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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Remote patient monitoring (RPM) has revolutionized the landscape of healthcare. From humble beginnings rooted in landline home telephone calls to present-day devices with near instantaneous wireless connectivity, the evolution of technology has ushered in an era of digital medicine and remote care. Presently, a vast array of healthcare data points can be automatically generated, analyzed, and forwarded to providers to supplement clinical decision-making. While RPM originated and was popularized within medicine, its role in orthopedics, and particularly within spine surgery, is evolving. We sought to provide an overview of RPM within orthopedics, with specific attention on spine care, analyzing its origins, present-day form, and prospects. ⋯ Technological advancements are not only reshaping the paradigm of musculoskeletal care but are also redefining the physician-patient relationship as well as reimagining traditional perspectives on healthcare data collection and privacy.
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The present study compared patients developing ASD after L4/5 spinal fusion with a control group using a patient-specific statistical shape model (SSM) to find alignment-differences between the groups. ⋯ Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.
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In cases of spine surgical revisions of patients affected by sagittal malalignment, the restoration of the ideal lumbar lordosis (LL) is mandatory. ALIF procedures represent a powerful and effective approach to improve the LL in case of hypolordosis. This study evaluates the feasibility of ALIF to overpower posterior lumbar instrumentation and fusion mass in revision spine surgery and secondarily to estimate complications, clinical and radiological outcomes. ⋯ Anterior implant of lordotic and hyperlordotic cages with increasing segmental lordosis is possible in the presence of posterior instrumentation and/or solid fusion mass. The biomechanical strength of this corrective technique can overcome posterior instrumentation and bone fusion resistance, therefore allowing a single-staged surgery for sagittal realignment.
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This study aims to compare the early subsidence rate (6-12 months) of standalone novel 3D-printed titanium (Ti) versus polyetheretherketone (PEEK) interbody cages after lateral lumbar interbody fusion (LLIF). ⋯ Our study demonstrated that 3D-printed novel Ti cages had a significantly lower early subsidence rate compared to PEEK cages in standalone LLIF patients.
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The cortical bone trajectory (CBT) is an alternative to the traditional pedicle screw trajectory (TT) in posterior spinal instrumentation, enhancing screw contact with cortical bone and therefore increasing fixation strength. Additional to the trajectory, insertion depth (pericortical vs. bicortical placement) could be a relevant factor affecting the fixation strength. However, the potential biomechanical benefit of a bicortical placement of CBT screws is unknown. Therefore, the aim of this study was to quantify the fixation strength of pericortical- versus bicortical-CBT (pCBT versus bCBT) screws in a randomized cadaveric study. ⋯ The authors do not recommend placing CBT screws bicortically, as no relevant biomechanical advantage is gained while the potential risk for iatrogenic injury to structures anterior to the spine is increased.