Accuracy of 837 pedicle screw positions in degenerative lumbar spine with conventional open surgery evaluated by computed tomography.

Background: The spatial and directional accuracy of the positioning of pedicle screws in the lumbosacral spine with conventional open surgery assessed by computed tomography (CT) has been published in several studies, systematic reviews and meta-analyses with a short-term follow-up. Inaccurate pedicle screw insertion may cause neurologic symptoms and weakens the construct.

Methods: The data of 147 patients operated on with transpedicular screw fixation based on anatomical landmarks, supported by fluoroscopy, by a senior neurosurgeon in our clinic between 2000 and 2010 were analyzed retrospectively.

[Rare causes of progressive paraparesis].

Progressive paraparesis is a neurosurgical and neurological emergency. The patient's neurological outcome relies on the course of the diagnostics and treatment. Physicians having experience in emergency medicine are familiar with the typical etiologies of paraparesis.

Posterolateral spondylodesis using bioactive glass S53P4 and autogenous bone in instrumented unstable lumbar spine burst fractures. A prospective 10-year follow-up study.

Background And Aims: A prospective long-term follow-up study of bioactive glass (BAG)-S53P4 and autogenous bone (AB) used as bone graft substitutes for posterolateral spondylodesis in treatment of unstable lumbar spine burst fractures during 1996-1998 was conducted.

Material And Methods: The lumbar fractures were fixed using posterior USS instrumentation. BAG was implanted on the left side of the fusion-bed and AB on the right side.

In Vivo and In Vitro Study of a Polylactide-Fiber-Reinforced β-Tricalcium Phosphate Composite Cage in an Ovine Anterior Cervical Intercorporal Fusion Model.

A poly-70L/30DL-lactide (PLA70)-β-tricalcium phosphate (β-TCP) composite implant reinforced by continuous PLA-96L/4D-lactide (PLA96) fibers was designed for in vivo spinal fusion. The pilot study was performed with four sheep, using titanium cage implants as controls. The composite implants failed to direct bone growth as desired, whereas the bone contact and the proper integration were evident with controls 6 months after implantation.

Instrumented spondylodesis in degenerative spondylolisthesis with bioactive glass and autologous bone: a prospective 11-year follow-up.

A prospective long-term follow-up study of bioactive glass (BAG)-S53P4 and autogenous bone (AB) used as bone graft substitutes for posterolateral spondylodesis in treatment of degenerative spondylolisthesis during 1996 to 1998 was conducted. The surgical procedure was a standardized instrumented posterolateral fusion that used USS/VAS. BAG was implanted on the left side of the fusion bed and AB on the right side.

Spinal epidural lipomatosis caused by corticosteroid treatment in ulcerative colitis.

Spinal epidural lipomatosis is the result of deposition of unencapsulated fat in the extradural space of the spinal canal. Most commonly, this rare condition is a complication secondary to corticosteroid treatment. We describe a 49-year-old patient with ulcerative colitis who developed paraparesis due to overgrowth of epidural fat tissue.

Aetiological diagnosis of brain abscesses and spinal infections: application of broad range bacterial polymerase chain reaction analysis.

Objective: To evaluate the usefulness of the broad range bacterial rDNA polymerase chain reaction (PCR) method combined with DNA sequencing in the aetiological diagnosis of intracranial or spinal infections in neurosurgical patients.

Methods: In addition to conventional methods, the broad range bacterial PCR approach was applied to examine pus or tissue specimens from cerebral or spinal lesions in patients treated in a neurosurgical unit for a clinical or neuroradiological suspicion of bacterial brain abscess or spondylitis.

Results: Among the 44 patients with intracranial or spinal lesions, the final diagnosis suggested bacterial disease in 25 patients, among whom the aetiological agent was identified in 17.

Association between decreased disc signal intensity in preoperative T2-weighted MRI and a 5-year outcome after lumbar minimally invasive discectomy.

A total of 39 patients who had undergone microdiscectomy or percutaneous nucleotomy for lumbar disc herniation were examined after a follow-up of 5 years. The overall outcome was satisfactory in 80% of the patients treated, and only 1 (3%) patient had been reoperated during the follow-up. Clinical signs and symptoms of lumbar instability were detected in 10 (26%) patients.

Neurologic manifestations of infective endocarditis: a 17-year experience in a teaching hospital in Finland.

Background: Many previous studies have endeavored to find appropriate means to reduce the occurrence of neurologic manifestations in patients with infective endocarditis (IE). We evaluated patients with IE-associated neurologic complications and compared them with patients with IE who did not have neurologic symptoms. Particular attention was focused on assessing the impact of cardiac surgery and the presence of potential risk factors for complications on the outcome of the patients.

Cerebrospinal fluid flow in patients with dilated ventricles studied with MR imaging.

The purpose of this study was to measure the cerebrospinal fluid (CSF) velocity and flow in the aqueduct in patients with wide ventricles with or without signs of normal pressure hydrocephalus (NPH) before and after shunt surgery. We studied 18 patients with wide ventricles with MRI and measured the CSF velocity values in the aqueducts. Twelve patients with the clinical triad of NPH were examined.

Direct amplification of rRNA genes in diagnosis of bacterial infections.

A broad-range bacterial PCR targeting rRNA genes (rDNAs) was used to directly analyze 536 clinical samples obtained from 459 hospitalized patients during a 4-year study period. The molecular diagnosis based on DNA sequencing of the PCR product was compared to that obtained by bacterial culture. The bacteriological diagnosis was concordant for 447 (83%) specimens.

Percutaneous nucleotomy in the treatment of cervical disc herniation: report of three cases and review.

We describe here three patients with cervical disc herniation who were treated at our department with manual percutaneous nucleotomy. These patients had suffered from cervical pain radiating into an upper extremity, with the duration of the conservative treatment varying between three and six months before the operation. After a follow-up of three years, radiating pain into the upper extremity was totally recovered in one patient, markedly diminished in one and remained unchanged in one.

A microsurgical technique for posterior lumbar interbody fusion: technical note.

Objective: To describe a microsurgical modification of the Ray Threaded Fusion Cage (TFC) instrumentation technique for achieving lumbar interbody fusion.

Technique: The lumbar fusion is established by application of two titanium cages through two different short skin incisions, first on one and then on the other side. The spinous processes and the whole interspinous ligament are preserved.

Long-term outcome of patients suffering from clinical instability after microsurgical treatment of lumbar disc herniation.

A total of 39 patients suffering from clinical instability of the lumbar spine after microdiscectomy were evaluated for their long-term outcome. Included there were 21 (54%) male and 18 (46%) female patients with a mean age of 55 years. All had been operated on for a virgin single-level lumbar disc herniation between the years 1985-1989 and they were evaluated for the presence of lumbar instability in 1991.

Long-term outcome of patients who underwent percutaneous nucleotomy for lumbar disc herniation: results after a mean follow-up of 5 years.

A total of 41 patients who had undergone percutaneous nucleotomy for a single level lumbar disc herniation were clinically examined after a mean postoperative follow-up of 5 years (range 4 to 7 years). There were 14 (34%) male and 27 (66%) female patients with a mean age of 49 years. By intra-operative discography, the herniation had been graded as a protrusion in 21 (51%) patients and as a prolapse in 20 (49%) patients.

Successful treatment of whiplash-type injury induced severe pain syndrome with epidural stimulation: a case report.

Chronic severe cervico-facial pain syndrome associated with a whiplash-type injury was successfully treated with epidural spinal cord stimulation. The patient had been in pain for 9 years, responding temporarily only to stellate ganglion blocks. The patient has now been painless for 18 months.

Proliferation potential of human lumbar disc after herniation.

To investigate the regenerative potential of human disc tissue, the disc samples were obtained during surgery from 24 adult patients with first lumbar prolapses and from 14 patients with recurrent lumbar prolapses. Preoperative magnetic resonance imaging (MRI) confirmed prolapse and disc degeneration in all cases. The proliferation activity of the sampled connective tissue cells was studied with the immunohistochemical expression of Ki-67(MIB-1) antigen.

Spontaneous epidural hematoma as a cause of sciatic pain in a schoolboy.

A previously healthy 13-year-old boy began to manifest radiating pain in his left leg after heavy physical exertion during judo training. He also had a sensation of numbness in his left buttock and leg. Initially, the patient was treated conservatively with a clinical diagnosis of disc herniation.

Paraparesis caused by a bilateral cervical synovial cyst.

We describe a 64-year-old man who suffered from rapidly progressive paraparesis. At operation the cervical cord of the patient was found to be displaced anteriorly due to compression caused by an epidural synovial cyst. The cyst was located bilaterally on the dorsolateral aspect of both CVII facet joints.