Publications by authors named "Hans-Jorg Meisel"
Study Design: Reliability study.
Objectives: The radiographic diagnosis of non-union is not standardized. Prior authors have suggested using a cutoff of <1 mm interspinous process motion (ISPM) on flexion-extension radiographs, but the ability of practicing surgeons to make these measurements reliably is not clear.
Article Synopsis
- The study aimed to compare the effectiveness of an intradiscal injection of allogeneic bone marrow mesenchymal stromal cells (BM-MSCs) to a sham placebo in chronic low back pain patients.
- 114 participants were randomly assigned to receive either the BM-MSC injection or a placebo, and outcomes were measured over 12 months using pain and disability scales, along with MRI assessments.
- The results showed no significant difference in effectiveness between the BM-MSC and placebo groups after 12 months, although the procedure was deemed safe with no serious adverse events reported.
Background Context: Lumbar disc herniation (LDH) is a leading cause of low back pain (LBP) and leg pain and may require surgical treatment in case of persistent pain and/or neurological deficits. Conventional discectomy involves removing the herniated fragment and additional material from the disc space, potentially accelerating disc degeneration and contributing to chronic LBP. Conversely, by resecting the herniated fragment only, sequestrectomy may reduce postoperative LBP while increasing the risk of LDH recurrence.
View Article and Find Full Text PDFImprovements in healthcare management have led to a decrease in perioperative and postoperative complications. However, perioperative medical complications and mortality rates continue to increase in patients undergoing elective spinal surgeries. This trend is driven by the increase in the older population and the rise in the number of patients with more than two comorbidities.
View Article and Find Full Text PDFArticle Synopsis
- The study reviews the effectiveness of decompression-only procedures for managing lumbar degenerative spondylolisthesis, highlighting their advantages such as shorter surgery time and minimized blood loss.
- It found an overall failure rate of 9.1%, with open decompression at 10.9% and microendoscopic decompression at 6.7%, suggesting varying outcomes based on the technique used.
- The analysis indicates that failure rates increase over time, peaking at 11.7% by the fifth year, but shows no significant differences between single-level and multilevel decompressions.
Background: Patients affected by lumbar spinal stenosis (LSS) suffer from a multifactorial degeneration of the lumbar spine resulting in narrowing of the neuroforamina and spinal canal, leading to various functional limitations. It remains unclear whether LSS patients after surgery would benefit from early post-operative rehabilitation, or if a delayed rehabilitation would be more advantageous. The purpose of this partially randomized patient preference trial is to evaluate the impact of post-operative rehabilitation timing as well as surgical intervention type on psychometric properties and functional outcomes in patients with LSS.
View Article and Find Full Text PDFStudy Design: Systematic literature review.
Objectives: In this study we assessed evidence for the use of osteobiologics in single vs multi-level anterior cervical discectomy and fusion (ACDF) in patients with cervical spine degeneration. The primary objective was to compare fusion rates after single and multi-level surgery with different osteobiologics.
Study Design: Systematic literature review.
Objectives: To analyze the evidence available reporting complications in single or two-level anterior cervical discectomy and fusion (ACDF) using a demineralized bone matrix (DBM), hydroxyapatite (HA), or beta-tricalcium phosphate (β-TCP).
Methods: A systematic review of the literature using PubMed, EMBASE, Cochrane Library, and ClinicalTrials.
Study Design: Systematic review.
Objectives: The study's primary objective was to determine how osteobiologic choice affects fusion rates in patients undergoing anterior cervical discectomy and fusion (ACDF). The study's secondary objectives were to 1) determine the optimal timing of fusion assessment following ACDF and 2) determine if osteobiologic type affects the timing and optimal modality of fusion assessment.
Study Design: Systematic review.
Objective: To assess the available evidence related to dose-dependent effectiveness (i.e.
Study Design: Systematic Review of the Literature.
Objective: The purpose of this study was to perform a systematic review describing fusion rates for anterior cervical discectomy and fusion (ACDF) using autograft vs various interbody devices augmented with different osteobiologic materials.
Methods: A systematic review limited to the English language was performed in Medline, Embase and Cochrane library using Medical Subject Heading (MeSH) terms.
Study Design: Systematic Literature Review.
Objective: Perform a systematic review evaluating postoperative fusion rates for anterior cervical discectomy and fusion (ACDF) using structural allograft vs various interbody devices augmented with different osteobiologic materials.
Methods: Comprehensive literature search using PubMed, Embase, The Cochrane Library, and Web of Science was performed.
Study Design: Systematic Review and Meta-Analysis.
Objectives: To compare complication incidence in patients with or without the use of recombinant human Bone Morphogenic Protein-2 (BMP2) undergoing anterior cervical discectomy and fusion (ACDF) for degenerative conditions.
Methods: A systematic search of eight online databases was conducted using PRISMA guidelines.
Study Design: Methodological study for guideline development.
Objective: AO Spine Guideline for Using Osteobiologics (AO-GO) project for spine degenerative pathologies was an international, multidisciplinary collaborative initiative to identify and evaluate evidence on existing use of osteobiologics in Anterior Cervical Fusion and Decompression (ACDF). The aim was to formulate precisely defined, clinically relevant and internationally applicable guidelines ensuring evidence-based, safe and effective use of osteobiologics, considering regional preferences and cost-effectiveness.
Article Synopsis
- This study is a systematic review and meta-analysis focused on comparing outcomes of two surgical methods—unplated vs. plated anterior cervical discectomy and fusion (ACDF)—for treating cervical degenerative disc disease, while also assessing the impact of osteobiologics.
- Researchers conducted a thorough search across various medical databases to identify relevant studies, ultimately including 38 that fit their criteria, and collected data on clinical outcomes, fusion rates, and complications.
- The findings suggest that both surgical methods lead to similar clinical results, but unplated ACDF showed benefits like less blood loss and shorter hospital stays, despite some differences in complications, indicating the need for caution in drawing firm conclusions due to study variability and risk of bias.
Article Synopsis
- * Out of 584 citations, 21 studies met the inclusion criteria, reporting a fusion rate between 68.5% and 100%, with common complications including postoperative dysphagia (0.5% to 14.4%) and revision surgery (0% to 10.3%).
- * Overall, complication reporting was low and suggests many issues may not be directly related to the allografts themselves but rather the ACDF procedure, indicating a need for more robust comparative
Study Design: Systematic literature review.
Objective: To analyze the literature and describe the evidence supporting osteobiologic use in revision anterior cervical discectomy and fusion (ACDF) surgery.
Methods: A systematic search of PubMed/MEDLINE, EMBASE, Cochrane library, and ClinicalTrials.
Study Design: Systematic review.
Objective: Examine the clinical evidence for the use of osteobiologics in hybrid surgery (combined anterior cervical discectomy and fusion (ACDF) and total disc replacement (TDR)) in patients with multilevel cervical degenerative disc disease (DDD).
Methods: PubMed and Embase were searched between January 2000 and August 2020.
Study Design: Guideline.
Objectives: To develop an international guideline (AOGO) about the use of osteobiologics in anterior cervical discectomy and fusion (ACDF) for treating degenerative spine conditions.
Methods: The guideline development process was guided by AO Spine Knowledge Forum Degenerative (KF Degen) and followed the Guideline International Network McMaster Guideline Development Checklist.
Article Synopsis
- The study conducts a systematic review to examine complications associated with multilevel anterior cervical discectomy and fusion (ACDF) using osteobiologics other than bone morphogenetic protein (BMP).
- A literature search yielded 584 articles, leading to the selection of 153 eligible studies that reported complications in patients undergoing 3 or 4-level ACDF with various osteobiologics.
- Key complications identified were dysphagia, adjacent segment disease, and pseudarthrosis; however, the limited existing evidence prevents definitive conclusions, highlighting the need for more detailed prospective studies.
Introduction: To date, the available guidance on venous thromboembolism (VTE) prevention in elective lumbar fusion surgery is largely open to surgeon interpretation and preference without any specific suggested chemoprophylactic regimen.
Research Question: This study aimed to comparatively analyze the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) with the use of commonly employed chemoprophylactic agents such as unfractionated heparin (UH) and low molecular weight heparin (LMWH) in lumbar fusion surgery.
Material And Methods: An independent systematic review of four scientific databases (PubMed, Scopus, clinicaltrials.
Do the Choice of Fusion Construct With and Without Autograft Influence the Fusion and Complication Rates in Patients Undergoing 1 or 2-Level Anterior Cervical Discectomy and Fusion Surgery? A PRISMA-Compliant Network Meta-Analysis.
Global Spine J
February 2024
Study Design: Network meta-analysis.
Objectives: To compare the fusion outcome and complications of different 1 or 2-level anterior cervical decompression and fusion (ACDF) constructs performed with and without the application of autografts.
Methods: We performed an independent and duplicate search in electronic databases including PubMed, Embase, Web of Science, Cochrane, and Scopus for relevant articles published between 2000 and 2020.
Study Design: This study constitutes a systematic review of the literature.
Objective: The aim of this study was to identify and present all available studies that report on the costs of osteobiologics used in anterior cervical discectomy and fusion (ACDF).
Methods: The literature was systematically reviewed to identify studies with specific inclusion criteria: (1) randomized controlled trials and observational studies, (2) in adult patients, (3) with herniated disc(s) or degenerative cervical spine disease, (4) reporting on either direct or indirect costs of using specific osteobiologics in an ACDF operation.
Importance: Glioblastoma is the most lethal primary brain cancer. Clinical outcomes for glioblastoma remain poor, and new treatments are needed.
Objective: To investigate whether adding autologous tumor lysate-loaded dendritic cell vaccine (DCVax-L) to standard of care (SOC) extends survival among patients with glioblastoma.