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 aimed to develop and validate a machine learning (ML) model to predict high-grade heterotopic ossification (HO) following Anterior cervical disc replacement (ACDR). ⋯ Through an ML approach, the model identified risk factors and predicted development of high grade HO following ACDR with good discrimination and overall performance. By addressing the shortcomings of traditional statistics and adopting a new logical approach, ML techniques can support discovery, clinical decision-making, and intraoperative techniques better.
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The sacral alar-iliac screw (SAIS) fixation technique has evolved from spinopelvic fixation which originated from S2AIS to sacroiliac joint fixation, with more reports regarding its application of S2AIS than S1AIS. However, there is a lack of comparative evidence to determine which technique is superior for sacroiliac joint fixation. This study aimed to determine which of the screws was superior in terms of implantation safety and biomechanical stability for sacroiliac joint fixation. ⋯ S1AIS and S2AIS have similar screw trajectories and stability. However, S1AIS has a larger insertable range, less breach of the posterior lateral sacral cortex and longer trajectory length on the sacral side than S2AIS, which indicates S1AIS has higher implantation safety and a trend of better mechanical performance over S2AIS for sacroiliac joint fixation. Furthermore, S2AIS with an excessively large diameter should be used with caution for sacroiliac joint fixation.
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Previous work comparing ASD to a normative population demonstrated that a large proportion of lumbar lordosis is lost proximally (L1-L4). The current study expands on these findings by collectively investigating regional angles and spinal contours. ⋯ As LL loss increases, the difference between ASD and normative shapes first occurs proximally and then progresses incrementally caudally. Understanding spinal contour and LL loss location may be key to achieving sustainable correction by identifying optimal and personalized postoperative shapes.
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Distinct lesions are derived from notochordal cells (NCDL), ranging from benign to malignant ones. This study presents fifty NCDL cases diagnosed in a tertiary hospital of reference from the past 55 years: forty-two conventional chordomas, including one chondroid chordoma subtype, four benign notochordal cell tumors (BNCT), two conventional chordomas with BNCT foci, and two dedifferentiated chordomas. All patients were adults. ⋯ Sixteen patients died due to tumor-related factors; twenty-eight presented local recurrence, and four developed distant metastases. New therapeutic options are being studied for chordoma cases. Clinical, radiological, and histopathological data are necessary to properly diagnose and follow up of NCDL.
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Unplanned readmissions after spine surgery are undesired, and cause significant functional, and financial distress to the patients and healthcare system. Though critical, knowledge about readmissions after surgery for traumatic spinal injuries (TSI) is scarce and under-evaluated. ⋯ The incidence of unplanned readmissions after TSI was 5%, which was similar to elective spine surgeries but the causes and risk factors are different. Non-surgical complications related to urinary tract, respiratory care and pressure sores were the most common causes. Pre-operative smoking status, diabetes mellitus and pressure sores noted in the index admission were important independent risk factors.