Lumbar spinal stenosis and surgical decompression affect sleep quality and position in patients. A prospective cross-sectional cohort study.

Introduction: It is reasonable to assume that lumbar spinal stenosis (LSS) affects the cauda nerve roots also at night.

Research Question: Does microsurgical decompression influence sleep quality and position?

Materials And Methods: A study nurse interviewed 140 patients scheduled for LSS decompression using the Pittsburgh Sleep Quality Index (PSQI), Spinal Stenosis Measure (SSM), Numeric Rating Scale (NRS) for back and leg pain, Douleur Neuropathique (DN4), and Charlson Comorbidity Index. Epidemiologic and MRI data were collected along with self-reported rankings of preferred sleep positions (prone, supine, side, and fetal).

Do TLIF and PLIF Techniques Differ in Perioperative Complications? - Comparison of Complications Rates of Two High Volume Centers.

Study Design: Retrospective bicentric Cohort Study.

Objective: Posterior (PLIF) and transforaminal lumbar interbody fusion (TLIF) have been clinically proven for the surgical treatment of degenerative spinal disorders. Despite many retrospective studies, the superiority of either technique has not been proven to date.

AO Spine Guideline for the Use of Osteobiologics (AOGO) in Anterior Cervical Discectomy and Fusion for Spinal Degenerative Cases.

Study Design: Guideline.

Objectives: To develop an international guideline (AOGO) about the use of osteobiologics in anterior cervical discectomy and fusion (ACDF) for treating degenerative spine conditions.

Methods: The guideline development process was guided by AO Spine Knowledge Forum Degenerative (KF Degen) and followed the Guideline International Network McMaster Guideline Development Checklist.

The prevalence of redundant nerve roots in standing positional MRI decreases by half in supine and almost to zero in flexed seated position: a retrospective cross-sectional cohort study.

Purpose: This retrospective cross-sectional cohort study investigated the influence of posture on lordosis (LL), length of the spinal canal (LSC), anteroposterior diameter (APD L1-L5), dural cross-sectional area (DCSA) of the lumbar spinal canal, and the prevalence of redundant nerve roots (RNR) using positional magnetic resonance imaging (MRI) (0.6 T).

Methods: Sixty-eight patients with single-level degenerative central lumbar spinal stenosis (cLSS) presenting with RNR in the standing position (STA) were also investigated in supine (SUP) or neutral seated (SIT) and flexed seated (FLEX) positions.

Surgical Treatment of Multilevel Degenerative Cervical Myelopathy: Open-Door Laminoplasty and Fixation via Unilateral Approach. A Feasibility Study.

Objective:  We compared open-door laminoplasty via a unilateral approach and additional unilateral lateral mass screw fixation (uLP) with laminectomy and bilateral lateral mass screw fixation (LC) in the surgical treatment of multilevel degenerative cervical myelopathy (mDCM).

Methods:  A retrospective cohort analysis of 46 prospectively enrolled patients (23 uLP and 23 LC). The minimum follow-up was 1 year.

Cervical Single-Level Pincer Stenosis Causing Myelopathy: A Technical Note and Medium-term Results of a One-Session Microsurgical 360-Degree Treatment.

Background And Study Aims:  Single-level circumferential or pincer stenosis (PS) affects few patients with degenerative cervical myelopathy (DCM). The surgical technique and medium-term results of a one-session microsurgical 360-degree (m360°) procedure are presented.

Patients:  Between 2013 and 2018, the data of 23 patients were prospectively collected out of 371 patients with DCM.

The prevalence of redundant nerve roots in patients with lumbar spinal stenosis is body position dependent: a retrospective observational study with repeated measures design in an upright MRI scanner.

Purpose: Redundant nerve roots (RNRs) are a negative prognostic factor in patients with central lumbar spinal stenosis (LSS). Forty percent of candidates for surgical decompression show RNRs (RNR+) on preoperative conventional magnetic resonance imaging (MRI). We investigated the prevalence of RNRs in three functional postures (standing, neutral sitting and flexed sitting) with an upright MRI (upMRI).

Revision surgery in cervical spine.

Purpose: To report the indications, presurgical planning, operative techniques, complications for making decisions in cervical revision surgery (CRS).

Methods: Hundred and two patients underwent CRS over a four-year period. Epidemiological data, the type of first surgery, CRS surgical techniques and complications were retrospectively evaluated.

Redundant nerve roots in lumbar spinal stenosis: inter- and intra-rater reliability of an MRI-based classification.

Purpose: Patients with central lumbar spinal stenosis (LSS) have a longer symptom history, more severe stenosis, and worse postoperative outcomes, when redundant nerve roots (RNRs) are evident in the preoperative MRI. The objective was to test the inter- and intra-rater reliability of an MRI-based classification for RNR.

Methods: This is a retrospective reliability study.

[Incidental durotomy: intraoperative aid in ten steps].

Objective: Management of the intradural structures safely, closure of the dura according to the tear, and minimizing the epidural dead space.

Indications: Incidental durotomy (ID).

Contraindications: None.

Degenerative Cervical Myelopathy: A 7-Letter Coding System That Supports Decision-Making for the Surgical Approach.

Objective: To validate with a prospective study a decision-supporting coding system for the surgical approach for multilevel degenerative cervical myelopathy.

Methods: Ten cases were presented on an internet platform, including clinical and imaging data. A single-approach (G1), a choice between 2 (G2), or 3 approaches (G3) were options.

Patient demographics and MRI-based measurements predict redundant nerve roots in lumbar spinal stenosis: a retrospective database cohort comparison.

Background: Up to 40% of patients diagnosed with lumbar spinal stenosis (LSS) show evidence of redundant nerve roots (RNR) of the cauda equina on their magnetic resonance images (MRI). The etiology of RNR is still unclear. Preoperative evidence of RNR is associated with a worse postsurgical outcome.

The clinical significance of redundant nerve roots of the cauda equina in lumbar spinal stenosis patients: A systematic literature review and meta-analysis.

Objectives: Decompression surgery for lumbar spinal stenosis (LSS) is the most performed spine surgery procedure in patients older than 65 years. Around 40% of LSS patients scheduled for decompression surgery have evidence of redundant nerve roots (RNR) of the cauda equina on their magnetic resonance images (MRI). Little is known about the clinical significance of RNR in LSS patients.

A retrospective analysis of bone mineral status in patients requiring spinal surgery.

Background: Impaired bone quality is associated with poor outcome of spinal surgery. The aim of the study was to assess the bone mineral status of patients scheduled to undergo spinal surgery and to report frequencies of bone mineral disorders.

Methods: We retrospectively analyzed the bone mineral status of 144 patients requiring spinal surgery including bone mineral density by dual-energy X-ray absorptiometry (DXA) as well as laboratory data with serum levels of 25-hydroxyvitamin D (25-OH-D), parathyroid hormone, calcium, bone specific alkaline phosphate, osteocalcin, and gastrin.

Open-door laminoplasty : What can the unilateral approach offer?

Objective: Multilevel posterior decompression of subaxial cervical spinal canal stenosis through a less-invasive unilateral approach.

Indications: Degenerative cervical myelopathy due to multilevel subaxial spinal canal stenosis.

Contraindications: Cervical kyphosis or instability, bilateral radiculopathy due to foraminal stenosis, involvement of C2 or C7.

Correction to: Minimally invasive posterior cervical foraminotomy for treatment of radiculopathy : An effective, time-tested, and cost-efficient motion-preservation technique.

Correction to: Oper Orthop Traumatol 2017 https://doi.org/10.1007/s00064-017-0516-6 In this article the following acknowledgement was missing:Acknowledgement: With the kind assistance of Deutsche Arthrose-Hilfe e.

Minimally invasive posterior cervical foraminotomy for treatment of radiculopathy : An effective, time-tested, and cost-efficient motion-preservation technique.

Objective: To relieve foraminal root impingement due to lateral soft disc fragments, bony spurs, or other rarer causes.

Indications: Soft disc fragment whose bulk is >2/3 lateral to the lateral border of the thecal sac. Intraforaminal dorsal bony narrowing of the root canal.

Unilateral laminoplasty with lateral mass screw fixation for less invasive decompression of the cervical spine: a biomechanical investigation.

Purpose: To compare the stabilization behavior of additional unilateral mass screw fixation with current standard procedures in patients with cervical spondylotic myelopathy (CSM) in a biomechanical study.

Methods: Ten human C2-C7 cervical specimens were tested under various segment conditions: native (NAT), laminoplasty (LP), laminoplasty with unilateral (LPU) or bilateral (LPB) stabilization, laminectomy with bilateral stabilization (LCB), and laminectomy. The instrumented level was from C3 to C6.

Incidental durotomy in spine surgery: first aid in ten steps.

Introduction: Incidental durotomy (ID) is the most common complication of spine surgery. Revision procedures, ossification of the yellow ligament, or synovial cysts are well-known risk factors. The size, shape, and severity of ID are unpredictable, ranging from a pinpoint hole to a several centimeters large dural laceration with transected fibers following the slippage of a cutting burr.

Microsurgical extraforaminal decompression of lumbar root canal stenosis.

Objective: To decompress the lumbar spinal nerve impinged peripherally to the lateral recess. To avoid in selected cases the pedicle screw fixation and fusion of the segment.

Indication: Single level radiculopathy in degenerative scoliosis or in degenerative disc disease without segmental instability.

The translaminar approach for cranially extruded lumbar disc herniations.

Objective: To remove extruded disc fragments impinging the exiting root. To spare the interlaminar space and the facet joint.

Indication: Cranially migrated disc herniation.

Lumbar spinal stenosis: prognostic factors for bilateral microsurgical decompression using a unilateral approach.

Objective: We describe a prospective cohort study that investigated the effectiveness of microsurgical bilateral decompression using unilateral laminotomy for lumbar spinal stenosis and assessed the factors influencing the outcome.

Methods: A total of 165 consecutive patients underwent decompression for lumbar spinal stenosis. They were divided into 3 age groups: A (<65 years), B (65-75 years), and C (>75 years).