Purpose of the study Lumbar Degenerative Disc Disease is a pathologic process that affects a large portion of aging population. Mobile lumbar disc replacement is a treatment option that preserves the natural movement of the functional spinal unit. The study aimed to evaluate the long-term functional and radiological outcomes of Maverick and Prodisc implants. Material and methods Monocentric longitudinal observational study with a follow up >= 10 years. ODI and VAS were assessed and functional radiographs were evaluated. Analysis of revision surgery via Cox regression, analysis of quantitative data by linear regression and Mann-Whitney-Wilcoxon test. Results There were 3 revision surgeries in the Maverick group and no revision surgery in the Prodisc group (p=0.1012). The mean ODI (Maverick) was 16.5 (95% CI10.3-22.8) vs. 11.8 (95% CI 5.6-17.9) in Prodisc, p = 0.5999. Mean lumbar VAS in Maverick reached 4.11 (2.78-5.45), in Pro-disc 3.13 (1.99-4.26), p = 0.3100. Both ODI and VAS correlated negatively with the left-sided lateroflexion. R = (-0.5084), p = 0.0312 for ODI and R = (-0.538), p = 0.0210 for VAS. Heterotopic calcifications were significantly higher in men with the mean grading of 2.8 vs.1.7 in women, p = 0.0251. Urogenital complication was reported in one patient. Discussion The results of our study were concordant with similar longitudinal studies. more detailed discussion is included our full-text paper. Conclusions The long-term outcomes were poorer than the short-term ones, but satisfactory. A decrease in the range of motion and an increase in ODI and VAS scores were observed due to ongoing degenerative changes of the posterior segment. The heterotopic calcifications were common but were not associated with the revision surgery.
Purpose of the study Open fractures represent complex injuries characterized by bone exposure, soft-tissue damage, and a high risk of infection, often requiring multidisciplinary management. In polytraumatized patients, these injuries further increase clinical complexity and hospital resource utilization. The purpose of this study was to evaluate adherence to international guidelines in the management of open fractures at a third-level trauma center and to identify clinical and organizational predictors of outcomes, complications, and hospitalization burden in polytraumatized and nonpolytraumatized patients. Material and methods A retrospective, single-center study was conducted including all patients treated for open fractures between January 2020 and December 2023. Demographic data, injury mechanisms, fracture location, Gustilo-Anderson grade, surgical timing, treatment strategy (Early Total Care or Damage Control Orthopedics), ICU admission, complications, and readmissions were collected. Polytrauma status was recorded. Primary outcomes included infection rate, length of hospital stay, number of admissions, and cumulative hospitalization time. Statistical analysis was performed using Student's t-test, Fisher's exact test, and Pearson correlation, with significance set at p < 0.05. Results A total of 115 patients were included, of whom 53(46.1%)were polytraumatized. The mean age was 47.1 years, with a male predominance. Lower-limb fractures were most common, particularly involving the tibia. Grade III injuries accounted for 61.7% of cases. Surgical debridement was performed within 6 hours in 65.2% of patients. External fixation for damage control was used in 73% of cases, with a mean fixation duration of 103 days. Postoperative ICU admission was required in 27.8% of patients. Overall infection rate was 15.7%. Polytraumatized patients experienced significantly longer hospital stays and a higher number of readmissions, but polytrauma status was not associated with increased infection risk. Higher Gustilo-Anderson grade showed a strong correlation with prolonged hospitalization and infection. Damage control strategies were associated with longer cumulative hospitalization and more frequent readmissions but not with higher infection rates. Discussion These findings indicate that fracture severity and local tissue damage, rather than polytrauma status itself, are the main determinants of infection risk and hospitalization burden. While polytrauma increases overall resource utilization, standardized multidisciplinary management allows comparable orthopedic outcomes. Damage control orthopedics remains essential in severe cases but implies longer and more fragmented care pathways. Conclusions In a high-volume trauma center adhering to international guidelines, open fracture outcomes are primarily driven by injury severity. Polytrauma influences hospitalization burden but not infection risk. Awareness of these factors is essential for optimizing trauma pathways, resource allocation, and patient counseling.
