Aims. To determine the value of scoliosis
Aims. The aim of this study was to identify the risk factors for adverse events following the surgical correction of cervical spinal deformities in adults. Methods. We identified adult patients who underwent corrective cervical spinal
Aims. The purpose of this study was to investigate the risk of additional
Aims. The purpose of this study was to evaluate the incidence and analyze the trends of surgeon-reported complications following
With the identification of literature shortfalls on the techniques employed in intraoperative navigated (ION) spinal
Wrong-level
Aims. The escalating demand for medical resources to address spinal diseases as society ages is an issue that requires careful evaluation. However, few studies have examined trends in spinal
Aims. The number of patients undergoing
Traumatic central cord syndrome (CCS) typically follows a hyperextension injury and results in motor impairment affecting the upper limbs more than the lower, with occasional sensory impairment and urinary retention. Current evidence on mortality and long-term outcomes is limited. The primary aim of this study was to assess the five-year mortality of CCS, and to determine any difference in mortality between management groups or age. Patients aged ≥ 18 years with a traumatic CCS between January 2012 and December 2017 in Wales were identified. Patient demographics and data about injury, management, and outcome were collected. Statistical analysis was performed to assess mortality and between-group differences.Aims
Methods
Aims. A variety of surgical methods and strategies have been demonstrated for Andersson lesion (AL) therapy. In 2011, we proposed and identified the feasibility of stabilizing the spine without curettaging the vertebral or discovertebral lesion to cure non-kyphotic AL. Additionally, due to the excellent reunion ability of ankylosing spondylitis, we further came up with minimally invasive spinal
Aims. The aim of this study was to assess the accuracy of pedicle screw placement, as well as intraoperative factors, radiation exposure, and complication rates in adult patients with degenerative disorders of the thoracic and lumbar spines who have undergone robotic-navigated spinal
Aims. To determine the major risk factors for unplanned reoperations (UROs) following corrective
Aims. Lumbar disc prolapse is a frequent indication for
Aims. People with severe, persistent low back pain (LBP) may be offered lumbar spine fusion
Aims. Repeated lumbar spine
Aims. The aim of this retrospective study was to compare the correction achieved using a convex pedicle screw technique and a low implant density achieved using periapical concave-sided screws and a high implant density. We hypothesized that there would be no difference in outcome between the two techniques. Methods. We retrospectively analyzed a series of 51 patients with a thoracic adolescent idiopathic scoliosis. There were 26 patients in the convex pedicle screw group who had screws implanted periapically (Group 2) and a control group of 25 patients with bilateral pedicle screws (Group 1). The patients’ charts were reviewed and pre- and postoperative radiographs evaluated. Postoperative patient-reported outcome measures (PROMs) were recorded. Results. The number of implants (14.5 vs 17.1) and the implant density (1.5 vs 1.9) were significantly lower in Group 2 (p < 0.001). Operating time was 27 minutes shorter in Group 2 than in Group 1, with a mean of 217 minutes (SD 50.5; 120 to 346). The duration of
Aims. Severe spinal deformity in growing patients often requires surgical management. We describe the incidence of spinal deformity surgery in a National Health Service. Methods. Descriptive study of prospectively collected data. Clinical data of all patients undergoing
Aims. The aim of this study was to explore the prognostic factors for postoperative neurological recovery and survival in patients with complete paralysis due to neoplastic epidural spinal cord compression. Patients and Methods. The medical records of 135 patients with complete paralysis due to neoplastic cord compression were retrospectively reviewed. Potential factors including the timing of
Aims. The aim of this study was to investigate the impact of the level of upper instrumented vertebra (UIV) in frail patients undergoing
Aims. With resumption of elective spine
Aims. The aim of this study was to evaluate the outcome of spinal instrumentation in haemodialyzed patients with native pyogenic spondylodiscitis. Spinal instrumentation in these patients can be dangerous due to rates of complications and mortality, and biofilm formation on the instrumentation. Patients and Methods. A total of 134 haemodialyzed patients aged more than 50 years who underwent surgical treatment for pyogenic spondylodiscitis were included in the study. Their mean age was 66.4 years (50 to 83); 66 were male (49.3%) and 68 were female (50.7%). They were divided into two groups according to whether spinal instrumentation was used or not. Propensity score matching was used to attenuate the potential selection bias. The outcome of treatment was compared between these two groups. Results. A total of 89 patients (66.4%) underwent non-instrumented
Aims. The outcome following the development of neurological complications after corrective
Aims. The aims of this study were to determine the rates of surgical complications, reoperations, and readmissions following herniated lumbar disc
To benchmark the radiation dose to patients during the course of treatment for a spinal deformity. Our radiation dose database identified 25,745 exposures of 6,017 children (under 18 years of age) and adults treated for a spinal deformity between 1 January 2008 and 31 December 2016. Patients were divided into surgical (974 patients) and non-surgical (5,043 patients) cohorts. We documented the number and doses of ionizing radiation imaging events (radiographs, CT scans, or intraoperative fluoroscopy) for each patient. All the doses for plain radiographs, CT scans, and intraoperative fluoroscopy were combined into a single effective dose by a medical physicist (milliSivert (mSv)).Aims
Methods
Aims. This study addressed two questions: first, does surgical correction of an idiopathic scoliosis increase the volume of the rib cage, and second, is it possible to evaluate the change in lung function after corrective
Aims. The current pandemic caused by COVID-19 is the biggest challenge for national health systems for a century. While most medical resources are allocated to treat COVID-19 patients, several non-COVID-19 medical emergencies still need to be treated, including vertebral fractures and spinal cord compression. The aim of this paper is to report the early experience and an organizational protocol for emergency spinal
Aims. Psychoeducative prehabilitation to optimize surgical outcomes is relatively novel in spinal fusion
Aims. Intraoperative 3D navigation (ION) allows high accuracy to be achieved in spinal
Aims. The direct posterior approach with subperiosteal dissection of the paraspinal muscles from the vertebrae is considered to be the standard approach for the surgical treatment of adolescent idiopathic scoliosis (AIS). We investigated whether or not a minimally-invasive
Aims. The aim of this study was to determine the influence of developmental spinal stenosis (DSS) on the risk of re-operation at an adjacent level. Patients and Methods. This was a retrospective study of 235 consecutive patients who had undergone decompression-only
The aim of this study was to determine if positive Waddell signs
were related to patients’ demographics or to perception of their
quality of life. This prospective cross-sectional study included 479 adult patients
with back pain from a university spine centre. Each completed SF-12
and Oswestry Disability Index (ODI) questionnaires and underwent
standard spinal examinations to elicit Waddell signs. The relationship
between Waddell signs and age, gender, ODI, Mental Component Score
(MCS), and Physical Component Score (PCS) scores was determined.Aims
Patients and Methods
Aims. During revision procedures for aseptic reasons, there remains a suspicion that failure may have been the result of an undetected subclinical infection. However, there is little evidence available in the literature about unexpected positive results in presumed aseptic revision spine
Aims. The aim of this study was to investigate the impact of maturity status at the time of
There have been few reports regarding the efficacy
of posterior instrumentation alone as surgical treatment for patients
with pyogenic spondylitis, thus avoiding the morbidity of anterior
surgery. We report the clinical outcomes of six patients with pyogenic
spondylitis treated effectively with a single-stage posterior fusion
without anterior debridement at a mean follow-up of 2.8 years (2
to 5). Haematological data, including white cell count and level
of C-reactive protein, returned to normal in all patients at a mean
of 8.2 weeks (7 to 9) after the posterior fusion. Rigid bony fusion
between the infected vertebrae was observed in five patients at
a mean of 6.3 months (4.5 to 8) post-operatively, with the remaining
patient having partial union. Severe back pain was immediately reduced
following
Pain catastrophising is an adverse coping mechanism,
involving an exaggerated response to anticipated or actual pain. The purpose of this study was to investigate the influence of
pain ‘catastrophising’, as measured using the pain catastrophising
scale (PCS), on treatment outcomes after
Aims. To evaluate the incidence of primary venous thromboembolism (VTE),
epidural haematoma, surgical site infection (SSI), and 90-day mortality
after elective spinal
Aims. The aim of this study was to report a retrospective, consecutive
series of patients with adolescent idiopathic scoliosis (AIS) who
were treated with posterior minimally invasive
Aims. The aim of this study was a quantitative analysis of a surgeon’s
learning curve for scoliosis
Aims. Our aim was to perform a systematic review of the literature
to assess the incidence of post-operative epidural haematomas and
wound infections after one-, or two-level, non-complex, lumbar surgery
for degenerative disease in patients with, or without post-operative
wound drainage. Patients and Methods. Studies were identified from PubMed and EMBASE, up to and including
27 August 2015, for papers describing one- or two-level lumbar discectomy
and/or laminectomy for degenerative disease in adults which reported
any form of subcutaneous or subfascial drainage. Results. Eight papers describing 1333 patients were included. Clinically
relevant post-operative epidural haematomas occurred in two (0.15%),
and wound infections in ten (0.75%) patients. Epidural haematomas
occurred in two (0.47%) patients who had wound drainage (n = 423)
and in none of those without wound drainage (n = 910). Wound infections
occurred in two (0.47%) patients with wound drainage and in eight
(0.88%) patients without wound drainage. Conclusion. These data suggest that the routine use of a wound drain in non-complex
lumbar
Minimal clinically important differences (MCID)
in the scores of patient-reported outcome measures allow clinicians to
assess the outcome of intervention from the perspective of the patient.
There has been significant variation in their absolute values in
previous publications and a lack of consistency in their calculation. The purpose of this study was first, to establish whether these
values, following spinal
Dysphagia is a common complication of anterior
surgery of the cervical spine. The incidence of post-operative dysphagia
may be as high as 71% within the first two weeks after
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
Objectives. We performed a systematic review of the literature to determine the safety and efficacy of bone morphogenetic protein (BMP) compared with bone graft when used specifically for revision spinal fusion
There have been a few reports of patients with
a combination of lumbar and thoracic spinal stenosis. We describe six
patients who suffered unexpected acute neurological deterioration
at a mean of 7.8 days (6 to 10) after lumbar decompressive
We studied 70 consecutive patients with adolescent idiopathic scoliosis who underwent corrective
We studied the use of autologous pre-donated blood transfusion in
We compared a group of 46 somatised patients with a control group of 41 non-somatised patients who had undergone elective surgery to the lumbar spine in an attempt to identify pre-operative factors which could predict the outcome. In a prospective single-centre study, the Distress and Risk Assessment method consisting of a modified somatic perception questionnaire and modified Zung depression index was used pre-operatively to identify somatised patients. The type and number of consultations were correlated with functional indicators of outcome, such as the Oswestry disability index and a visual analogue score for pain in the leg after follow-up for six and 12 months. Similar improvements in the Oswestry disability index were found in the somatised and non-somatised groups. Somatised patients who had a good outcome on the Oswestry disability index had an increased number of orthopaedic consultations (50 of 83 patients (60%) vs 29 of 73 patients (39.7%); p = 0.16) and waited less time for their
We retrospectively examined the prevalence and
natural history of asymptomatic lumbar canal stenosis in patients treated
surgically for cervical compressive myelopathy in order to assess
the influence of latent lumbar canal stenosis on the recovery after
surgery. Of 214 patients who had undergone cervical laminoplasty
for cervical myelopathy, we identified 69 (32%) with myelographically
documented lumbar canal stenosis. Of these, 28 (13%) patients with
symptomatic lumbar canal stenosis underwent simultaneous cervical
and lumbar decompression. Of the remaining 41 (19%) patients with
asymptomatic lumbar canal stenosis who underwent only cervical surgery,
39 were followed up for ≥ 1 year (mean 4.9 years (1 to 12)) and
were included in the analysis (study group). Patients without myelographic
evidence of lumbar canal stenosis, who had been followed up for ≥ 1
year after the cervical surgery, served as controls (135 patients;
mean follow-up period 6.5 years (1 to 17)). Among the 39 patients
with asymptomatic lumbar canal stenosis, seven had lumbar-related
leg symptoms after the cervical surgery. Kaplan–Meier analysis showed that 89.6% (95% confidence interval
(CI) 75.3 to 96.0) and 76.7% (95% CI 53.7 to 90.3) of the patients
with asymptomatic lumbar canal stenosis were free from leg symptoms
for three and five years, respectively. There were no significant
differences between the study and control groups in the recovery
rate measured by the Japanese Orthopaedic Association score or improvement
in the Nurick score at one year after
The aim of this study was to compare the outcomes of surgery
using growing rods in patients with severe A review of a multicentre EOS database identified 107 children
with severe EOS (major curve ≥ 90°) treated with growing rods before
the age of ten years with a minimum follow-up of two years and three
or more lengthening procedures. From the same database, 107 matched
controls with moderate EOS were identified.Aims
Patients and Methods
We compared the clinical, radiological and quality-of-life
outcomes between hybrid and total pedicle screw instrumentation
in patients undergoing