Idiopathic Epidural Lipomatosis Associated with Degenerative Discopathy: Grand Round Presentation of Unusual Lumbar Canal Stenosis Resolved by Weight Loss.

Here, we report a case of idiopathic epidural lipomatosis presented with a clinical picture of lumbar canal stenosis with neurogenic claudication which resolved completely only by weight loss. A 53-year-old obese male with a body mass index of 36 without significant past medical history presented to the outpatient clinic with neurogenic claudication and bilateral sciatic radiculopathy. Initially, magnetic resonance imaging (MRI) showed epidural lipomatosis at the level of L5 vertebral body and L5-S1 intervertebral disc.

Multiple-rod constructs in adult spinal deformity surgery for pelvic-fixated long instrumentations: an integral matched cohort analysis.

Purpose: Multiple-rod constructs (Multi-Rod: extra rods for additional pillar support) are occasionally used in adult spinal deformity (ASD) surgery. We aimed to compare and analyze the general outcome of multi-rod constructs with a matched two-rod cohort, to better understand the differences and the similitudes.

Methods: This is a retrospective matched cohort study including patients with ASD that underwent surgical correction with long posterior instrumentation (more than five levels), pelvic fixation and a minimum 1-year follow-up.

Traumatic posterior Atlanto-axial dislocation: case report of an atypical C1-C2 dislocation with an anterior arch fracture of C1.

Background: An atypical case of a traumatic posterior C1-C2 dislocation with an anterior arch fracture of C1 is reported. A novel conservative treatment for this rare lesion is described.

Case Presentation: An eighty-nine-year-old male fell off a ladder at home and presented with an acute traumatic cervical spine trauma, which we believe involved a distraction mechanism.

Carbon-fibre cage reconstruction in anterior cervical corpectomy for multilevel cervical spondylosis: mid-term outcomes.

Background: Mid-term clinical and radiological evaluation of a carbon-fiber cage in multilevel cervical spondylosis (MCS). Anterior cervical corpectomy and fusion (ACCF) using titanium mesh cages (TMC) has shown satisfactory outcomes, but with subsidence of up to 20%. Conventional long-fiber carbon fiber cages have shown a safe profile in discectomy/fusion (ACDF) but with minimal data in the setting of corpectomy.

Clinical results of cervical disc replacement with the Baguera C prosthesis after two years follow-up.

We studied pain, neurological, and functional outcomes of one and two-levels cervical arthroplasties using a semi-constrained prosthesis for symptomatic cervical degenerative discopathies. Retrospective analysis of 95 patients in a multicentric registry over 2 years FU. Implant-related complications, subsequent surgery and neurological deterioration were not observed.

Risk factors for anterior bone loss in cervical disc arthroplasty.

OBJECTIVE The objective of this study was to identify the risk factors of anterior bone loss (ABL) in cervical disc arthroplasty (CDA) and the subsequent effect of this phenomenon. METHODS The authors performed a retrospective radiological review of 185 patients with a minimum 5-year follow-up after CDA (using Bryan, Discocerv, Mobi-C, or Baguera C). Postoperative radiographs were examined and compared to the initial postoperative films to determine the percentage of ABL.

Treatment of spinal metastases in renal cell carcinoma: A critical review.

Kidney cancer is the 9th most common cancer in men and the 14th most common in women worldwide. Renal cell carcinoma (RCC) constitutes 90% of all malignancies of the kidney. RCC, is known to be highly vascular and relatively radioresistant.

Spondylolisthesis adjacent to a cervical disc arthroplasty does not increase the risk of adjacent level degeneration.

Purpose: To understand whether a spondylolisthesis in the sub-axial spine cranial to a cervical disc arthroplasty (CDA) construes a risk of adjacent level disease (ALD).

Methods: A retrospective review of 164 patients with a minimum 5-year follow-up of a cervical disc arthroplasty was performed. Multi-level surgeries, including hybrid procedures, were included.

Bisphosphonate therapy for spinal aneurysmal bone cysts.

Purpose: To assess the efficacy of bisphosphonate therapy in the management of spinal aneurysmal bone cysts (ABCs).

Methods: A prospective study of six consecutive patients aged between 7 and 22 years with spinal ABCs treated with pamidronate (1 mg/kg) or zoledronate (4 mg). A visual analogue scale (VAS) for pain and radiological (contrast-enhanced MRI and CT scan at 3 and 6 months, then yearly X-rays) follow-up was continued for a minimum of 6 years.

Identifying the superior and inferior gluteal arteries during a sacrectomy via a posterior approach.

Background: Identifying the gluteal vessels during a posterior sacrectomy can be challenging. This study defines anatomical landmarks that can be used to approximate the location of the superior and inferior gluteal arteries (SGA and IGA) during a posterior sacrectomy.

Methods: Cadaveric dissection of six fresh adult pelvises to determine the location of the SGA and IGA in relation to the posterior-inferior aspect of the sacroiliac joint (PISIJ), lateral sacral margin and sacrococcygeal joint (SCJ).

Outcomes of the Bryan cervical disc replacement: fifteen year follow-up.

Background: The CTDR is a technique that treats cervical disc degenerative disease. Initial shorter-term studies showed good clinical and radiological results.

Purpose: To assess the clinical and radiological results of Bryan cervical disc replacement (Medtronic Sofamor Danek Inc.

L5 pedicle subtraction osteotomy: indication, surgical technique and specificities.

Purpose: To evaluate the radiographic, functional outcomes, complications and surgical specificities of L5 pedicle subtraction osteotomy for fixed sagittal and coronal malalignment.

Methods: A retrospective cohort of consecutive patients with prospectively collected data. Ten patients who underwent PSO at L5 were eligible for a 2-year minimum follow-up (average, 4.

Cerebral ischaemia following anterior upper thoracic spinal surgery utilizing a partial manubrial resection.

Purpose: Firstly, to describe two cases of cerebral ischaemia complicating anterior upper thoracic spinal surgery and define the likely cause of this complication. Secondly, to describe preventative measures and the effect these have had in reducing this complication within our institution.

Methods: Firstly, a review of two cases of cerebral ischaemia complicating anterior upper thoracic spinal surgery utilizing a partial manubrial resection.

Single Level Proximal Thoracic Pedicle Subtraction Osteotomy for Fixed Hyperkyphotic Deformity: Surgical Technique and Patient Series.

Background: Thoracic hyperkyphosis can display pathological deterioration, resulting in either hyperlordotic cervical compensation or sagittal malalignment. Various techniques have been described to treat fixed malalignment. Pedicle subtraction osteotomy (PSO) is commonly used in the lumbar spine and frequently limited to the distal thoracic spine.

THE GLOBAL TILT: EVALUATION OF A PARAMETER CONSIDERING THE GLOBAL SPINOPELVIC ALIGNMENT.

Purpose: Regarding the close interaction between the spinal balance and the pelvis orientation no parameter is routinely used to describe and to evaluate the global spinopelvic balance, taking into account simultaneously the spinal part and the pelvic part of the global alignment. The global tilt was described to analyze malalignment, considering spinal and pelvic imbalance together. From a geometrical point of view, the global tilt is the sum of the C7 vertical tilt and the pelvic tilt.

Global Spinal Alignment in Patients With Cervical Spondylotic Myelopathy.

Study Design: A prospective radiographic analysis of cervical spondylotic myelopathy (CSM).

Objective: The aim of this study was to clarify the pathophysiology of CSM, and use the characteristic of global spinal alignment for determining the surgical strategy.

Summary Of Background Data: Radiographic evaluation of CSM, in general, comprises cervical magnetic resonance imaging (MRI) and regional cervical radiography, which cannot distinguish between cervical hyperlodorsis with spinopelvic compensation and cervical lordorsis with normal global alignment.

Advantages and Disadvantages of Adult Spinal Deformity Surgery and Its Impact on Health-Related Quality of Life.

Study Design: Prospective multicenter study of adult spinal deformity (ASD) surgery.

Objective: To clarify the effect of ASD surgery on each health-related quality of life (HRQOL) subclass/domain.

Summary Of Background Data: For patients with ASD, surgery offers superior radiological and HRQOL outcomes compared with nonoperative care.

Endovascular Embolization of a Nondominant Vertebral Artery Compressed by an Osteophyte to Prevent Recurrence of Vertebrobasilar Infarctions.

Background: Vertebral artery compression by cervical osteophyte is a rare cause of vertebrobasilar ischemic stroke. This mechanism of stroke has been reported as the Bow Hunter syndrome defined by vertebrobasilar insufficiency because of mechanical stenosis of the vertebral artery at the cervical level triggered by head movement. The most common treatment is surgical decompression.

Cervical spine balance: postoperative radiologic changes in adult scoliosis surgery.

Purpose: Cervical spine alignment interests appeared recently and relationships between the pelvis and the cervical spine have been reported but remain unclear. In this study, postoperative changes for cranial, cervical, lumbar and sagittal balance parameters have been measured in adult scoliosis surgery without major sagittal malalignment to appreciate the adaptation of the cervical spine.

Methods: Twenty-nine consecutive patients with a surgical adult degenerative scoliosis treated with a T8-T11 to iliac fusion without PSO or multiple Ponte's osteotomies had preoperative and postoperative full spine EOS radiographies to measure spino-pelvic parameters.

Cervical spine alignment following lumbar pedicle subtraction osteotomy for sagittal imbalance.

Purpose: The alignment of the cervical spine is of primary importance to maintain horizontal gaze and contributes to the functional outcome of patients. Cervical spine alignment after correction of major sagittal imbalance has rarely been reported in the literature.

Methods: Retrospective review of 31 consecutive patients with sagittal plane deformities operated by lumbar pedicle subtraction osteotomy.

Management of a major atlanto-axial instability secondary to a lytic lesion of C2.

Introduction: Management of C1-C2 instability is very challenging, especially when tumoral lesions are involved.

Case Report: We present the case of a 65-year-old male, with a recently discovered small cell lung carcinoma, presenting progressive tetraparesis due to a secondary lesion involving the body of C2 with complete collapse of its anterior part and major C1-C2 instability in all planes. The patient underwent a reconstructive surgery of the upper cervical spine during two sessions.

Intravertebral pseudomeningocele: an unusual complication after disc surgery.

Background Context: Pseudomeningoceles are most commonly the result of dural tear during spine surgery. They may sometimes slowly enlarge but they generally develop inside the spinal canal, toward the foramina or toward the surgical incision.

Purpose: To describe a late and exceptional complication of a surgical discectomy.

Intraspinal canal rod migration causing late-onset paraparesis 8 years after scoliosis surgery.

Introduction: Complete intraspinal canal rod migration with posterior bone reconstitution has never been described in the adolescent idiopathic scoliosis (AIS) population. We present an unusual but significant delayed neurological complication after spinal instrumentation surgery.

Case Report: A 24-year-old woman presented with lower limb weakness (ASIA D) 8 years after posterior instrumentation from T2 to L4 for AIS.