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Several recent studies have described the finding that applying vancomycin powder to the surgical bed may reduce the incidence of SSI. However, applying vancomycin in high concentrations has been shown in vitro to inhibit osteoblast proliferation and to induce cell death. Vancomycin may have a deleterious effect on dural healing after repair of an intentional or unintentional durotomy. This study was therefore undertaken to assess the effect of different concentrations of vancomycin on a human dura mater cell culture.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>METHODS\u003C\u002Fjats:title>\n\u003Cjats:p>Human dura intended for disposal after decompressive craniectomy was harvested. Explant primary cultures and subcultures were subsequently performed. Cells were characterized through common staining and immunohistochemistry. A growth curve was performed to assess the effect of different concentrations of vancomycin (40, 400, and 4000 μg\u002Fml) on cell count. The effect of vancomycin on cellular shape, intercellular arrangement, and viability was also evaluated.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>RESULTS\u003C\u002Fjats:title>\n\u003Cjats:p>All dural tissue samples successfully developed into fusiform cells, demonstrating pseudopod projections and spindle formation. The cells demonstrated vimentin positivity and also had typical features of fibroblasts. When applied to the cultures, the highest dose of vancomycin induced generalized cell death within 24 hours. The mean (± SD) cell counts for control, 40, 400, and 4000 μg\u002Fml were 38.72 ± 15.93, 36.28 ± 22.87, 19.48 ± 6.53, and 4.07 ± 9.66, respectively (p < 0.0001, ANOVA). Compared with controls, vancomycin-exposed cells histologically demonstrated a smaller cytoplasm and decreased pseudopodia formation resulting in the inhibition of normal spindle intercellular arrangement.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>CONCLUSIONS\u003C\u002Fjats:title>\n\u003Cjats:p>When vancomycin powder is applied locally, dural cells are exposed to a concentration several times greater than when delivered systemically. In this in vitro model, vancomycin induced dural cell death, inhibited growth, and altered cellular morphology in a concentration-dependent fashion. 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They also compared outcomes after classification of cases into thoracic and lumbar PSO subgroups.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>Methods\u003C\u002Fjats:title>\n\u003Cjats:p>he authors analyzed data obtained in 35 consecutive PSO-treated patients with sagittal imbalance. One surgeon performed all surgeries. The minimal follow-up period was 2 years. Events during the perioperative course and complications were noted. Standing long-film radiographs of the spine were obtained and measurements were made preoperatively, immediately postoperatively, and at most recent follow-up examination. The modified Prolo Scale and the 22-item Scoliosis Research Society (SRS-22) Outcomes Questionnaire were administered.\u003C\u002Fjats:p>\n\u003Cjats:p>Early complications after PSO included neurological injury, wound-related problems, and nosocomial infections. Late complications were limited to pseudarthrosis and attendant instrumentation failure. Early and late complication rates ranged from 10 to 30% for both thoracic and lumbar PSO cohorts.\u003C\u002Fjats:p>\n\u003Cjats:p>Lumbar PSO was associated with improvements in local, segmental, and global measures of sagittal balance, whereas thoracic PSO was only associated with local improvement. Most patients rated their functional status as fair to good according to the modified Prolo Scale and reported, according to the SRS-22 Outcomes Questionnaire, that they were satisfied with the overall treatment of their back condition.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>Conclusions\u003C\u002Fjats:title>\n\u003Cjats:p>The ability to perform a PSO at both lumbar and thoracic levels is a powerful asset for the spine surgeon treating spinal deformity. In the present study radiographic and clinical outcomes were superior when PSO was used to treat lumbar deformity rather than thoracic deformity because of several anatomical and technical obstacles that hindered the thoracic procedure. 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Surgical technique, 86, 44, 10.2106\u002F00004623-200403001-00007",{"doi":758},"10.2106\u002F00004623-200403001-00007",{"id":24,"text":760,"url":24,"identifiers":761},"2003, Complications and outcomes of pedicle subtraction osteotomies for fixed sagittal imbalance, 28, 2093, 10.1097\u002F01.BRS.0000090891.60232.70",{"doi":762},"10.1097\u002F01.BRS.0000090891.60232.70",{"id":24,"text":764,"url":24,"identifiers":765},"2003, Pedicle subtraction osteotomy for the treatment of fixed sagittal imbalance, 85, 454, 10.2106\u002F00004623-200303000-00009",{"doi":766},"10.2106\u002F00004623-200303000-00009",{"id":24,"text":768,"url":24,"identifiers":769},"2001, Notch sensitivity of titanium alloy, commercially pure titanium, and stainless steel spinal implants, 26, 1668, 10.1097\u002F00007632-200108010-00008",{"doi":770},"10.1097\u002F00007632-200108010-00008",{"id":24,"text":772,"url":24,"identifiers":773},"2004, Surgical correction of kyphosis. Posterior total wedge resection osteotomy in 32 patients, 75, 449, 10.1080\u002F00016470410001231-1",{"doi":774},"10.1080\u002F00016470410001231-1",{"id":24,"text":776,"url":24,"identifiers":777},"1997, Management of flatback and related kyphotic decompensation syndromes, 22, 2452, 10.1097\u002F00007632-199710150-00025",{"doi":778},"10.1097\u002F00007632-199710150-00025",{"id":24,"text":780,"url":24,"identifiers":781},"2005, Correlation of radiographic parameters and clinical symptoms in adult scoliosis, 30, 682, 10.1097\u002F01.brs.0000155425.04536.f7",{"doi":782},"10.1097\u002F01.brs.0000155425.04536.f7",{"id":24,"text":784,"url":24,"identifiers":785},"1991, Roentgenographic analysis of posture in spinal osteoporotics, 16, 750, 10.1097\u002F00007632-199107000-00011",{"doi":786},"10.1097\u002F00007632-199107000-00011",{"id":24,"text":788,"url":24,"identifiers":789},"2002, Clinical outcome results of pedicle subtraction osteotomy in ankylosing spondylitis with kyphotic deformity, 27, 612, 10.1097\u002F00007632-200203150-00010",{"doi":790},"10.1097\u002F00007632-200203150-00010",{"id":24,"text":792,"url":24,"identifiers":793},"2005, The prophylactic use of inferior vena cava filters in patients undergoing high-risk spinal surgery, 19, 442, 10.1007\u002Fs10016-005-0025-1",{"doi":794},"10.1007\u002Fs10016-005-0025-1",{"id":24,"text":796,"url":24,"identifiers":797},"1989, Decreasing homologous blood transfusion in spinal surgery by use of the cell saver and predeposited blood, 14, 1296, 10.1097\u002F00007632-198912000-00005",{"doi":798},"10.1097\u002F00007632-198912000-00005",{"id":24,"text":800,"url":24,"identifiers":801},"2002, Transpedicular decompression and pedicle subtraction osteotomy (eggshell procedure): a retrospective review of 59 patients, 27, 2338, 10.1097\u002F00007632-200211010-00006",{"doi":802},"10.1097\u002F00007632-200211010-00006",{"id":24,"text":804,"url":24,"identifiers":805},"2002, Spinal deformity: the role of the neurosurgeon, 50, 228",{},{"id":24,"text":807,"url":24,"identifiers":808},"1986, Toward uniformity in evaluating results of lumbar spine operations. A paradigm applied to posterior lumbar interbody fusions, 11, 601, 10.1097\u002F00007632-198607000-00012",{"doi":809},"10.1097\u002F00007632-198607000-00012",{"id":24,"text":811,"url":24,"identifiers":812},"2003, Staged posterior surgery for severe adult spinal deformity, 28, 2116, 10.1097\u002F01.BRS.0000090890.02906.A4",{"doi":813},"10.1097\u002F01.BRS.0000090890.02906.A4",{"id":24,"text":815,"url":24,"identifiers":816},"2004, Prophylactic placement of an inferior vena cava filter in high-risk patients undergoing spinal reconstruction, 17, E6",{},{"id":24,"text":818,"url":24,"identifiers":819},"2005, Surgical management of degenerative scoliosis, 17, 205, 10.1053\u002Fj.semss.2005.06.011",{"doi":820},"10.1053\u002Fj.semss.2005.06.011",{"id":24,"text":822,"url":24,"identifiers":823},"1990, Long scoliosis fusion to the sacrum in adults with nonparalytic scoliosis. An improved method, 15, 650, 10.1097\u002F00007632-199007000-00007",{"doi":824},"10.1097\u002F00007632-199007000-00007",{"id":24,"text":826,"url":24,"identifiers":827},"1945, Osteotomy of the spine for correction of flexion deformity in rheumatoid arthritis, 27, 1",{},{"id":24,"text":829,"url":24,"identifiers":830},"1993, Transpedicular decancellation closed wedge vertebral osteotomy for treatment of fixed flexion deformity of spine in ankylosing spondylitis, 18, 2517, 10.1097\u002F00007632-199312000-00023",{"doi":831},"10.1097\u002F00007632-199312000-00023",{"id":24,"text":833,"url":24,"identifiers":834},"1985, Vertebral osteotomy for correction of kyphosis in ankylosing spondylitis, 194, 142",{},{"id":836,"createTime":837,"updateTime":838,"relativeEntities":839,"slug":840,"properties":841,"entityType":150,"verifyStatus":151,"verifyTime":837,"verifyNote":153,"languages":855,"translateLanguages":24,"viewCount":25,"primaryUrl":856,"fullTextUrl":24,"authors":857,"publicationType":380,"publisherRelationship":928,"citationCount":991,"citationInfo":992,"publishDate":1001,"publishYear":446,"citationAnalyzeStatus":449,"lastCitationAnalyze":1002,"indexDatabases":1003,"openAccess":24,"references":1004,"isForceReanalyzing":536},"8a389e04-7787-402b-80cd-5c511a51ddb0","2024-10-10T08:20:05.618+00:00","2026-03-06T16:47:47.033+00:00",[],"Perioperative-outcomes-and-adverse-events-of-minimally-invasive-versus-open-posterior-lumbar-fusion-meta-analysis-and-systematic-review",{"mag":842,"gsPaper":844,"openalex":845,"abstract":847,"title":849,"pm":851,"doi":853},{"VOID":843},"2178924743",{"VOID":139},{"VOID":846},"W2178924743",{"EN":848},"\u003Cjats:sec>\n\u003Cjats:title>OBJECT\u003C\u002Fjats:title>\n\u003Cjats:p>The objective of this study was to determine the clinical comparative effectiveness and adverse event rates of posterior minimally invasive surgery (MIS) compared with open transforaminal or posterior lumbar interbody fusion (TLIF\u002FPLIF).\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>METHODS\u003C\u002Fjats:title>\n\u003Cjats:p>A systematic review of the Medline, EMBASE, PubMed, Web of Science, and Cochrane databases was performed. A hand search of reference lists was conducted. Studies were reviewed by 2 independent assessors to identify randomized controlled trials (RCTs) or comparative cohort studies including at least 10 patients undergoing MIS or open TLIF\u002FPLIF for degenerative lumbar spinal disorders and reporting at least 1 of the following: clinical outcome measure, perioperative clinical or process measure, radiographic outcome, or adverse events. Study quality was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) protocol. When appropriate, a meta-analysis of outcomes data was conducted.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>RESULTS\u003C\u002Fjats:title>\n\u003Cjats:p>The systematic review and reference list search identified 3301 articles, with 26 meeting study inclusion criteria. All studies, including 1 RCT, were of low or very low quality. No significant difference regarding age, sex, surgical levels, or diagnosis was identified between the 2 cohorts (856 patients in the MIS cohort, 806 patients in the open cohort). The meta-analysis revealed changes in the perioperative outcomes of mean estimated blood loss, time to ambulation, and length of stay favoring an MIS approach by 260 ml (p < 0.00001), 3.5 days (p = 0.0006), and 2.9 days (p < 0.00001), respectively. Operative time was not significantly different between the surgical techniques (p = 0.78). There was no significant difference in surgical adverse events (p = 0.97), but MIS cases were significantly less likely to experience medical adverse events (risk ratio [MIS vs open] = 0.39, 95% confidence interval 0.23–0.69, p = 0.001). No difference in nonunion (p = 0.97) or reoperation rates (p = 0.97) was observed. Mean Oswestry Disability Index scores were slightly better in the patients undergoing MIS (n = 346) versus open TLIF\u002FPLIF (n = 346) at a median follow-up time of 24 months (mean difference [MIS – open] = 3.32, p = 0.001).\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>CONCLUSIONS\u003C\u002Fjats:title>\n\u003Cjats:p>The result of this quantitative systematic review of clinical comparative effectiveness research examining MIS versus open TLIF\u002FPLIF for degenerative lumbar pathology suggests equipoise in patient-reported clinical outcomes. Furthermore, a meta-analysis of adverse event data suggests equivalent rates of surgical complications with lower rates of medical complications in patients undergoing minimally invasive TLIF\u002FPLIF compared with open surgery. The quality of the current comparative evidence is low to very low, with significant inherent bias.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>",{"EN":850},"Perioperative outcomes and adverse events of minimally invasive versus open posterior lumbar fusion: meta-analysis and systematic review",{"VOID":852},"26565767",{"VOID":854},"10.3171\u002F2015.2.spine14973",[155],"https:\u002F\u002Fthejns.org\u002Fview\u002Fjournals\u002Fj-neurosurg-spine\u002F24\u002F3\u002Farticle-p416.xml",[858,877,894,911],{"id":859,"sortIndex":25,"researcher":24,"roles":860,"affiliations":861,"properties":870},"7c579130-a10b-45d1-be52-df5edf09f9e9",[],[862],{"id":863,"sortIndex":25,"affiliation":864,"properties":24},"cddf7664-72a1-4cbf-9b31-37a6d5f694d6",{"id":863,"createTime":24,"updateTime":24,"relativeEntities":865,"slug":24,"properties":866,"entityType":24,"verifyStatus":24,"verifyTime":24,"verifyNote":24,"languages":24,"translateLanguages":24,"viewCount":24,"url":24,"parentIds":869,"statistic":24},[],{"title":867},{"EN":868},"Divisions of Neurosurgery and",[],{"orcid":871,"title":873,"openalex":875},{"VOID":872},"https:\u002F\u002Forcid.org\u002F0000-0001-7741-5667",{"EN":874},"Christina L. Goldstein",{"VOID":876},"A5051010273",{"id":878,"sortIndex":113,"researcher":24,"roles":879,"affiliations":880,"properties":889},"39a30bc0-410c-452d-a4e4-ed493d1f47e0",[],[881],{"id":882,"sortIndex":25,"affiliation":883,"properties":24},"28594ae8-1fba-4faf-96f2-da37587a85f1",{"id":882,"createTime":24,"updateTime":24,"relativeEntities":884,"slug":24,"properties":885,"entityType":24,"verifyStatus":24,"verifyTime":24,"verifyNote":24,"languages":24,"translateLanguages":24,"viewCount":24,"url":24,"parentIds":888,"statistic":24},[],{"title":886},{"EN":887},"Orthopedics, Toronto Western Hospital, University of Toronto, Ontario, Canada",[],{"title":890,"openalex":892},{"EN":891},"Kevin Macwan",{"VOID":893},"A5032723603",{"id":895,"sortIndex":114,"researcher":24,"roles":896,"affiliations":897,"properties":904},"c57e54b5-5b83-4658-be37-b3b6f9f513b1",[],[898],{"id":882,"sortIndex":25,"affiliation":899,"properties":24},{"id":882,"createTime":24,"updateTime":24,"relativeEntities":900,"slug":24,"properties":901,"entityType":24,"verifyStatus":24,"verifyTime":24,"verifyNote":24,"languages":24,"translateLanguages":24,"viewCount":24,"url":24,"parentIds":903,"statistic":24},[],{"title":902},{"EN":887},[],{"orcid":905,"title":907,"openalex":909},{"VOID":906},"https:\u002F\u002Forcid.org\u002F0000-0001-5788-5645",{"EN":908},"Kala Sundararajan",{"VOID":910},"A5031806905",{"id":912,"sortIndex":233,"researcher":24,"roles":913,"affiliations":914,"properties":921},"8758f8b3-d5cd-4667-b4d1-9c193ddfc128",[],[915],{"id":882,"sortIndex":25,"affiliation":916,"properties":24},{"id":882,"createTime":24,"updateTime":24,"relativeEntities":917,"slug":24,"properties":918,"entityType":24,"verifyStatus":24,"verifyTime":24,"verifyNote":24,"languages":24,"translateLanguages":24,"viewCount":24,"url":24,"parentIds":920,"statistic":24},[],{"title":919},{"EN":887},[],{"orcid":922,"title":924,"openalex":926},{"VOID":923},"https:\u002F\u002Forcid.org\u002F0000-0002-2521-5900",{"EN":925},"Y. 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Part 1 of 3 An overview of the GRADE approach and grading quality of evidence about interventions, 64, 669, 10.1111\u002Fj.1398-9995.2009.01973.x",{"doi":1015},"10.1111\u002Fj.1398-9995.2009.01973.x",{"id":24,"text":1017,"url":24,"identifiers":1018},"Carreon, 2003, Perioperative complications of posterior lumbar decompression and arthrodesis in older adults, 85-A, 2089",{},{"id":24,"text":1020,"url":24,"identifiers":1021},"Cho, 2007, Complications in posterior fusion and instrumentation for degenerative lumbar scoliosis, 32, 2232, 10.1097\u002FBRS.0b013e31814b2d3c",{"doi":1022},"10.1097\u002FBRS.0b013e31814b2d3c",{"id":24,"text":1024,"url":24,"identifiers":1025},"De la Garza-Ramos, 2014, The impact of obesity on short- and long-term outcomes following lumbar fusion",{},{"id":24,"text":1027,"url":24,"identifiers":1028},"DerSimonian, 1986, Meta-analysis in clinical trials, 7, 177, 10.1016\u002F0197-2456(86)90046-2",{"doi":1029},"10.1016\u002F0197-2456(86)90046-2",{"id":24,"text":1031,"url":24,"identifiers":1032},"Dhall, 2008, Clinical and radiographic comparison of mini-open transforaminal lumbar interbody fusion with open transforaminal lumbar interbody fusion in 42 patients with long-term follow-up, 9, 560, 10.3171\u002FSPI.2008.9.08142",{"doi":1033},"10.3171\u002FSPI.2008.9.08142",{"id":24,"text":1035,"url":24,"identifiers":1036},"Fan, 2010, Multifldus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach, 19, 316, 10.1007\u002Fs00586-009-1191-6",{"doi":1037},"10.1007\u002Fs00586-009-1191-6",{"id":24,"text":1039,"url":24,"identifiers":1040},"Foley, 2003, Minimally invasive lumbar fusion, 28, S26, 10.1097\u002F01.BRS.0000076895.52418.5E",{"doi":1041},"10.1097\u002F01.BRS.0000076895.52418.5E",{"id":24,"text":1043,"url":24,"identifiers":1044},"Fourney, 2010, Does minimal access tubular assisted spine surgery increase or decrease complications in spinal decompression or fusion?, 35, S57, 10.1097\u002FBRS.0b013e3181d82bb8",{"doi":1045},"10.1097\u002FBRS.0b013e3181d82bb8",{"id":24,"text":1047,"url":24,"identifiers":1048},"Garry, 2004, The eVALuate study: two parallel randomised trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy, 328, 129, 10.1136\u002Fbmj.37984.623889.F6",{"doi":1049},"10.1136\u002Fbmj.37984.623889.F6",{"id":24,"text":1051,"url":24,"identifiers":1052},"Ghahreman, 2010, Minimal access versus open posterior lumbar interbody fusion in the treatment of spondylolisthesis, 66, 296, 10.1227\u002F01.NEU.0000363600.24074.D0",{"doi":1053},"10.1227\u002F01.NEU.0000363600.24074.D0",{"id":24,"text":1055,"url":24,"identifiers":1056},"Glassman, 2009, Lumbar fusion outcomes stratified by specific diagnostic indication, 9, 13, 10.1016\u002Fj.spinee.2008.08.011",{"doi":1057},"10.1016\u002Fj.spinee.2008.08.011",{"id":24,"text":1059,"url":24,"identifiers":1060},"Goldstein, 2014, Comparative outcomes of minimally invasive surgery for posterior lumbar fusion: a systematic review, 472, 1727, 10.1007\u002Fs11999-014-3465-5",{"doi":1061},"10.1007\u002Fs11999-014-3465-5",{"id":24,"text":1063,"url":24,"identifiers":1064},"Harris, 2011, Mini-open versus open decompression and fusion for lumbar degenerative spondylolisthesis with stenosis, 40, E257",{},{"id":24,"text":1066,"url":24,"identifiers":1067},"Isaacs, 2005, Minimally invasive microendoscopy-assisted transforaminal lumbar interbody fusion with instrumentation, 3, 98, 10.3171\u002Fspi.2005.3.2.0098",{"doi":1068},"10.3171\u002Fspi.2005.3.2.0098",{"id":24,"text":1070,"url":24,"identifiers":1071},"Kalanithi, 2012, Morbid obesity increases cost and complication rates in spinal arthrodesis, 37, 982, 10.1097\u002FBRS.0b013e31823bbeef",{"doi":1072},"10.1097\u002FBRS.0b013e31823bbeef",{"id":24,"text":1074,"url":24,"identifiers":1075},"Karikari, 2011, Minimally invasive lumbar interbody fusion in patients older than 70 years of age: analysis of periand postoperative complications, 68, 897, 10.1227\u002FNEU.0b013e3182098bfa",{"doi":1076},"10.1227\u002FNEU.0b013e3182098bfa",{"id":24,"text":1078,"url":24,"identifiers":1079},"Karikari, 2010, Minimally invasive transforaminal lumbar interbody fusion: a review of techniques and outcomes, 35, S294, 10.1097\u002FBRS.0b013e3182022ddc",{"doi":1080},"10.1097\u002FBRS.0b013e3182022ddc",{"id":24,"text":1082,"url":24,"identifiers":1083},"Kotani, 2012, Midterm clinical results of minimally invasive decompression and posterolateral fusion with percutaneous pedicle screws versus conventional approach for degenerative spondylolisthesis with spinal stenosis, 21, 1171, 10.1007\u002Fs00586-011-2114-x",{"doi":1084},"10.1007\u002Fs00586-011-2114-x",{"id":24,"text":1086,"url":24,"identifiers":1087},"Lau, 2011, Complications and perioperative factors associated with learning the technique of minimally invasive transforaminal lumbar interbody fusion (TLIF), 18, 624, 10.1016\u002Fj.jocn.2010.09.004",{"doi":1088},"10.1016\u002Fj.jocn.2010.09.004",{"id":24,"text":1090,"url":24,"identifiers":1091},"Lee, 2012, Learning curve and clinical outcomes of minimally invasive transforaminal lumbar interbody fusion: our experience in 86 consecutive cases, 37, 1548, 10.1097\u002FBRS.0b013e318252d44b",{"doi":1092},"10.1097\u002FBRS.0b013e318252d44b",{"id":24,"text":1094,"url":24,"identifiers":1095},"Lee, 2014, Learning curve of a complex surgical technique: minimally invasive transforaminal lumbar interbody fusion (MIS TLIF), 27, E234, 10.1097\u002FBSD.0000000000000089",{"doi":1096},"10.1097\u002FBSD.0000000000000089",{"id":24,"text":1098,"url":24,"identifiers":1099},"Lee, 2012, Clinical and radiological outcomes of open versus minimally invasive transforaminal lumbar interbody fusion, 21, 2265, 10.1007\u002Fs00586-012-2281-4",{"doi":1100},"10.1007\u002Fs00586-012-2281-4",{"id":24,"text":1102,"url":24,"identifiers":1103},"Martin, 2008, Expenditures and health status among adults with back and neck problems, 299, 656, 10.1001\u002Fjama.299.6.656",{"doi":1104},"10.1001\u002Fjama.299.6.656",{"id":24,"text":1106,"url":24,"identifiers":1107},"McGirt, 2011, Comparative analysis of perioperative surgical site infection after minimally invasive versus open posterior\u002Ftransforaminal lumbar interbody fusion: analysis of hospital billing and discharge data from 5170 patients, 14, 771, 10.3171\u002F2011.1.SPINE10571",{"doi":1108},"10.3171\u002F2011.1.SPINE10571",{"id":24,"text":1110,"url":24,"identifiers":1111},"Mirza, 2006, Towards standardized measurement of adverse events in spine surgery: conceptual model and pilot evaluation, 7, 53, 10.1186\u002F1471-2474-7-53",{"doi":1112},"10.1186\u002F1471-2474-7-53",{"id":24,"text":1114,"url":24,"identifiers":1115},"Mobbs, 2012, Minimally invasive surgery compared to open spinal fusion for the treatment of degenerative lumbar spine pathologies, 19, 829, 10.1016\u002Fj.jocn.2011.10.004",{"doi":1116},"10.1016\u002Fj.jocn.2011.10.004",{"id":24,"text":1118,"url":24,"identifiers":1119},"Moher, 2009, Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement, 62, 1006, 10.1016\u002Fj.jclinepi.2009.06.005",{"doi":1120},"10.1016\u002Fj.jclinepi.2009.06.005",{"id":24,"text":1122,"url":24,"identifiers":1123},"Neyeloff, 2012, Meta-analyses and forest plots using a Microsoft Excel spreadsheet: Step-by-step guide focusing on descriptive data analysis, 5, 52, 10.1186\u002F1756-0500-5-52",{"doi":1124},"10.1186\u002F1756-0500-5-52",{"id":24,"text":1126,"url":24,"identifiers":1127},"Ntoukas, 2010, Minimally invasive approach versus traditional open approach for one level posterior lumbar interbody fusion, 53, 21, 10.1055\u002Fs-0030-1247560",{"doi":1128},"10.1055\u002Fs-0030-1247560",{"id":24,"text":1130,"url":24,"identifiers":1131},"Pace, 2003, Health-related quality of life after laparoscopic and open nephrectomy, 17, 143, 10.1007\u002Fs00464-002-8902-y",{"doi":1132},"10.1007\u002Fs00464-002-8902-y",{"id":24,"text":1134,"url":24,"identifiers":1135},"Park, 2008, The impact of minimally invasive spine surgery on perioperative complications in overweight or obese patients, 62, 693, 10.1227\u002F01.neu.0000317318.33365.f1",{"doi":1136},"10.1227\u002F01.neu.0000317318.33365.f1",{"id":24,"text":1138,"url":24,"identifiers":1139},"Park, 2007, Comparison of one-level posterior lumbar interbody fusion performed with a minimally invasive approach or a traditional open approach, 32, 537, 10.1097\u002F01.brs.0000256473.49791.f4",{"doi":1140},"10.1097\u002F01.brs.0000256473.49791.f4",{"id":24,"text":1142,"url":24,"identifiers":1143},"Parker, 2011, Post-operative infection after minimally invasive versus open transforaminal lumbar interbody fusion (TLIF): literature review and cost analysis, 54, 33, 10.1055\u002Fs-0030-1269904",{"doi":1144},"10.1055\u002Fs-0030-1269904",{"id":24,"text":1146,"url":24,"identifiers":1147},"Pelton, 2012, A comparison of perioperative costs and outcomes in patients with and without workers’ compensation claims treated with minimally invasive or open transforaminal lumbar interbody fusion, 37, 1914, 10.1097\u002FBRS.0b013e318257d490",{"doi":1148},"10.1097\u002FBRS.0b013e318257d490",{"id":24,"text":1150,"url":24,"identifiers":1151},"Peng, 2009, Clinical and radiological outcomes of minimally invasive versus open transforaminal lumbar interbody fusion, 34, 1385, 10.1097\u002FBRS.0b013e3181a4e3be",{"doi":1152},"10.1097\u002FBRS.0b013e3181a4e3be",{"id":24,"text":1154,"url":24,"identifiers":1155},"Proietti, 2013, Complications in lumbar spine surgery: A retrospective analysis, 47, 340, 10.4103\u002F0019-5413.114909",{"doi":1156},"10.4103\u002F0019-5413.114909",{"id":24,"text":1158,"url":24,"identifiers":1159},"Rampersaud, 2012, Commentary: complications in spine surgery: “the devil is in the details”, 12, 207, 10.1016\u002Fj.spinee.2012.02.030",{"doi":1160},"10.1016\u002Fj.spinee.2012.02.030",{"id":24,"text":1162,"url":24,"identifiers":1163},"Rampersaud, 2011, Cost-utility analysis of posterior minimally invasive fusion compared with conventional open fusion for lumbar spondylolisthesis, 5, 29, 10.1016\u002Fj.esas.2011.02.001",{"doi":1164},"10.1016\u002Fj.esas.2011.02.001",{"id":24,"text":1166,"url":24,"identifiers":1167},"Scheufler, 2007, Percutaneous transforaminal lumbar interbody fusion for the treatment of degenerative lumbar instability, 60, 203",{},{"id":24,"text":1169,"url":24,"identifiers":1170},"Schizas, 2009, Minimally invasive versus open transforaminal lumbar interbody fusion: evaluating initial experience, 33, 1683, 10.1007\u002Fs00264-008-0687-8",{"doi":1171},"10.1007\u002Fs00264-008-0687-8",{"id":24,"text":1173,"url":24,"identifiers":1174},"Schoenfeld, 2011, Risk factors for immediate postoperative complications and mortality following spine surgery: a study of 3475 patients from the National Surgical Quality Improvement Program, 93, 1577, 10.2106\u002FJBJS.J.01048",{"doi":1175},"10.2106\u002FJBJS.J.01048",{"id":24,"text":1177,"url":24,"identifiers":1178},"Selznick, 2009, Minimally invasive interbody fusion for revision lumbar surgery: technical feasibility and safety, 22, 207, 10.1097\u002FBSD.0b013e318169026f",{"doi":1179},"10.1097\u002FBSD.0b013e318169026f",{"id":24,"text":1181,"url":24,"identifiers":1182},"Silva, 2013, Learning curve and complications of minimally invasive transforaminal lumbar interbody fusion, 35, E7, 10.3171\u002F2013.5.FOCUS13157",{"doi":1183},"10.3171\u002F2013.5.FOCUS13157",{"id":24,"text":1185,"url":24,"identifiers":1186},"Starkweather, 2008, The multiple benefits of minimally invasive spinal surgery: results comparing transforaminal lumbar interbody fusion and posterior lumbar fusion, 40, 32, 10.1097\u002F01376517-200802000-00006",{"doi":1187},"10.1097\u002F01376517-200802000-00006",{"id":24,"text":1189,"url":24,"identifiers":1190},"Street, 2012, Morbidity and mortality of major adult spinal surgery. A prospective cohort analysis of 942 consecutive patients, 12, 22, 10.1016\u002Fj.spinee.2011.12.003",{"doi":1191},"10.1016\u002Fj.spinee.2011.12.003",{"id":24,"text":1193,"url":24,"identifiers":1194},"Stroup, 2000, Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group, 283, 2008, 10.1001\u002Fjama.283.15.2008",{"doi":1195},"10.1001\u002Fjama.283.15.2008",{"id":24,"text":1197,"url":24,"identifiers":1198},"Thomsen, 1997, 1997 Volvo Award winner in clinical studies. The effect of pedicle screw instrumentation on functional outcome and fusion rates in posterolateral lumbar spinal fusion: a prospective, randomized clinical study, 22, 2813, 10.1097\u002F00007632-199712150-00004",{"doi":1199},"10.1097\u002F00007632-199712150-00004",{"id":24,"text":1201,"url":24,"identifiers":1202},"Topçu, 2003, Comparison of long-term quality of life after laparoscopic and open cholecystectomy, 17, 291, 10.1007\u002Fs00464-001-9231-2",{"doi":1203},"10.1007\u002Fs00464-001-9231-2",{"id":24,"text":1205,"url":24,"identifiers":1206},"Tsutsumimoto, 2009, Miniopen versus conventional open posterior lumbar interbody fusion for the treatment of lumbar degenerative spondylolisthesis: comparison of paraspinal muscle damage and slip reduction, 34, 1923, 10.1097\u002FBRS.0b013e3181a9d28e",{"doi":1207},"10.1097\u002FBRS.0b013e3181a9d28e",{"id":24,"text":1209,"url":24,"identifiers":1210},"Valentine, 2010, How many studies do you need? A primer on statistical power for meta-analysis, 35, 215, 10.3102\u002F1076998609346961",{"doi":1211},"10.3102\u002F1076998609346961",{"id":24,"text":1213,"url":24,"identifiers":1214},"Villavicencio, 2010, Minimally invasive versus open transforaminal lumbar interbody fusion, 1, 12, 10.4103\u002F2152-7806.63905",{"doi":1215},"10.4103\u002F2152-7806.63905",{"id":24,"text":1217,"url":24,"identifiers":1218},"Wang, 2011, Minimally invasive lumbar interbody fusion via MAST Quadrant retractor versus open surgery: a prospective randomized clinical trial, 124, 3868",{},{"id":24,"text":1220,"url":24,"identifiers":1221},"Wang, 2014, Comparison of clinical outcome in overweight or obese patients after minimally invasive versus open transforaminal lumbar interbody fusion, 27, 202, 10.1097\u002FBSD.0b013e31825d68ac",{"doi":1222},"10.1097\u002FBSD.0b013e31825d68ac",{"id":24,"text":1224,"url":24,"identifiers":1225},"Wang, 2010, Comparison of one-level minimally invasive and open transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2, 19, 1780, 10.1007\u002Fs00586-010-1404-z",{"doi":1226},"10.1007\u002Fs00586-010-1404-z",{"id":24,"text":1228,"url":24,"identifiers":1229},"Wang, 2011, Minimally invasive or open transforaminal lumbar interbody fusion as revision surgery for patients previously treated by open discectomy and decompression of the lumbar spine, 20, 623, 10.1007\u002Fs00586-010-1578-4",{"doi":1230},"10.1007\u002Fs00586-010-1578-4",{"id":24,"text":1232,"url":24,"identifiers":1233},"Wang, 2010, An analysis of the differences in the acute hospitalization charges following minimally invasive versus open posterior lumbar interbody fusion, 12, 694, 10.3171\u002F2009.12.SPINE09621",{"doi":1234},"10.3171\u002F2009.12.SPINE09621",{"id":24,"text":1236,"url":24,"identifiers":1237},"Wu, 2010, Minimal access versus open transforaminal lumbar interbody fusion: meta-analysis of fusion rates, 35, 2273, 10.1097\u002FBRS.0b013e3181cd42cc",{"doi":1238},"10.1097\u002FBRS.0b013e3181cd42cc",{"id":24,"text":1240,"url":24,"identifiers":1241},"Zhang, 2009, Clinical diagnosis for discogenic low back pain, 5, 647",{},{"id":1243,"createTime":1244,"updateTime":1244,"relativeEntities":1245,"slug":1246,"properties":1247,"entityType":150,"verifyStatus":151,"verifyTime":1260,"verifyNote":153,"languages":1261,"translateLanguages":24,"viewCount":25,"primaryUrl":1262,"fullTextUrl":24,"authors":1263,"publicationType":380,"publisherRelationship":1420,"citationCount":364,"citationInfo":1483,"publishDate":1486,"publishYear":1484,"citationAnalyzeStatus":23,"lastCitationAnalyze":24,"indexDatabases":1487,"openAccess":24,"references":1488,"isForceReanalyzing":536},"9e62caf0-a260-40b0-a2f0-6b5de2cf135f","2025-01-28T04:55:31.198+00:00",[],"Contributions-of-the-fourth-spinal-nerve-to-the-brachial-plexus-without-prefixation",{"openalex":1248,"mag":1250,"abstract":1252,"title":1254,"pm":1256,"doi":1258},{"VOID":1249},"W1508714845",{"VOID":1251},"1508714845",{"EN":1253},"\u003Cjats:sec>\n\u003Cjats:title>Object\u003C\u002Fjats:title>\n\u003Cjats:p>The intradural contributions of the C-4 nerve rootlets have not been previously evaluated for their connections to the brachial plexus. The authors undertook a cadaveric study to evaluate the C-4 contributions to the upper trunk of the brachial plexus.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>Methods\u003C\u002Fjats:title>\n\u003Cjats:p>The posterior cervical triangles from 60 adult cadavers were dissected. All specimens that were found to have extradural C-4 contributions to the upper trunk of the brachial plexus were excluded from further study. In specimens found to have no extradural C-4 contributions to the brachial plexus a C1–T1 laminectomy was performed. Observations were made of any neural communications between adjacent spinal rootlets, specifically between C-4 and C-5.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>Results\u003C\u002Fjats:title>\n\u003Cjats:p>Nine (15%) of the 60 sides were found to have extradural C-4 contributions to the upper trunk of the brachial plexus. These sides were excluded from further study. No specimen was found to have a postfixed brachial plexus. Of the remaining 51 sides, 11 (21.6%) were found to have intradural neural connections between C-4 and C-5 dorsal rootlets and 1 (1.96%) had a connection between the ventral roots of C-4 and C-5. Communications between these 2 adjacent dorsal cervical cord levels were of 3 types. Type I was a vertical communication between the more horizontally traveling dorsal roots. Type II was a forked communication between adjacent C-4 and C-5 dorsal rootlets. The Type III designation was applied to connections between ventral rootlets. Although communications were slightly more frequent on left sides, this did not reach statistical significance.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>Conclusions\u003C\u002Fjats:title>\n\u003Cjats:p>In ~ 20% of normally composed brachial plexuses (those with extradural contributions from only C5–T1) we found intradural C4–5 neural connections. Such variations may lead to misinterpretation of spinal levels in pathological conditions of the spinal axis and should be considered in surgical procedures of this region, such as rhizotomy.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>",{"EN":1255},"Contributions of the fourth spinal nerve to the brachial plexus without prefixation",{"VOID":1257},"18518676",{"VOID":1259},"10.3171\u002Fspi\u002F2008\u002F8\u002F6\u002F548","2025-01-28T04:55:31.197+00:00",[155],"https:\u002F\u002Fthejns.org\u002Fview\u002Fjournals\u002Fj-neurosurg-spine\u002F8\u002F6\u002Farticle-p548.xml",[1264,1291,1318,1337,1354,1371,1386,1405],{"id":1265,"sortIndex":25,"researcher":24,"roles":1266,"affiliations":1267,"properties":1284},"b3376d4b-bcfc-45d4-a194-d7c70898ae2f",[],[1268,1276],{"id":1269,"sortIndex":25,"affiliation":1270,"properties":24},"df9a3c36-f683-4927-b9cc-6d177efcf162",{"id":1269,"createTime":24,"updateTime":24,"relativeEntities":1271,"slug":24,"properties":1272,"entityType":24,"verifyStatus":24,"verifyTime":24,"verifyNote":24,"languages":24,"translateLanguages":24,"viewCount":24,"url":24,"parentIds":1275,"statistic":24},[],{"title":1273},{"EN":1274},"1Section of Pediatric Neurosurgery, Children's Hospital, and",[],{"id":1277,"sortIndex":113,"affiliation":1278,"properties":24},"4005eed6-8e9b-4c25-a057-0664bc82845d",{"id":1277,"createTime":24,"updateTime":24,"relativeEntities":1279,"slug":24,"properties":1280,"entityType":24,"verifyStatus":24,"verifyTime":24,"verifyNote":24,"languages":24,"translateLanguages":24,"viewCount":24,"url":24,"parentIds":1283,"statistic":24},[],{"title":1281},{"EN":1282},"2Department of Cell Biology, University of Alabama at Birmingham, Alabama;",[],{"orcid":1285,"title":1287,"openalex":1289},{"VOID":1286},"https:\u002F\u002Forcid.org\u002F0000-0003-1317-1047",{"EN":1288},"R. Shane Tubbs",{"VOID":1290},"A5053911734",{"id":1292,"sortIndex":113,"researcher":24,"roles":1293,"affiliations":1294,"properties":1311},"fd2c8f00-5321-4ae5-9b8f-bc42592badca",[],[1295,1303],{"id":1296,"sortIndex":25,"affiliation":1297,"properties":24},"a93c7003-202f-48ef-9ef3-23bc90be206d",{"id":1296,"createTime":24,"updateTime":24,"relativeEntities":1298,"slug":24,"properties":1299,"entityType":24,"verifyStatus":24,"verifyTime":24,"verifyNote":24,"languages":24,"translateLanguages":24,"viewCount":24,"url":24,"parentIds":1302,"statistic":24},[],{"title":1300},{"EN":1301},"3Department of Anatomical Sciences, St. George's University, Grenada;",[],{"id":1304,"sortIndex":113,"affiliation":1305,"properties":24},"44b1dd7c-4688-4357-b5fb-d90522f4612b",{"id":1304,"createTime":24,"updateTime":24,"relativeEntities":1306,"slug":24,"properties":1307,"entityType":24,"verifyStatus":24,"verifyTime":24,"verifyNote":24,"languages":24,"translateLanguages":24,"viewCount":24,"url":24,"parentIds":1310,"statistic":24},[],{"title":1308},{"EN":1309},"4Department of Education and Development, Harvard Medical School, Boston, Massachusetts;",[],{"orcid":1312,"title":1314,"openalex":1316},{"VOID":1313},"https:\u002F\u002Forcid.org\u002F0000-0003-2811-6657",{"EN":1315},"Marios Loukas",{"VOID":1317},"A5073862979",{"id":1319,"sortIndex":114,"researcher":24,"roles":1320,"affiliations":1321,"properties":1330},"1673812e-0dca-45d4-84e4-ed9fb43c73c6",[],[1322],{"id":1323,"sortIndex":25,"affiliation":1324,"properties":24},"52821641-24f1-445d-9e2a-e645fbf7f65d",{"id":1323,"createTime":24,"updateTime":24,"relativeEntities":1325,"slug":24,"properties":1326,"entityType":24,"verifyStatus":24,"verifyTime":24,"verifyNote":24,"languages":24,"translateLanguages":24,"viewCount":24,"url":24,"parentIds":1329,"statistic":24},[],{"title":1327},{"EN":1328},"5Tuberculosis and Lung Research Center and",[],{"orcid":1331,"title":1333,"openalex":1335},{"VOID":1332},"https:\u002F\u002Forcid.org\u002F0000-0001-9668-5558",{"EN":1334},"Mohammadali M. 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Br J Pharmacol. 2008;153(3):536–543.1805932310.1038\u002Fsj.bjp.0707595",{"id":24,"text":1743,"url":24,"identifiers":24},"Alexander JH, Jordan SW, West JM, Targeted muscle reinnervation in oncologic amputees: early experience of a novel institutional protocol. J Surg Oncol. 2019;120(3):348–358.10.1002\u002Fjso.2558631197851",{"id":24,"text":1745,"url":24,"identifiers":24},"Devulapalli C, Broyles JM, Bello R, Soft-tissue reconstruction of large spinal defects: a 12-year institutional experience. Plast Reconstr Surg. 2017;140(4):806–814.10.1097\u002FPRS.000000000000367928617741",{"id":24,"text":1747,"url":24,"identifiers":24},"Franz MG, Steed DL, Robson MC. Optimizing healing of the acute wound by minimizing complications. Curr Probl Surg. 2007;44(11):691–763.10.1067\u002Fj.cpsurg.2007.07.00118036992",{"id":24,"text":1749,"url":24,"identifiers":24},"Chieng LO, Hubbard Z, Salgado CJ, Reconstruction of open wounds as a complication of spinal surgery with flaps: a systematic review. Neurosurg Focus. 2015;39(4):E17.10.3171\u002F2015.7.FOCUS1524526424341",{"id":24,"text":1751,"url":24,"identifiers":24},"Mericli AF, Tarola NA, Moore JH, Paraspinous muscle flap reconstruction of complex midline back wounds: risk factors and postreconstruction complications. Ann Plast Surg. 2010;65(2):219–224.10.1097\u002FSAP.0b013e3181c47ef420585231",{"id":24,"text":1753,"url":24,"identifiers":24},"Omeis IA, Dhir M, Sciubba DM, Postoperative surgical site infections in patients undergoing spinal tumor surgery: incidence and risk factors. Spine (Phila Pa 1976). 2011;36(17):1410–1419.10.1097\u002FBRS.0b013e3181f48fa921240050",{"id":24,"text":1755,"url":24,"identifiers":24},"Atkinson RA, Jones A, Ousey K, Stephenson J. Management and cost of surgical site infection in patients undergoing surgery for spinal metastasis. J Hosp Infect. 2017;95(2):148–153.2802778910.1016\u002Fj.jhin.2016.11.016",{"id":24,"text":1757,"url":24,"identifiers":24},"Bernatz JT, Anderson PA. Thirty-day readmission rates in spine surgery: systematic review and meta-analysis. Neurosurg Focus. 2015;39(4):E7.10.3171\u002F2015.7.FOCUS153426424347",{"id":24,"text":1759,"url":24,"identifiers":24},"Kuhns BD, Lubelski D, Alvin MD, Cost and quality of life outcome analysis of postoperative infections after subaxial dorsal cervical fusions. J Neurosurg Spine. 2015;22(4):381–386.2561563010.3171\u002F2014.10.SPINE14228",{"id":24,"text":1761,"url":24,"identifiers":24},"Yeramaneni S, Robinson C, Hostin R. Impact of spine surgery complications on costs associated with management of adult spinal deformity. Curr Rev Musculoskelet Med. 2016;9(3):327–332.10.1007\u002Fs12178-016-9352-927278531",{"id":24,"text":1763,"url":24,"identifiers":24},"Khalafallah AA, Kirkby BE, Wong S, Venous thromboembolism in medical patients during hospitalisation and 3 months after hospitalisation: a prospective observational study. BMJ Open. 2016;6(8):e012346.2748915810.1136\u002Fbmjopen-2016-012346",{"id":24,"text":1765,"url":24,"identifiers":24},"Lynch JP III. Hospital-acquired pneumonia: risk factors, microbiology, and treatment. Chest. 2001;119(2)(suppl):373S–384S.10.1378\u002Fchest.119.2_suppl.373S11171773",{"id":24,"text":1767,"url":24,"identifiers":24},"Shah NK, Farber A, Kalish JA, Occurrence of “never events” after major open vascular surgery procedures. J Vasc Surg. 2016;63(3):738–745.e28.10.1016\u002Fj.jvs.2015.09.02426610649",{"id":24,"text":1769,"url":24,"identifiers":24},"Calderone RR, Garland DE, Capen DA, Oster H. Cost of medical care for postoperative spinal infections. Orthop Clin North Am. 1996;27(1):171–182.853904710.1016\u002FS0030-5898(20)32060-5",{"id":24,"text":1771,"url":24,"identifiers":24},"Zucherman J, Hsu K, White A, Wynne G. Early results of spinal fusion using variable spine plating system. Spine (Phila Pa 1976). 1988;13(5):570–579.10.1097\u002F00007632-198805000-000242973134",{"id":24,"text":1773,"url":24,"identifiers":24},"Khalil HH, Malahias MN, Balasubramanian B, Multidisciplinary oncoplastic approach reduces infection in chest wall resection and reconstruction for malignant chest wall tumors. Plast Reconstr Surg Glob Open. 2016;4(7):e809.2753648810.1097\u002FGOX.0000000000000751",{"id":24,"text":1775,"url":24,"identifiers":24},"Leary OP, Liu DD, Boyajian MK, Complex wound closure by plastic surgery following resection of spinal neoplasms minimizes postoperative wound complications in high-risk patients. J Neurosurg Spine. 2020;33(1):77–86.10.3171\u002F2019.12.SPINE191238",{"id":1777,"createTime":1778,"updateTime":1779,"relativeEntities":1780,"slug":1781,"properties":1782,"entityType":150,"verifyStatus":151,"verifyTime":1778,"verifyNote":153,"languages":1799,"translateLanguages":1800,"viewCount":25,"primaryUrl":1802,"fullTextUrl":24,"authors":1803,"publicationType":380,"publisherRelationship":1892,"citationCount":1954,"citationInfo":1955,"publishDate":1958,"publishYear":1956,"citationAnalyzeStatus":23,"lastCitationAnalyze":24,"indexDatabases":1959,"openAccess":24,"references":1960,"isForceReanalyzing":536},"410aedee-7a1a-4652-93e2-8799881bcc0f","2024-09-28T05:41:59.983+00:00","2024-12-26T14:22:15.192+00:00",[],"C-2-neurectomy-during-atlantoaxial-instrumented-fusion-in-the-elderly-patient-satisfaction-and-surgical-outcome",{"mag":1783,"keywords":1785,"openalex":1787,"abstract":1789,"title":1792,"pm":1795,"doi":1797},{"VOID":1784},"1553709480",{"VI":1786},"C1–2 instability; atlantoaxial stabilization; C-2 neurectomy; fusion rate; patient satisfaction; elderly; surgical outcome; postoperative neuralgia.",{"VOID":1788},"W1553709480",{"EN":1790,"VI":1791},"\u003Cjats:sec>\n\u003Cjats:title>Object\u003C\u002Fjats:title>\n\u003Cjats:p>The originally described technique of atlantoaxial stabilization using C-1 lateral mass and C-2 pars screws includes a C-2 neurectomy to provide adequate hemostasis and visualization for screw placement, enable adequate joint decortication and arthrodesis, and prevent new-onset postoperative C-2 neuralgia. However, inclusion of a C-2 neurectomy for this procedure remains controversial, likely due in part to a lack of studies that have specifically addressed whether it affects patient outcome. The authors' objective was to assess the surgical and clinical impact of routine C-2 neurectomy performed with C1–2 segmental instrumented arthrodesis in a consecutive series of elderly patients with C1–2 instability.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>Methods\u003C\u002Fjats:title>\n\u003Cjats:p>Forty-four consecutive patients (mean age 71 years) underwent C1–2 instrumented fusion, including C-1 lateral mass screw insertion. Bilateral C-2 neurectomies were performed. Standardized clinical assessments were performed both pre- and postoperatively. Numbness or discomfort in a C-2 distribution was documented at follow-up. Fusion was assessed using the Lenke fusion grade.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>Results\u003C\u002Fjats:title>\n\u003Cjats:p>Among all 44 patients, mean blood loss was 200 ml (range 100–350 ml) and mean operative time was 129 minutes (range 87–240 minutes). There were no intraoperative complications, and no patients reported new postoperative onset or worsening of C-2 neuralgia postoperatively. Outcomes for the 30 patients with a minimum 13-month follow-up (range 13–72 months) were assessed. At a mean follow-up of 36 months, Nurick grade and pain numeric rating scale scores improved from 3.7 to 1.0 (p < 0.001) and 9.4 to 0.6 (p < 0.001), respectively. The mean postoperative Neck Disability Index score was 7.3%. The fusion rate was 97%, and the patient satisfaction rate was 93%. All 24 patients with preoperative occipital neuralgia reported relief. Seventeen patients noticed C-2 distribution numbness only during examination in the clinic, and 2 patients reported C-2 numbness, but it did not affect their daily function.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>Conclusions\u003C\u002Fjats:title>\n\u003Cjats:p>In this series of C1–2 instrumented arthrodesis in elderly patients, excellent fusion rates were achieved, and patient satisfaction was not negatively affected by C-2 neurectomy. In the authors' experience, C-2 neurectomy enhanced surgical exposure of the C1–2 joint, thereby facilitating hemostasis, placement of instrumentation, and decortication of the joint space for arthrodesis. Importantly, with C-2 neurectomy in the present series, no cases of new onset postoperative C-2 neuralgia occurred, in contrast to a growing number of reports in the literature documenting new-onset C-2 neuralgia without C-2 neurectomy. On the contrary, 80% of patients in the present series had preoperative occipital neuralgia and in all of these patients this neuralgia was relieved following C1–2 instrumented arthrodesis with C-2 neurectomy.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>","\u003Cjats:sec>\n\u003Cjats:title>Mục tiêu\u003C\u002Fjats:title>\n\u003Cjats:p>Kỹ thuật ban đầu về ổn định atlantoaxial bằng các đinh vít vào khối bên C-1 và pars C-2 bao gồm cả cắt bỏ thần kinh C-2 để cung cấp đủ tầm nhìn và cầm máu trong quá trình đặt vít, đảm bảo cắt mài và nối khớp, ngăn ngừa đau dây thần kinh C-2 sau phẫu thuật. Tuy nhiên, việc thực hiện cắt bỏ thần kinh C-2 trong quy trình này vẫn còn gây tranh cãi, có thể do thiếu các nghiên cứu cụ thể xem xét nó có ảnh hưởng đến kết quả của bệnh nhân hay không. Mục tiêu của tác giả là đánh giá tác động phẫu thuật và lâm sàng của cắt bỏ thần kinh C-2 thường xuyên cùng với nối tầng đốt sống cổ-đầu bằng dụng cụ trong chuỗi liên tiếp các bệnh nhân cao tuổi với bất ổn cổ C1-C2. \u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>Phương pháp\u003C\u002Fjats:title>\n\u003Cjats:p>44 bệnh nhân liên tiếp (tuổi trung bình 71 năm) đã thực hiện nối tầng C1-C2 bằng dụng cụ, bao gồm việc đặt vít khối bên C-1. Cắt bỏ thần kinh C-2 hai bên được thực hiện. Đánh giá lâm sàng tiêu chuẩn được thực hiện trước và sau phẫu thuật. Cảm giác tê hoặc khó chịu trong phạm vi phân phối C-2 được ghi lại khi tái khám. Tình trạng liền xương được đánh giá bằng cách sử dụng thang điểm liền xương Lenke. \u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>Kết quả\u003C\u002Fjats:title>\n\u003Cjats:p>Trong tất cả 44 bệnh nhân, mức mất máu trung bình là 200 ml (khoảng từ 100-350 ml) và thời gian phẫu thuật trung bình là 129 phút (khoảng từ 87-240 phút). Không có biến chứng nào xảy ra trong phẫu thuật, và không có bệnh nhân nào báo cáo khởi phát mới hoặc nặng thêm cơn đau thần kinh C-2 sau phẫu thuật. Kết quả đối với 30 bệnh nhân đã có thời gian theo dõi tối thiểu là 13 tháng (khoảng từ 13–72 tháng) đã được đánh giá. Sau trung bình 36 tháng theo dõi, giá trị Nurick và thang điểm đánh giá đau đã giảm từ 3.7 xuống 1.0 (p \u003C 0.001) và từ 9.4 xuống 0.6 (p \u003C 0.001) tương ứng. Điểm chỉ số khuyết tật cổ sau phẫu thuật trung bình là 7.3%. Tỷ lệ liền xương là 97% và tỷ lệ hài lòng của bệnh nhân là 93%. Tất cả 24 bệnh nhân có đau thần kinh chẩm trước phẫu thuật báo cáo đã giảm đau. Mười bảy bệnh nhân chỉ nhận thấy tê trong phạm vi C-2 trong quá trình kiểm tra tại phòng khám, và 2 bệnh nhân báo cáo tê C-2 nhưng không ảnh hưởng đến chức năng hàng ngày của họ. \u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>Kết luận\u003C\u002Fjats:title>\n\u003Cjats:p>Trong chuỗi đoạn nối tầng C1–2 bằng dụng cụ trong những bệnh nhân cao tuổi này, đã đạt được tỷ lệ liền xương xuất sắc và sự hài lòng của bệnh nhân không bị ảnh hưởng xấu bởi việc cắt bỏ thần kinh C-2. Theo kinh nghiệm của tác giả, việc cắt bỏ thần kinh C-2 cải thiện khả năng phô bày phẫu thuật của khớp C1–2, do đó hỗ trợ việc cầm máu, đặt dụng cụ và cắt mài không gian khớp để nối xương. Đáng chú ý, với việc cắt bỏ thần kinh C-2 trong loạt bệnh nhân hiện tại, không có trường hợp nào bị khởi phát sau phẫu thuật thần kinh C-2, trái ngược với số lượng báo cáo ngày càng tăng trong tài liệu cho thấy đau thần kinh C-2 khởi phát mới mà không có cắt bỏ thần kinh C-2. Ngược lại, 80% bệnh nhân trong chuỗi bệnh nhân hiện tại có đau thần kinh chẩm tiền phẫu và trong tất cả những bệnh nhân này, đau thần kinh này đã được giảm bớt sau phẫu thuật dụng cụ nối tầng C1–2 với cắt bỏ thần kinh C-2. \u003C\u002Fjats:p>\u003C\u002Fjats:sec>",{"EN":1793,"VI":1794},"C-2 neurectomy during atlantoaxial instrumented fusion in the elderly: patient satisfaction and surgical outcome","Cắt bỏ thần kinh C-2 trong phẫu thuật dung cụ hóa nối tầng đốt sống cổ-đầu trong người cao tuổi: sự hài lòng của bệnh nhân và kết quả phẫu thuật",{"VOID":1796},"21456890",{"VOID":1798},"10.3171\u002F2011.1.spine10417",[155],[1801],"VI","https:\u002F\u002Fthejns.org\u002Fview\u002Fjournals\u002Fj-neurosurg-spine\u002F15\u002F1\u002Farticle-p3.xml",[1804,1822,1841,1858,1875],{"id":1805,"sortIndex":25,"researcher":24,"roles":1806,"affiliations":1807,"properties":1816},"8ac70a1f-1c76-4b4a-93b9-dd16974eca76",[],[1808],{"id":1809,"sortIndex":25,"affiliation":1810,"properties":24},"372beffe-d0b6-4c28-8f50-6faf0d7022f0",{"id":1809,"createTime":24,"updateTime":24,"relativeEntities":1811,"slug":24,"properties":1812,"entityType":24,"verifyStatus":24,"verifyTime":24,"verifyNote":24,"languages":24,"translateLanguages":24,"viewCount":24,"url":24,"parentIds":1815,"statistic":24},[],{"title":1813},{"EN":1814},"1Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland; and",[],{"orcid":1817,"title":1819,"openalex":1820},{"VOID":1818},"https:\u002F\u002Forcid.org\u002F0009-0000-1534-340X",{"EN":324},{"VOID":1821},"A5040206437",{"id":1823,"sortIndex":113,"researcher":24,"roles":1824,"affiliations":1825,"properties":1834},"b5ed8f9e-fe47-4ed1-af86-e024cb2266b7",[],[1826],{"id":1827,"sortIndex":25,"affiliation":1828,"properties":24},"4a14d5a2-93c1-450d-966b-fa4524220dc0",{"id":1827,"createTime":24,"updateTime":24,"relativeEntities":1829,"slug":24,"properties":1830,"entityType":24,"verifyStatus":24,"verifyTime":24,"verifyNote":24,"languages":24,"translateLanguages":24,"viewCount":24,"url":24,"parentIds":1833,"statistic":24},[],{"title":1831},{"EN":1832},"2Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia",[],{"orcid":1835,"title":1837,"openalex":1839},{"VOID":1836},"https:\u002F\u002Forcid.org\u002F0000-0003-0467-5534",{"EN":1838},"Justin S. Smith",{"VOID":1840},"A5061204327",{"id":1842,"sortIndex":114,"researcher":24,"roles":1843,"affiliations":1844,"properties":1851},"3a15783e-6106-428c-8078-c12b1b1e0ba8",[],[1845],{"id":1809,"sortIndex":25,"affiliation":1846,"properties":24},{"id":1809,"createTime":24,"updateTime":24,"relativeEntities":1847,"slug":24,"properties":1848,"entityType":24,"verifyStatus":24,"verifyTime":24,"verifyNote":24,"languages":24,"translateLanguages":24,"viewCount":24,"url":24,"parentIds":1850,"statistic":24},[],{"title":1849},{"EN":1814},[],{"orcid":1852,"title":1854,"openalex":1856},{"VOID":1853},"https:\u002F\u002Forcid.org\u002F0009-0001-7115-8484",{"EN":1855},"Charles A. 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tools exist to stratify perioperative risk in patients undergoing spinal procedures. The modified frailty index (mFI) based on the Canadian Study of Health and Aging Frailty Index (CSHA-FI), constructed from standard demographic variables, has been applied to various other surgical populations for risk stratification. The authors hypothesized that it would be predictive of postoperative morbidity and mortality in patients undergoing spine surgery.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>METHODS\u003C\u002Fjats:title>\n\u003Cjats:p>The 2006–2010 National Surgical Quality Improvement Program (NSQIP) data set was accessed for patients undergoing spine surgeries based on Current Procedural Terminology (CPT) codes. Sixteen preoperative clinical NSQIP variables were matched to 11 CSHA-FI variables (changes in daily activities, gastrointestinal problems, respiratory problems, clouding or delirium, hypertension, coronary artery and peripheral vascular disease, congestive heart failure, and so on). The outcomes assessed were 30-day occurrences of adverse events. These were then summarized in groups: any infection, wound-related complication, Clavien IV complications (life-threatening, requiring ICU admission), and mortality.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>RESULTS\u003C\u002Fjats:title>\n\u003Cjats:p>A total of 18,294 patients were identified. In 8.1% of patients with an mFI of 0 there was at least one morbid complication, compared with 24.3% of patients with an mFI of ≥ 0.27 (p < 0.001). An mFI of 0 was associated with a mortality rate of 0.1%, compared with 2.3% for an mFI of ≥ 0.27 (p < 0.001). Patients with an mFI of 0 had a 1.7% rate of surgical site infections and a 0.8% rate of Clavien IV complications, whereas patients with an mFI of ≥ 0.27 had rates of 4.1% and 7.1% for surgical site infections and Clavien IV complications, respectively (p < 0.001 for both). Multivariate analysis showed that the preoperative mFI and American Society of Anesthesiologists classification of ≥ III had a significantly increased risk of leading to Clavien IV complications and death.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>CONCLUSIONS\u003C\u002Fjats:title>\n\u003Cjats:p>A higher mFI was associated with a higher risk of postoperative morbidity and mortality, providing an additional tool to improve perioperative risk stratification.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>",{"EN":2091},"Use of the modified frailty index to predict 30-day morbidity and mortality from spine surgery",{"VOID":2093},"27153143",{"VOID":2095},"10.3171\u002F2015.10.spine14582",[155],"https:\u002F\u002Fthejns.org\u002Fview\u002Fjournals\u002Fj-neurosurg-spine\u002F25\u002F4\u002Farticle-p537.xml",[2099,2126,2143,2162,2179],{"id":2100,"sortIndex":25,"researcher":24,"roles":2101,"affiliations":2102,"properties":2119},"659c59c0-c594-4538-9efd-22650222d2e6",[],[2103,2111],{"id":2104,"sortIndex":25,"affiliation":2105,"properties":24},"2bfdd126-fab2-4397-9f89-3a816841ea5c",{"id":2104,"createTime":24,"updateTime":24,"relativeEntities":2106,"slug":24,"properties":2107,"entityType":24,"verifyStatus":24,"verifyTime":24,"verifyNote":24,"languages":24,"translateLanguages":24,"viewCount":24,"url":24,"parentIds":2110,"statistic":24},[],{"title":2108},{"EN":2109},"Department of Neurosurgery, Henry Ford Hospital;",[],{"id":2112,"sortIndex":113,"affiliation":2113,"properties":24},"09903f8a-9eed-4a6d-9a04-930959bfb998",{"id":2112,"createTime":24,"updateTime":24,"relativeEntities":2114,"slug":24,"properties":2115,"entityType":24,"verifyStatus":24,"verifyTime":24,"verifyNote":24,"languages":24,"translateLanguages":24,"viewCount":24,"url":24,"parentIds":2118,"statistic":24},[],{"title":2116},{"VI":2117},"Department of Surgery, Henry Ford Hospital, Detroit, Michigan",[],{"orcid":2120,"title":2122,"openalex":2124},{"VOID":2121},"https:\u002F\u002Forcid.org\u002F0000-0001-7759-1468",{"EN":2123},"Rushna Ali",{"VOID":2125},"A5079654392",{"id":2127,"sortIndex":113,"researcher":24,"roles":2128,"affiliations":2129,"properties":2136},"1030aa15-61a6-4eab-aa49-f7cfe6fab409",[],[2130],{"id":2104,"sortIndex":25,"affiliation":2131,"properties":24},{"id":2104,"createTime":24,"updateTime":24,"relativeEntities":2132,"slug":24,"properties":2133,"entityType":24,"verifyStatus":24,"verifyTime":24,"verifyNote":24,"languages":24,"translateLanguages":24,"viewCount":24,"url":24,"parentIds":2135,"statistic":24},[],{"title":2134},{"EN":2109},[],{"orcid":2137,"title":2139,"openalex":2141},{"VOID":2138},"https:\u002F\u002Forcid.org\u002F0000-0002-8714-161X",{"EN":2140},"Jason M. 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colectomy patients using the National Surgical Quality Improvement Program: exploring frailty and aggressive laparoscopic approaches, 72, 878, 10.1097\u002FTA.0b013e31824d0f70",{"doi":2320},"10.1097\u002FTA.0b013e31824d0f70",{"id":24,"text":2322,"url":24,"identifiers":2323},"Robinson, 2009, Redefining geriatric preoperative assessment using frailty, disability and co-morbidity, 250, 449, 10.1097\u002FSLA.0b013e3181b45598",{"doi":2324},"10.1097\u002FSLA.0b013e3181b45598",{"id":24,"text":2326,"url":24,"identifiers":2327},"Rockwood, 2007, A comparison of two approaches to measuring frailty in elderly people, 62, 738, 10.1093\u002Fgerona\u002F62.7.738",{"doi":2328},"10.1093\u002Fgerona\u002F62.7.738",{"id":24,"text":2330,"url":24,"identifiers":2331},"Rubinfeld, 2010, Predicting surgical risk: how much data is enough?, 2010, 777",{},{"id":24,"text":2333,"url":24,"identifiers":2334},"Shiloach, 2010, Toward robust information: data quality and inter-rater reliability in the American College of Surgeons National Surgical Quality Improvement Program, 210, 6, 10.1016\u002Fj.jamcollsurg.2009.09.031",{"doi":2335},"10.1016\u002Fj.jamcollsurg.2009.09.031",{"id":24,"text":2337,"url":24,"identifiers":2338},"Tsiouris, 2013, A modified frailty index to assess morbidity and mortality after lobectomy, 183, 40, 10.1016\u002Fj.jss.2012.11.059",{"doi":2339},"10.1016\u002Fj.jss.2012.11.059",{"id":24,"text":2341,"url":24,"identifiers":2342},"Urrutia, 2012, Can the Surgical Apgar Score predict morbidity and mortality in general orthopaedic surgery?, 36, 2571, 10.1007\u002Fs00264-012-1696-1",{"doi":2343},"10.1007\u002Fs00264-012-1696-1",{"id":24,"text":2345,"url":24,"identifiers":2346},"Velanovich, 2013, Accumulating deficits model of frailty and postoperative mortality and morbidity: its application to a national database, 183, 104, 10.1016\u002Fj.jss.2013.01.021",{"doi":2347},"10.1016\u002Fj.jss.2013.01.021",{"id":24,"text":2349,"url":24,"identifiers":2350},"Wang, 2007, Complications and mortality associated with cervical spine surgery for degenerative disease in the United States, 32, 342, 10.1097\u002F01.brs.0000254120.25411.ae",{"doi":2351},"10.1097\u002F01.brs.0000254120.25411.ae",{"id":2353,"createTime":2354,"updateTime":2354,"relativeEntities":2355,"slug":2356,"properties":2357,"entityType":150,"verifyStatus":151,"verifyTime":2370,"verifyNote":153,"languages":2371,"translateLanguages":24,"viewCount":25,"primaryUrl":2372,"fullTextUrl":24,"authors":2373,"publicationType":380,"publisherRelationship":2672,"citationCount":2734,"citationInfo":2735,"publishDate":2738,"publishYear":2736,"citationAnalyzeStatus":23,"lastCitationAnalyze":24,"indexDatabases":2739,"openAccess":24,"references":2740,"isForceReanalyzing":536},"30d90158-8afb-4256-8d26-56b7f53fd826","2024-12-10T10:08:06.281+00:00",[],"Morbidity-and-mortality-in-the-surgical-treatment-of-10-242-adults-with-spondylolisthesis",{"openalex":2358,"mag":2360,"abstract":2362,"title":2364,"pm":2366,"doi":2368},{"VOID":2359},"W1562172430",{"VOID":2361},"1562172430",{"EN":2363},"\u003Cjats:sec>\n\u003Cjats:title>Object\u003C\u002Fjats:title>\n\u003Cjats:p>This is a retrospective review of 10,242 adults with degenerative spondylolisthesis (DS) and isthmic spondylolisthesis (IS) from the morbidity and mortality (M&M) index of the Scoliosis Research Society (SRS). This database was reviewed to assess complication incidence, and to identify factors that were associated with increased complication rates.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>Methods\u003C\u002Fjats:title>\n\u003Cjats:p>The SRS M&M database was queried to identify cases of DS and IS treated between 2004 and 2007. Complications were identified and analyzed based on age, surgical approach, spondylolisthesis type\u002Fgrade, and history of previous surgery. Age was stratified into 2 categories: > 65 years and ≤ 65 years. Surgical approach was stratified into the following categories: decompression without fusion, anterior, anterior\u002Fposterior, posterior without instrumentation, posterior with instrumentation, and interbody fusion. Spondylolisthesis grades were divided into low-grade (Meyerding I and II) versus high-grade (Meyerding III, IV, and V) groups. Both univariate and multivariate analyses were performed.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>Results\u003C\u002Fjats:title>\n\u003Cjats:p>In the 10,242 cases of DS and IS reported, there were 945 complications (9.2%) in 813 patients (7.9%). The most common complications were dural tears, wound infections, implant complications, and neurological complications (range 0.7%–2.1%). The mortality rate was 0.1%. Diagnosis of DS had a significantly higher complication rate (8.5%) when compared with IS (6.6%; p = 0.002). High-grade spondylolisthesis correlated strongly with a higher complication rate (22.9% vs 8.3%, p < 0.0001). Age > 65 years was associated with a significantly higher complication rate (p = 0.02). History of previous surgery and surgical approach were not significantly associated with higher complication rates. On multivariate analysis, only the grade of spondylolisthesis (low vs high) was in the final best-fit model of factors associated with the occurrence of complications (p < 0.0001).\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>Conclusions\u003C\u002Fjats:title>\n\u003Cjats:p>The rate of total complications for treatment of DS and IS in this series was 9.2%. The total percentage of patients with complications was 7.9%. On univariate analysis, the complication rate was significantly higher in patients with high-grade spondylolisthesis, a diagnosis of DS, and in older patients. Surgical approach and history of previous surgery were not significantly correlated with increased complication rates. On multivariate analysis, only the grade of spondylolisthesis was significantly associated with the occurrence of complications.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>",{"EN":2365},"Morbidity and mortality in the surgical treatment of 10,242 adults with spondylolisthesis",{"VOID":2367},"21039149",{"VOID":2369},"10.3171\u002F2010.5.spine09529","2024-12-10T10:08:06.280+00:00",[155],"https:\u002F\u002Fthejns.org\u002Fview\u002Fjournals\u002Fj-neurosurg-spine\u002F13\u002F5\u002Farticle-p589.xml",[2374,2390,2405,2419,2441,2458,2475,2494,2511,2528,2545,2564,2581,2601,2620,2639,2658],{"id":2375,"sortIndex":25,"researcher":24,"roles":2376,"affiliations":2377,"properties":2386},"74326441-eafc-4354-bd6a-a29379aebcd3",[],[2378],{"id":2379,"sortIndex":25,"affiliation":2380,"properties":24},"f0a2508d-f9ec-4d9f-b0ab-a927703137e8",{"id":2379,"createTime":24,"updateTime":24,"relativeEntities":2381,"slug":24,"properties":2382,"entityType":24,"verifyStatus":24,"verifyTime":24,"verifyNote":24,"languages":24,"translateLanguages":24,"viewCount":24,"url":24,"parentIds":2385,"statistic":24},[],{"title":2383},{"EN":2384},"1Department of Neurosurgery, University of Maryland Medical Center, Baltimore, Maryland;",[],{"orcid":2387,"title":2388,"openalex":2389},{"VOID":1853},{"EN":1855},{"VOID":1857},{"id":2391,"sortIndex":113,"researcher":24,"roles":2392,"affiliations":2393,"properties":2400},"3dec0d11-ce67-405c-8bb2-152fcb33e597",[],[2394],{"id":1827,"sortIndex":25,"affiliation":2395,"properties":24},{"id":1827,"createTime":24,"updateTime":24,"relativeEntities":2396,"slug":24,"properties":2397,"entityType":24,"verifyStatus":24,"verifyTime":24,"verifyNote":24,"languages":24,"translateLanguages":24,"viewCount":24,"url":24,"parentIds":2399,"statistic":24},[],{"title":2398},{"EN":1832},[],{"title":2401,"openalex":2403},{"EN":2402},"Davis L. 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Kyphoplasty and vertebroplasty have become the standard treatment for these types of fractures. In certain conditions that cause local kyphosis, such as spinal cord compression due to a metastatic epidural tumor or the shortening of the spinal canal secondary to vertebral compression, the surgical treatment should provide decompression and stabilization during a short intervention. In this study the authors evaluated a surgical technique that frequently combines a same-session surgical decompression, such as a laminectomy, and posterior instrumentation-assisted stabilization during the same open intervention in which the VB is stabilized by kyphoplasty.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>Methods\u003C\u002Fjats:title>\n\u003Cjats:p>During an 18-month period, the authors treated 18 patients with VB fractures according to this protocol: 14 patients with vertebral metastatic lesions and four with osteoporosis. The patients' mean age was 60 years. All suffered severe pain preoperatively (mean visual analog scale [VAS] score of 7). Fourteen of the 18 patients suffered a neurological deficit. Twenty-three vertebral levels were treated; in 15 patients it was necessary to place posterior instrumentation. The mean duration of the intervention was 90 minutes.\u003C\u002Fjats:p>\n\u003Cjats:p>Pain in all patients improved 3 days after the intervention, and the mean VAS score decreased to 2. Patients with a neurological dysfunction improved. The mean quantity of injected cement for the kyphoplasty procedure was 7 ml. The mean duration of hospitalization was 7 days. Neuroimaging revealed cement leaks in two cases: one into the disc interspace and one anteriorly into the fractured part of the vertebra. After the intervention, most patients with metastatic lesions underwent radiotherapy. No procedure-related complications occurred.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>\n\u003Cjats:sec>\n\u003Cjats:title>Conclusions\u003C\u002Fjats:title>\n\u003Cjats:p>This procedure allows decompression of the spinal cord, consolidation of the VB and thus a stabilization of the vertebral column, and may provide an alternative treatment to invasive VB excision in patients in poor general health.\u003C\u002Fjats:p>\u003C\u002Fjats:sec>",{"EN":2810},"Open kyphoplasty for management of metastatic and severe osteoporotic spinal fracture",{"VOID":2812},"17355030",{"VOID":2814},"10.3171\u002Fspi.2007.6.3.284",[155],"https:\u002F\u002Fthejns.org\u002Fview\u002Fjournals\u002Fj-neurosurg-spine\u002F6\u002F3\u002Farticle-p284.xml",[2818,2837,2846,2855,2864,2873],{"id":2819,"sortIndex":25,"researcher":24,"roles":2820,"affiliations":2821,"properties":2830},"e475e695-ff44-47bf-a7ee-554d615f9e23",[],[2822],{"id":2823,"sortIndex":25,"affiliation":2824,"properties":24},"c120281e-c310-429c-a79b-c7d82b539b86",{"id":2823,"createTime":24,"updateTime":24,"relativeEntities":2825,"slug":24,"properties":2826,"entityType":24,"verifyStatus":24,"verifyTime":24,"verifyNote":24,"languages":24,"translateLanguages":24,"viewCount":24,"url":24,"parentIds":2829,"statistic":24},[],{"title":2827},{"EN":2828},"Service de Neurochirurgie, Hôpital de la Timone, Marseille, France. sfuentes@ap-hm.fr",[],{"orcid":2831,"title":2833,"openalex":2835},{"VOID":2832},"https:\u002F\u002Forcid.org\u002F0000-0002-9940-6187",{"EN":2834},"S. 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content-type=\"fine-print\">\u003Cjats:italic>Object.\u003C\u002Fjats:italic> Percutaneous vertebro- and kyphoplasty have become established methods for the treatment of uncomplicated osteoporotic vertebral fractures. In the setting of severe fractures involving fragmentation of the posterior wall and neural compromise, however, decompressive surgery cannot be performed and epidural cement leakage is poorly controlled. A microsurgical interlaminary approach for vertebro- and kyphoplasty was developed to allow spinal decompression and control of the spinal canal during augmentation.\u003C\u002Fjats:p>\n\u003Cjats:p content-type=\"fine-print\">\u003Cjats:italic>Methods.\u003C\u002Fjats:italic> Interlaminary vertebro- or kyphoplasty was performed in 24 patients with osteoporotic fractures involving neural compression or posterior wall fragmentation. After unilateral microsurgical fenestration, decompression of the spine, and gentle mobilization of the thecal sac, vertebro- or kyphoplasty was performed directly through the posterior wall of the fractured vertebral body. Cement was injected under microscopic and fluoroscopic control, with the option of immediate exploration of the exposed spinal canal. Thirty-four levels (T-8 to L-5) were treated. Mean blood loss was less than 100 ml and augmentation added 10 to 40 minutes to the entire procedure. Cement leakage associated with the kyphoplasty procedure was less than that in vertebroplasty. There were no major complications. One patient was lost to follow up. Clinical outcome was good or excellent in 17 of the 23 patients available for follow-up (1 to 31—month) evaluation.\u003C\u002Fjats:p>\n\u003Cjats:p content-type=\"fine-print\">\u003Cjats:italic>Conclusions.\u003C\u002Fjats:italic> The present microsurgical interlaminary approach for vertebro- and kyphoplasty enables treatment of severe osteoporotic fractures involving fragmentation of the posterior wall and neural compromise. Decompressive surgery is possible and the risk of epidural cement leakage is controlled intraoperatively. 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