دورية أكاديمية
Radiographic Outcomes and Complications of Anterior Column Realignment (ACR): A Systematic Review.
| العنوان: | Radiographic Outcomes and Complications of Anterior Column Realignment (ACR): A Systematic Review. |
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| المؤلفون: | Mundis GM Jr; San Diego Spine Foundation, 6190 Cornerstone CT #212 San Diego California, 92121 USA; Scripps Clinic, Spine section, Department of Orthopaedic Surgery., Elsebaie H; San Diego Spine Foundation, 6190 Cornerstone CT #212 San Diego California, 92121 USA., Shahidi B; San Diego Spine Foundation, 6190 Cornerstone CT #212 San Diego California, 92121 USA; University of California, San Diego, Department of Orthopaedic Surgery., Love I; San Diego Spine Foundation, 6190 Cornerstone CT #212 San Diego California, 92121 USA., Haldeman PB; University of California, San Diego, Department of Orthopaedic Surgery., Eastlack RK; San Diego Spine Foundation, 6190 Cornerstone CT #212 San Diego California, 92121 USA; Scripps Clinic, Spine section, Department of Orthopaedic Surgery., Akbarnia BA; San Diego Spine Foundation, 6190 Cornerstone CT #212 San Diego California, 92121 USA; University of California, San Diego, Department of Orthopaedic Surgery. Electronic address: bakbarnia@ucsd.edu. |
| المصدر: | The spine journal : official journal of the North American Spine Society [Spine J] 2024 Aug 16. Date of Electronic Publication: 2024 Aug 16. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article; Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Science Inc Country of Publication: United States NLM ID: 101130732 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-1632 (Electronic) Linking ISSN: 15299430 NLM ISO Abbreviation: Spine J Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, NY : Elsevier Science Inc., c2001- |
| مستخلص: | Background: Anterior Column Realignment (ACR) was introduced to serve as a powerful segmental kyphosis correction technique in minimally invasive Adult Spinal Deformity (ASD) surgery. Releasing the Anterior Longitudinal Ligament (ALL) and annulus allows opening of the disc space to accommodate hyperlordotic cages. The overall safety and efficacy of ACR has been difficult to determine due to the heterogenicity of surgical techniques, complications reporting, and a paucity of published studies leading to preliminary and controversial conclusions. Purpose: To determine the efficacy and complications rates associated with ACR. Study Design: Systematic Review METHODS: : We queried the MEDLINE, Google Scholar, and EMBASE databases for all literature related to ACR procedure with a publication cutoff start date of January 1, 2010. This systematic review was performed utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Non-English, nonhuman, case reports and review article publications were excluded. Results: A total of 298 studies were identified. Following screening of title, abstract, and full text, 16 articles were included in the review with a total 756 patients. All the studies included in this systematic review were retrospective case series with a level of evidence IV. Ten studies reported ACR-related complications, with an average rate of 27.2%. The rate of reoperations was reported in 5 studies, for which the average reoperation rate was 9.5%. Cage Subsidence (CS) occurred in 13.7%, Proximal Junctional Kyphosis (PJK) in 12.2%, neurologic injury in 7.3%, and Proximal Junctional Failure (PJF) in 2.7%. The vascular injury rate was 0.5%, with bowel perforation and ureteric injury occurring in 0.2%. For the Patient Reported Outcome Measures (PROMs) and radiological outcome analysis we excluded studies with less than 12 months follow up leaving 8 studies eligible for the analysis. There was a significant improvement of both local Motion Segment Angle (MSA) and Intra Discal Angle (IDA) with a mean segmental correction of 20° lordosis in the 3 studies that reported these parameters. Conclusion: Based on the limited data available in this systematic review, the ACR technique has significant ability to restore and, when needed, correct the local segmental intervertebral angulation and thereby influencing the overall regional and global sagittal alignment. The associated risk of vascular, bowel, and nerve injury did not seem to be significantly higher in this review than other alternative lumbar interbody fusion techniques. Additional higher quality studies, including a consensus for reporting complications is required to reach definitive conclusions regarding its possible associated risks. (Copyright © 2024. Published by Elsevier Inc.) |
| فهرسة مساهمة: | Keywords: ACR; Adult Spine Deformity; Anterior Column Realignment; Anterior Column Release; Anterior Column Resection; Anterior Longitudinal Ligament Release; Anterior Longitudinal Ligament Resection; Sagittal Balance |
| تواريخ الأحداث: | Date Created: 20240818 Latest Revision: 20240818 |
| رمز التحديث: | 20240819 |
| DOI: | 10.1016/j.spinee.2024.08.003 |
| PMID: | 39154950 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1878-1632 |
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| DOI: | 10.1016/j.spinee.2024.08.003 |