Early management of adult traumatic spinal cord injury in patients with polytrauma: a consensus and clinical recommendations jointly developed by the World Society of Emergency Surgery (WSES) & the European Association of Neurosurgical Societies (EANS).

Background: The early management of polytrauma patients with traumatic spinal cord injury (tSCI) is a major challenge. Sparse data is available to provide optimal care in this scenario and worldwide variability in clinical practice has been documented in recent studies.

Methods: A multidisciplinary consensus panel of physicians selected for their established clinical and scientific expertise in the acute management of tSCI polytrauma patients with different specializations was established.

Assessment of rehabilitation effects in children with mild intellectual disability.

Research on effectiveness of rehabilitation programmes continues to investigate impact of therapeutic interventions on various motor parameters in children with intellectual disability (ID). This study compared the effectiveness of rehabilitation, reflected by physical fitness, static balance, and dynamic balance measurements, in children with mild ID. A total of 70 children with mild ID were enrolled for the study and were divided into two equal groups based on their body mass index (BMI) percentile, reflecting obesity or normal weight.

Comparative Analysis of Mandibular and Cervical Mobility in Young Adults with Temporomandibular Joint Disorders: A Case-Control Study.

BACKGROUND Temporomandibular joint disorders (TMJD) affect the muscles of the mandible or the temporomandibular joint (TMJ). The objective of this case-control study was to compare mandibular and cervical joint mobility in young adults diagnosed with TMJD to a healthy control group. MATERIAL AND METHODS We enrolled 60 participants aged 18-30 years, split evenly between 30 TMJD patients and 30 healthy controls.

Determinants of health-related quality of life in patients with fracture of the axis vertebrae.

The study is designed to evaluate quality of life and functional performance in patients with type II and III odontoid fracture treated with anterior odontoid screw fixation. We investigated the relationship between quality of life and: (1) the range of axial rotation of the cervical spine, (2) neck pain intensity, and (3) level of disability in these patients. The study involved 60 patients operated on for type II and III fractures with the use of direct osteosynthesis of the dens.

Anterior odontoid screw fixation extrusion as reason for oesophagus perforation.

Background: Type II odontoid fractures are mostly encountered in the elderly. Due to a high risk of non-union fractures in the case of conservative treatment, surgical fixation is widely recommended. Anterior odontoid screw fixation (AOSF) is a method that allows for a wide range of cervical mobility, and it is a relatively safe procedure that is recommended as the method of choice, although rare complications can be fatal when it leads to life-threatening oesophageal perforation.

Ulnar and Median Nerve Abnormalities in Carpal Tunnel Syndrome.

Background: Nerve compression underlying carpal tunnel syndrome (CTS) results in an increase in the threshold of superficial sensation in the area supplied by the median nerve, which is a mixed nerve dominated by sensory fibres. The distribution of sensory symptoms is strongly dependent on the degree of electrophysiological dysfunction of the median nerve. The association between carpal tunnel syndrome and ulnar nerve entrapment at wrist level is still unclear.

C7 extension crosswise osteotomy: a novel osteotomy for correction of chin-on-chest deformity in a patient with ankylosing spondylitis.

Extension crosswise osteotomy at C7 (C7 ECO) was developed for the correction of forward gaze in patients with chin-on-chest deformity due to ankylosing spondylitis. A modification of cervicothoracic extension osteoclasis (C/T EO), C7 ECO replaces osteoclasis of the anterior column with a crosswise cut of the C7 vertebral body to eliminate the risks of unintended dislocation of the cervical spine. C7 ECO also eliminates the risks of C7 and T1 pedicle subtraction osteotomies (C/T PSOs), in which a posteriorly based wedge excision may lead to stretching injuries of the lower cervical roots and/or failure to achieve the exact angle of excision required for an optimal correction.

Assessment of Interrater and Intrarater Reliability of Cervical Range of Motion (CROM) Goniometer.

Purpose: The current study was designed to assess interrater and intrarater validity of cervical range of motion measurements performed with a CROM goniometer. The study involved 95 healthy university students (31 males and 64 females) aged 20-24 years. Two examiners performed measurements of cervical range of motion using a CROM goniometer.

Long-Term Antibiotic Prophylaxis in Urology and High Incidence of Infections in Surgical Adult Patients.

Clostridioides infections are the main cause of antibiotic-related diarrhea. Most of them come in the form of healthcare-associated Clostridioides infections (HA-CDI). The aim of the study was to analyze HA-CDI epidemiology and the relationship between antibiotic consumption and CDI epidemiology at St Luke's Provincial Hospital in Tarnow, Poland.

Impact of Foehn Wind and Related Environmental Variables on the Incidence of Cardiac Events.

In Poland there is no data related to the impact of halny wind and the related environmental variables on the incidence of cardiac events. We decided to investigate the relationship between this weather phenomenon, as well as the related environmental variables, and the incidence of cardiac events in the population of southern Poland, a region affected by this type of wind. We also decided to determine whether the environmental changes coincide with or predate the event examined.

Range of motion in the cervical spine after odontoid fracture treated with anterior screw fixation.

Background: It is believed that direct odontoid screw fixation preserves the physiological cervical range of motion following surgery. However, there are no clinical studies confirming the motion sparing value of this technique. This study aims to (1) to assess active cervical range of motion following types II and III odontoid fracture, successfully treated with anterior odontoid screw fixation, and (2) to examine the relationship between the range of motion of the head and duration of collar usage, neck pain, quality of life, and patients' age.

Posture control in patients with herniated nucleus pulposus in cervical and lumbosacral spine subjected to operative treatment.

Background: Patients with lumbar degenerative disc disease suffer from impairments in deep trunk muscles, which may lead to poorer posture control.

Objective: The purpose of the study was to assess body balance during double limb stance in patients with herniated nucleus pulposus in cervical and lumbosacral spine, subjected to surgical treatment.

Methods: The qualified subjects included patients operated due to herniated nucleus pulposus in lumbosacral (L-S group) and in cervical area (C group) as well as healthy controls.

Assessment of cervical range of motion in patients after axis fracture.

Background: Surgical treatment of odontoid fractures with posterior C1/C2 fusion always leads to severe limitations in mobility of the cervical spine and head.

Purpose: To assess the mobility of the cervical spine in patients treated with various surgical methods after an axis body fracture.

Material And Methods: A group of 61 subjects receiving surgical treatment in a group of 214 subjects treated for odontoid fractures at one ward of neurosurgery at a regional hospital.

Correlation between correction of pelvic balance and clinical outcomes in mid- and low-grade adult isthmic spondylolisthesis.

Background: Pelvic balance is a version of the pelvis defined by pelvic orientation parameters of PT and SS. Two distinct versions of pelvis are defined: (1) balanced characterized by a relatively low PT and high SS, and (2) unbalanced with relatively high PT and low SS meaning excessive retroversion of the pelvis. It was proved for patients with a high-grade spondylolisthesis that rebalancing of the pelvis can positively affect clinical outcomes.

[Frameless image-guided brain and spine surgery].

The author discusses the principles and role of frameless image-guided surgery in operative treatment of brain and spine. Short overview of the method is presented in a way comprehensible for medical professionals from outside neurosurgical and orthopaedic fields. The author presents the importance of image-guided technologies in development of minimally invasive and less destructive surgery of brain and spine.

Pathophysiology of Minimally Invasive Surgical Approaches: Current Concepts.

Spine surgery is a continuously evolving field. Traditional posterior midline approaches to the lumbar spine are associated with muscle injury. Common mechanisms of injury include ischemia, denervation, and mechanical disruption of tendinous attachments of lumbar muscles.

Comparison of fusion rates between rod-based laminar claw hook and posterior cervical screw constructs in Type II odontoid fractures.

Background: This study was aimed (i) to compare the fusion rates of rod-based laminar claw hook constructs to that of posterior C1/C2 screw constructs in odontoid fractures, and (ii) to evaluate any complications associated with claw hook/rod constructs. To our knowledge, no study in contemporary literature has presented the effects of using modern rod-based laminar claw hooks for treating odontoid fractures. Unlike laminar clamps from the 1980s, contemporary laminar hook-rod instrumentation systems provide better immobilisation of the cervical spine and allows for building reliable frame-like constructs similar to cervical screw-rod systems.

Results of surgical treatment of carpal tunnel syndrome.

Background: The method of carpal tunnel syndrome (CTS) treatment depends on the severity of the symptoms. It is generally accepted that patients with mild and moderate CTS may be referred for conservative treatment while surgical treatment is recommended in patients with severe symptoms. The conclusions drawn on the basis of our study results should facilitate predicting treatment outcomes in patients with various degrees of disturbance in median nerve conduction and the severity of accompanying symptoms.

Changes in spino-pelvic alignment after surgical treatment of isthmic spondylolisthesis.

Background And Purpose: To analyze the changes in spino-pelvic parameters after surgical treatment of lumbar isthmic spondylolisthesis.

Materials And Methods: Sixty patients recruited from a group of consecutive series of 128 cases with isthmic spondylolisthesis operated on between 2002 and 2012 in the Department of Neurosurgery, Tarnow, Poland. All patients were operated on by the same surgeon (the first author).

Strategy in the diagnostics and therapy of tumours of the spine.

The authors present the diagnostic methods and basic surgical procedures used in treatment of spinal neoplasms. Both metastatic and primary spinal tumours lead to instability and loss of the protective function. Spinal cord can be damaged by compression or increased mobility of the vertebral column.

Posterior keyhole corpectomy with percutaneous pedicle screw stabilization in the surgical management of lumbar burst fractures.

Objective: The authors present a new method of minimally invasive surgical management of lumbar burst fractures through the posterior approach. The method includes minimally invasive corpectomy and interbody fusion, both of which are performed through a keyhole approach, and percutaneous pedicle screw fixation of the fracture. The technique of the posterior keyhole corpectomy presented in this report is a novel and original concept of the first author (AM).

[Minimally invasive posterior corpectomy of the lumbar spine with transpedicular fixation].

The authors present their experience in the minimally invasive posterior keyhole lumbar corpectomy with transpedicular stabilization. This technique involves the removal of the posterior part of the affected vertebral body with the pedicle screw fixation through four 2-3 cm long skin incisions on the back. Two cephalad skin incisions provide an approach for corpectomy and instrumentation of the upper pedicles of the construct.

[Problems in the selection of surgical approach for the treatment of non-traumatic deformities of the craniocervical junction].

Developmental abnormalities or inflammatory disorders provoke deformations and instability of the craniocervical junction. The most dangerous results of these lesions are: sudden brainstem compression or cervical myelopathy. The authors propose the guidelines for surgical management of non-traumatic deformities caused by: a) rheumatoid arthritis of the spine, b) congenital anatomic changes of the occipit and odontoid.