Application of Wearable Sensors Technology for Lumbar Spine Kinematic Measurements during Daily Activities following Microdiscectomy Due to Severe Sciatica.

Background: The recurrence rate of lumbar spine microdiscectomies (rLSMs) is estimated to be 5-15%. Lumbar spine flexion (LSF) of more than 10° is mentioned as the most harmful load to the intervertebral disc that could lead to recurrence during the first six postoperative weeks. The purpose of this study is to quantify LSFs, following LSM, at the period of six weeks postoperatively.

Spinal Surgery Complications and Failures in Patients with Parkinsons Disease.

Parkinson's disease is a degenerative disorder of the central nervous system affecting the substantia nigra in the midbrain. It accounts for 1.5% of the population in Europe over 60 years of age.

Apex of deformity for three-column osteotomy. Does it matter in the occurrence of complications?

Background: Posterior vertebral column resection (PVCR) is a challenging but effective technique for the correction of complex spinal deformity. However, it has a high complication rate and carries a substantial risk for neurologic injury.

Purpose: The aim was to test whether the apex of the deformity influences the clinical outcomes and complications in patients undergoing PVCR.

Incidence and Risk Factors for Major Surgical Complications in Patients With Complex Spinal Deformity: A Report From an SRS GOP Site.

Study Design: Retrospective analysis of a prospectively collected single-center database.

Objectives: To report the incidence of and identify risk factors for perioperative complications in surgically treated pediatric and adult patients with complex spine deformities in an underserved region and Scoliosis Research Society Global Outreach Program site.

Summary Of Background Data: Surgical treatment for complex spinal deformity is challenging and requires a multidisciplinary approach for optimal management.

Surgical Risk Stratification Based on Preoperative Risk Factors in Severe Pediatric Spinal Deformity Surgery.

Study Design: Retrospective review.

Objective: The purpose of this study is to review the postoperative complications in pediatric patients undergoing spine surgery and to establish a preoperative classification that stratifies surgical risk and case difficulty.

Summary Of Background Data: Pediatric spinal deformity (PSD) surgery can be challenging technically as well as economically.

Uncommon complication after revision hip surgery.

Cauda equina syndrome is an uncommon complication of ankylosing spondylitis characterized by the slow and insidious development of severe neurologic impairment related to dural ectasia. This report describes a unique case of cauda equina syndrome in a patient with ankylosing spondylitis after hip revision surgery. A 70-year-old man with long-standing ankylosing spondylitis underwent standard hip revision surgery; combined spinal and general anesthesia was administered.

Early outcomes and complications of posterior vertebral column resection.

Background Context: Hyperkyphosis confers a significant risk for neurologic deterioration as well as compromised cardiopulmonary function. Posterior vertebral column resection (PVCR) is a challenging but effective technique for spinal cord decompression and deformity correction that even under the setting of limited resources can be performed to reduce the technical difficulties, the operating time, and possibly the complications of the traditional two-staged vertebral column resection (VCR).

Purpose: To report on the results of VCR performed through a single posterior approach (PVCR) in the treatment of severe rigid kyphosis in a series of patients treated and followed at a Scoliosis Research Society Global Outreach Program site in West Africa.

Common surgical complications in degenerative spinal surgery.

The rapid growth of spine degenerative surgery has led to unrelenting efforts to define and prevent possible complications, the incidence of which is probably higher than that reported and varies according to the region of the spine involved (cervical and thoracolumbar) and the severity of the surgery. Several issues are becoming progressively clearer, such as complication rates in primary versus revision spinal surgery, complications in the elderly, the contribution of minimally invasive surgery to the reduction of complication rate. In this paper the most common surgical complications in degenerative spinal surgery are outlined and discussed.

Late treatment of tuberculosis-associated kyphosis: literature review and experience from a SRS-GOP site.

Introduction: Spinal tuberculosis (TB) accounts for approximately half of all cases of musculoskeletal tuberculosis. Kyphosis is the rule in spinal tuberculosis and has potential detrimental effects on both the spinal cord and pulmonary function. Late-onset paraplegia is best avoided with the surgical correction of severe kyphosis, where at the same time anterior decompression of the cord is performed and the remnants of the tuberculosis-destroyed vertebral bodies are excised.

Pathophysiology and biomechanics of the aging spine.

AGING OF THE SPINE IS CHARACTERIZED BY TWO PARALLEL BUT INDEPENDENT PROCESSES: the reduction of bone mineral density and the development of degenerative changes. The combination of degeneration and bone mass reduction contribute, to a different degree, to the development of a variety of lesions. This results in a number of painful and often debilitating disorders.

Posterior decompression and stabilization, and surgical vertebroplasty with the vertebral body stenting for metastatic vertebral and epidural cauda equina compression.

We present the technique of combined posterior decompression and spinal instrumentation, and surgical (open) vertebroplasty using a novel system called vertebral body stenting (VBS) during a single session in a patient with metastatic vertebral and epidural cauda equina compression.

Spontaneous posterior iliac crest regeneration enabling second bone graft harvest; a case report.

We present a case of a revision spinal fusion in which successful bone graft reharvesting was performed from the posterior iliac crest 4 years after initial intracortical harvesting. To date, only anterior iliac crest regeneration has been reported in orthopedic trauma patients. A 70-year-old man with a history of two prior instrumented lumbar fusion operations developed thoracolumbar kyphosis junctional to the lumbosacral fusion mass.

Unipedicular balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures: early results.

Introduction: The traditional bipedicular kyphoplasty was proved to be safe and effective for the treatment of pain associated with osteoporotic vertebral compression fractures (VCFs). Nevertheless, unilateral kyphoplasty would be an attractive alternative to the traditional bipedicular kyphoplasty owing to theoretical speed, safety, and less expense; thus far, the biomechanical testing showed that experimental unilateral kyphoplasty had properties comparable with bipedicular kyphoplasty. To date, no clinical data are available regarding the efficacy and safety of unilateral balloon kyphoplasty.

Sacral fractures complicating thoracolumbar fusion to the sacrum.

Study Design: Case series.

Objective: To report on the rare complication of sacral fractures after long instrumented thoracolumbar fusions to the sacrum.

Summary Of Background Data: Rigid spinal fusion with instrumentation results in redistribution of forces in the spine that can cause the adjacent segments to degenerate and fail.

Osteoporotic vertebral fractures and collapse with intravertebral vacuum sign (Kümmel's disease).

The intravertebral vacuum phenomenon was first described by Kümmel and is also known as delayed vertebral collapse or vertebral pseudarthrosis. Clinically, it occurs in approximately 10% of vertebral osteoporotic fractures, mainly in the thoracolumbar zone, is accentuated on extension views and associated with benign fractures. Most patients are neurologically intact, and continued pain is a common symptom that responds well to stabilization.

Total knee arthroplasty in patients with pre-existing fracture deformity.

Pre-existing femoral or tibial extra-articular fracture deformity may adversely affect the results of total knee arthroplasty (TKA). This deformity can be addressed with asymmetrical intra-articular resection or with correctional osteotomy performed prior to or at the time of primary TKA. Careful preoperative planning obviates many potential problems that can occur at the time of surgery with correction of many complex deformities.

Lumbar microdiscectomy under epidural anesthesia: a comparison study.

Background Context: Lumbar microdiscectomy is most commonly performed under general anesthesia, which can be associated with several perioperative morbidities including nausea, vomiting, atelectasis, pulmonary aspiration, and prolonged post-anesthesia recovery. It is possible that fewer complications may occur if the procedure is performed under epidural anesthesia.

Purpose: To investigate the safety and efficacy of epidural anesthesia in elective lumbar microdiscectomies.

Outcome of revision discectomies following recurrent lumbar disc herniation.

Study Design: Retrospective study.

Objectives: To assess the difference in the outcome score between a primary surgery to treat lumbar disc herniation and a revision surgery for recurrent herniation at the same location with the use of a validated lumbar spine outcome instrument.

Summary Of Background Data: Paucity of studies comparing the results of revision discectomy for true recurrent disc herniation at the same location to that reported for primary discectomy.

Measurement error of lumbar total disc replacement range of motion.

Study Design: A retrospective review of lumbar total disc replacement (TDR) radiographs.

Objective: To determine the error and variability in measuring TDR radiographic range of motion (ROM).

Summary Of Background Data: Motion preservation is the driving force behind lumbar TDR technology.

Three-level anterior cervical discectomy and fusion with plate fixation: radiographic and clinical results.

Study Design: Retrospective review of patients with cervical spondylosis treated with 3-level anterior cervical discectomy and fusion with plate fixation.

Objective: To assess the radiographic and clinical outcome of 3-level instrumented anterior cervical discectomy.

Summary Of Background Data: Three-level cervical discectomy without plate fixation has shown high rates of pseudarthrosis and poor outcomes.

Postoperative infections in interbody fusion for degenerative spinal disease.

Unlabelled: Scant literature exists on the treatment of infection after interbody fusion. Some authors advocate removal of the interbody grafts. Salvage of the grafts was possible in 92.

Spinal infections in patients with compromised immune systems.

Unlabelled: Spinal infections are relatively uncommon but have potentially devastating consequences if not diagnosed and treated correctly. Compromised immunologic responsiveness, either transient or permanent, predisposes patients to more frequent and more severe infections. Through a Medline review of the English-language literature from 1990 to 2005, we examined the current understanding of the etiology of common immunocompromising conditions, how these diagnoses impact the relative spine infection rates including diagnosis and therapeutic monitoring, and practice trends regarding surgical intervention.