[Isolated osseous tuberculosis : Differential diagnosis of treatment refractory osteomyelitis?].

We report the case of a 66-year-old female patient with a treatment refractory disorder of wound healing of the knee, who had already been treated several times surgically and with antibiotics for several months. The examination revealed a skin defect with a fistula in the region of the knee joint. The X‑ray imaging showed an extensive bony defect of unclear etiology.

Tips and tricks for using cement augmentation of pedicle screws and vertebral body replacements-A literature review supported by two case reports.

Background: The prevalence of osteoporosis is escalating alongside an aging global population, increasing the demand for spinal surgeries, including those necessitating cement augmentation for enhanced construct stability.

Objective: This article delves into the nuanced application of cement augmentation techniques for pedicle screws and vertebral body replacements (VBR), aimed at optimizing surgical outcomes in osteoporotic spines.

Method: Drawing from a comprehensive literature review according to important clinical and biomechanical studies and the authors' clinical experiences, we elucidate strategies to mitigate complications and improve surgical efficacy.

Clinical Outcome after Endoscopic Facet Denervation in Patients with Chronic Low Back Pain.

Several studies have reported that low back pain has a high prevalence among the population, with up to 85%. Percutaneous radiofrequency facet denervation (PRFD) is the gold standard of today's rhizotomy for chronic low back pain (CLBP). However, previously published studies present controversial results for the efficacy of PRFD.

Technical aspects of rod-insertion forceps (persuader) application in reducing construct failure after lumbar spine fusion surgery: a biomechanical cadaveric study in Germany.

Study Design: A prospective experimental study.

Purpose: This biomechanical in vitro study aimed to examine the extent to which the use of a rod persuader (RP) leads to additional mechanical stress on the screw-rod system and determine its influence on the bony anchoring of primary pedicle screws.

Overview Of Literature: Degenerative spine diseases and deformities are the most common indications for the stabilization and fusion of spinal segments.

Tips and tricks for using cement augmentation of pedicle screws and vertebral body replacements-A literature review supported by two case reports.

Background: The prevalence of osteoporosis is escalating alongside an aging global population, increasing the demand for spinal surgeries, including those necessitating cement augmentation for enhanced construct stability.

Objective: This article delves into the nuanced application of cement augmentation techniques for pedicle screws and vertebral body replacements (VBR), aimed at optimizing surgical outcomes in osteoporotic spines.

Method: Drawing from a comprehensive literature review according to important clinical and biomechanical studies and the authors' clinical experiences, we elucidate strategies to mitigate complications and improve surgical efficacy.

The Future of Total Elbow Arthroplasty: A Statistical Forecast Model for Germany.

This study provides a statistical forecast for the development of total elbow arthroplasties (TEAs) in Germany until 2045. The authors used an autoregressive integrated moving average (ARIMA), Error-Trend-Seasonality (ETS), and Poisson model to forecast trends in total elbow arthroplasty based on demographic information and official procedure statistics. They predict a significant increase in total elbow joint replacements, with a higher prevalence among women than men.

Perioperative complications associated with fluoroscopy C1 lateral mass screw fixation (Goel technique) versus computed tomography-guided navigation technique: A review of 202 cases from the German Spine Registry (DWG-Register).

Background: Overview of the literature - Fractures of the C1 constitute 3%-13% of all cervical spine injuries in adults. Most isolated C1 fractures are stable and can be treated nonoperatively with external immobilization. Traditional surgical options for C1 fracture treatment are occiput-to-C2 fusion or C1 with lateral mass screws (LMSs).

Double Squeeze Reduction Clamp Technique for Fracture Stabilization: A Case Report.

Introduction: The double squeeze technique for fracture stabilization is a technique in which the surgeon uses a second reduction clamp to hold and stabilize a smaller reduction clamp that reduces a fracture or plate yet is too small to hold by itself. This technique greatly assists anatomic fracture reduction and stabilization and allows the surgeon to complete the operation when there is limited reduction instrumentation available, or the surgeon needs more excursion on a small clamp holding a fracture and does not want to change instruments and possibly lose a reduction. We present a case of the double squeeze clamp technique, which to our knowledge has not been reported, to facilitate limited open reduction percutaneous plate stabilization in a distal tibia fracture.

Economic Implications of Dural Tears in Lumbar Microdiscectomies: A Retrospective, Observational Study.

Objective: Dural tears (DTs) are a frequent complication after lumbar spine surgery. We sought to determine the incidence of DTs and the related impact on health care expenditures after lumbar discectomies.

Methods: In this retrospective cohort study, all patients with first-time single-level lumbar discectomies at our institution who underwent minimally invasive surgery from 2015 to 2019 were reviewed.

The projected increase of vertebral osteomyelitis in Germany implies a demanding challenge for future healthcare management of aging populations.

Purpose: Since an increase in the occurrence of native vertebral osteomyelitis (VO) is expected and reliable projections are missing, it is urgent to provide a reliable forecast model and make it a part of future health care considerations.

Methods: Comprehensive nationwide data provided by the Federal Statistical Office of Germany were used to forecast total numbers and incidence rates (IR) of VO as a function of age and gender until 2040. Projections were done using autoregressive integrated moving average model on historical data from 2005 to 2019 in relation to official population projections from 2020 to 2040.

Compartment Syndrome of the Gluteal Region: A Rare Condition Requiring a High Index of Suspicion.

Introduction: Compartment syndrome, an exceptionally rare condition, is a surgical emergency that can quickly escalate to limb ischemia and necrosis without treatment. Most cases occur post-trauma, typically affecting the anterior compartment of the leg. Patients present with pain out of proportion to their physical examination findings and often have an early hallmark discovery of pain with passive extension.

Increased stability due to symmetric cement volume in augmented pedicle screws? A biomechanical study.

Pedicle screw instrumentation has become "state of the art" in surgical treatment of many spinal disorders. Loosening of pedicle screws due to poor bone mineral density is a frequent complication in osteoporotic patients. As prevalence of osteoporosis and spinal disorders are increasing with an aging demographic, optimizing the biomechanical properties of pedicle screw constructions and therefore outcome after spinal surgery in osteoporotic patients is a key factor in future surgical therapy.

Does index-level pedicle screw instrumentation affect cage subsidence after vertebral body replacement? - A biomechanical study in human cadaveric osteoporotic specimens.

Background: Vertebral body replacement is a common surgical procedure for treatment of disorders associated with spinal instability. Therefore, pedicle screws are usually inserted in adjacent vertebrae for stabilization of the posterior column, however, there is lack of evidence whether implantation of index-level pedicle screws is beneficial or not. This biomechanical study aims to investigate the effect of pedicle screw instrumentation on axial stability following vertebral body replacement.

Patient-related risk factors and lifestyle factors for lumbar degenerative disc disease: a systematic review.

Objective: Back pain is a very widespread disease pattern and is one of the most frequent causes for consultation of a physician in general. In most cases, discogenic changes are the pathomorphological correlate of back pain. Numerous risk factors have been identified for these degenerative changes, but the influence and significance of the risk factors remain unclear, which was the aim of this systematic review.

Severity of spinal degeneration does not affect the pain reduction under continuous epidural analgesia.

Purpose: To outline clinical effectiveness of continuous epidural analgesia (CEA) in patients with failed back surgery syndrome (FBSS) or lumbar spinal stenosis (LSS) depending on severity of spinal degeneration.

Methods: In this retrospective cohort study, all patients with FBSS or LSS who underwent CEA within an inpatient rehabilitation program were evaluated. The pain reduction was measured by VAS on an hourly basis.

Postoperative Surgical Site Infections in Spine Surgery: Can the Duration of Surgery Predict the Pathogen Spectrum?

Background/aim: Surgical site infection (SSI) is a severe complication of spinal surgery, which typically results in prolonged length of hospital stay, an increased number of revision surgeries, re-hospitalizations, worse clinical functional outcomes, and increased healthcare costs. The aim of the present study was to analyse if the duration of surgery can predict the spectrum of pathogens causing SSI in orthopaedic spine surgery.

Patients And Methods: We conducted a retrospective study over a period of two years at the University Hospital of Cologne in which all patients with postoperative surgical site infections were included.

Diagnostic value of DECT-based colored collagen maps for the assessment of cruciate ligaments in patients with acute trauma.

Objectives: The purpose of this study was to evaluate the diagnostic accuracy of third-generation dual-source dual-energy CT (DECT) color-coded collagen reconstructions for the assessment of the cruciate ligaments compared to standard grayscale image reconstruction.

Methods: Patients who underwent third-generation dual-source DECT followed by either 3-T MRI or arthroscopy of the knee joint within 14 days between January 2016 and December 2021 were included in this retrospective study. Five radiologists independently evaluated conventional grayscale DECT for the presence of injury to the cruciate ligaments; after 4 weeks, readers re-evaluated the examinations using grayscale images and color-coded collagen reconstructions.

Projections From Surgical Use Models in Germany Suggest a Rising Number of Spinal Fusions in Patients 75 Years and Older Will Challenge Healthcare Systems Worldwide.

Background: Spinal fusion is a well-established procedure in the treatment of degenerative spinal diseases. Previous research shows that the use of this operative treatment has been growing in recent decades in industrialized countries and has become one of the most cost-intensive surgical procedures. It seems that in some countries such as Germany-with its large, industrialized, European population-this increase is mainly driven by demographic changes with low fertility rates, increasing life expectancy, and an aging population.

Current evidence on where to end a fusion within the thoracolumbar junction most preferably - A systematic literature review.

Proximal junctional kyphosis (PJK) is one main complication in the surgical treatment of adult spinal deformities. Ending within the thoracolumbar junction (TLJ) should but cannot always be avoided to reduce the risk for PJK. With this systematic review we sought to define the most preferable vertebra within the TLJ to minimize the risk for PJK and establish recommendations based on our findings.

Long-term Radiological and Clinical Outcome after Lumbar Spinal Fusion Surgery in Patients with Degenerative Spondylolisthesis: A Prospective 6-Year Follow-up Study.

Objective: To assess which radiological alignment parameters are associated with a satisfactory long-term clinical outcome after performing lumbar spinal fusion for treating degenerative spondylolisthesis.

Methods: This single-center prospective study assessed the relation between radiological alignment parameters measured on standing lateral lumbar spine radiographs and the patient-reported outcome using four different questionnaires (COMI, EQ-5D, ODI and VAS) as primary outcome measures (level of evidence: II). The following spinopelvic alignment parameters were used: gliding angle, sacral inclination, anterior displacement, sagittal rotation, lumbar lordosis, sacral slope, pelvic tilt and pelvic incidence.

Bisphenol A-Related Effects on Bone Morphology and Biomechanical Properties in an Animal Model.

Bisphenol A (BPA), which is contained in numerous plastic products, is known to act as an endocrine-disruptive, toxic, and carcinogenic chemical. This experimental series sought to determine the influence of BPA exposure on the femoral bone architecture and biomechanical properties of male and female Wistar rats. BPA was applied subcutaneously by using osmotic pumps.

Feasibility of continuous epidural analgesia in patients with failed back surgery syndrome and spinal stenosis.

Purpose: The purpose of this study was to outline the feasibility of continuous epidural analgesia in the treatment of failed back surgery syndrome (FBSS) or spinal stenosis.

Methods: We queried our prospective collected institutional database to include all consecutive patients, who underwent continuous epidural analgesia with accompanying intensive physiotherapeutic exercise within a timeframe of 4 years. Patients suffered from FBSS or spinal stenosis; protocolled continuous epidural analgesia was planned for 4 days within the framework of an inpatient multimodal pain therapy concept.

Impact of lordotic cages in the restoration of spinopelvic parameters after dorsal lumbar interbody fusion: a retrospective case control study.

Purpose: Aim of this study was to compare the reconstruction of radiological sagittal spinopelvic parameters between lordotic (10°) and normal cages (0°) after dorsal lumbar spondylodesis.

Methods: This retrospective monocentric study included patients who received dorsal lumbar spondylodesis between January 2014 and December 2018. Inclusion criteria were degenerative lumbar diseases and mono- or bi-segmental fusions in the middle and lower lumbar region.