Stand-Alone Oblique Lumbar Interbody Fusion (OLIF) for the Treatment of Adjacent Segment Disease (ASD) after Previous Posterior Lumbar Fusion: Clinical and Radiological Outcomes and Comparison with Posterior Revision Surgery.

: Radiological evidence of adjacent segment disease (ASD) has been reported to have a prevalence of more than 30% and several risk factors have been reported. The aim of this study is to evaluate the clinical and radiological outcomes of patients with symptomatic ASD treated with stand-alone OLIF and compare results with a posterior revision surgery cohort. : This is a retrospective case-control study.

COVID-19 pandemic: An update on the reaction attitude of the spine societies and their members worldwide.

Background: All surgical specialties have been influenced by the coronavirus disease 2019 (COVID-19) pandemic, and substantial changes have been determined in medical assistance, especially in elective surgery. Several spine societies have published recommendations to provide optimal care during this unique situation.

Aim: To discuss the recommendations by many spine societies for the management of spinal diseases during the COVID-19 pandemic.

The anterior-to-psoas approach for interbody fusion at the L5-S1 segment: clinical and radiological outcomes.

Objective: Over the last few decades, many surgical techniques for lumbar interbody fusion have been reported. The anterior-to-psoas (ATP) approach is theoretically supposed to benefit from the advantages of both anterior and lateral approaches with similar complication rates, even in L5-S1. At this segment, the anterior lumbar interbody fusion (ALIF) requires retroperitoneal dissection and retraction of major vessels, whereas the iliac crest does not allow the lateral transpsoas approach.

Rapid spontaneous resolution of lumbar ganglion cysts: A case report.

Background: To discuss the rare event of spontaneous resolution of a lumbar ganglion cyst, a personal case report and 25 cases culled from the literature were described in detail. We focused on demographic, classification, clinical and radiological findings, treatment, outcome and radiological resolution.

Case Summary: A 51-year-old man presented to our observation with complaints of low back and right leg pain.

Spatial and temporal characteristics of the spine muscles activation during walking in patients with lumbar instability due to degenerative lumbar disk disease: Evaluation in pre-surgical setting.

Our purpose was to investigate the spatial and temporal profile of the paraspinal muscle activation during gait in a group of 13 patients with lumbar instability (LI) in a pre-surgical setting compared to the results with those from both 13 healthy controls (HC) and a sample of 7 patients with failed back surgery syndrome (FBSS), which represents a chronic untreatable condition, in which the spine muscles function is expected to be widely impaired. Spatiotemporal gait parameters, trunk kinematics, and muscle activation were measured through a motion analysis system integrated with a surface EMG device. The bilateral paraspinal muscles (longissimus) at L3-L4, L4-L5, and L5-S1 levels and lumbar iliocostalis muscles were evaluated.

Comparison of pure lateral and oblique lateral inter-body fusion for treatment of lumbar degenerative disk disease: a multicentric cohort study.

Purpose: The most effective interbody fusion technique for degenerative disk disease (DDD) is still controversial. The purpose of our study is to compare pure lateral (LLIF) and oblique lateral (OLIF) approaches for the treatment of lumbar DDD from L1-L2 to L4-L5, in terms of clinical and radiological outcomes.

Materials And Methods: 45 patients underwent lumbar interbody fusion for pure lumbar DDD from  L1-L2 to L4-L5 through LLIF (n = 31, mean age 62.

Thoraco-lumbar fractures with blunt traumatic aortic injury in adult patients: correlations and management.

Purpose: Traumatic thoraco-lumbar spine fracture spine with a concomitant blunt aortic injury is uncommon but potentially a fatal association. Our aim was to clarify: morphology of spinal fractures related to vascular damages and vice versa, diagnostic procedures and decision-making process for the best treatment options for spine and vessels.

Methods: We enrolled 42 cases culled from the literature and five personal ones, reviewing in detail by AO Spine Classification, Society of Vascular Surgery classification and Abbreviated Injury Scale for neurological evaluation.

Lumbar ganglion cyst: Nosology, surgical management and proposal of a new classification based on 34 personal cases and literature review.

Aim: To analyze different terms used in literature to identify lumbar extradural cysts and propose a common scientific terminology; to elaborate a new morphological classification of this pathology, useful for clinical and surgical purposes; and to describe the best surgical approach to remove these cysts, in order to avoid iatrogenic instability or treat the pre-existing one.

Methods: We retrospectively reviewed 34 patients with symptomatic lumbar ganglion cysts treated with spinal canal decompression with or without spinal fixation. Microsurgical approach was the main procedure and spinal instrumentation was required only in case of evident pre-operative segmental instability.

Long-term Clinical Outcomes and Quality of Life in Elderly Patients Treated with Interspinous Devices for Lumbar Spinal Stenosis.

Background And Objective:  Lumbar spinal stenosis (LSS) is a common degenerative condition that occurs in the spine with increasing age. Clinically, LSS causes a progressive reduction in walking autonomy, resulting in a poor quality of life and impaired functional capacity. The aim of this study was to evaluate the clinical outcome and quality of life of elderly patients presenting with LSS and associated comorbidities after a 5-year follow-up who were treated with an interspinous process device (IPD).

Spinal epidural hematomas: personal experience and literature review of more than 1000 cases.

OBJECTIVE The goal of this study was to identify factors that contribute to the formation of acute spinal epidural hematoma (SEH) by correlating etiology, age, site, clinical status, and treatment with immediate results and long-term outcomes. METHODS The authors reviewed their series of 15 patients who had been treated for SEH between 1996 and 2012. In addition, the authors reviewed the relevant international literature from 1869 (when SEH was first described) to 2012, collecting a total of 1010 cases.

Surgical management of coronal and sagittal imbalance of the spine without PSO: a multicentric cohort study on compensated adult degenerative deformities.

Purpose: Sagittal imbalance of severe adult degenerative deformities requires surgical correction to improve pain, mobility and quality of life. Our aim was a harmonic and balanced spine, treating a series of adult degenerative thoracolumbar and lumbar kyphoscoliosis by a non posterior subtraction osteotomy technique.

Methods: We operated 22 painful thoracolumbar and lumbar compensated degenerative deformities by anterior (ALIF), extreme lateral (XLIF) and transforaminal (TLIF) interbody fusion and grade 2 osteotomy (SPO) to restore lumbar lordosis and mobilize the coronal curve.

Comparison of minimally invasive surgery with standard open surgery for vertebral thoracic metastases causing acute myelopathy in patients with short- or mid-term life expectancy: surgical technique and early clinical results.

OBJECT Spinal metastasis is common in patients with cancer. About 70% of symptomatic lesions are found in the thoracic region of the spine, and cord compression presents as the initial symptom in 5%-10% of patients. Minimally invasive spine surgery (MISS) has recently been advocated as a useful approach for spinal metastases, with the aim of decreasing the morbidity associated with more traditional open spine surgery; furthermore, the recovery time is reduced after MISS, such that postoperative chemotherapy and radiotherapy can begin sooner.

Traumatic spondylolisthesis and spondyloptosis of the subaxial cervical spine without neurological deficits: closed re-alignment, surgical options and literature review.

Introduction: Cervical subaxial malalignment due to complete or partial post-traumatic dislocation is generally associated to neurological impairment of ranging severity. Literature lacks reporting this entity in patients with no neurological issues. Cervical traction is not widely accepted in treating this kind of injury, due to its potential for neurological damage, although surgery seems to represent the gold standard.

The use of surgical sealants in the repair of dural tears during non-instrumented spinal surgery.

Purpose: To compare the success in repair of dural tears (DTs) using two different surgical sealants in non-instrumented lumbar spinal surgery and evaluate the incidence of associated short- and long-term complications.

Methods: Twenty-three patients undergoing non-instrumented spinal surgery with intraoperative DTs were included both retrospectively and prospectively in this study. External signs of CSF leakage, neurological deficits, and infection-related complications were investigated postoperatively.

Acute traumatic instability of the coccyx: results in 28 consecutive coccygectomies.

Introduction: Coccygeal instability includes hypermobility, subluxation and fracture-dislocation. Surgical resection is still controversial, with intractable post-traumatic coccygodynia being an indication to surgery.

Materials And Methods: From 2001 to 2010, we enrolled 31 patients with post-traumatic coccygodynia (19 females, 12 males; mean age 31 years, range 21-47).

Neurological L5 burst fracture: posterior decompression and lordotic fixation as treatment of choice.

Purpose: We report our experience and literature review concerning surgical treatment of neurological burst fractures of the fifth lumbar vertebra.

Materials And Methods: Nineteen patients with L5 neurological burst fractures were consecutively enrolled; 6 patients had complete motor deficits, and 12 had sphincter dysfunction. We performed 18 posterior and one combined approaches.

Microsurgical excision without fusion as a safe option for resection of synovial cyst of the lumbar spine: long-term follow-up in mono-institutional experience.

Spinal synovial cysts are cystic dilatations of the synovial membrane that may arise at all levels of the spine. We describe our experience, paying attention to diagnosis, surgical treatment, and long-term follow-up. Between 1995 and 2007, 18 patients were surgically treated.

Conservative treatment of neural arch fractures of the axis: computed tomography scan and X-ray study on consolidation time.

Background: Computed tomography (CT) scan and X-ray study on consolidation time of C2 neural arch fractures treated conservatively were examined.

Methods: A prospective study was undertaken: 28 conservatively treated fractures of the neural arch of the axis (11 hanged-man type I, 5 type II, and 12 miscellaneous fractures) were monitored during the period of orthosis by means of CT scan and plain X-rays performed on admission, and then at intervals between 2 and 120 days afterward. In patients treated with a halo vest (20 cases), a CT scan of the skull was performed to make sure that the pins were correctly positioned and to evaluate the osteolytic processes at the pin-bone interface.

Spine surgery in neurological lesions of the cervicothoracic junction: multicentric experience on 33 consecutive cases.

Surgical treatment of the cervico-thoracic junction (CTJ) in the spine require special evaluation due to the anatomical and biomechanical characteristics of this spinal section. The transitional zone between the mobile cervical and the relatively rigid thoracic spine can be the site of serious unstable traumas or neoplastic lesions. Frequently, injury is associated with neurological impairment due to the small caliber of the spinal canal and/or spinal cord vascular insufficiency.

Blunt abdominal aortic disruption (BAAD) in shear fracture of the adult thoraco-lumbar spine: case report and literature review.

To present a rare case of association of abdominal aorta rupture and flexion-distraction fracture of thoracolumbar spine and to review the literature on this condition. In non-penetrating abdominal traumatic injuries with flexion-distraction fractures of the thoracolumbar spine, rupture of the abdominal aorta is an extremely rare occurrence but its outcome is potentially lethal. This association of skeletal and vascular lesions mainly affects young patients and involves the thoraco-lumbar junction and the portion of the aorta that lies in front of it.

Effectiveness of posterior tension band fixation in the thoracolumbar seat-belt type injuries of the young population.

We report results in the surgical treatment of thoracolumbar flexion-distraction fractures, both associated or not with neurological impairment. Items in the present study include function, pain (back pain rating scale) and neurological recovery (Asia Score). A prospective series of 19 consecutive flexion-extension thoracolumbar injuries (T11-L2), occurred in young patients (20-33 years) due to motor vehicle crashes wearing the 3-point safety belts, includes 2 Chance and 17 seat-belt fractures, with different amount of vertebral dislocation and neurological impairment.

Pseudo-aneurysm of a lumbar artery after flexion-distraction injury of the thoraco-lumbar spine and surgical realignment: rupture treated by endovascular embolization.

Study Design: A unique case of pseudo-aneurysm of a lumbar artery after injury of the thoracolumbar spine was presented.

Objective: To describe the exceptional occurrence of pseudo-aneurysm of a lumbar artery after flexion-distraction fracture of thoracolumbar junction and to discuss the mechanism of formation and the therapeutic solution.

Summary Of Background Data: Injury of a lumbar artery represents a potential cause of massive, life-threatening, retroperitoneal bleeding.

Cervicothoracic epidural hematoma after chiropractic spinal manipulation therapy. Case report and review of the literature.

A spinal epidural hematoma is an extremely rare complication of cervical spine manipulation therapy (CSMT). The authors present the case of an adult woman, otherwise in good health, who developed Brown-Séquard syndrome after CSMT. Decompressive surgery performed within 8 hours after the onset of symptoms allowed for complete recovery of the patient's preoperative neurological deficit.

Lumbar hemorrhagic synovial cysts: diagnosis, pathogenesis, and treatment. Report of 3 cases.

Background: To define the etiologic, clinical, histological, and surgical features of lumbar hemorrhagic synovial cysts (LHSCs). Three personal cases are reported together with a review of the pertinent literature.

Methods: We identified 3 cases of LHSC treated in our departments and 20 cases culled from the literature.

Late vertebral body fracture after lumbar transpedicular fixation. Report of three cases.

Late-onset vertebral body (VB) fracture after lumbar transpedicular fixation has not been previously described in the literature. The authors present three cases in which VB fracture occurred several months after posterolateral fixation in patients with degenerative disease or traumatic injury. The authors suggest that postoperative osteopenia, modified load-sharing function, and intravertebral clefts were responsible for the fractures.