Journal of Craniovertebral Junction and Spine最新文献

{"title":"Iatrogenic intracranial hypotension secondary to subarachnoid-pleural fistula after transthoracic surgery for the treatment of lateral thoracic meningocele.","authors":"Francesco Signorelli, Samuele Santi, Antonio Leone, Massimiliano Visocchi","doi":"10.4103/jcvjs.jcvjs_39_24","DOIUrl":"10.4103/jcvjs.jcvjs_39_24","url":null,"abstract":"<p><p>Subarachnoid-pleural fistula (SPF), a rare complication following transthoracic spinal surgery, results in the accumulation of cerebrospinal fluid (CSF) in the pleural space. Hindered spontaneous closure, attributed to negative pleural pressure, gives rise to CSF hypotension and subdural blood collections. Despite numerous reported cases, achieving consensus on management remains elusive. Treatment options encompass conservative measures, surgical repair, epidural blood patch, and diverse approaches such as multilayer dural closure or meningocele resection. Presented herein is a distinctive case following lateral thoracic meningocele surgery, where SPF-induced CSF hypotension found successful resolution through the innovative use of titanium hemostatic clips to occlude the meningocele. This novel approach, emphasizing the utility of titanium clips, deviates from conventional strategies. Surgical SPF exclusion, particularly leveraging titanium clips, emerges as a potential solution, effectively alleviating symptoms of CSF hypotension. The article also aims to present a personal experience, contributing an effective and alternative approach for the etiological treatment of thoracic meningocele.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"375-379"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of postoperative complications and outcomes following primary versus revision discectomy: A national database analysis.","authors":"Ryan Hoang, Junho Song, Justin Tiao, Sarah Trent, Alex Ngan, Timothy Hoang, Jun S Kim, Samuel K Cho, Andrew C Hecht, David Essig, Sohrab Virk, Austen D Katz","doi":"10.4103/jcvjs.jcvjs_97_24","DOIUrl":"10.4103/jcvjs.jcvjs_97_24","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Lumbar microdiscectomy is a surgical procedure that is frequently used in the treatment of symptomatic lumbar herniation. Differences in outcomes following primary and revision lumbar microdiscectomy have been previously studied, with reports of comparably satisfactory results from the Spine Patient Outcomes Research Trial. In this study, we further investigate these outcomes, including length of stay, bleeding events, and durotomy. We hypothesized that length of stay, incidence of bleeding events, and dural tear would be greater in the revision cohort.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The ACS-National Surgical Quality Improvement Program database was queried for patients undergoing single-level primary and revision lumbar microdiscectomy between 2019 and 2022. Eligibility for inclusion was determined by age &gt;18 years and current procedural terminology codes 63030 and 63042. Patients with preoperative sepsis or cancer were excluded. Length of stay, wound infection, bleeding events requiring transfusion, cerebrospinal fluid leak, dural tear, and neurological injury were compared between the cohorts. Multivariable Poisson regression adjusted for demographics and comorbidities, including age, sex, race, body mass index, diabetes, smoking, and hypertension, was used to determine if revision was predictive of complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 37,669 patients were included, of whom 3,635 (9.6%) required revision surgery. Patients in the revision cohort were older (54.25 ± 15.7 vs. 50.85 ± 16.0 years, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) and had higher proportions of male (59.0% vs. 55.7%, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) and non-Hispanic White patients (82.0% vs. 77.4%, &lt;i&gt;P&lt;/i&gt; &lt; 0.001). Length of stay (1.11 ± 2.5 vs. 1.58 ± 2.7, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) and rates of wound infection (2.1% vs. 1.4%, &lt;i&gt;P&lt;/i&gt; = 0.002) and bleeding events requiring transfusion (1.3% vs. 0.7%, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) were greater in the revision cohort compared to primary patients. Differences in cerebrospinal fluid leak (0.2% vs. 0.1%, &lt;i&gt;P&lt;/i&gt; = 0.116), dural tear complication (0.01% vs. 0.01%, &lt;i&gt;P&lt;/i&gt; = 0.092), and neurological injury (0.008% vs. 0.006%, &lt;i&gt;P&lt;/i&gt; = 0.691) between the revision and primary cohorts were nonsignificant. Poisson log-linear regression adjusted for demographics and comorbidities demonstrated revision as a significant predictor for length of stay (&lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 462.95, &lt;i&gt;P&lt;/i&gt; &lt; 0.001), wound infection (&lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 9.22, &lt;i&gt;P&lt;/i&gt; = 0.002), and bleeding events (&lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 9.74, &lt;i&gt;P&lt;/i&gt; = 0.002), while it was a nonsignificant predictor of cerebrospinal fluid leak (&lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 2.61, &lt;i&gt;P&lt;/i&gt; = 0.106), dural tear (&lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 2.37, &lt;i&gt;P&lt;/i&gt; = 0.123), and neurological injury (&lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 0.229, &lt;i&gt;P&lt;/i&gt; = 0.632).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Revision surgery was a significant predictor of increased length of stay, wound infection, and bleeding events requiring t","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"303-307"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Odontoid remodeling with occipital condyle stabilization in patients with metastatic C2 involvement.","authors":"Mehmet Yigit Akgun, Nazenin Durmus, Caner Gunerbuyuk, Sezer Onur Gunara, Tunc Oktenoglu, Mehdi Sasani, Ozkan Ates, Ali Fahir Ozer","doi":"10.4103/jcvjs.jcvjs_83_24","DOIUrl":"10.4103/jcvjs.jcvjs_83_24","url":null,"abstract":"<p><p>The occipitocervical junction (OCJ) is a complex anatomical region crucial for protecting the lower brain stem, upper spinal cord, and lower cranial nerves. Instability in this area can lead to severe outcomes such as chronic pain, neurological deficits, or death. Various surgical techniques have been developed for OCJ stabilization, particularly using occipital condyle screws, which have shown promise in providing stability and preserving neck rotation. This article presents two cases of OCJ instability caused by metastatic involvement of the C2 vertebra, managed successfully with occipital condyle screw fixation. The first case involved a 22-year-old female with Ewing sarcoma metastasis, and the second case involved a 62-year-old male with multiple myeloma. Both patients exhibited significant improvements in neurological function and cervical stability postoperatively, with observable den remodeling. Our findings suggest that occipital condyle screw fixation is not only feasible but also effective in managing OCJ instability due to metastatic disease. Detailed preoperative evaluation and the use of advanced intraoperative imaging technologies, such as the O-arm and neuronavigation, are essential for maximizing safety and ensuring optimal outcomes. This study underscores the potential of occipital condyle screw fixation as a primary surgical method for stabilizing the OCJ in appropriate cases.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"367-370"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The \"Mustache sign:\" An ancillary radiological sign for detecting L5/S1 spondylolisthesis.","authors":"Amirul Adlan, Sisith Ariyaratne, Sandeep Velicheti, Elias Petrou, Karthikeyan P Iyengar, Nathan Jenko, Rajesh Botchu","doi":"10.4103/jcvjs.jcvjs_69_24","DOIUrl":"10.4103/jcvjs.jcvjs_69_24","url":null,"abstract":"<p><strong>Introduction and aims: </strong>Grade 1 spondylolisthesis can be challenging to detect on magnetic resonance imaging (MRI), particularly for spinal surgeons and radiologists with limited experience interpreting spinal MRIs. This study aims to describe a unique sign described as a \"mustache sign,\" which may assist in detecting subtle Grade I spondylolisthesis on sagittal sequences on MRI of the spine.</p><p><strong>Patients and methods: </strong>A retrospective review of 50 lumbar spine MRI scans of patients with Grade I spondylolisthesis of L5/S1 performed over 3 years was conducted at a tertiary orthopedic spinal center in the United Kingdom. The scans were assessed for the presence of the \"mustache sign\" and findings were independently recorded by one musculoskeletal radiology registrar and one fellowship trained musculoskeletal radiologist with over 10 years of experience.</p><p><strong>Results: </strong>There were 35 females (70%) and 15 males (30%). The patient's mean age was 54.3 years (13-82). The \"mustache sign\" was present in 13 (26%) of these patients. Twelve of 13 scans (92%) positive for the sign also demonstrated pars interarticularis defects (P < 0.001, Fisher's Exact test), compared to those without the sign. There was excellent interobserver reliability with a kappa of 1.</p><p><strong>Conclusion: </strong>The \"mustache sign\" on MRI spine correlates well with the presence of Grade I spondylolisthesis. This ancillary sign can complement other previously described radiological findings on sagittal MRI sequences to confirm Grade I spondylolisthesis.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"343-346"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology study on the prognostic factors of intradural extramedullary spinal tumors.","authors":"Anuchit Phankhongsab, Intouch Sopchokchai, Patorn Piromchai","doi":"10.4103/jcvjs.jcvjs_53_24","DOIUrl":"10.4103/jcvjs.jcvjs_53_24","url":null,"abstract":"<p><strong>Introduction: </strong>Intradural extramedullary (IDEM) tumors are rare tumors of the spinal cord. Currently, there is no evidence on the factors that predict poor outcomes in the patients. The objective of this study was to determine the prognostic factors that are associated with poor outcomes in IDEM tumors.</p><p><strong>Materials and methods: </strong>Patients 18 years and older with IDEM tumors who underwent surgery at our institute were identified and retrospectively reviewed. The patient's demographic data, risk factors, and modified McCormick Scale score were collected.</p><p><strong>Results: </strong>A total of 129 patients with IDEM were included in this study. The age ranged from 19 to 79 years (mean 51.3 years), with a predominantly female population (85 patients, 65.9%). Eighty-nine (68.9%) patients had a good outcome, while 40 (31.0%) patients had a poor outcome. The significant factors for poor outcomes included the number of vertebral levels removed for tumor access (adjusted odds ratio [OR] = 3.80, 95% confidence interval [CI] =1.30-11.08, <i>P</i> = 0.013); pathology other than meningioma, schwannoma, and neurofibroma (adjusted OR = 18.86, 95% CI = 2.16-164.49, <i>P</i> = 0.007); and bowel/bladder involvement (adjusted OR = 3.47, 95% CI = 1.15-10.39, <i>P</i> = 0.027).</p><p><strong>Conclusion: </strong>We found that the factors for poor outcomes included bowel/bladder involvement, number of vertebral levels removed for tumor access, and pathology other than meningioma, schwannoma, and neurofibroma.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"361-366"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unprecedented journey to 650 transpedicular screws using freehand technique and intraoperative C-arm imaging with technical nuances.","authors":"Mohsin Fayaz, Sarabjit Singh Chibber, Kaushal Deep Singh, Lamkordor Tyngkam, Amir Hela, Bipin Chaurasia","doi":"10.4103/jcvjs.jcvjs_56_24","DOIUrl":"10.4103/jcvjs.jcvjs_56_24","url":null,"abstract":"<p><strong>Introduction: </strong>Pedicle screw placement plays a crucial role in treating various cases such as fractures, scoliosis, degenerative spine issues, and kyphosis, reinforcing all three spinal columns simultaneously. While three-dimensional navigation-assisted pedicle screw placement is considered superior, the freehand technique relies on anatomical landmarks and tactile feedback, with observed low complication rates.</p><p><strong>Materials and methods: </strong>This was a prospective single-center study conducted over a period of 3 years. It included all patients of dorsal, lumbar, and sacral spinal instability of myriad etiology. Previously operated patients and sick obtunded patients were excluded from the study.</p><p><strong>Results: </strong>In our study, we included 102 patients including 62 (60.7%) males and 40 (39.2%) females. More than half of patients were young in the age group of 20-50 years. Our study population had a varied etiology with 43.1% of patients having vertebral column instability due to trauma. The other etiologies were spondylolisthesis and lumbar canal stenosis (39.2%), Pott's spine (11.7%), tumors (2.9%), and osteoporotic fractures (2.9%). Majority of patients (44.1%) presented with lower backache with radiculopathy. All the transpedicular screws inserted were evaluated by C-arm to assess for screw fixation. In the first year of our study, an average of 4 anteroposterior (AP) and 4 lateral C-arm X-ray shots were taken per screw placement. In the next year, an average of 3 AP and 3 lateral shots and finally in the last year of our study only 2 AP and 2 lateral C-arm X-ray shots were taken per screw placement. Out of 650 screws placed, 4 screws were identified to cause breach with maximum breaches in the lumbar spine fixation. In dorsal spine fixation, there was 1 lateral breach at D10. In lumbar spine fixation, there were 3 breaches: two medial one each at L4 and L5 and one anterior at L2 level. The various complications include wound infection, temporary and permanent neurological deficit, screw breakage, screw misplacement, cerebrospinal fluid leaks, nonunion, and spinal epidural hematoma.</p><p><strong>Conclusions: </strong>Our study has provided strong encouragement to persist with the freehand technique in transpedicular fixation surgeries after a certain number of cases given the minimal breaches and complications observed. There are subtle technical nuances as we increase the number of cases with less exposure of anatomical landmarks and X-rays. Success hinges on experience, adherence to technique, and thorough preoperative planning. Further research and extended follow-up periods are necessary to firmly establish this technique as the gold standard.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"326-330"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The new proposal of the relationship between axial pain and hinge fracture and facet involvement after open-door laminoplasty with titanium spacers.","authors":"Kazuma Doi, Toshiyuki Okazaki, Satoshi Tani, Junichi Mizuno","doi":"10.4103/jcvjs.jcvjs_33_24","DOIUrl":"10.4103/jcvjs.jcvjs_33_24","url":null,"abstract":"<p><strong>Study design: </strong>This was a retrospective, observational study.</p><p><strong>Objectives: </strong>Postoperative axial pain (AP) is a well-known complication of cervical posterior surgery. It can be caused by various reasons, but the etiology remains unclear. This study aimed to investigate risk factors for postoperative AP after open-door laminoplasty. A previous meta-analysis revealed muscle damage, female, age of <60 years, and longer collar application as possible risk factors for postoperative AP after cervical posterior procedures. However, the postoperative AP etiology, specifically for open-door laminoplasty, has been inconclusive and remains conflicting.</p><p><strong>Methods: </strong>This retrospective study included 129 adult patients who underwent open-door cervical laminoplasty for degenerative diseases in our single institution from January 2015 to October 2021. Postoperative AP was defined as intolerable pain on the neck or shoulder that lasted for >1 month postoperatively. We compared the demographic and radiographic characteristics of AP and non-AP groups.</p><p><strong>Results: </strong>Postoperative AP developed in 62 (48.1%) patients. Intraoperative hinge fracture (HF) and facet involvement by miniscrews were significantly greater in the AP group than in the non-AP group (P < 0.05). Using a logistic regression model, multivariate analysis revealed that HF was significantly associated with postoperative AP (odds ratio = 2.83, 95% confidence interval = 1.28-6.44, P = 0.011).</p><p><strong>Conclusions: </strong>HF and facet involvement were risk factors for postoperative AP after open-door laminoplasty with titanium spacers. Careful surgical manipulation is required to prevent postoperative AP.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"321-325"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of physical exercise (strength and stretching) on repairing craniovertebral and reducing neck pain: A systematic review and meta-analysis.","authors":"Tommy Alfandy Nazwar, Farhad Bal'afif, Donny Wisnu Wardhana, Mustofa Mustofa","doi":"10.4103/jcvjs.jcvjs_107_24","DOIUrl":"10.4103/jcvjs.jcvjs_107_24","url":null,"abstract":"<p><strong>Background: </strong>The craniovertebral (CV) junction is crucial for head support, mobility, and protecting the upper spinal cord and vital nerve structures. Disorders in this area can cause severe symptoms such as neck pain, restricted movement, and neurological issues such as headaches and balance problems. Exercise and physical activity improves muscle strength, flexibility, joint stability, reducing pain, and enhancing joint function, while specifically for the CV junction, exercise can relieve muscle tension, boost blood flow, and improve posture, although the specific impact on CV junction health remains underexplored.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using databases MEDLINE, Cochrane, Lilacs, and ScienceDirect, alongside manual searches through reference lists. The review focuses on exercise and CV junction issues and includes randomized controlled trials, cohort or case-control studies, and systematic reviews. Primary outcomes include pain levels, joint mobility, function, and quality of life.</p><p><strong>Results: </strong>Results yield four meta-analyses with corrective exercise and conventional exercise in improving forward head posture risk difference 0.00 (-0.09, 0.09) 95% confidence interval (CI), between cervical and thoracic exercises odds ratio 1.04 (0.59, 1.84) 95% CI. Comparing exercise treatment and physiotherapy showed risk difference 0.11 (-0.10, 0.32) 95% CI and the comparative analysis between training and no treatment showed risk difference 0.09 (-0.01, 0.20) 95% CI.</p><p><strong>Conclusion: </strong>Exercise-based rehabilitation programs tailored to patients with CV junction problems offer robust evidence, benefiting clinical management, and prevention efforts.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"266-279"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lumbar intervertebral disc replacement in Australia: An epidemiological study.","authors":"Zac Dragan, Adam R George, Ryan J Campbell, Randolph Gray, Brahman Shankar Sivakumar, Michael Symes","doi":"10.4103/jcvjs.jcvjs_119_24","DOIUrl":"10.4103/jcvjs.jcvjs_119_24","url":null,"abstract":"<p><strong>Introduction: </strong>Favorable short- and long-term outcomes have been reported for lumbar intervertebral total disc replacement (L-TDR). However, there is little evidence regarding the uptake of L-TDR in practice. The objective of this study was to analyze Australian-based population trends in L-TDR over the past 5 years.</p><p><strong>Methods: </strong>The 5-year incidence of L-TDR from 2019 to 2023 in adult patients was analyzed using the Medicare Benefits Schedule (MBS) database. Data were stratified by sex and year, with an offset term introduced using population data from the Australian Bureau of Statistics to account for population changes over the study period.</p><p><strong>Results: </strong>A total of 1558 L-TDRs were completed in Australia under the MBS in the 5 years of interest. The 5-year annual mean case volume was 311.6 cases per annum. A downtrend and plateau in the rate of L-TDR has been seen from 2021 onward. The distribution of L-TDR across ages showed a significantly higher concentration in the 35-44 and 45-54 age groups (P < 0.05). More operations were performed in males (n = 876, 56.2%) than females (n = 682, 43.8%).</p><p><strong>Conclusions: </strong>The uptake of L-TDR has declined throughout the 5-year study period in Australia. Despite modest use currently, the future of L-TDR will rely on more robust long-term outcome data.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"338-342"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term assessment of functional outcomes and quality of life after thoracic and lumbar spinal metastasis surgery.","authors":"Mahmoud Mohamed Abousayed, Hossam Salah El-Din Taha, Raafat Elsayed Farag, Mostafa Salahdin Salem, Walid Atef Ebeid","doi":"10.4103/jcvjs.jcvjs_112_24","DOIUrl":"10.4103/jcvjs.jcvjs_112_24","url":null,"abstract":"<p><strong>Background: </strong>Because of improvements in initial tumor identification and treatment, as well as longer life expectancies, more people are receiving diagnoses for spinal metastases.</p><p><strong>Objective: </strong>The aim of this study was to assess early functional outcomes and quality of life (QOL) after surgical management of patients with spinal metastases.</p><p><strong>Patients and methods: </strong>In this prospective cohort study, a total of 33 patients with thoracic and lumbar spine metastases who underwent surgical management between November 2021 and August 2023 were followed up for 1 year or until death. Oswestry Disability Index and the Eastern Cooperative Oncology Group Performance Status were used for the functional outcome; QOL was assessed using European Quality of Life 5-Dimensions (EuroQOL-5D). Scores were recorded preoperatively, 4 weeks postoperatively, and 6 and 12 months postoperatively.</p><p><strong>Results: </strong>The mean age was 52.12 ± 13.4 years (range: 23-70 years), 22 (66.7%) were females, and 11 (33.3%) were males. Patients were divided into three groups according to the revised Katagiri score: 12 (36.4%) patients were at low risk (0-3), 18 (54.5%) patients were at intermediate risk (4-6), and 3 (9.1%) patients were at high risk (7-10). The mean survival was 5.44 ± 3.46 months (range 1-13), and there was no perioperative death (within 1 month postoperative). Sixteen (48.5%) patients survived for more than 1 year and 17 (51.5%) patients died from different causes related to the natural history of tumor metastasis.</p><p><strong>Conclusion: </strong>Following surgical treatment of the spinal metastases, improvements in QoL and functional results were seen in the short-term. For patients with a projected life expectancy of longer than 3 months, surgery is a good alternative.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"353-360"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}