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
Incidence of postoperative symptomatic spinal epidural hematoma requiring surgical evacuation: a systematic review and meta-analysis.
This systematic review and meta-analysis aimed to determine the incidence of symptomatic spinal epidural hematoma (SSEH) following spine surgery. ⋯ We evaluated the overall incidence proportion of SSEH after spine surgery and performed stratified analysis, including sex, surgical indication, site, approach, minimally invasive surgery, and delayed onset of SSEH. Our research would be helpful for patients to be accurately informed of their risk and for spinal surgeons to estimate the probability of SSEH after spine surgery.
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Review
Learning curve for minimally invasive transforaminal lumbar interbody fusion: a systematic review.
Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) is commonly used to treat degenerative lumbar spinal disorders. It facilitates a full-scale spinal decompression and interbody fusion with minimal neural retraction using the tubular retractor system. Despite the benefits of surgical efficiency and minimalism, this technique requires a long learning curve. There is currently no consensus on the learning curve characteristics and proper training methods for MI-TLIF. Thus, this systematic review aimed to discuss the cutoff point at which technical proficiency is achieved and ways to enhance the learning process. ⋯ The plateau point in the learning curve for MI-TLIF may differ according to the outcome measures used. Most studies have demonstrated the learning progress based on simple task efficiency, rather than patient outcomes. Moreover, the learning rate may be affected by the patients' and technical conditions. Therefore, great care is required in interpreting the learning curve and cutoff point for MI-TLIF proficiency.
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Review Case Reports
Intercostal lung herniation; a rare complication after mini-transthoracic approach (TTA) for thoracic disc herniation. Two case reports and review of literature.
Lung herniation is a rare condition, most often due to thoracic injury, but has also been described as a complication following cardiothoracic surgery. Here, we report two cases of post-surgical lung herniation following a neurosurgical mini-transthoracic (mini-TTA) for treatment of thoracic herniated discs. With this report we aim to make surgeons aware of this rare complication, review existing literature on surgical repairs and describe our novel correction technique using video assisted thoracic surgery (VATS) and a combination of mesh covering the muscle defect internally and nitinol rib plates for rib approximation on the outside of the thoracic cavity. ⋯ These cases should make surgeons aware of the possibility of post-surgical development of lung herniation and describe successful correction using a combination of mesh material and NiTi-Rib H-plates through a VATS technique.
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To evaluate the relationship between lifestyle behaviours, emotional health factors, and low back pain (LBP) resilience. ⋯ Findings from this study suggest that people who adopt optimal lifestyle behaviours and positive emotional factors are more likely to be resilient and maintain high levels of function despite suffering from LBP.
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To present a case of delayed aortic perforation due to a nondisplaced fracture of the 9th rib after vertebral osteotomy for degenerative kyphoscoliosis in patients with osteoporosis. ⋯ This report describes a new critical complication after spinal correction surgery. Even without pedicle screw malposition, aortic injuries can happen to patients with osteoporosis after corrective osteotomy for degenerative kyphoscoliosis due to positional change of aorta and fragility of the ribs. The spine surgeon should be aware of this type of complication, and rib fractures around the aorta after vertebral osteotomy should not be neglected even when there is no displacement.