Development and temporal validation of clinical prediction models for 1-year disability and pain after lumbar decompressive surgery. The Norwich Lumbar Surgery Predictor (development version).

Purpose: To identify clinical predictors and build prediction models for 1-year patient-reported outcomes measures (PROMs) after lumbar decompressive surgery for disc herniation or spinal stenosis.

Methods: The study included 1835 cases, with or without additional single-level fusion, from a single centre from 2008 through 2020. General linear models imputed with 37 clinical variables identified 18 significant 1-year PROM predictors for retention in development models.

Incidence and risk factors for five-year recurrent disc herniation after primary single-level lumbar discectomy.

To identify the incidence and risk factors for five-year same-site recurrent disc herniation (sRDH) after primary single-level lumbar discectomy. Secondary outcome was the incidence and risk factors for five-year sRDH reoperation. A retrospective study was conducted using prospectively collected data and patient-reported outcome measures, including the Oswestry Disability Index (ODI), between 2008 and 2019.

Incidence of vascular complications arising from anterior spinal surgery in the thoraco-lumbar spine.

Study Design: Modern biomaterials and instrumentation have popularised surgery of the thoraco-lumbar spine through an anterior route. The advantage of anterior surgery is that it allows for a direct decompression of the compromised spinal canal. However, the potential for devastating long-term sequelae as a result of complications is high.

Nontraumatic fracture of the femoral condylar prosthesis in a total knee arthroplasty leading to mechanical failure.

This paper reports a case of fatigue fracture of the femoral component in a cruciate-retaining cemented total knee arthroplasty (TKA). A 64-year-old man had undergone a primary TKA for osteoarthritis 10 years previously at another institution using the PFC-Sigma prosthesis. The patient recovered fully and was back to his regular activities.

Arachnoiditis following caudal epidural injections for the lumbo-sacral radicular pain.

Caudal epidural steroid injection is a very common intervention in treatment of low back pain and sciatica symptoms. Although extensively used, it is not devoid of complications. A few reports of chemical and infective arachnoiditis exist following lumbar epidural anaesthesia, but none following a caudal epidural steroid injection.

In-hospital complications following primary total hip and knee arthroplasty in octogenarian and nonagenarian patients.

Background: As life expectancy of patients increases, more elderly patients are undergoing primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). There is a general perception of increased risk of complications in elderly patients. Our objective was to analyse the incidence of in-hospital medical and surgical complications following THA and TKA in octogenarian and nonagenarians.

Is ultrasound diagnosis reliable in acute extensor tendon injuries of the knee?

Ruptures of the patellar and quadriceps tendon are rare injuries requiring immediate repair to re-establish knee extensor continuity and allow early motion. Ultrasound is extensively used as a diagnostic tool before surgery on acute traumatic tears of the patellar tendon and quadriceps tendons. The aim of our study was to evaluate the role of sonography in diagnosing quadriceps and patellar tendon rupture and in differentiating partial from complete tears.

A study investigating the validity of modified Tokuhashi score to decide surgical intervention in patients with metastatic spinal cancer.

Purpose: Predicted survival of a patient is the most important parameter that helps to guide the treatment of a patient with metastatic spinal cancer. We aimed to investigate the reliability of modified Tokuhashi score in the decision-making process in patients with metastatic spinal cancer.

Methods: We performed a review of our prospectively collected Metastatic Cancer Database over a period of 4 years (2007-2010).

Revision of failed unicompartmental knee replacement to total knee replacement.

Recent reports suggest good outcome results following unicompartmental knee replacement (UKR). However, a number of authors have commented on the problem of osseous defects requiring technically difficult revision surgery. We reviewed clinical outcomes following revision total knee replacement (TKR) for failed UKR and analysed the reasons for failure and the technical aspects of the revision surgery.