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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Surgeons' interest in image and/or robotic guidance for spinal implant placement is increasing. This technology is continually improving and may be particularly useful in patients with challenging anatomy. Only through careful clinical evaluation can its successful applications, limitations, and areas for improvement be defined. This study evaluates the outcomes of robotic-assisted screw placement in a consecutive series of 102 patients. ⋯ Of the 960 screws that were implanted using the robot, 949 (98.9 %) were successfully and accurately implanted and 11 (1.1 %) were malpositioned, despite the fact that the majority of patients had significant spinal deformities and/or previous spine surgeries. "Tool skiving" was thought to be the inciting issue with the misplaced screws. Intraoperative anteroposterior and oblique fluoroscopic imaging for registration is critical and was the limiting issue in four of the seven aborted cases.
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To review and summarize the current knowledge regarding the outcome measures used to evaluate scoliosis surgery. ⋯ Evaluation of scoliosis treatment should include the patient's perspective, which can be obtained with the use of patient-reported outcome measures.
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The diagnostic assessment and prognostic value of the posterior ligamentous complex (PLC) remains a controversial topic in the management of patients with thoracolumbar spinal injury. The purpose of this review was to critically appraise the literature and present an overview of the: (1) precision, (2) accuracy, and (3) validity of detecting PLC injuries in patients with thoracic and lumbar spine trauma. ⋯ A wide variety of methods have been applied in the evaluation of precision and accuracy of PLC injury detection, leaving spinal surgeons with a multitude of variable results. There is scant clinical evidence demonstrating the true prognostic value of detected PLC injuries in patients with thoracic and lumbar spine injuries. We recommend the conduct of longitudinal clinical follow-up studies on those cases assessed for precision and/or accuracy of PLC injuries.
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To identify the independent risk factors, based on available evidence in the literature, for patients developing surgical site infections (SSI) after spinal surgery. ⋯ Although there is no conclusive evidence for why postoperative SSI occurs, these data provide evidence to guide clinicians in admitting patients who will have spinal operations and to choose an optimal prophylactic strategy. Further research is still required to evaluate the effects of these above risk factors.
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Review Case Reports
Solitary spinal epidural cavernous angioma: report of nine surgically treated cases and review of the literature.
We intend to report the largest series of spinal epidural cavernomas (SEC), discuss their clinical features, imaging characteristics, surgical findings, outcome analysis and compare them with similar reports in the literature. ⋯ SEC is hard to be differentiated from other epidural spinal lesions before intervention but should be considered in the list of differential diagnosis regarding its favorable outcome.