Skip to main content
Erschienen in: Current Reviews in Musculoskeletal Medicine 3/2016

13.07.2016 | Complications in Spine Surgery (E Klineberg, Section Editor)

Role of minimally invasive surgery for adult spinal deformity in preventing complications

verfasst von: Chun-Po Yen, Yusef I. Mosley, Juan S. Uribe

Erschienen in: Current Reviews in Musculoskeletal Medicine | Ausgabe 3/2016

Einloggen, um Zugang zu erhalten

Abstract

With the aging population, there is a rising prevalence of degenerative spinal deformity and need of surgical care for these patients. Surgical treatment for adult spinal deformity (ASD) is often fraught with a high rate of complications. Minimally invasive surgery (MIS) has for the past decade been adopted by spine surgeons to treat ASD in the hopes of reducing access-related morbidity and perioperative complications. The benefits of MIS approach in general and recent development of MIS techniques to avoid long-term complications such as pseudoarthrosis or proximal junctional kyphosis are reviewed.
Literatur
1.
Zurück zum Zitat Schwab F, Dubey A, Gamez L, et al. Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population. Spine (Phila Pa 1976). 2005;30(9):1082–5.CrossRef Schwab F, Dubey A, Gamez L, et al. Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population. Spine (Phila Pa 1976). 2005;30(9):1082–5.CrossRef
2.
Zurück zum Zitat Best NM, Sasso RC. Outpatient lumbar spine decompression in 233 patients 65 years of age or older. Spine (Phila Pa 1976). 2007;32(10):1135–9.CrossRef Best NM, Sasso RC. Outpatient lumbar spine decompression in 233 patients 65 years of age or older. Spine (Phila Pa 1976). 2007;32(10):1135–9.CrossRef
3.
Zurück zum Zitat Bridwell KH, Glassman S, Horton W, et al. Does treatment (nonoperative and operative) improve the two-year quality of life in patients with adult symptomatic lumbar scoliosis: a prospective multicenter evidence-based medicine study. Spine (Phila Pa 1976). 2009;34(20):2171–8.CrossRef Bridwell KH, Glassman S, Horton W, et al. Does treatment (nonoperative and operative) improve the two-year quality of life in patients with adult symptomatic lumbar scoliosis: a prospective multicenter evidence-based medicine study. Spine (Phila Pa 1976). 2009;34(20):2171–8.CrossRef
4.
Zurück zum Zitat Li G, Passias P, Kozanek M, et al. Adult scoliosis in patients over sixty-five years of age: outcomes of operative versus nonoperative treatment at a minimum two-year follow-up. Spine (Phila Pa 1976). 2009;34(20):2165–70.CrossRef Li G, Passias P, Kozanek M, et al. Adult scoliosis in patients over sixty-five years of age: outcomes of operative versus nonoperative treatment at a minimum two-year follow-up. Spine (Phila Pa 1976). 2009;34(20):2165–70.CrossRef
5.
Zurück zum Zitat Smith JS, Klineberg E, Schwab F, et al. Change in classification grade by the SRS-Schwab adult spinal deformity classification predicts impact on health-related quality of life measures: prospective analysis of operative and nonoperative treatment. Spine (Phila Pa 1976). 2013;38(19):1663–71.CrossRef Smith JS, Klineberg E, Schwab F, et al. Change in classification grade by the SRS-Schwab adult spinal deformity classification predicts impact on health-related quality of life measures: prospective analysis of operative and nonoperative treatment. Spine (Phila Pa 1976). 2013;38(19):1663–71.CrossRef
6.
Zurück zum Zitat Glassman SD, Hamill CL, Bridwell KH, Schwab FJ, Dimar JR, Lowe TG. The impact of perioperative complications on clinical outcome in adult deformity surgery. Spine (Phila Pa 1976). 2007;32(24):2764–70.CrossRef Glassman SD, Hamill CL, Bridwell KH, Schwab FJ, Dimar JR, Lowe TG. The impact of perioperative complications on clinical outcome in adult deformity surgery. Spine (Phila Pa 1976). 2007;32(24):2764–70.CrossRef
7.
Zurück zum Zitat Pateder DB, Gonzales RA, Kebaish KM, Cohen DB, Chang JY, Kostuik JP. Short-term mortality and its association with independent risk factors in adult spinal deformity surgery. Spine (Phila Pa 1976). 2008;33(11):1224–8.CrossRef Pateder DB, Gonzales RA, Kebaish KM, Cohen DB, Chang JY, Kostuik JP. Short-term mortality and its association with independent risk factors in adult spinal deformity surgery. Spine (Phila Pa 1976). 2008;33(11):1224–8.CrossRef
8.•
Zurück zum Zitat Smith JS, Klineberg E, Lafage V, Shaffrey CI, Schwab F, Lafage R, et al. Prospective multicenter assessment of perioperative and minimum 2-year postoperative complication rates associated with adult spinal deformity surgery. J Neurosurg Spine. 2016;6:1–14. A prospective multicenter study detailing complications associated with open surgery for adult spinal deformities. Smith JS, Klineberg E, Lafage V, Shaffrey CI, Schwab F, Lafage R, et al. Prospective multicenter assessment of perioperative and minimum 2-year postoperative complication rates associated with adult spinal deformity surgery. J Neurosurg Spine. 2016;6:1–14. A prospective multicenter study detailing complications associated with open surgery for adult spinal deformities.
9.
Zurück zum Zitat Kim CW. Scientific basis of minimally invasive spine surgery: prevention of multifidus muscle injury during posterior lumbar surgery. Spine (Phila Pa 1976). 2010;35(26 Suppl):S281–6.CrossRef Kim CW. Scientific basis of minimally invasive spine surgery: prevention of multifidus muscle injury during posterior lumbar surgery. Spine (Phila Pa 1976). 2010;35(26 Suppl):S281–6.CrossRef
10.
Zurück zum Zitat Fan SW, Hu ZJ, Fang XQ, Zhao FD, Huang Y, Yu HJ. Comparison of paraspinal muscle injury in one-level lumbar posterior inter-body fusion: modified minimally invasive and traditional open approaches. Orthop Surg. 2010;2(3):194–200.CrossRefPubMed Fan SW, Hu ZJ, Fang XQ, Zhao FD, Huang Y, Yu HJ. Comparison of paraspinal muscle injury in one-level lumbar posterior inter-body fusion: modified minimally invasive and traditional open approaches. Orthop Surg. 2010;2(3):194–200.CrossRefPubMed
11.
Zurück zum Zitat Parker SL, Adogwa O, Witham TF, Aaronson OS, Cheng J, McGirt MJ. Post-operative infection after minimally invasive versus open transforaminal lumbar interbody fusion (TLIF): literature review and cost analysis. Minim Invasive Neurosurg. 2011;54(1):33–7.CrossRefPubMed Parker SL, Adogwa O, Witham TF, Aaronson OS, Cheng J, McGirt MJ. Post-operative infection after minimally invasive versus open transforaminal lumbar interbody fusion (TLIF): literature review and cost analysis. Minim Invasive Neurosurg. 2011;54(1):33–7.CrossRefPubMed
12.
Zurück zum Zitat McGirt MJ, Parker SL, Lerner J, Engelhart L, Knight T, Wang MY. Comparative analysis of perioperative surgical site infection after minimally invasive versus open posterior/transforaminal lumbar interbody fusion: analysis of hospital billing and discharge data from 5170 patients. J Neurosurg Spine. 2011;14(6):771–8.CrossRefPubMed McGirt MJ, Parker SL, Lerner J, Engelhart L, Knight T, Wang MY. Comparative analysis of perioperative surgical site infection after minimally invasive versus open posterior/transforaminal lumbar interbody fusion: analysis of hospital billing and discharge data from 5170 patients. J Neurosurg Spine. 2011;14(6):771–8.CrossRefPubMed
13.
Zurück zum Zitat Bach K, Ahmadian A, Deukmedjian A, Uribe JS. Minimally invasive surgical techniques in adult degenerative spinal deformity: a systematic review. Clin Orthop Relat Res. 2014;472(6):1749–61.CrossRefPubMedPubMedCentral Bach K, Ahmadian A, Deukmedjian A, Uribe JS. Minimally invasive surgical techniques in adult degenerative spinal deformity: a systematic review. Clin Orthop Relat Res. 2014;472(6):1749–61.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Mundis GM, Akbarnia BA, Phillips FM. Adult deformity correction through minimally invasive lateral approach techniques. Spine (Phila Pa 1976). 2010;35(26 Suppl):S312–21.CrossRef Mundis GM, Akbarnia BA, Phillips FM. Adult deformity correction through minimally invasive lateral approach techniques. Spine (Phila Pa 1976). 2010;35(26 Suppl):S312–21.CrossRef
15.
Zurück zum Zitat Oliveira L, Marchi L, Coutinho E, Pimenta L. A radiographic assessment of the ability of the extreme lateral interbody fusion procedure to indirectly decompress the neural elements. Spine (Phila Pa 1976). 2010;35(26 Suppl):S331–7.CrossRef Oliveira L, Marchi L, Coutinho E, Pimenta L. A radiographic assessment of the ability of the extreme lateral interbody fusion procedure to indirectly decompress the neural elements. Spine (Phila Pa 1976). 2010;35(26 Suppl):S331–7.CrossRef
16.
Zurück zum Zitat Kelleher MO, Timlin M, Persaud O, et al. Success and failure of minimally invasive decompression for focal lumbar spinal stenosis in patients with and without deformity. Spine. 2010;35:E981–7.CrossRefPubMed Kelleher MO, Timlin M, Persaud O, et al. Success and failure of minimally invasive decompression for focal lumbar spinal stenosis in patients with and without deformity. Spine. 2010;35:E981–7.CrossRefPubMed
17.
Zurück zum Zitat Castro C, Oliveira L, Amaral R, Marchi L, Pimenta L. Is the lateral transpsoas approach feasible for the treatment of adult degenerative scoliosis? Clin Orthop Relat Res. 2014;472(6):1776–83.CrossRefPubMed Castro C, Oliveira L, Amaral R, Marchi L, Pimenta L. Is the lateral transpsoas approach feasible for the treatment of adult degenerative scoliosis? Clin Orthop Relat Res. 2014;472(6):1776–83.CrossRefPubMed
18.
Zurück zum Zitat Chung SK, Lee SH, Lim SR, et al. Comparative study of laparoscopic L5-S1 fusion versus open mini-ALIF, with a minimum 2-year follow-up. Eur Spine J. 2003;12(6):613–7.CrossRefPubMedPubMedCentral Chung SK, Lee SH, Lim SR, et al. Comparative study of laparoscopic L5-S1 fusion versus open mini-ALIF, with a minimum 2-year follow-up. Eur Spine J. 2003;12(6):613–7.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Wang MY, Cummock MD, Yu Y, Trivedi RA. An analysis of the differences in the acute hospitalization charges following minimally invasive versus open posterior lumbar interbody fusion. J Neurosurg Spine. 2010;12(6):694–9.CrossRefPubMed Wang MY, Cummock MD, Yu Y, Trivedi RA. An analysis of the differences in the acute hospitalization charges following minimally invasive versus open posterior lumbar interbody fusion. J Neurosurg Spine. 2010;12(6):694–9.CrossRefPubMed
20.
Zurück zum Zitat Cannestra AF, Peterson MD, Parker SR, Roush TF, Bundy JV, Turner AW. MIS expandable interbody spacers: a literature review and biomechanical comparison of an expandable MIS TLIF with conventional TLIF and ALIF. Spine (Phila Pa 1976). 2016;41 Suppl 8:S44–9. Cannestra AF, Peterson MD, Parker SR, Roush TF, Bundy JV, Turner AW. MIS expandable interbody spacers: a literature review and biomechanical comparison of an expandable MIS TLIF with conventional TLIF and ALIF. Spine (Phila Pa 1976). 2016;41 Suppl 8:S44–9.
21.
Zurück zum Zitat Ozgur BM, Aryan HE, Pimenta L, Taylor WR. Extreme lateral interbody fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion. Spine J. 2006;6(4):435–43.CrossRefPubMed Ozgur BM, Aryan HE, Pimenta L, Taylor WR. Extreme lateral interbody fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion. Spine J. 2006;6(4):435–43.CrossRefPubMed
22.
Zurück zum Zitat Uribe JS, Arredondo N, Dakwar E, Vale FL. Defining the safe working zones using the minimally invasive lateral retroperitoneal transpsoas approach: an anatomical study. J Neurosurg Spine. 2010;13(2):260–6.CrossRefPubMed Uribe JS, Arredondo N, Dakwar E, Vale FL. Defining the safe working zones using the minimally invasive lateral retroperitoneal transpsoas approach: an anatomical study. J Neurosurg Spine. 2010;13(2):260–6.CrossRefPubMed
23.
Zurück zum Zitat Isaacs RE, Hyde J, Goodrich JA, Rodgers WB, Phillips FM. A prospective, nonrandomized, multicenter evaluation of extreme lateral interbody fusion for the treatment of adult degenerative scoliosis: perioperative outcomes and complications. Spine (Phila Pa 1976). 2010;35(26 Suppl):S322–30.CrossRef Isaacs RE, Hyde J, Goodrich JA, Rodgers WB, Phillips FM. A prospective, nonrandomized, multicenter evaluation of extreme lateral interbody fusion for the treatment of adult degenerative scoliosis: perioperative outcomes and complications. Spine (Phila Pa 1976). 2010;35(26 Suppl):S322–30.CrossRef
24.•
Zurück zum Zitat Beckman JM, Murray G, Bach K, Deukmedjian A, Uribe JS. Percutaneous Minimally Invasive (MIS) Guide Wire-less Self-Tapping Pedicle Screw Placement in the Thoracic and Lumbar Spine: Safety and Initial Clinical Experience: Technical Note. Neurosurgery. 2015. A novel technique of placing percutaneous pedicle screws. Beckman JM, Murray G, Bach K, Deukmedjian A, Uribe JS. Percutaneous Minimally Invasive (MIS) Guide Wire-less Self-Tapping Pedicle Screw Placement in the Thoracic and Lumbar Spine: Safety and Initial Clinical Experience: Technical Note. Neurosurgery. 2015. A novel technique of placing percutaneous pedicle screws.
25.
Zurück zum Zitat Wang MY, Ludwig SC, Anderson DG, Mummaneni PV. Percutaneous iliac screw placement: description of a new minimally invasive technique. Neurosurg Focus. 2008;25(2), E17.CrossRefPubMed Wang MY, Ludwig SC, Anderson DG, Mummaneni PV. Percutaneous iliac screw placement: description of a new minimally invasive technique. Neurosurg Focus. 2008;25(2), E17.CrossRefPubMed
26.
Zurück zum Zitat O’Brien JR, Matteini L, Yu WD, Kebaish KM. Feasibility of minimally invasive sacropelvic fixation: percutaneous S2 alar iliac fixation. Spine (Phila Pa 1976). 2010;35(4):460–4.CrossRef O’Brien JR, Matteini L, Yu WD, Kebaish KM. Feasibility of minimally invasive sacropelvic fixation: percutaneous S2 alar iliac fixation. Spine (Phila Pa 1976). 2010;35(4):460–4.CrossRef
27.
Zurück zum Zitat Schwab F, Patel A, Ungar B, Farcy JP, Lafage V. Adult spinal deformity-postoperative standing imbalance: how much can you tolerate? An overview of key parameters in assessing alignment and planning corrective surgery. Spine (Phila Pa 1976). 2010;35(25):2224–31.CrossRef Schwab F, Patel A, Ungar B, Farcy JP, Lafage V. Adult spinal deformity-postoperative standing imbalance: how much can you tolerate? An overview of key parameters in assessing alignment and planning corrective surgery. Spine (Phila Pa 1976). 2010;35(25):2224–31.CrossRef
28.
Zurück zum Zitat Acosta FL, Liu J, Slimack N, Moller D, Fessler R, Koski T. Changes in coronal and sagittal plane alignment following minimally invasive direct lateral interbody fusion for the treatment of degenerative lumbar disease in adults: a radiographic study. J Neurosurg Spine. 2011;15(1):92–6.CrossRefPubMed Acosta FL, Liu J, Slimack N, Moller D, Fessler R, Koski T. Changes in coronal and sagittal plane alignment following minimally invasive direct lateral interbody fusion for the treatment of degenerative lumbar disease in adults: a radiographic study. J Neurosurg Spine. 2011;15(1):92–6.CrossRefPubMed
29.
Zurück zum Zitat Dakwar E, Cardona RF, Smith DA, Uribe JS. Early outcomes and safety of the minimally invasive, lateral retroperitoneal transpsoas approach for adult degenerative scoliosis. Neurosurg Focus. 2010;28(3), E8.CrossRefPubMed Dakwar E, Cardona RF, Smith DA, Uribe JS. Early outcomes and safety of the minimally invasive, lateral retroperitoneal transpsoas approach for adult degenerative scoliosis. Neurosurg Focus. 2010;28(3), E8.CrossRefPubMed
30.
Zurück zum Zitat Wang MY, Mummaneni PV. Minimally invasive surgery for thoracolumbar spinal deformity: initial clinical experience with clinical and radiographic outcomes. Neurosurg Focus. 2010;28, E9.CrossRefPubMed Wang MY, Mummaneni PV. Minimally invasive surgery for thoracolumbar spinal deformity: initial clinical experience with clinical and radiographic outcomes. Neurosurg Focus. 2010;28, E9.CrossRefPubMed
31.
Zurück zum Zitat Park P, Wang MY, Lafage V, et al. Comparison of two minimally invasive surgery strategies to treat adult spinal deformity. J Neurosurg Spine. 2015;22:374–80.CrossRefPubMed Park P, Wang MY, Lafage V, et al. Comparison of two minimally invasive surgery strategies to treat adult spinal deformity. J Neurosurg Spine. 2015;22:374–80.CrossRefPubMed
32.•
Zurück zum Zitat Uribe JS, Deukmedjian AR, Mummaneni PV, et al. Complications in adult spinal deformity surgery: an analysis of minimally invasive, hybrid, and open surgical techniques. Neurosurg Focus. 2014;36(5), E15. A retrospective multicenter study comparing complication profiles between patients undergoing minimally invasive surgery, hybrid surgery and open surgery.CrossRefPubMed Uribe JS, Deukmedjian AR, Mummaneni PV, et al. Complications in adult spinal deformity surgery: an analysis of minimally invasive, hybrid, and open surgical techniques. Neurosurg Focus. 2014;36(5), E15. A retrospective multicenter study comparing complication profiles between patients undergoing minimally invasive surgery, hybrid surgery and open surgery.CrossRefPubMed
33.
Zurück zum Zitat Glattes RC, Bridwell KH, Lenke LG, Kim YJ, Rinella A, Edwards 3rd C. Proximal junctional kyphosis in adult spinal deformity following long instrumented posterior spinal fusion: incidence, outcomes, and risk factor analysis. Spine (Phila Pa 1976). 2005;30(14):1643–9.CrossRef Glattes RC, Bridwell KH, Lenke LG, Kim YJ, Rinella A, Edwards 3rd C. Proximal junctional kyphosis in adult spinal deformity following long instrumented posterior spinal fusion: incidence, outcomes, and risk factor analysis. Spine (Phila Pa 1976). 2005;30(14):1643–9.CrossRef
34.
Zurück zum Zitat Mummaneni PV, Park P, Fu K-M, et al. Does minimally invasive percutaneous posterior instrumentation reduce risk of proximal junctional kyphosis in adult spinal deformity surgery? A propensity-matched cohort analysis. Neurosurgery. 2016;78:101–8.CrossRefPubMed Mummaneni PV, Park P, Fu K-M, et al. Does minimally invasive percutaneous posterior instrumentation reduce risk of proximal junctional kyphosis in adult spinal deformity surgery? A propensity-matched cohort analysis. Neurosurgery. 2016;78:101–8.CrossRefPubMed
35.
Zurück zum Zitat Charosky S, Guigui P, Blamoutier A, Roussouly P, Chopin D, Study Group on Scoliosis. Complications and risk factors of primary adult scoliosis surgery: a multicenter study of 306 patients. Spine (Phila Pa 1976). 2012;37(8):693–700.CrossRef Charosky S, Guigui P, Blamoutier A, Roussouly P, Chopin D, Study Group on Scoliosis. Complications and risk factors of primary adult scoliosis surgery: a multicenter study of 306 patients. Spine (Phila Pa 1976). 2012;37(8):693–700.CrossRef
36.
Zurück zum Zitat Wang MY, Bordon G. Mini-open pedicle subtraction osteotomy as a treatment for severe adult spinal deformities: case series with initial clinical and radiographic outcomes. J Neurosurg Spine. 2016;24(5):769–76.CrossRefPubMed Wang MY, Bordon G. Mini-open pedicle subtraction osteotomy as a treatment for severe adult spinal deformities: case series with initial clinical and radiographic outcomes. J Neurosurg Spine. 2016;24(5):769–76.CrossRefPubMed
37.
Zurück zum Zitat Deukmedjian AR, Dakwar E, Ahmadian A, Smith DA, Uribe JS. Early outcomes minimally invasive anterior longitudinal ligament release for correction of sagittal imbalance in patients with adult spinal deformity. Sci World J. 2012;2012:789698.CrossRef Deukmedjian AR, Dakwar E, Ahmadian A, Smith DA, Uribe JS. Early outcomes minimally invasive anterior longitudinal ligament release for correction of sagittal imbalance in patients with adult spinal deformity. Sci World J. 2012;2012:789698.CrossRef
38.
Zurück zum Zitat Deukmedjian AR, Le TV, Baaj AA, Dakwar E, Smith DA, Uribe JS. Anterior longitudinal ligament release using the minimally invasive lateral retroperitoneal transpsoas approach: a cadaveric feasibility study and report of 4 clinical cases. J Neurosurg Spine. 2012;17(6):530–9.CrossRefPubMed Deukmedjian AR, Le TV, Baaj AA, Dakwar E, Smith DA, Uribe JS. Anterior longitudinal ligament release using the minimally invasive lateral retroperitoneal transpsoas approach: a cadaveric feasibility study and report of 4 clinical cases. J Neurosurg Spine. 2012;17(6):530–9.CrossRefPubMed
39.
Zurück zum Zitat Wang MY, Mummaneni PV, Fu KM, et al. Less invasive surgery for treating adult spinal deformities: ceiling effects for deformity correction with 3 different techniques. Neurosurg Focus. 2014;36, E12.CrossRefPubMed Wang MY, Mummaneni PV, Fu KM, et al. Less invasive surgery for treating adult spinal deformities: ceiling effects for deformity correction with 3 different techniques. Neurosurg Focus. 2014;36, E12.CrossRefPubMed
40.
Zurück zum Zitat Kanter AS, Tempel ZJ, Ozpinar A, Okonkwo DO. A review of minimally invasive procedures for the treatment of adult spinal deformity. Spine (Phila Pa 1976). 2016;41 Suppl 8:S59–65. Kanter AS, Tempel ZJ, Ozpinar A, Okonkwo DO. A review of minimally invasive procedures for the treatment of adult spinal deformity. Spine (Phila Pa 1976). 2016;41 Suppl 8:S59–65.
41.
Zurück zum Zitat Mummaneni PV, Shaffrey CI, Lenke LG, et al. The minimally invasive spinal deformity surgery algorithm: a reproducible rational framework for decision making in minimally invasive spinal deformity surgery. Neurosurg Focus. 2014;36(5), E6.CrossRefPubMed Mummaneni PV, Shaffrey CI, Lenke LG, et al. The minimally invasive spinal deformity surgery algorithm: a reproducible rational framework for decision making in minimally invasive spinal deformity surgery. Neurosurg Focus. 2014;36(5), E6.CrossRefPubMed
Metadaten
Titel
Role of minimally invasive surgery for adult spinal deformity in preventing complications
verfasst von
Chun-Po Yen
Yusef I. Mosley
Juan S. Uribe
Publikationsdatum
13.07.2016
Verlag
Springer US
Erschienen in
Current Reviews in Musculoskeletal Medicine / Ausgabe 3/2016
Elektronische ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-016-9355-6

Weitere Artikel der Ausgabe 3/2016

Current Reviews in Musculoskeletal Medicine 3/2016 Zur Ausgabe

Complications in Spine Surgery (E Klineberg, Section Editor)

Proximal junctional kyphosis and failure—diagnosis, prevention, and treatment

Complications in Spine Surgery (E Klineberg, Section Editor)

Neurological complications in adult spinal deformity surgery

Complications in Spine Surgery (E Klineberg, Section Editor)

Predictive modeling of complications

Complications in Spine Surgery (E Klineberg, Section Editor)

Complications of surgical intervention in adult lumbar scoliosis

Cervical Injuries and Treatment (HJ Kim, Section Editor)

C1 fractures: a review of diagnoses, management options, and outcomes

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.