Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · Jul 2014
Pedicle subtraction osteotomy in the lumbar spine: indications, technical aspects, results and complications.
Pedicle subtraction osteotomy (PSO) consists of creating posteriorly trapezoidal shape of a vertebra, usually L3 or L4, in order to recreate lordosis in the lumbar spine. It is usually indicated to treat rigid kyphotic lumbar spine associated with sagittal imbalance and due to degenerative changes or to iatrogenic flat back. PSO is technically demanding with high rates of complications and should be performed by experienced teams. ⋯ It was associated with a non-negligible, but acceptable rate of complications. To limit the risk of mechanical complications, we recommend fusing the adjacent disks whatever the approach (PLIF/TLIF/XLIF). Most complications can be reduced with adequate environment, informed anesthesiologists and experienced surgical team.
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Eur J Orthop Surg Tr · Jul 2014
A retrospective study of treating thoracolumbar spine fractures in ankylosing spondylitis.
Spinal fractures are commonly encountered in ankylosing spondylitis (AS) patients. This study compares the outcome of early surgical treatment with initial conservative treatment for thoracolumbar fractures in patients with AS. From 1996 to 2008, 28 patients with AS were treated either operatively or conservatively for thoracolumbar fractures; however, only 25 patients met the inclusion criteria with a minimum follow-up of 2 years. ⋯ Fracture union was achieved in three cases, and pseudoarthrosis occurred in eight cases. Operative treatment can achieve solid fusion and improve the neurological status, while conservative treatment may result in pseudoarthrosis and progressive neurologic deficit. The results suggest that AS patients with unstable spinal fractures should receive early surgical management to prevent further sequelae.
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Eur J Orthop Surg Tr · Jul 2014
Review Meta Analysis Comparative StudyAdjacent segment degeneration and disease after lumbar fusion compared with motion-preserving procedures: a meta-analysis.
The purpose of our study was to compare lumbar fusion and motion-preserving procedures to determine whether lumbar fusion may be associated with a higher prevalence of adjacent segment degeneration (ASDeg) or adjacent segment disease (ASDis). ⋯ The current evidence suggests that lumbar fusion may result in a higher prevalence of adjacent segment degeneration or disease than motion-preserving procedures.
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Eur J Orthop Surg Tr · Jul 2014
Randomized Controlled Trial Comparative Study Observational StudyPosition of polyaxial versus monoaxial screws in locked plating for proximal humeral fractures: analysis of a prospective randomized study.
Aim of the study was to compare the chosen position of polyaxial locking screws with the position of monoaxial screws in the humeral head of proximal humeral fractures treated by locked plating. ⋯ Treatment Study, Level II.
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Eur J Orthop Surg Tr · Jul 2014
ReviewComplex osteotomies vertebral column resection and decancellation.
Pedicle subtraction osteotomy (PSO) is nowadays widely used to treat sagittal imbalance. Some complex malalignment cases cannot be treated by a PSO, whereas the imbalance is coronal or mixed or the sagittal imbalance is major and cannot be treated by a single PSO. The aim of this article was to review these complex situations--coronal imbalance, mixed imbalance, two-level PSO, vertebral column resection, and vertebral column decancellation, and to focus on their specificities. It wills also to evoke the utility of navigation in these complex cases.