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.

Long-term core outcomes in cauda equina syndrome.

Aims: Cauda equina syndrome (CES) can be associated with chronic severe lower back pain and long-term autonomic dysfunction. This study assesses the recently defined core outcome set for CES in a cohort of patients using validated questionnaires.

Methods: Between January 2005 and December 2019, 82 patients underwent surgical decompression for acute CES secondary to massive lumbar disc prolapse at our hospital.

Anterior cervical osteophytes causing dysphagia and dyspnoea.

A 75-year-old man presents to his general practitioner (GP) with dyspnoea, and dysphagia to liquids and solids, with regurgitation causing recurrent episodes of dyspnoea. He had a background of osteoarthritis, was an ex heavy smoker and had undergone coronary artery bypass graft five years previously. After several emergency admissions, initial investigation by the GP, and referral to ear, nose and throat specialists with no cause for dysphagia found, he underwent computed tomography imaging of the neck and thorax which demonstrated large cervical osteophytes at the level of C3-C4.

Using Transcranial Magnetic Stimulation to Evaluate the Motor Pathways After an Intraoperative Spinal Cord Injury and to Predict the Recovery of Intraoperative Transcranial Electrical Motor Evoked Potentials: A Case Report.

The authors report a case of unilateral loss of intraoperative transcranial electrical motor evoked potentials (TES MEP) associated with a spinal cord injury during scoliosis correction and the subsequent use of extraoperative transcranial magnetic stimulation to monitor the recovery of spinal cord function. The authors demonstrate the absence of TES MEPs and absent transcranial magnetic stimulation responses in the immediate postoperative period, and document the partial recovery of transcranial magnetic stimulation responses, which corresponded to partial recovery of TES MEPs. Intraoperative TES MEPs were enhanced using spatial facilitation technique, which enabled the patient to undergo further surgery to stabilize the spine and correct her scoliosis.

An evaluation of multimodal spinal cord monitoring in scoliosis surgery: a single centre experience of 354 operations.

Purpose: To evaluate the effectiveness of multimodal intraoperative neuromonitoring in the early detection of impending spinal cord injury during surgery for spinal deformity.

Method: A retrospective review of prospectively collected data in 354 consecutive spinal deformity operations from June 2003 to October 2013. Patients were sub-grouped according to demographics, diagnosis and operative features.

Morbidity and mortality in adult spinal deformity surgery: Norwich Spinal Unit experience.

Purpose: This study analyses the complications of spinal deformity surgery in adults to highlight pre-disposing factors.

Methods: The clinical records and imaging were reviewed for 48 consecutive patients, 12 males and 36 females, with a mean age of 64 (31-86), who had surgery for spinal deformity. Mean follow-up time was 36 months (24-60).

Pulmonary cement embolism during cement augmentation of pedicle screw fixation: a case report.

We present a case of pulmonary cement embolism during cement augmentation of pedicle screw fixation for severe degenerative scoliosis. During intra-operative C-arm fluoroscopy, a radio-opaque substance was incidentally noted to pulsate in synchrony with the patient's heartbeat. A diagnosis of pulmonary cement embolism was made.

Mortality following hip fracture: trends and geographical variations over the last 40 years.

Hip fractures are an ever increasing cause of morbidity and mortality. Treatment of this condition requires an all-encompassing approach from prevention to post-operative care. It is important in such a situation to gather data on the incidence and trends of hip fractures to aid in the future treatment planning of this important condition.

Classification of trochanteric fracture of the proximal femur: a study of the reliability of current systems.

Five observers using the Jensen modification of the Evans classification and the AO classification (with and without subgroups) classified the radiographs of 88 trochanteric hip fractures. Each observer classified the radiographs independently on two occasions 3 months apart. Kappa statistical analysis was used for determination of intra- and inter-observer variation.

The distress and risk assessment method (DRAM).

Our aim was to judge the influence of preoperative psychological disturbance on the outcome of lumbar discectomy. We evaluated 66 patients, before and after operation, using a self-administered questionnaire. Disability was assessed using the Oswestry disability index and psychological disturbance the Distress and Risk Assessment Method (DRAM) score.

Phytophotodermatitis associated with parsnip picking.

Phytophotodermatitis to certain plant groups is a well recognised entity. The combination of sunlight exposure and contact with plants of the umbelliferae family leads to the development of painful, erythematous, and bullous lesions and later to cutaneous hyperpigmentation. Agricultural workers and many clinicians often fail to make this link when patients present with these lesions.