The spine journal : official journal of the North American Spine Society
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Randomized Controlled Trial
Choice of plate may affect outcomes for single versus multilevel ACDF: results of a prospective randomized single-blind trial.
Conflicting views exist according to the individual philosophy about various plate designs that can be used in anterior cervical discectomy and fusion (ACDF) to achieve clinical and radiological improvement within shortest time period. No prospective randomized study has ever been conducted to clarify the relationship between clinical outcomes, fusion rates, and the choice of plate (static vs. dynamic design). ⋯ Although clinical improvement is a good predictor of successful ACDF, radiological evidence of fusion alone is not reliable as a parameter of success. The design of plate does not affect the outcomes in single-level fusions but statistics indicate that multiple-level fusions may have better clinical outcome when a dynamic plate design is used.
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The objective of the North American Spine Society's (NASS) Evidence-Based Clinical Guideline on Antibiotic Prophylaxis in Spine Surgery is to provide evidence-based recommendations on key clinical questions concerning the use of prophylactic antibiotics in spine surgery. The guideline is intended to address these questions based on the highest quality clinical literature available on this subject as of December 2006. The goal of the guideline recommendations is to assist in delivering optimum, efficacious treatment to prevent surgical site infection. ⋯ A clinical guideline addressing the use of antibiotic prophylaxis in spine surgery has been created using the techniques of evidence-based medicine and the best available evidence. This educational tool will assist spine surgeons in preventing surgical site infections. The entire guideline document, including the evidentiary tables, suggestions for future research, and references, is available electronically at the NASS Web site (www.spine.org) and will remain updated on a timely schedule.
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Pneumorrhachis (intraspinal air) is usually asymptomatic. Therefore, most patients with pneumorrhachis usually are managed conservatively. Rarely, pneumorrhachis is symptomatic and associated with discomfort, pain, and neurological deficits. ⋯ The possibility that neurological symptoms could be caused by non-traumatic intraspinal air should be considered.
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Back problems (BPs), with their cost and disability, are a substantial burden for individuals, employers, and society. ⋯ Systematic review Level I evidence.
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Cervical arthroplasty is designed to maintain cervical motion of the functional spinal unit after cervical discectomy. The impact of the ProDisc-C (Synthes Spine, Paoli, PA) on in vivo kinematics and sagittal alignment requires further assessment. ⋯ The ProDisc-C increased overall segmental ROM. A lordotic SA may be associated with restricted segmental ROM and translation in extension. This study did not detect any change in overall cervical spinal alignment after insertion of the device.