MASTERS-D: Final Results of a Prospective Multicenter Observational Data-Monitored Study of Minimally Invasive Fusion to Treat Degenerative Lumbar Disorders
Notice bibliographique
Résumé
Introduction Evaluation of 1- or 2-level minimally invasive posterior lumbar interbody fusion (MILIF) for degenerative lumbar (DL) disorders in a multicenter 1-year prospective observational study (NCT01143324). Material and Methods A total of 252 patients (56% female patients, mean age: 54 years, mean BMI: 28, mean duration of symptoms: 29 months [m]) enrolled by 19 centers in 14 countries underwent 1- (83%) or 2-level (17%) MILIF (TLIF: 95%; PLIF: 5%) for treatment of leg pain (52%), back pain (39%), or claudication (9%) due to DL pathologies, including spondylolisthesis (53%), stenosis (71%), and/or disc pathology (94%). Participating surgeons were required to have a minimum prestudy experience of 30 MILIF cases. A total of 15.1% of patients had previous decompression surgery at the target level. Patient demographics, intraoperative data, complications, time to first ambulation, time to study-defined recovery, surgical duration, blood loss, fluoroscopy time, and adverse events (AEs) were recorded. Outcome scores (VAS back and leg, ODI, EQ-5D) were assessed preoperatively and at defined time points through 12 m postoperatively. Results Available for the follow-up: 249 (99%) patients at 4 weeks (w) and 233 (92.5%) at 12 m. One-level surgery occurred at L4–5 or L5–S1 in 91% and 2-level surgery at L4–S1 in 74%. Mean surgical duration, blood loss, and intraoperative fluoro-time were 128 versus 182 minutes, 164 versus 233 mL, and 115 versus 154 seconds in 1- and 2-level cases, respectively. The mean time to first ambulation was 1.3 days and time to study-defined recovery was 3.2 days. Mean preoperative VAS back (6.2) and VAS leg (5.9) scores dropped significantly ( p < .0001) to 3.1 (2.9) and 1.9 (2.5) at discharge (4 w), respectively. VAS improvement was sustained between 4 w and final follow-up at 12 m. Fusion rates: 90.8% fusion in 1- and 90.7% for 2-level procedures (141 and 27 patients evaluated, respectively). Preoperative ODI (45.5%) and EQ-VAS (52.9) changed to 34.5% (22.4%) and 65.4 (71.0) at 4 w (12 m) ( p < 0.0001). There was a constant improvement in EQ-5D subscales and reduction of pain medication from 4 w to 12 m. A total of 50 AEs in 39 patients (15.5%) were attributed to surgery, approach, or device (including 9 AEs in 8 patients), out of which 3 AEs in 3 patients (1.2%) were due to the minimally invasive approach (including 1 SAE); no deep surgical site infections and 7 reoperations occurred. Conclusion This is the largest data-monitored prospective multicenter observational study of MILIF to date, following routine local standard of practice and providing objective results for this procedure. MILIF demonstrated favorable clinical results with early and sustained improvement in patient-reported outcomes and low major perioperative morbidity.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».