This study compares the clinical and radiological results of three most commonly used dynamic stabilization systems in the field of orthopedic surgery. A total of 71 patients underwent single-level posterior transpedicular dynamic stabilization between 2011 and 2014 due to lumbar degenerative disc disease. Three different dynamic systems used include: (1) the Dynesys system; (2) a dynamic screw with a PEEK rod; and (3) a full dynamic system (a dynamic screw with a dynamic rod; BalanC). The mean patient age was 45.8 years. The mean follow-up was 29.7 months. Clinical and radiological data were obtained for each patient preoperatively and at 6, 12, and 24 months of follow-up. Clinical outcomes were significantly improved in all patients. There were no significant differences in the radiological outcomes among the groups divided according to the system used. Screw loosening was detected in 2 patients, and 1 patient developed screw breakage. All patients with screw loosening or breakage underwent revision surgery. Each procedure offered satisfactory outcome regardless of which system was applied.

AIM: To evaluate and compare open cranial vault remodeling (OCVR) and endoscopy-assisted craniosynostosis surgery (EACS) in patients with non-syndromic craniosynostosis and to develop an algorithm to determine the most appropriate surgery for each patient. MATERIAL and METHODS: Eighty-five children with craniosynostosis who underwent surgery between 2010 and 2022 were retrospectively analyzed. Demographic data, comorbidities, and peri-operative findings of the patients were recorded. Pre-and post-operative comparisons were made between predetermined measurement techniques for each deformation. In addition, measurements were obtained by computed tomography (CT) or 3D stereophotogrammetric (3DSPG) methods from eligible patients and compared with one another. RESULTS: In our study, 61 patients underwent EACS, whereas 24 underwent OCVR. The operating time of OCVR was approximately 54.4 minutes longer than that of EACS (p<0.001). The intra-operative blood loss was around 139 ml higher in OCVR (p<0.001). The length of hospital stay for patients who underwent EACS was shorter at 8.4 days on average (p<0.001). Surprisingly, 5 complications were observed in OCVR compared with 7 in EACS. While the cosmetic outcome of EACS was superior in most of the pathology-specific measurement techniques, the metopic index increased only in patients with metopic synostosis after both surgical operations. Still, this increase was lower in EACS than in OCVR. CONCLUSION: This study suggests that endoscopic craniosynostosis surgery has lower estimated blood loss and operation and hospitalization times, as well as comparable cosmetic results compared with open vault surgeries on long-term follow-up. CT and 3DSPG methods can help distinguish between different types of measurement techniques for synostoses. However, no significant differences were found in the comparisons since 3DSPG can also provide reliable measurements comparable to those on CT during follow-up.

Ozer AF, et al. Korean J Spine. 2016 Mar;13(1):37-39. http://dx.doi.org/10.14245/kjs.2016.13.1.37

Background and Objectives: This study aims to evaluate the adequacy of the liberal transfusion strategy applied in patients undergoing endoscopy-assisted Metopic, Coronal, or Sagittal craniosynostosis surgery according to the Pre-Transfusion and Post-Transfusion Estimated Red Blood Cell Mass (ERCM) ratios. Materials and Methods: This retrospective cohort study, conducted at the Pamukkale University Faculty of Medicine (2017–2023), utilized anesthesia, surgical records, and hospital electronic data of patients undergoing endoscopic craniosynostosis surgery. The primary endpoints were the rates of Post-Transfusion 1st-hour ERCM/Pre-Transfusion ERCM (%) and Post-Transfusion 24th-hour ERCM/Pre-Transfusion ERCM (%). The secondary endpoints were determined as Hemoglobin (Hb) and Hematocrit (Hct) values at the 1st and 24th hours after surgery, Calculated Blood Loss (CBL) during surgery (%), total 24 h CBL (%), ERCM (%), and Estimated Blood Loss (EBV) during surgery and total 24 h transfusions, Packed Red Blood Cells (PRBCs) (mL/kg) amounts during surgery, and total 24 h transfusions. Results: A total of 86 pediatric craniosynostosis cases were evaluated and categorized into Metopic (n = 38), Sagittal (n = 33), and Coronal (n = 15) groups, with Post-Transfusion evaluation conducted across these groups. Post-Transfusion 1st-hour ERCM/Pre-Transfusion ERCM ratios were found to have median values of 90.70% in the Metopic group, 91.61% in the Sagittal group, and 93.09% in the Coronal group. Post-Transfusion 24th-hour ERCM/Pre-Transfusion ERCM ratios were found to be median values of 94.05% in the Metopic group, 88.3% in the Sagittal group, and 87.08% in the Coronal group. Conclusions: The liberal transfusion strategy provided adequate transfusion, maintaining ERCM ratios within the 85–115% range across all groups. Significant decreases in Hb and Hct levels were observed from preoperative to postoperative measurements at 1 and 24 h. Changes in CBL, ERCM, EBV, and PRBC volumes were noted between the postoperative 1 h and 24 h measurements across all groups.