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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The treatment of low back pain associated to Disc Degenerative Disease (DDD) is still controversial. Segmental Fusion is the gold standard, but many studies have reported that motion-preserving devices bring substantial clinical benefits to patients. Concerns on the associated complications and on the long-term clinical effectiveness of such instrumentations are still present and have led recently to a decrease of the number of Lumbar Total Disk Replacements (TDR). The objective of this prospective study is to present the clinical and radiographic outcomes of the Maverick Lumbar disk prostheses (Medtronic, TE, Memphis, USA) at long-term follow-up. ⋯ A significant, clinically relevant, and lasting reduction of back pain has been achieved in patients who underwent a total disk arthroplasty or a Hybrid construct with Maverik prosthesis. TDR is a safe and effective technique to decrease pain in patients with one or two levels of DDD.
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Recently, strategies aimed at optimizing provider factors have been proposed, including regionalization of surgeries to higher volume centers and adoption of volume standards. With limited literature promoting the regionalization of spine surgeries, we undertook a systematic review to investigate the impact of surgeon volume on outcomes in patients undergoing spine surgery. ⋯ Findings suggest a trend towards better outcomes for higher volume surgeons; however, further study needs to be carried out to define objective volume thresholds for individual spine surgeries for surgeons to use as a marker of proficiency.
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To investigate incidence, risk factors, and complications of vertebral subluxation (VS) during three-column osteotomy in surgical correction of adult spine deformity. ⋯ VS occurred in one-tenth of patients receiving three-column osteotomies, one-fourth of which would develop neurological deficits. Older age, rigid kyphosis, and the pre-existence of VS were risk factors for developing VS.
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The purpose of this study was to compare patient-reported outcomes (PROs), morbidity, and costs of TLIF vs PLF to determine whether one treatment was superior in the setting of single-level degenerative spondylolisthesis. ⋯ Overall costs and health care utilization were similar in both the groups. Both TLIF and PLF for single-level degenerative spondylolisthesis provide improvement in disability, pain, quality of life, and general health.