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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Review Meta Analysis
Can prophylactic negative pressure wound therapy improve clinical outcomes in spinal fusion surgery? A meta-analysis.
Recently negative pressure wound therapy (NPWT) is increasingly being prophylactically used to prevent wound complications in various types of surgeries, but its role in spinal fusion surgery was less well established. This study aimed to evaluate the efficacy of prophylactic NPWT (PNPWT) usage in spinal fusion surgery. ⋯ The current evidence suggested PNPWT could effectively reduce postoperative surgical site infection, but it had no significant benefit on reducing the incidence of wound dehiscence, overall wound complication, readmission and reoperation.
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Foraminal stenosis is commonly investigated with radiological methods in patients with radiating pain in extremities. However, there is a lack of consensus regarding the methodology to assess compression of the nerve roots. This systematic review was performed to identify validated classification systems for foraminal stenosis in the lumbar and cervical spine based on magnetic resonance imaging (MRI). ⋯ The three classification systems demonstrated moderate to good reliability and have all been shown feasible in the clinical setting. There is however a need for further studies testing the validity of these classifications in relation to both clinical findings and to surgical outcome data.
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Clinical Trial
The impact of lumbar alignment targets on mechanical complications after adult lumbar scoliosis surgery.
The purpose of this study was to determine the discriminatory ability of age-adjusted alignment offset and the global alignment and proportion (GAP) score parameters to predict postoperative mechanical complications. ⋯ Radiographic alignment targets using either age-adjusted alignment target offset or GAP score parameters had minimal ability to predict mechanical complications in isolation. Mechanical complications following adult spinal deformity surgery are complex, and patient factors play a critical role. Clinical trial registeration This study was registered at ClinicalTrials.gov (number NCT00854828) in March 2009.
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This review provides an overview of the patent literature on posteriorly placed intrapedicular bone anchors. Conventional pedicle screws are the gold standard to create a fixation in the vertebra for spinal fusion surgery but may lack fixation strength, especially in osteoporotic bone. The ageing population demands new bone anchors that have an increased fixation strength, that can be placed safely, and, if necessary, can be removed without damaging the surrounding tissue. ⋯ This review provides insights into worldwide patented intrapedicular bone anchors that aim to increase the fixation strength compared to the conventional pedicle screw. The identified anchoring methods and their working principles can be used for clinical decision-making and as a source of inspiration when designing novel bone anchors.