体积34: Issue 5 (May 2021)
inJournal of Neurosurgery: SpineIIllustration from Godzik et al. (pp 691–699). © Barrow Neurological Institute, Phoenix, Arizona. Published with permission.
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In Brief
In this study, the authors investigated the impact of different types of accessory rod connectors on stability and instrumentation strain in a long-segment deformity construct using human cadavers. The risk of instrumentation failure and fracture is high in long-segment deformity, and while we know that accessory rods are beneficial, we do not understand the ideal nature of the connector, nor the ideal orientation; an improved understanding would yield decreased failure and fracture rates.
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In Brief
The authors used augmented reality neuronavigation via a head-mounted display with an integrated optical tracking camera to perform an en bloc spondylectomy of an L1 chordoma. Augmented reality projection of neuronavigation data overlaid onto the surgical field resulted in simultaneous visualization for guidance and positioning of an ultrasonic osteoplastic blade. The technique enabled minimized tissue dissection by providing precise navigational data for avoiding a tumor capsule breach while still performing the narrowest cuts possible.
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In Brief
Pseudarthrosis including rod fracture is a common complication in adult spinal deformity surgery. In this study, researchers analyzed the methods for reducing rod fracture in deformity correction of adult spinal deformity. Greater preoperative sagittal spinopelvic malalignment including preoperative pelvic incidence minus lumbar lordosis mismatch was the crucial risk factor in patients 65 years or older. Application of the cobalt chrome rod, accessory rod technique, or lateral lumbar interbody fusion was found to be effective for reducing the risk of rod fracture.
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In Brief
Patients with cervical deformity (CD) have severe disability and poor health status. Little is known about how patients with fixed CD compare with those with flexible CD. In this study, the authors set out to determine whether patients with rigid CD have worse baseline alignment and require more aggressive surgical corrections than flexible CD patients and found that their outcomes are similar.
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In Brief
In this study the authors determined the concurrent validity, discriminant ability, and responsiveness of the Patient-Reported Outcomes Measurement Information System (PROMIS) in adult spinal deformity, and they calculated minimal clinically important differences for PROMIS scores. With this information, clinicians will be better equipped to interpret changes in PROMIS scores after surgery for adult spinal deformity.
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In Brief
The authors sought to investigate the safety and efficiency of growing rods in early-onset scoliosis (EOS) patients with untreated intraspinal anomalies (IAs). Through comparing the clinical and radiological outcomes between EOS patients with and those without untreated IAs, no significant difference in surgical outcomes was observed between the two groups. These results indicate that repeated lengthening procedures may be safe and effective for EOS patients with untreated IAs.
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In Brief
Minimally invasive surgery (MIS) for spinal deformity uses interbody techniques for correction, indirect decompression, and arthrodesis. Selection criteria for choosing a particular interbody approach are lacking. The authors created the minimally invasive interbody selection algorithm (MIISA) to provide a framework for rational decision-making in MIS for deformity. Understanding the limitations and differences in segmental lordosis for each level by approach can assist surgeons in optimizing care.
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In Brief
In patients undergoing surgery for cervical ossification of the posterior longitudinal ligament, the authors compared neurological recoveries based on patient presentation with mild, moderate, or severe preoperative myelopathy. Important determinants of unfavorable outcome were patient-related factors such as age or diabetes in patients with mild preoperative myelopathy and high signal intensity change in the spinal cord, male sex, and age older than 60 years in patients with moderate to severe myelopathy. The authors recommend anterior decompression with fusion for patients with moderate to severe preoperative myelopathy.
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In Brief
Patients with cervical deformity (CD) have severe disability and poor health status. Little is known about how patients with fixed CD compare with those with flexible CD. In this study, the authors set out to determine whether patients with rigid CD have worse baseline alignment and require more aggressive surgical corrections than flexible CD patients and found that their outcomes are similar.
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In Brief
The objective of this work was to simplify the complex field of predictive models for the practicing neurosurgeon. The authors graded each model based on characteristics of the original study, in addition to its performance in subsequent validation studies. They found this to stratify existing models in a useful manner. The hope is that in addition to simplifying these models, the utility of prediction model score can push future model development to incorporate the most generalizable and statistically robust methodologies.
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In Brief
研究人员调查了安全性和神经al recovery results in patients with complete (i.e., no function below the level of injury) thoracic spinal cord injury who were implanted with a novel bioresorbable scaffold (Neuro-Spinal Scaffold) during open spine surgery. The results from this first-in-human study are important because they demonstrate that the potential benefits of the Neuro-Spinal Scaffold outweigh the risks in this patient population and support further clinical investigation in a randomized controlled trial.
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