Purpose: Hybrid cervical spine surgery (HS) is a novel surgical strategy wherein an artificial disc replacement is done with a cervical fusion nearby with a stand-alone titanium cage to combine the advantages in both procedures. The aim of this study was to evaluate interactions of these devices within the same patient, and to analyze, if the different goal of each implant is accomplished.
Methods: Thirty-six patients were treated surgically within a non-randomized retrospective study framework with HS.
Decompression of spinal stenosis represents one of the most commonly performed procedures in spine surgery. With constantly increasing patient age and changing demographics, reducing the invasiveness of surgical procedures has become increasingly important. Over the past decades, microsurgical decompression has been established as a gold standard technique for the surgical treatment of spinal stenosis.
View Article and Find Full Text PDFIntroduction: Anterior stand-alone fusion (ASAF) devices have been developed in an attempt to reduce adjacent segment degenerative changes observed with posterior instrumented fusion techniques.
Research Question: The purpose of this study was to assess mid- to long-term clinical and radiological results following ASAF at the lumbosacral junction with special emphasis on the assessment of adjacent level pathologies.Materials & Methods: Clinical outcome scores and radiological data were acquired within an ongoing single-center prospective cohort study.
Purpose: Decompression is one of the most common interventions in spinal surgery. Obesity has become an increasing issue in surgical patients. Therefore, the aim of this study was to analyze the clinical outcome following lumbar microsurgical decompression in correlation with the patient's body mass index (BMI).
View Article and Find Full Text PDFCervical disc replacement (CDR) is a motion-preserving surgical procedure for treating patients with degenerative disorders. Numerous reports of first generation CDR "ball-and-socket" articulating devices have shown satisfactory clinical results. As a result, CDR devices have been safely implemented in the surgeon's armamentarium on a global scale.
View Article and Find Full Text PDFStudy Design: International consensus paper on a unified nomenclature for full-endoscopic spine surgery.
Objectives: Minimally invasive endoscopic spinal procedures have undergone rapid development during the past decade. Evolution of working-channel endoscopes and surgical instruments as well as innovation in surgical techniques have expanded the types of spinal pathology that can be addressed.
Oper Orthop Traumatol
June 2020
Objective: Stable interbody fusion of the lumbosacral segment via an anterior retroperitoneal approach using an interbody spacer as an anterior stand-alone device which is fixed with four locking screws.
Indications: Degenerative disc disease without instability or deformity; adjacent segment degeneration; pseudarthrosis.
Contraindications: Translational instabilities as in spondylolisthesis at the index segment; deformities; steep sacral slope.
Purpose: Previous studies have demonstrated that total cervical disc replacement (cTDR) represents a viable treatment alternative to the 'gold standard' anterior cervical discectomy and fusion for the treatment of well-defined cervical pathologies at short- and mid-term follow-up (FU). However, the implementation and acceptance of a non-fusion philosophy is closely associated with its avoidance of adjacent segment degeneration. Proof of the functional sustainability and clinical improvement of symptoms at long-term FU is still pending.
View Article and Find Full Text PDFBackground Context: Total lumbar disc replacement (TDR) intends to avoid fusion-related negative side effects by means of motion preservation. Despite their widespread use, the adequate quality and quantity of motion, as well as the correlation between radiographic data with the patient's clinical symptomatology, remains to be established. Long-term data are lacking in particular.
View Article and Find Full Text PDFBackground: During the last 20 years several less-invasive anterior approaches to the lumbar spine have become standard, including the extreme lateral transpsoas approach. Although it is associated with a lower risk of vascular injury compared with anterior midline approaches, neuromonitoring is considered mandatory to avoid neurologic complications. Interestingly, despite neuromonitoring, the reported risk of neurologic deficits with the extreme lateral transpsoas approach is greater than observed with other anterior approaches.
View Article and Find Full Text PDFPurpose: The purpose of this study was to assess the mid-term clinical and radiological results as well as patient safety in terms of complication and reoperation rates in patients treated with a novel anterior stand-alone fusion (ASAF) device (Synfix-LR, DePuy Synthes, West Chester, PA, USA) in a cohort of patients with predominant and intractable low back pain originating from monosegmental degenerative disc disease at the lumbosacral junction.
Methods: Clinical outcome scores visual analog scale (VAS), Oswestry disability index (ODI) and patient satisfaction rates were acquired within the framework of an ongoing single-center prospective clinical trial. Evaluation of radiological data included segmental and global lumbar lordosis, neuroforaminal height and width.
Background Context: The role of fusion of lumbar motion segments for the treatment of intractable low back pain (LBP) from degenerative disc disease (DDD) without deformities or instabilities remains controversially debated. Total lumbar disc replacement (TDR) has been used as an alternative in a highly selected patient cohort. However, the amount of long-term follow-up (FU) data on TDR is limited.
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