RSA in Spine: A Review.

STUDY DESIGN: Systematic review of literature. OBJECTIVES: This systematic review was conducted to investigate the accuracy of radiostereometric analysis (RSA), its assessment of spinal motion and disorders, and to investigate the limitations of this technique in spine assessment. METHODS: Systematic review in all current literature to invesigate the role of RSA in spine. RESULTS: The results of this review concluded that RSA is a very powerful tool to detect small changes between 2 rigid bodies such as a vertebral segment. The technique is described for animal and human studies for cervical and lumbar spine and can be used to analyze range of motion, inducible displacement, and fusion of segments. However, there are a few disadvantages with the technique; RSA percutaneous procedure needs to be performed to implant the markers (and cannot be used preoperatively), one needs a specific knowledge to handle data and interpret the results, and is relatively time consuming and expensive. CONCLUSIONS: RSA should be looked at as a very powerful research instrument and there are many questions suitable for RSA studies.

A Meta-Analysis of Cervical Laminoplasty Techniques: Are Mini-Plates Superior?

STUDY DESIGN: Meta-analysis and systematic review of literature. OBJECTIVE: In the late 1990s, spinal surgeons experimented by using maxillofacial fixation plates as an alternative to sutures, anchors, and local spinous process autografts to provide a more rigid and lasting fixation for laminoplasty. This eventually led to the advent of laminoplasty mini-plates, which are currently used. The objective is to compare laminoplasty techniques with plate and without plate with regard to functional outcome results. METHODS: Qualitative and quantitative analyses were performed to evaluate the currently available studies in an attempt to justify the use of a plate in laminoplasty. RESULTS: The principal finding of this study was that there was no statistically significant difference in clinical outcome between the 2 different techniques of laminoplasty. CONCLUSION: There is not enough evidence in the literature to support one technique over the other, and hence, there is no evidence to support change in practice (using or not using the plate in laminoplasty). A randomized controlled trial will give a better comparison between the 2 groups.