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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Validated deep learning models represent a valuable option to perform large-scale research studies aiming to evaluate muscle quality and quantity of paravertebral lumbar muscles at the population level. This study aimed to assess lumbar spine muscle cross-sectional area (CSA) and fat infiltration (FI) in a large cohort of subjects with back disorders through a validated deep learning model. ⋯ CSA and FI values of paravertebral muscles vary a lot in accordance with subjects' sex, age and clinical conditions. Given also the large inter-muscle differences in CSA and FI, the choice of muscles needs to be considered with attention by spine surgeons or physiotherapists when investigating changes in lumbar muscle morphology in clinical practice.
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Review Meta Analysis
Clinical validation of grouping conservative treatments in neck pain for use in a network meta-analysis: a Delphi consensus study.
A network meta-analysis aims to help clinicians make clinical decisions on the most effective treatment for a certain condition. Neck pain is multifactorial, with various classification systems and treatment options. Classifying patients and grouping interventions in clinically relevant treatment nodes for a NMA is essential, but this process is poorly defined. ⋯ With this consensus we clinically validated two neck pain classifications and grouped conservative treatments into 17 well-defined and clinically relevant nodes.
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Anterior cervical X-shape-corpectomy and fusion (ACXF) is a novel cervical surgery, designed as partial alternative to the classic technique, anterior cervical corpectomy and fusion (ACCF). The aim of this study was to evaluate the early-stage outcomes of ACXF in treating two-level cervical spondylosis (CS) through comparisons with ACCF. ⋯ ACXF is a potential surgical alternative for certain patients with two-level CS, as it provides both adequate decompression range and fewer adverse events than ACCF. The further modifications on ACXF worth exploration.
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Randomized Controlled Trial
Clinical and radiological results of TLIF surgery with titanium-coated PEEK or uncoated PEEK cages: a prospective single-centre randomised study.
A comparison of fusion rates and clinical outcomes of instrumented transforaminal interbody fusion (TLIF) between polyetheretherketone (PEEK) and titanium-coated PEEK (Ti-PEEK) cages is not well documented. ⋯ There is no significant advantage of TiPEEK cages over PEEK cages in clinical outcome and fusion rate 2 years after surgery.
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Dorsal instrumentation using pedicle screws is a standard treatment for multiple spinal pathologies, such as trauma, infection, or degenerative indications. Intraoperative three-dimensional (3D) imaging and navigated pedicle screw placement are used at multiple centers. For the present study, we evaluated a new navigation system enabling augmented reality (AR)-supported pedicle screw placement while integrating navigation cameras into the reference array and drill guide. The present study aimed to evaluate its clinical application regarding safety, efficacy, and accuracy. ⋯ The current study's results could confirm the use of the present AR-supported system for navigated pedicle screw placement for dorsal instrumentation in clinical routine. It provides a reliable and safe tool for 3D imaging-based pedicle screw placement, only requires a minimal intraoperative setup, and provides new opportunities by integrating AR.