SPINE20 recommendations 2023: One Earth, one family, one future WITHOUT spine DISABILITY.

Introduction: The purpose is to report on the fourth set of recommendations developed by SPINE20 to advocate for evidence-based spine care globally under the theme of "One Earth, One Family, One Future WITHOUT Spine DISABILITY".

Research Question: Not applicable.

Material And Methods: Recommendations were developed and refined through two modified Delphi processes with international, multi-professional panels.

SPINE20 recommendations 2021: spine care for people's health and prosperity.

Purpose: The focus of SPINE20 is to develop evidence-based policy recommendations for the G20 countries to work with governments to reduce the burden of spine disease, and disability.

Methods: On September 17-18, 2021, SPINE20 held its annual meeting in Rome, Italy. Prior to the meeting, the SPINE20 created six proposed recommendations.

SPINE20 A global advocacy group promoting evidence-based spine care of value.

Purpose: The Global Burden of Diseases (GBD) Studies have estimated that low back pain is one of the costliest ailments worldwide. Subsequent to GBD publications, leadership of the four largest global spine societies agreed to form SPINE20. This article introduces the concept of SPINE20, the recommendations, and the future of this global advocacy group linked to G20 annual summits.

Multicenter evaluation of therapeutic strategies of inpatients with osteoporotic vertebral fractures in Germany.

Purpose: The aim of this study was to assess therapeutic strategies of inpatients with osteoporotic thoracolumbar fractures (OTF) in Germany.

Methods: Prospective multi-center study including 16 German-speaking trauma centers over a period of 7 months. All inpatients with OTF were included.

Can cavity-based pedicle screw augmentation decrease screw loosening? A biomechanical in vitro study.

Purpose: In an osteoporotic vertebral body, cement-augmented pedicle screw fixation could possibly be optimized by the creation of an initial cavity. The aim of this study is to compare three test groups with regard to their loosening characteristics under cyclic loading.

Methods: Eighteen human, osteoporotic spine segments were divided in three groups.

[Nonsurgical and surgical management of osteoporotic vertebral body fractures : Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU)].

Study Design: Prospective clinical cohort study (data collection); expert opinion (recommendation development).

Objectives: Treatment options for nonsurgical and surgical management of osteoporotic vertebral body fractures differ widely. Based on the current literature, the knowledge of the experts, and their classification for osteoporotic fractures (OF classification), the Spine Section of the German Society for Orthopaedics and Trauma has now introduced general treatment recommendations.

Nonsurgical and Surgical Management of Osteoporotic Vertebral Body Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU).

Study Design: Prospective clinical cohort study (data collection); expert opinion (recommendation development).

Objectives: Treatment options for nonsurgical and surgical management of osteoporotic vertebral body fractures are widely differing. Based on current literature, the knowledge of the experts, and their classification for osteoporotic fractures (OF classification) the Spine Section of the German Society for Orthopaedics and Trauma has now introduced general treatment recommendations.

Classification of Osteoporotic Thoracolumbar Spine Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU).

Study Design: Expert opinion.

Objectives: Osteoporotic vertebral fractures are of increasing medical importance. For an adequate treatment strategy, an easy and reliable classification is needed.

Treatment of Odontoid Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU).

Study Design: Narrative review.

Objective: To establish recommendations for the treatment of odontoid fractures based on current literature and the knowledge of the experts of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU).

Methods: Narrative review of the literature.

[Thoracolumbar spinal fractures in the elderly : Classification and treatment].

Thoracolumbar fractures in the elderly are frequently associated with osteoporosis. Osteoporosis can cause fractures or be a significant comorbidity in traumatic fractures. The OF classification is based on conventional X‑ray, computed tomography (CT) scan and magnetic resonance imaging (MRI).

Rate and mode of screw misplacements after 3D-fluoroscopy navigation-assisted insertion and 3D-imaging control of 1547 pedicle screws in spinal levels T10-S1 related to vertebrae and spinal sections.

Purpose: In the field of spinal surgery, 3D-fluoroscopy navigation-assisted pedicle screw (PS) insertion with intra-operative 3D-image control represents a modern application of contemporary navigation technology. In literature, sectional or vertebral accuracy limitations of this image-guidance approach are not profoundly specified. This observational study explicitly differentiates accuracy rates and misplacement mode between spinal sections and single vertebrae from T10 to S1 using a navigation-assisted approach.

[Cement augmentation of pedicle screws : Pros and cons].

Cement augmentation of pedicle screws biomechanically increases screw purchase in the bone. However, clinical complications may occur. The pros and cons of the technique are discussed from different clinical perspectives.

Treatment of Osteoporotic Vertebral Compression Fractures: Applicability of Appropriateness Criteria in Clinical Practice.

Background: Appropriate treatment choice for osteoporotic vertebral compression fractures (OVCF) is challenging due to patient heterogeneity. Using the RAND/UCLA method, an international multidisciplinary expert panel established patient-specific criteria for the choice between non-surgical management (NSM), vertebroplasty (VP), and balloon kyphoplasty (BKP).

Objectives: To assess the applicability of the appropriateness criteria in real-life practice.

Criteria for the appropriate treatment of osteoporotic vertebral compression fractures.

Background: The heterogeneity of patients with osteoporotic vertebral compression fractures (VCF) necessitates a tailored approach of balancing the benefits and limitations of available treatments. Current guidelines are divergent, sometimes contradictory, and often insufficiently detailed to guide practice decisions.

Objectives: This study aimed at establishing treatment recommendations at the patient-specific level.

Anterior column reconstruction in thoracolumbar injuries utilizing a computer-assisted navigation system.

Background: Discectomy, corpectomy, and resection of isolated posterior wall fragments are technically demanding steps requiring maximum surgical precision during anterior reconstruction of the unstable thoracolumbar spine.

Purpose: This study investigates the feasibility of computer-aided guidance for these steps. It also analyzes the precision, advantages, and disadvantages of the procedure.

3D-based navigation in posterior stabilisations of the cervical and thoracic spine: problems and benefits. Results of 451 screws.

Introduction: Navigated procedures in spinal surgery have been established due to an increasing demand for precision. Especially, 3D C-arms connected to navigation systems are being used more often and can be utilised intraoperatively for the planning and controlling of screw positions. This prospective study analyses our experiences with 3D-based navigation in posterior stabilisations in the cervical and thoracic spine.

[Percutaneous techniques in the thoracic and lumbar spine].

Techniques of percutaneous spinal instrumentation have in the meantime become standard methods in many hospitals. While several indications have been established that are excellently suited to this technique, uncertainty prevails for other indications. This contribution intends to clarify the technical prerequisites for performing percutaneous instrumentation in the region of the thoracic and lumbar spine in addition to describing customary indications and various techniques of percutaneous instrumentation.

Osteoid osteoma of the proximal fibula: an uncommon location with the indication for open surgery.

Purpose. This is a case report of a patient with an osteoid osteoma of the proximal fibula. The objective is to illustrate a rare tumor location that requires open surgery due to closeness of neurological structures.

Posterior Fusion in Patients with Trauma, Instability, and Tumor of the Cervical Spine.

Trauma, instabilities and tumors of the cervical spine are treated with established methods of surgery. Therefore, anterior fusion is considered to be a standardized procedure for the lower cervical spine, while posterior and anterior instrumentation facilitates stabilization of the upper cervical spine. However, special situations that particularly require posterior instrumentation in traumatic lesions, tumor or other kinds of instabilities arise again and again.