The National Center for Spinal Disorders is located in the 12th District of Budapest, Hungary, on Királyhágó Street.[citation needed] It is the only hospital in Hungary that covers virtually the entire diagnostic and treatment spectrum of spinal disorders from diagnosis and non-surgical and surgical treatments through to rehabilitation.[citation needed] It is financed by the National Health Insurance Fund.[citation needed].
BACKGROUND:3D printed anatomical models offer new possibilities in operative medicine, especially in planning complex surgical procedures and patient education. However, the use of such models is not yet widespread, and spinal surgeons' attitudes toward their clinical application remain incompletely understood. OBJECTIVE:The aim of the study is to assess spinal surgeons' attitudes towards 3D-printed anatomical models, with a particular focus on their clinical applications. METHODS:A multicenter questionnaire-based survey was conducted among 41 spine surgeons from 3 major Hungarian spine centers, generating 1476 evaluative data points. Surgeons rated the utility of conventional imaging (X-ray, CT, MRI) and 3D printed models across multiple clinical domains and case scenarios. RESULTS:Overall, 3D printed models were rated significantly higher than traditional imaging, with a median utility score of 10 [IQR: 8-10] versus 8 [IQR: 7-9] (P < 0.001, r = 0.25). The largest benefit was observed in patient education (median 10 vs. 7, P < 0.001) and surgical planning (median 9 vs. 8, P < 0.001). In complex congenital scoliosis with metal artifacts, 3D models significantly outperformed traditional imaging (median 10 vs. 7, P < 0.001), whereas no difference was observed in degenerative lumbar pathology (median 9 vs. 9, P = 0.99). Perceived utility did not differ significantly by specialty, experience level, case complexity workload or prior exposure to 3D printing (all P > 0.05). CONCLUSIONS:Spine surgeons in Hungary perceive 3D printed anatomical models as significantly more useful than traditional imaging, particularly for patient education and complex surgical planning. Their perceived value appears driven primarily by case complexity rather than surgeon demographics or prior experience.
Vertebral metastatic disease results from many types of cancer and can have a devastating impact on patient mobility, psychological health, quality of life, and ultimately overall patient survival. However, the development of radiotherapy and surgical techniques has rapidly surged in conjunction with ongoing advances in basic science and translational studies. In this review, we discuss the paradigm shift in our understanding of the epidemiology and treatment algorithms for spinal oncology, ranging from preoperative optimization strategies, radiation and surgical techniques, the utilization of molecular markers and targeted therapeutics in medical oncology, and prognostication tools that underscore a new multidisciplinary approach to spinal oncology care.
The aim of the study was to compare the safety, perioperative outcomes, and radiographic fusion rate of oblique lumbar interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF) in patient population including highly comorbid patients who underwent lumbar fusion for degenerative pathology. This retrospective cohort study included 268 patients who underwent one- or two-level lumbar interbody fusion (L3–L5) between 2017 and 2021. 201 patients underwent TLIF and 67 received OLIF surgery. Demographic, operative, postoperative clinical, and radiographic data were collected. One-year CT and X-ray scans in a subset (n = 157 and n = 174) were used to evaluate bony fusion. Adverse Events (AEs) were categorized using the SAVES-V2 system. Multivariate logistic and linear regressions models were applied to identify predictors of AEs and LOS. Baseline characteristics were comparable between groups. OLIF demonstrated significantly reduced intraoperative blood loss, minor perioperative decline in serum Hgb and shorter hospital stay, whereas TLIF had shorter operative times. Early postoperative AEs and reoperation rates did not differ significantly. High-comorbidity patients showed similar safety profiles. The overall one-year fusion rate was high in both groups (CT: 90.9
Study Design Systematic review. Objective In patients with extradural metastatic spine disease, we sought to systematically review the outcomes and complications of patients with intermediate Spinal Instability Neoplastic Score (SINS) lesions undergoing radiation therapy, percutaneous interventions, minimally invasive surgeries, or open spinal surgeries. Methods Following PRISMA guidelines for systematic reviews, MEDLINE, EMBASE, Web of Science, the Cochrane Database of Systematic Reviews and the Cochrane Center Register of Controlled Trials were queried for studies that reported on SINS intermediate patients who underwent: 1) radiotherapy, 2) percutaneous intervention, 3) minimally invasive, or 4) open surgery. Dates of publication were between 2013-22. Patients with low- or high-grade SINS were excluded. Outcome measures were pain score, functional status, neurological outcome, ambulation, survival, and perioperative complications. Results Thirty-nine studies (n = 4554) were included that analyzed outcomes in the SINS intermediate cohort. Radiotherapy appeared to provide temporary improvement in pain score; however, recurrent pain led to surgery in 15%–20% of patients. Percutaneous vertebral augmentation provided improvement in pain. Minimally invasive surgery and open surgery offered improvement in pain, quality of life, neurological, and ambulatory outcomes. Open surgery may be associated with more complications. There was limited evidence for radiofrequency ablation. Conclusion In the SINS intermediate group, radiotherapy was associated with temporary improvement of pain but may require subsequent surgery. Both minimally invasive surgery and open spinal surgery achieved improvements in pain, quality of life, and neurological outcomes for patients with spine metastases. Open surgery may be associated with more complications.
