Team management in complex posterior spinal surgery allows blood loss limitation.

Purpose: The objective is to analyse peri-operative blood loss (BL) and hidden blood loss (HBL) rates in spinal deformity complex cases surgery, with a focus on the strategies to prevent major bleeding.

Methods: We retrospectively analysed surgical and anaesthesiologic data of patients who had been operated for adolescent idiopathic scoliosis (AIS) or adult spinal deformities (ASD) with a minimum of five levels fused. A statistical comparison among AIS, ASD without a pedicle subtraction osteotomy (PSO) (ASD-PSO( -)) and ASD with PSO (ASD-PSO( +)) procedures was performed with a view to identifying patient- and/or surgical-related factors affecting peri-operative BL and HBL.

Computed Tomography Intraoperative Navigation in Spinal Surgery: Assessment of Patient Radiation Exposure in Current Practices.

Background: Patient radiation exposure associated with the use of computed tomography (CT) navigation during spinal surgeries was widely compared with other intraoperative imaging techniques. The aim of this study is to explore the use of navigation with regard to current spinal surgery practices and the technical limitations of such imaging systems.

Methods: Dosimetric data from 101 patients who underwent intraoperative, CT-navigated spine surgery were retrospectively collected.

Original Surgical Treatment and Long-term Follow-up for Chronic Inflammatory Demyelinating Polyradiculoneuropathy Causing a Compressive Cervical Myelopathy: Review of the Literature.

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a chronic relapsing disease of unknown aetiology. The diagnosis of this disease is still very complicated. The treatment is medical but, in some cases, a surgical decompression might be required.

A painful unknown: sacroiliac joint diagnosis and treatment.

The sacroiliac joint (SIJ) is a complex anatomical structure located near the centre of gravity of the body.Micro-traumatic SIJ disorders are very difficult to diagnose and require a complete clinical and radiological examination.To diagnose micro-trauma SIJ pain it is recommended to have at least three positive provocative specific manoeuvres and then a radiologically controlled infiltration test.

Revision after spinal stenosis surgery.

Purpose: To make a literature review on spinal stenosis recurrence after a first surgery and edit rules to avoid this complication.

Methods: We conducted two separate PUBMED searches to evaluate the revision post-stenosis and degenerative scoliosis surgery using the terms: lumbar vertebrae/surgery, spinal stenosis, spine, scoliosis and reoperation. The resulting papers were categorized into three groups: (1) those that evaluated reoperation post-simple decompression; (2) those that evaluated spinal decompression and fusion for short (3 levels or less) or long (more than 3 levels) segment spinal fusion; and (3) those diagnosing the stenosis during the surgery.

Mismatch between rod bending and actual post-operative lordosis in lumbar arthrodesis with poly axial screws.

Background: The question of rod bending is essential during posterior lumbar fusion. The role of posterior instrumentation during spinal surgery remains to be defined. Despite an appropriate bending, a mismatch between rod lordosis and lumbar lordosis can occur.

Erratum to: Delayed post-operative tension pneumocephalus and pneumorrhachis.

Unfortunately, two author names were missed out in author group of the original publication.

Delayed post-operative tension pneumocephalus and pneumorrhachis.

Introduction: The incidence of pneumocephalus and pneumorrhachis after spinal surgery is unknown, with a paucity of literature on this complication.

Materials And Methods: We present the first published case of delayed onset tension pneumocephalus and pneumorrhachis associated with spinal surgery.

Results: This complication occurred from a cerebro-spinal fluid (CSF) leak after posterior instrumentation removal and was successfully treated with emergent wound debridement and the formation of a CSF fistula.

Anatomic feasibility of a new endopelvic approach for iliac crest bone harvesting.

Purpose: For the past few years, anterior exposure for surgery of the lumbar spine has gained popularity for the treatment of disk disease or spondylosis. Cancellous bone remains the gold standard for fusion. Iliac crest bone harvesting is safe but there are donor site complications.

Thoracic osteotomy for Gorham-Stout disease of the spine: a case report and literature review.

Introduction: Gorham-Stout syndrome is an aggressive, non-heritable skeletal disease characterized by osteolysis following minor trauma. The primary involvement of the spine is less common (10 %) and has been described in only about 20 cases; there is no consensus about the best way to treat this condition.

Purpose Of The Study: To report a case of Gorham-Stout syndrome involving the thoracic spine and to review the literature to suggest a post-operative treatment to prevent osteolysis.