Full-Endoscopic J-Shaped Transforaminal L5 Nerve Decompression in Bertolotti Syndrome.

This case report and video demonstrate the technique of full-endoscopic J-shaped transforaminal L5 exiting nerve decompression in Bertolotti syndrome. Bertolotti syndrome, characterized by a congenital lumbosacral transitional vertebra, often results in mechanical lower back pain and nerve root compression. A 69-year-old male presented with progressive radiating pain in the right leg and tingling in the L5 dermatome.

Traumatic Anterior Cervical Disc Herniation Presenting as Severe Dysphagia.

Due to the anatomical characteristics of the cervical spine, few cases of traumatic anterior cervical disc herniation have been reported in the literature. Here, we present a rare case of a traumatic anterior cervical disc herniation presenting as severe dysphagia. A 75-year-old male patient presented with severe dysphagia following an accident three days prior when he fell from a height of stairs.

Open Surgery for Osteoporotic Compression Fracture Within One Month of Single Level Balloon Kyphoplasty.

Objective: This study aimed to analyze the reasons for open surgery performed within one month of balloon kyphoplasty (BKP) for osteoporotic compression fractures.

Methods: This study included 15 patients treated with open surgery within one month of BKP in our institution from 2013 to 2020. Among them, 10 patients underwent BKP in our institution and 5 patients were transferred because of adverse events after undergoing BKP at another hospital.

Acute Paraparesis Caused by Spinal Epidural Fluid After Balloon Kyphoplasty for Traumatic Avascular Necrosis: A Case Report.

Minimally invasive procedures, such as percutaneous vertebroplasty or balloon kyphoplasty (BK), eliminate motion at the fracture site and relieve pain associated with traumatic avascular necrosis when conservative treatment fails. However, these are associated with complications, most of which are directly related to cement leakage. Herein, we report a rare case of acute paraparesis caused by spinal cord compression by epidural fluid following BK for the treatment of Kummell's disease in the absence of cement leakage.

Massive Epidural Hematoma Caused by Percutaneous Epidural Neuroplasty: A Case Report.

Percutaneous epidural neuroplasty (PEN) has been used to manage chronic back pain or radicular pain refractory to other conservative treatments, such as medication, injection, and physical therapy. However, similar to all invasive treatment modalities, it has serious complications, such as dural tears, infections, and hematoma formation. Herein, we present a rare case of an 81-year-old female patient on dementia medication who developed paraplegia 5 days after PEN.

Risk Factors of Restenosis After Full Endoscopic Foraminotomy for Lumbar Foraminal Stenosis: Case-Control Study.

Objective: To investigate risk factors associated with postoperative restenosis after full endoscopic lumbar foraminotomy (FELF) in patients with lumbar foraminal stenosis (LFS).

Methods: A single-center, retrospective case-control study was conducted on patients diagnosed with foraminal stenosis who underwent FELF between August 2019 and April 2022. The study included 56 patients, comprising 18 cases and 38 controls.

Complications of Cervical Endoscopic Spinal Surgery: A Systematic Review and Narrative Analysis.

Background: There are no systematic evidence-based medical data on the complications of endoscopic cervical spinal surgery. This narrative analysis compiled data from various studies that examined endoscopic complications, such as cervical disc herniation and foraminal stenosis. This study aimed to investigate the efficacy and safety of endoscopic surgery in cervical radiculopathy.

Complications and Management of Endoscopic Spinal Surgery.

In the past, the use of endoscopic spine surgery was limited to intervertebral discectomy; however, it has recently become possible to treat various spinal degenerative diseases, such as spinal stenosis and foraminal stenosis, and the treatment range has also expanded from the lumbar spine to the cervical and thoracic regions. However, as endoscopic spine surgery develops and its indications widen, more diverse and advanced surgical techniques are being introduced, and the complications of endoscopic spine surgery are also increasing accordingly. We searched the PubMed/MEDLINE databases to identify articles on endoscopic spinal surgery, and key words were set as "endoscopic spinal surgery," "endoscopic cervical foramoinotomy," "PECD," "percutaneous transforaminal discectomy," "percutaneous endoscopic interlaminar discectomy," "PELD," "PETD," "PEID," "YESS" and "TESSYS.

Contraindications and Complications of Full Endoscopic Lumbar Decompression for Lumbar Spinal Stenosis: A Systematic Review.

Objective: The purpose of this study was to suggest appropriate indications and contraindications for full endoscopic surgery and to predict the prognosis for the incidence of complications by reviewing the literature on full endoscopic lumbar decompression for various spinal stenoses and systematically analyzing the contraindications and complications of endoscopic surgery.

Methods: We searched the PubMed/MEDLINE database to identify articles on full endoscopic decompression for lumbar spinal stenosis. The levels of evidence in all studies were classified according to the method adopted by the North American Spine Society (NASS) 2005.

Tracheostomy Following Anterior Cervical Discectomy and Fusion With Plating in Trauma Patients: Is It Safe?

Objective: This study aimed to evaluate the safety and necessity of tracheostomy after anterior cervical discectomy and fusion (ACDF) with plating, despite the close proximity of the two surgical skin incisions.

Methods: Sixty-three patients with traumatic cervical fractures or spinal cord injury (SCI) who underwent single-level ACDF and plating between January 2014 and June 2019 were included in this study. The patients included 45 men and 18 women, with a mean age of 48.

Pyogenic Andersson Lesion in a Patient With Ankylosing Spondylitis.

Although the exact etiology of the Andersson lesion (AL) remains unclear, it is known to occur mostly in patients with long-standing ankylosing spondylitis (AS). Among the various theories for the etiology of AL, repetitive trauma and inflammatory causes are the most common. The histopathological appearance of the AL in this report was consistent with that of chronic inflammation without any infection.

Treatment of Extensive Spinal Epidural Abscess with Skipped Laminotomy Using a Pediatric Feeding Tube: A Case Report.

Spinal epidural abscess (SEA) is an unusual form of spinal infection. Performing multilevel laminectomies is controversial in cases of extensive SEA considering the long surgical time and mechanical instability. Here, we report the case of an older woman with extensive SEA and poor general condition who was successfully treated with a less invasive treatment, namely skipped laminotomy using a pediatric feeding tube.

Anterior Approaches for Two-Level Cervical Degenerative Disease: A Comparative Study of at least 6-Year Follow-Up.

Objective: To compare the clinical and radiogrincaphic results of a hybrid surgery (HS) and cervical artificial disc replacement (ADR) for contiguous two-level cervical spondylosis.

Methods: A total of 56 patients with contiguous two-level degenerative cervical spondylosis who underwent cervical HS and ADR via an anterior approach and completed at least 6 years of follow-up were included in this study. Patients were divided into two groups: group I, comprising 22 patients who underwent ADR, and group II, comprising 34 patients who underwent HS combined ADR and anterior cervical discectomy and fusion using a cage.

Efficacy of Antibiotic-Loaded Cement Augmentation for Correcting Low Grade Pedicle Screw Loosening.

Objective: Altered biomechanics and bone fragility can contribute to pedicle screw loosening. This study aimed to evaluate the efficacy of antibiotic-loaded cement augmentation for correcting symptomatic screw loosening as a minimally invasive alternative to open revision surgery.

Methods: Ten consecutive patients who underwent percutaneous cement augmentation for pedicle screw loosening were included in this study.

Extradural Spinal Arachnoid Cyst as a Cause of Cauda Equina Syndrome in a Child.

Although spinal arachnoid cysts are relatively common findings observed incidentally in adults, they are much rarely reported in children. They are usually asymptomatic and are mainly located in the middle and lower thoracic regions. However, in rare circumstances, these cysts can cause mass effects that lead to neurologic symptoms.

Technical Considerations of the Transforaminal Approach for Lumbar Disk Herniation.

Transforaminal full endoscopic lumbar diskectomy (TELD) is a typical minimally invasive surgery, with the associated benefit of decreased possibility of anatomic structural injury, and is an effective alternative to open diskectomy. Among the various endoscopic spinal surgical techniques currently available, TELD is the most basic and traditional surgery that can be performed through the transforaminal route; it has been used for >30 years. Recently, with the advancements in surgical techniques, TELD has been successfully performed for patients with lumbar disk herniation of different types.

Predictive Scoring and Risk Factors of Early Recurrence after Percutaneous Endoscopic Lumbar Discectomy.

Purpose: To predict the early recurrence after full endoscopic lumbar discectomy, we analyzed factors related to demographic factor anatomical factors, operative method, and postoperative management, and predicted the possibility of recurrence according to the scoring system.

Materials And Methods: In this prospective study, we enrolled 300 patients who underwent 1 out of 3 surgical procedures. The patients were randomized into one of the following groups: group A ( = 100), transforaminal inside-out approach; group B ( = 100), transforaminal outside-in approach; and group C ( = 100), interlaminar approach.

Anterior Approach Following Intraoperative Reduction for Cervical Facet Fracture and Dislocation.

Objective: The purpose of this study was to evaluate the efficacy of the anterior approach following intraoperative reduction under general anesthesia in patients with cervical facet fracture and dislocation.

Methods: Twenty-three patients with single level cervical facet fracture and dislocation who were subjected to the anterior approach alone following immediate intraoperative reduction under general anesthesia from March 2013 to December 2017 were enrolled in this study. Neurological status, clinical outcome, and radiological studies were evaluated preoperatively, postoperatively, and during the follow-up period.

Traumatic Cervical Epidural Hematoma without Osseous Fracture Presenting as Hemiparesis.

Traumatic cervical epidural hematoma (EDH) with no osseous fracture or underlying hematological abnormalities is a rare disorder that sometimes requires emergent surgical decompressive therapy. A 47-year-old woman was admitted to our emergency room due to severe neck pain and rapid onset hemiparesis after a car accident. Plain cervical radiographs and computed tomography scan did not reveal any abnormality.

Malignant Metastasis Misdiagnosed as Osteoporotic Compression Fracture: A Case Report.

In cases of vertebral collapse after a trivial injury in elderly patients with severe osteoporosis, it can be a diagnostic challenge to determine whether the cause is a benign compression fracture or malignant metastasis. A 78-year-old male patient was referred to the emergency department for the evaluation of weakness of the left lower limb. He had undergone percutaneous vertebroplasty four months earlier after being diagnosed with L3 osteoporotic compression fracture.

Posterior Screw Fixation in Previously Augmented Vertebrae with Bone Cement: Is It Inapplicable?

Objective: The purpose of this study was to determine the feasibility of screw fixation in previously augmented vertebrae with bone cement. We also investigated the influence of cement distribution pattern on the surgical technique.

Methods: Fourteen patients who required screw fixation at the level of the previous percutaneous vertebroplasty or balloon kyphoplasty were enrolled in this study.

Decompressive L5 Transverse Processectomy for Bertolotti's Syndrome: A Preliminary Study.

Background: Bertolotti's syndrome is a spinal disorder characterized by abnormal enlargement of the transverse process of the most caudal lumbar vertebra. The L5 transverse process may be enlarged either unilaterally or bilaterally and may articulate or fuse with the sacrum or ilium. Pseudoarticulation between the transverse process of the L5 and the alar of the sacrum can cause buttock pain and leg pain.

Spinal Instability Predictive Scoring System for Subsequent Fracture After Bone Cement Augmentation in Patients with Osteoporotic Vertebral Compression Fracture.

Objective: Bone cement augmentation procedures (vertebroplasty and kyphoplasty) are the primary treatments for osteoporotic vertebral compression fracture (VCF). However, these procedures are associated with various problems resulting in subsequent fracture. The purpose of this study was to evaluate the spinal instability factors related to subsequent fracture after vertebral augmentation procedures.

A New Sling Technique in Cervical Radiculopathy Caused by Vertebral Artery Loop Compression.

Background: A 52-year-old woman had a 20-month history of progressive radiating pain in the left arm and numbness on C7 dermatome.

Case Description: On physical examination, left head rotation aggravated the radiculopathic pain. For an anatomic diagnosis of the vertebral artery and nerve root, magnetic resonance angiography was performed (computed tomography angiography was not possible because of her dye allergy history).