Aims. Whether to perform hybrid surgery (HS) in contrast to anterior cervical discectomy and fusion (ACDF) when treating patients with multilevel cervical disc
Aims. The aim of this study was to determine how the short- and medium-
to long-term outcome measures after total disc replacement (TDR)
compare with those of anterior cervical discectomy and fusion (ACDF),
using a systematic review and meta-analysis. Patients and Methods. Databases including Medline, Embase, and Scopus were searched.
Inclusion criteria involved prospective randomized control trials
(RCTs) reporting the surgical treatment of patients with symptomatic
degenerative cervical disc disease. Two independent investigators
extracted the data. The strength of evidence was assessed using
the Grading of Recommendations, Assessment, Development and Evaluation
(GRADE) criteria. The primary outcome measures were overall and
neurological success, and these were included in the meta-analysis. Standardized
patient-reported outcomes, including the incidence of further surgery
and adjacent segment disease, were summarized and discussed. Results. A total of 22 papers published from 14 RCTs were included, representing
3160 patients with follow-up of up to ten years. Meta-analysis indicated
that TDR is superior to ACDF at two years and between four and seven
years. In the short-term, patients who underwent TDR had better
patient-reported outcomes than those who underwent ACDF, but at
two years this was typically not significant. Results between four
and seven years showed significant differences in Neck Disability
Index (NDI), 36-Item Short-Form Health Survey (SF-36) physical component
scores, dysphagia, and satisfaction, all favouring TDR. Most trials
found significantly less adjacent segment disease after TDR at both
two years (short-term) and between four and seven years (medium-
to long-term). Conclusion. TDR is as effective as ACDF and superior for some outcomes. Disc
replacement reduces the risk of adjacent segment disease. Continued
uncertainty remains about
There is inconsistent evidence on whether prior spinal fusion surgery adversely impacts outcomes following total hip arthroplasty (THA). We conducted a systematic review and meta-analysis to assess the association between pre-existing spinal fusion surgery and the rate of complications following primary THA. We searched MEDLINE, Embase, Web of Science, and Cochrane Library up to October 2019 for randomized controlled trials (RCTs) and observational studies comparing outcomes of dislocation, revision, or reasons for revision in patients following primary THA with or without pre-existing spinal fusion surgery. Furthermore, we compared short (two or less levels) or long (three or more levels) spinal fusions to no fusion. Summary measures of association were relative risks (RRs) (with 95% confidence intervals (CIs)).Aims
Methods
Computer-based applications are increasingly being used by orthopaedic surgeons in their clinical practice. With the integration of technology in surgery, augmented reality (AR) may become an important tool for surgeons in the future. By superimposing a digital image on a user’s view of the physical world, this technology shows great promise in orthopaedics. The aim of this review is to investigate the current and potential uses of AR in orthopaedics. A systematic review of the PubMed, MEDLINE, and Embase databases up to January 2019 using the keywords ‘orthopaedic’ OR ‘orthopedic AND augmented reality’ was performed by two independent reviewers.Aims
Materials and Methods