's disease demonstrated a very similar correction loss for the AP group and the PO group. A meta-regression supported that correction loss did decrease as time moved on for the PO procedure, which could be explained by the improvements to instrumentation and techniques. For other outcomes, the PO group showed advantages in blood loss, surgery time, and junctional kyphosis. Similar outcomes were observed in relation to aspects of cosmetic improvement and pain relief for the AP and PO groups. The revision rate was mildly lower in the PO group than in the AP group.
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Review Meta Analysis
Is reduction better than arthrodesis in situ in surgical management of low-grade spondylolisthesis? A system review and meta analysis.
To compare the clinical and radiographic outcomes of arthrodesis in situ with arthrodesis after reduction in low-grade spondylolisthesis. ⋯ Therapeutic Level IIa.