Three-level thoracic disc herniation: transthoracic decompression without fixation.

Thoracic disc herniation is a rare pathology compared to the rest of the herniated discs. Due to their difficult access to the area of compromise and proximity to the spinal cord they represent a real challenge for the spine surgeon. The objective is to report an atypical case with three symptomatic dorsal disc herniations which required surgical treatment.

Association between Modic changes and intervertebral vacuum phenomenon severity in patients undergoing percutaneous cement discoplasty.

Background: Modic changes and intervertebral vacuum phenomenon (IVP) are considered spinal degenerative changes. The correlation between Modic and IVP has not been analyzed in the literature.

Purpose: To analyze the correlation between IVP severity, Modic changes, and subchondral sclerosis across the lumbar spine in patients with lumbar degeneration.

Extensive spinal epidural abscess after nerve root injection in a young non-immunocompromised Patient. Case Report and Literature Review.

Introduction: Epidural injections are frequent and safe procedures. Severe complications are infrequent, and they have been reported in elderly comorbid patients with predisposing factors. The objectives of this work are to present a case of an extensive epidural lumbar abscess in a young non-comorbid male patient after a therapeutic L5-S1 injection and a literature review about this subject.

Accuracy of intraoperative neuromonitoring during percutaneous cement discoplasty.

Introduction: Percutaneous cement discoplasty is a minimally invasive procedure to treat low back pain due to advanced degenerative disc disease in elderly patients. Complications of this procedure has been described such as infection, vertebral fracture, cement leakage and nerve injury. Intraoperative neuromonitoring is used to detect the latter.

Percutaneous Cement Discoplasty for Degenerative Low Back Pain with Vacuum Phenomenon: A Multicentric Study with a Minimum of 2 Years of Follow-Up.

Background: To report clinical results after percutaneous cement discoplasty (PCD) in a multicentric case series with a minimum of 2 years of follow-up.

Methods: Between December 2014 and January 2019, 180 patients with low back pain and advanced degeneration were treated with percutaneous discoplasty in 2 centers. The inclusion criteria were as follows: patients 65 years or older, with mechanical low back pain with or without spinal stenosis, who did not respond to conservative management.

Symptomatic Atlas Hypoplasia in a Latin-American Patient: Case Report and Literature Review.

Background: Atlas hypoplasia is an infrequent cause of upper cervical stenosis. Only 24 cases in nonsyndromic adult population have been published. We are not aware of previous reports describing isolated fully formed atlas hypoplasia in a Latin-American patient.

[La Frailty as a predictor index in spine surgery].

Introduction: Frailty is a term used to quantify the physiological age of patients. Higher levels of frailty correlate with higher complications and mortality rates after different surgical procedures. The objective of this work is to evaluate the relationship between frailty and the complications and mortality rates after elective spinal surgeries within 90 days.

Chylothorax, a rare complication after anterior lumbar interbody fusion. Case report.

Introduction: Chylous leakage into the retroperitoneum is a rare complication after spinal surgery using an anterior retroperitoneal approach. Chylothorax is the presence of lymphatic fluid in the pleural cavity and it is even less frequent during these surgeries. The aim of this work is to report the first case of isolated left chylothorax after a retroperitoneal Left Oblique Lumbar Interbody Fusion in supine position in an adult female patient.

Development of a New Therapy-Oriented Classification of Intervertebral Vacuum Phenomenon With Evaluation of Intra- and Interobserver Reliabilities.

Study Design: Diagnostic study, level of evidence III.

Objectives: Low back pain is a common cause of disability among elderly patients. Percutaneous discoplasty has been developed as a tool to treat degenerative disease when conservative management is not successful.

Percutaneous Cement Discoplasty for the Treatment of Advanced Degenerative Disc Conditions: A Case Series Analysis.

Study Design: Retrospective analysis. Level of evidence III.

Objectives: To describe the results after a minimum 1-year follow-up in patients treated with percutaneous discoplasty (PD), a minimally invasive technique to treat low back pain in elderly patients with advanced degenerative disc disease.

[Vertebral cryptococosis. Case report and literature review].

Cryptococcosis is an infectious disease caused by a ubiquitous encapsulated yeast called Cryptococcus neoformans, it is usually associated with immunosuppressed patients. Osteomyelitis occurs in 5-10%, the spine involvement is one of the most reported. The purpose of this work is to present a case of isolated vertebral cryptococcosis and detail the results of a literature review.

Analysis of Risk Factors for New Vertebral Fracture After Percutaneous Vertebroplasty.

Study Design: Retrospective analysis. Level of evidence III.

Objectives: Low-energy vertebral compression fractures are an increasing socioeconomic problem among elderly patients.

Percutaneous cement discoplasty for the treatment of advanced degenerative disk disease in elderly patients.

Purpose: The authors describe a percutaneous technique to treat advanced degenerative disk disease in elderly patients.

Method: A step-by-step technical description based on our experience in selected cases.

Result: Postoperative imaging results are presented as well as indications and recommendations.

Monosegmental combined anterior posterior instrumentation for the treatment of a severe lumbar tuberculous spondylodiscitis: case report and literature review.

Spinal tuberculosis (Pott disease) can produce severe deformities when it is not properly treated. Long instrumentations through single or combined double approaches are usually required to prevent and correct the deformity. The authors present a case of severe deformity secondary to tuberculous spondylodiscitis in the lumbar spine treated with a monosegmental instrumentation through a double approach in a patient with idiopathic scoliosis.

Usefulness of Tokuhashi Score in Survival Prediction of Patients Operated for Vertebral Metastatic Disease.

Study Design: Retrospective study.

Objective: Spinal metastasis can produce pain, deformity, neurological compromise and can decrease life expectancy. Surgical management is usually indicated for pain control, neurological decompression, and to avoid deformity progression.

Craniocervical spinal instability after type 1 Arnold Chiari decompression: a case report.

To present and describe an unusual case of spinal instability after craniocervical spinal decompression for a type-1 Chiari malformation. Type-1 Chiari malformation is a craniocervical disorder characterized by tonsillar displacement greater than 5 mm into the vertebral canal; posterior fossa decompression is the most common surgical treatment for this condition. Postoperative complications have been described: cerebrospinal fluid leak, pseudomeningocele, aseptic meningitis, wound infection, and neurological deficit.

Monitoring lumbar plexus integrity in extreme lateral transpsoas approaches to the lumbar spine: a new protocol with anatomical bases.

Unlabelled: XLIF is an increasingly popular procedure that requires traversing the psoas, with the potential risk of injuring the lumbar plexus nerves. Intraoperative neurophysiological monitoring (IOM) is, therefore, critical in this kind of procedures; nevertheless, there were some reports of neural damage.

Purpose: To determine the effectiveness of a new protocol for IOM during XLIF.

Endovascular treatment of iatrogenic aortic injury after spinal surgery.

A 59-year-old female presented to our institution with paraparesis caused by medullar compression secondary to multiple myeloma. Spinal cord decompression and transpedicular spine fixation were performed. A month later, the patient complained of sudden pain in her middle back.

Use of CT-guided periradicular injection for the treatment of foraminal and extraforaminal disc herniations.

Study Design:  Retrospective case series. Evidence level IV.

Objectives:  To evaluate surgical candidates with foraminal or extraforaminal lumbar disc herniation treated with CT-guided periradicular injection (CTGPI) as a valid treatment option for avoiding surgery.

The influence of anatomy (normal versus scoliosis) on the free-hand placement of pedicle screws: Is misplacement more frequent in patients with anatomical deformity?

Study Design:  Retrospective prognostic study.

Objective:  To evaluate whether patients with anatomical deformity due to scoliosis have a higher frequency of inaccurate pedicle screw insertion and related complications using the free-hand technique compared with those whose normal anatomy had been impacted by trauma.

Methods:  Consecutively treated trauma patients with otherwise normal anatomy (48 patients instrumented with 291 screws, group A) and scoliosis patients (24 patients instrumented with 287 screws, group B) were evaluated.

Geographic and seasonal patterns and limits on the adaptive response to temperature of European Mytilus spp. and Macoma balthica populations.

Seasonal variations in seawater temperature require extensive metabolic acclimatization in cold-blooded organisms inhabiting the coastal waters of Europe. Given the energetic costs of acclimatization, differences in adaptive capacity to climatic conditions are to be expected among distinct populations of species that are distributed over a wide geographic range. We studied seasonal variations in the metabolic adjustments of two very common bivalve taxa at European scale.

Ultraclean air for prevention of postoperative infection after posterior spinal fusion with instrumentation: a comparison between surgeries performed with and without a vertical exponential filtered air-flow system.

Study Design: This study retrospectively compared infection rates between adult patients after posterior spinal instrumentation procedures performed in a conventional versus an ultraclean air operating room.

Objective: To evaluate if the use of ultraclean air technology could decrease the infection rate after posterior spinal arthrodesis with instrumentation.

Summary Of Background Data: Postoperative wound infection after posterior arthrodesis remains a feared complication in spinal surgery.