Complications associated with lumbar discectomy surgical techniques: a systematic review.

Background: Open discectomy (OD) and microdiscectomy (MD) are routine procedures for the treatment of lumbar disc herniation. Minimally invasive surgery (MIS), such as micro-endoscopic discectomy (MED) and full endoscopic discectomy (FED), offers potential advantages (less pain, less bleeding, shorter hospitalisation and earlier return to work), but their complications have not yet been fully evaluated. The aim of this paper was to identify the frequency of these complications with a focus on MIS in comparison to OD/MD.

The Management of Symptomatic Lumbar Disc Herniation in Pregnancy: A Systematic Review.

Study Design: Systematic review.

Objectives: Lumbar disc herniation (LDH) has been reported to affect 1 in 10 000 pregnant women. There is limited evidence available regarding the optimal management of LDH in pregnant patients.

Predicting the need for surgical intervention in patients with spondylodiscitis: the Brighton Spondylodiscitis Score (BSDS).

Purpose: Spondylodiscitis represents a condition with significant heterogeneity. A significant proportion of patients are managed without surgical intervention, but there remains a group where surgery is mandated. The aim of our study was to create a scoring system to guide clinicians as to which patients with spondylodiscitis may require surgery.

The Evaluation of Digital Rectal Examination for Assessment of Anal Tone in Suspected Cauda Equina Syndrome.

Study Design: Seventy-five doctors completed a questionnaire documenting their grade, specialty, and experience in performing digital rectal examination (DRE). A model anus, using a pressure transducer surrounding an artificial canal, was assembled and calibrated. Participants performed 4 DREs on the model (with a break between attempts) and predicted tone as "reduced" or "normal" (35 and 60 mm Hg, respectively), followed by a "squeeze" test.

Experience of a fellowship in spinal surgery: a quantitative analysis.

Objectives: The objective of our paper was to ascertain the self-reported competency level of surgeons who had completed a 1-year spine fellowship versus those who had not. Our secondary objective was to determine whether there was any difference between orthopaedic and neurosurgeons.

Methods: A 60 question online questionnaire was provided to AOSpine Europe members for completion online.

Congenital C1 arch deficiency: Grand Round presentation.

Introduction: We present an uncommon and yet interesting congenital anomaly and discuss the difficulties with diagnosis and controversies in management. C1 arch deficiency is an important consideration in the differential diagnosis of neck pain in children.

Material And Methods: A 12-year-old girl presented initially with a loud clicking emanating from the cervical spine during nappy changes in early childhood.

Freehand correction of scoliosis in Rett's syndrome.

We present the case of an 18-year-old girl with a scoliosis (long C-shaped curve) in association with an atypical Rett's syndrome. In order to attain a full correction and to provide her with adequate posture and sitting balance, segmental instrumentation was utilised from the high thoracic spine to the pelvis. We describe the procedure including the relevant pre-operative, intra-operative and post-operative imaging.

A traumatic, high-energy and unstable fracture of the C5 vertebra managed with kyphoplasty: a previously unreported case.

Unstable cervical fractures commonly require fusion surgery. We present a case of an unstable cervical fracture (AO classification A2.2) affecting the fifth cervical vertebra which was managed by kyphoplasty to achieve a pain-free, functional and stable outcome.

L5-S1 disc replacement after two previous fusion surgeries for scoliosis.

Following scoliosis surgery, lumbar motion segment degeneration below the level of fusion is not uncommon. Especially long fusions extending to the mid and lower lumbar spine increase the likelihood of degeneration of the remaining motion segments. The management for these patients is controversial and depends on the clinical presentation and level of degeneration.

Sharps injury reporting amongst surgeons.

Introduction: The aim of this study was to evaluate the level of sharps injury reporting amongst surgeons.

Subjects And Methods: A total of 164 surgeons completed a questionnaire on the reporting of sharps injuries, on the reasons for not reporting and their practise of universal precautions.

Results: Out of 164 surgeons, only 25.

Familial pseudarthrosis of the clavicle: does it need treatment?

The eighth family with multiple cases of congenital pseudarthrosis of the clavicle is described. This usually presents as a clavicular lump and is distinct from more common conditions such as birth fractures, craniocleidal dysostosis and neurofibromatosis. There has so far been no clear indication on whether familial pseudarthrosis of the clavicle should be treated operatively.

Revisiting the concept of talar shift in ankle fractures.

Background: In 1976, Ramsey and Hamilton published a classic experiment investigating the biomechanical effects of talar shift in a simple ankle fracture model. Their finding was that 1 mm of talar shift resulted in a 42% decrease in tibiotalar contact surface area. Based on this conclusion, 1 mm of talar shift became the recognized indication for operative fixation.