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Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_4 | Pages 33 - 33
1 Feb 2014
Gardner C Davies C Tandon V Smith R
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Introduction. Decompression is the gold standard surgical technique in patients with symptomatic spinal stenosis not responding to conservative management. We present an audit of outcomes in a population of patients undergoing this procedure over a four year period. Method. All patients undergoing lumbar decompression were assessed preoperatively and between 4 and 12 months postoperatively using the Oswestry Disabilty Index (ODI %), pain scale (0–10) and patient satisfaction. The patient's age, the number of levels decompressed and the incidence of complications were recorded. Results. Data is expressed as mean ±SD. Of 127 patients 112 were available for follow up. Mean age at surgery was 68.8±11.8 years. 55% of patients had a single level decompression, 36% 2 levels, 9% 3 levels. L4/5 was the most frequently decompressed level (51%) Improvement in ODI was 13.9±11.7(p<0.0001), improvement in pain scores 2.9±3.0 (p<0.0001). Improvement was the same regardless of number of levels decompressed (ANOVA p=0.84). There was no association between outcome and age. Dural tears occurred in 8.9% of patients, with post operative infection in 2.7%. The presence or absence of post operative complications did not significantly affect outcome. Based on outcome 87% of patients were happy with their surgical experience and outcome. Conclusion. Lumbar decompression remains an effective treatment for stenosis by improving ODI and pain scores. Age and number of decompression levels do not influence outcome. There is a high level of patient satisfaction with the procedure


Bone & Joint Research
Vol. 9, Issue 10 | Pages 653 - 666
7 Oct 2020
Li W Li G Chen W Cong L

Aims

The aim of this study was to systematically compare the safety and accuracy of robot-assisted (RA) technique with conventional freehand with/without fluoroscopy-assisted (CT) pedicle screw insertion for spine disease.

Methods

A systematic search was performed on PubMed, EMBASE, the Cochrane Library, MEDLINE, China National Knowledge Infrastructure (CNKI), and WANFANG for randomized controlled trials (RCTs) that investigated the safety and accuracy of RA compared with conventional freehand with/without fluoroscopy-assisted pedicle screw insertion for spine disease from 2012 to 2019. This meta-analysis used Mantel-Haenszel or inverse variance method with mixed-effects model for heterogeneity, calculating the odds ratio (OR), mean difference (MD), standardized mean difference (SMD), and 95% confidence intervals (CIs). The results of heterogeneity, subgroup analysis, and risk of bias were analyzed.


The Bone & Joint Journal
Vol. 99-B, Issue 10 | Pages 1373 - 1380
1 Oct 2017
Rienmüller A Buchmann N Kirschke JS Meyer EL Gempt J Lehmberg J Meyer B Ryang YM

Aims

We aimed to retrospectively assess the accuracy and safety of CT navigated pedicle screws and to compare accuracy in the cervical and thoracic spine (C2-T8) with (COMB) and without (POST) prior anterior surgery (anterior cervical discectomy or corpectomy and fusion with ventral plating: ACDF/ACCF).

Patients and Methods

A total of 592 pedicle screws, which were used in 107 consecutively operated patients (210 COMB, 382 POST), were analysed. The accuracy of positioning was determined according to the classification of Gertzbein and Robbins on post-operative CT scans.