Pratica di Shadowing: Decompression alone versus decompression with instrumented fusion in the t | Kaiser | EUROSPINE 2025 - Impara a parlare inglese con i video

Creazione lezione...
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Good morning ladies and gentlemen.
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So this study is from Czech Republic
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and it's about decompression alone versus decompression with instrumented fusion in the treatment of a degenerative spondylolisthesis.
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I have nothing to declare.
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So this talk will be about minimally invasive surgery because MIS is not only about fancy tools and about new technologies,
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but it's a concept of achieving the same outcome by using smaller approach and or less invasive procedure.
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So we have various types of decompression, we have various types of fusion techniques,
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but the main question remains whether it's necessary to fuse or to just decompress.
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We all agree and we have enough data nowadays that so -called simple lumbar stenosis should be treated by simple decompression.
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But what happens when we have a slip?
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And how should be managed a patient where there are signs of instability,
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although the instability is still not yet clearly defined in the literature?
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So that's why we performed and designed a systematic review with meta -analysis
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and this work was part of the development of Czech clinical practice guidelines, something similar to NICE guidelines in the UK,
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the surgical treatment of the degenerative diseases of the spine
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and the review was discussed and validated by a national panel of experts, six orthopedic surgeons and six neurosurgeons experienced in this topic.
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And we incorporated only trials using pedicle screw fixation fusion and excluded those using other old techniques or non -instrumented fusion.
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So the population was adults with degenerative lumbar spondylolisthesis.
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We compared isolated decompression with decompression with pedicle screw fixation.
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And primary outcomes were improvement in ODI and VAS in low back pain and leg pain.
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And secondary outcomes, re -operation rate, complication rate, length of stay, duration of surgery, blood loss and quality of life.
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And these are the basic results.
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So we found only four randomized trials in the literature
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and you have the comparison of the numbers between the two groups in each study.
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The first one is the largest one, the most recent one, Austerwals study.
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And we have enough or we had enough data for comparison.
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However, you can see that the main problem was incorporation of dynamic or so -called dynamic instability in some of the studies.
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So from 21 % to 42 % first didn't even measure the instability and only Gogovawa incorporated only stable stenosis.
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So the results are quite clear.
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There was no difference in ODI, back and leg pain between the two techniques at two -year follow -up in stable degenerative spondylolisthesis spondylolisthesis.
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This is the most important statement because we couldn't do analysis for unstable spondylolisthesis.
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And these results are confirmed even by follow -up studies with long -term results
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and they found that there is no difference at 5
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and 12 years follow -up between the risk of instability after simple decompression and risk of adjacent segment disease after the fusion.
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And this is the current practice.
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Although similar recommendations were already published before these trials by NAS,
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for example, in 2016, they recommended decompression in symptomatic degenerative spondylolisthesis with maximum 20 % slip.
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Or spinal section WFNS, decompression without instability and with dominant leg pain
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but the current practice you can see below 62 % increase of fusions in the US of
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which degenerative spondylolisthesis counted for 45 % with more than 100 % increase
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and 40 % of spinal surgeons would always fuse every degenerative spondylolisthesis regardless of stability
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and below are some other studies from from other countries
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and you can see the proportion for example in a US study almost all patients with degenerative spondylolisthesis were fused.
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So in conclusion, we can make a clear statement that decompression only should be recommended for isolated stable degenerative spondylolisthesis,
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especially in higher age groups, but every case should be individually evaluated based on age of the patient,
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general condition, signs of instability, sleep grade.
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disc height, spinal deformity and dominant back pain over claudications.
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So this study was published in the Journal of Neurology Neurosurgery
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and Psychiatry and this meta -analysis was also part of this clinical practice guidelines which were published in the Czech Orthopaedic Journal.
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Thank you very much.

Cosa imparerai

Con questo video, migliorerai la capacità di seguire un discorso tecnico in inglese, come quello scientifico, e di capire strutture complesse come confronto tra tecniche chirurgiche. Inoltre, eserciterai la comprensione di termini specifici del settore medico, come "decompression" o "fusion", e imparerai a identificare l'ordine logico di un presentazione (introduzione, metodi, risultati, conclusioni). Infine, potrai lavorare sulla tua pronuncia tramite lo shadowing in inglese, imitando la velocità e l'intonazione del relatore.

Ascolta questi suoni

Nella conversazione, noterai numerosi esempi di connected speech (collegamento tra le parole). Ad esempio, "it's a concept" diventa "it'sa concept" e "we have enough data" si trasforma in "wehavenough data". Inoltre, ci sono riduzioni comuni come "I have nothing to declare" pronunciato quasi "I havenothin' to declare" e "what happens when" che diventa "whathappens when". Questi collegamenti rendono il discorso più fluido: ascolta attentamente per non perdere il filo!

Parla come un madrelingua

Per imitare il ritmo del relatore, focalizzati sulla shadow speech: ripeti le frasi subito dopo di lui, cercando di corrispondere alla sua intonazione (alta nelle domande, bassa nelle conclusioni) e alla sua enfasi. Ad esempio, nella frase "the main question remains whether it's necessary to fuse or to just decompress", la parola "main" e "necessary" sono accentuate: metti energia lì. Inoltre, praticare con il shadowing aiuta a ridurre l'accento e a rendere la pronuncia più naturale. Ricorda: l'obiettivo è non solo capire, ma anche essere capito! Usa questo video per esercitarti quotidianamente e migliorare la pronuncia inglese in modo concreto.

Imparare l'inglese con i video è un modo efficace per combinare comprensione e produzione linguistica. Con questo contenuto, hai l'opportunità di lavorare su competenze chiave come la fluidità e l'accento, sfruttando tecniche come lo shadowspeaks. Non rinunciare all'impegno: ogni ripetizione ti avvicina di più a un inglese fluido e confidente!

Cos'è la tecnica dello Shadowing?

Shadowing è una tecnica di apprendimento delle lingue supportata da studi scientifici, originariamente sviluppata per la formazione dei traduttori professionisti e resa popolare dal poliglotta Dr. Alexander Arguelles. Il metodo è semplice ma potente: ascolti un audio in inglese di madrelingua e lo ripeti immediatamente ad alta voce — come un'ombra che segue il parlante con un ritardo di solo 1–2 secondi. A differenza dell'ascolto passivo o degli esercizi di grammatica, lo shadowing costringe il tuo cervello e i muscoli della bocca a elaborare e riprodurre simultaneamente i modelli di discorso reale. La ricerca dimostra che migliora significativamente la precisione della pronuncia, l'intonazione, il ritmo, il discorso connesso, la comprensione dell'ascolto e la fluidità del parlato — rendendolo uno dei metodi più efficaci per la preparazione alla prova di speaking dell'IELTS e per la comunicazione reale in inglese.