Predictors for quality of life, pain and functional outcomes after surgical treatment of metastatic disease in the spine.

Background: While predictors for postoperative survival in spine tumour patients have been identified, there is limited evidence for predictors of postoperative Quality of Life (QoL), pain and functional outcome.

Methods: One hundred and fifty-three consecutive patients, who had undergone surgery for symptomatic spinal metastases between June 2016 and April 2019, were interviewed preoperatively and during follow-ups at three, six and 12 months using the EQ-5D-3L, COMI, and ODI questionnaires. Differences in means exceeding the specific Minimal Clinically Important Difference (MCID) values were considered clinically significant.

[Acute spinal cord compression under systemic therapy - radiotherapy or surgery?].

Vertebral bodies are one of the most common metastasis sites found in advanced prostate cancer and have a significant impact on patients' quality of life. Spinal metastases frequently cause severe back pain and in some occasions can lead to secondary complications, with serious neurological deficits and loss of function. The main treatment goals include adequate pain management, controlling tumour growth and restoring spinal stability.

Risk Factors for Neurologic Deficits in Patients With Spinal Epidural Abscess: An Analysis of One-Hundred-Forty Cases.

Study Design: retrospective study.

Objectives: In addition to surgical treatment of spinal epidural abscesses (SEA), a conservative, medical treatment for patients without acute neurologic deficits has been proposed. However, the risk factors for neurologic deficits are unclear.

Epidemiology of Surgically Treated Spinal Tumors: A Multicenter Surveillance Study of 9686 Patients from the German Spine Registry (DWG Register).

Tumors of the spine are challenging in terms of diagnoses and interdisciplinary treatment. This study was conducted to evaluate and characterize a large multicenter cohort of surgically treated spine tumor patients.Data of the German Spine Society (DWG) were used to characterize a cohort of all surgically treated spine tumor cases that were registered between 2017 and 2021.

The Diagnosis and Treatment of Osteosarcoma and Ewing's Sarcoma in Children and Adolescents.

Background: Osteosarcoma and Ewing's sarcoma in children and adolescents require age-specific interdisciplinary diagnosis and treatment to achieve optimal therapeutic outcomes.

Methods: The diagnosis and treatment of malignant bone tumors in childhood and adolescence are presented in the light of publications retrieved by a selective search, pertinent guidelines, and the authors' extensive experience in an interdisciplinary cancer center.

Results: Bone sarcomas make up approximately 5% of all malignancies in children and adolescents; the most common types are Ewing's sarcoma and osteosarcoma.

Role of Decompressive Surgery in Neurologically Intact Patients with Low to Intermediate Intraspinal Metastatic Tumor Burden.

Background: Surgical decompression (SD) followed by radiotherapy (RT) is superior to RT alone in patients with metastatic spinal disease with epidural spinal cord compression (ESCC) and neurological deficit. For patients without neurological deficit and low- to intermediate-grade intraspinal tumor burden, data on whether SD is beneficial are scarce. This study aims to investigate the neurological outcome of patients without neurological deficit, with a low- to intermediate-ESCC, who were treated with or without SD.

Complications associated to wound drainages in tumor spine surgery: a multicenter surveillance study from the German Spine Registry (DWG-Register).

There is an ongoing debate whether a surgical drainage is beneficial to prevent local accumulation of hematoma and to reduce the rate of wound infections, and neurological deficits. Data from the German Spine Society (DWG) registry were filtered for surgically treated spine tumor cases between 2017 and 2021. Cases were categorized into with (Group I) and without (Group II) placement of a surgical drainage.

What Do We Know about Spondylodiscitis in Children? A Retrospective Study.

Pediatric spondylodiscitis (PSD) is a rare disease with a major impact on mobility and functional status. Data concerning demographic and microbiological characteristics, clinical course, treatment, and outcome are scarce. Therefore, the aim of this study was to present clinical experiences of a third-level hospital (2009-2019) in PSD and compare these with adult spondylodiscitis (ASD).

Mid-term Follow-Up after Closed Reduction in Developmental Dysplastic Hips.

Purpose: Closed reduction and subsequent spica casting is the gold standard for treatment of unstable or dislocated developmental dysplastic hips (DDHs). There are few data on mid-term results after treatment of DDH, especially on closed reduction.

Methods: Thirty-one consecutive patients with unstable or dislocated hips (n = 36) that were treated by fluoroscopic, contrast agent-supported closed reduction and spica casting were included and evaluated clinically and radiologically 2 and 5 years after treatment.

Impact of Spinal Instrumentation on Neurological Outcome in Patients with Intermediate Spinal Instability Neoplastic Score (SINS).

Background: Adequate assessment of spinal instability using the spinal instability neoplastic score (SINS) frequently guides surgical therapy in spinal epidural osseous metastases and subsequently influences neurological outcome. However, how to surgically manage ‘impending instability’ at SINS 7−12 most appropriately remains uncertain. This study aimed to evaluate the necessity of spinal instrumentation in patients with SINS 7−12 with regards to neurological outcome.

In-Depth Characterization of Stromal Cells within the Tumor Microenvironment Yields Novel Therapeutic Targets.

Cells within the tumor stroma are essential for tumor progression. In particular, cancer-associated fibroblasts (CAF) and CAF precursor cells (resident fibroblasts and mesenchymal stromal cells) are responsible for the formation of the extracellular matrix in tumor tissue. Consequently, CAFs directly and indirectly mediate inflammation, metastasis, immunomodulation, angiogenesis, and the development of tumor chemoresistance, which is orchestrated by complex intercellular cytokine-mediated crosstalk.

Quality of life and mortality after surgical treatment for vertebral osteomyelitis (VO): a prospective study.

Purpose: Vertebral osteomyelitis (VO) has a high mortality and leads to chronic pain and functional disability. Surgical treatment is often necessary. To date, little is known about the consequences of surgery on patient outcome.

Hip Pain in Children.

Background: Atraumatic hip pain in children is one of the most common symptoms with which pediatricians, orthopedists, and general practitioners are confronted, with an incidence of 148 cases per 100 000 persons per year.

Methods: This article is based on publications up to April 2019 that were retrieved by a selective search in the PubMed data- base, including case reports and reviews.

Results: Infants with fever often have purulent coxitis, which can be diagnosed by blood tests and ultrasonography.

Analysis of seven prognostic scores in patients with surgically treated epidural metastatic spine disease.

Background: Prognostic scores have been proposed to guide the treatment of patients with metastatic spine disease (MSD), but their accuracy and usefulness are controversial. The aim of this study was to evaluate seven such prognostic scoring systems. The following prognostic scores were compared: Tomita, Van der Linden (VDL), Bauer modified (BM), Oswestry Spinal Risk Index (OSRI), Tokuhashi original (T90), Tokuhashi revised (TR05), and modified Tokuhashi revised (TR17).

Quality of life and functional outcomes after surgery for spinal metastases: Results of a cohort study.

Background: Spinal metastases are being diagnosed more frequently because of increasing life expectancies and advances in the diagnosis and therapy of primary tumours.

Objective: This aim of this study was to assess the quality of life (QoL) and functional outcomes after surgical intervention for spinal metastases in a large cohort.

Methods: A single-centre, prospective, observational study was conducted from June 2016 to February 2018.

Suitability of serum cytokine profiling for early diagnosis of implant-associated infections after orthopaedic surgery: A preliminary prospective study.

The C-reactive protein (CRP) is still the conventional marker used to diagnose implant-associated infections (IAI) after orthopaedic surgery. However, the CRP level can lead to misdiagnosis since it is up-regulated not only during bacterial infection. In this prospective study, we evaluated the serum cytokine profile before (pre-OP) and after orthopaedic surgery (post-OP) as well as after confirmation of a developed infection (COI) to identify candidate biomarkers for diagnosis of IAI.

Material failure in dynamic spine implants: are the standardized implant tests before market launch sufficient?

Purpose: International Standards Organization (ISO) 12189 and American Society for Testing and Materials F2624 are two standard material specification and test methods for spinal implant devices. The aim of this study was to assess whether the existing and required tests before market launch are sufficient.

Methods: In three prospective studies, patients were treated due to degenerative disease of the lumbar spine or spondylolisthesis with lumbar interbody fusion and dynamic stabilization of the cranial adjacent level.

[Management of osseous complications in multiple myeloma].

Skeletal lesions caused by multiple myeloma often lead to pain, pathological fractures, spinal instability, and compression of the spinal cord and nerve roots. The choice of therapy options is made by an interdisciplinary basis with oncologists and radiotherapists on the basis of comorbidities, prognosis, localization, and number of lesions. Surgical management has a supportive role in pain relief, the prevention and treatment of pathological fractures, and the decompression of the spinal cord and nerve roots.

Injuries in equestrian vaulting: results of a prospective study.

Background: Equestrian vaulting is a sport, particularly popular among children and adolescents, in which gymnastic and dance routines are performed on horseback. Current data regarding injuries and thus, the risks of this sport, is meager and based only on retrospective studies.

Methods: In the current prospective study, 233 active members of a vaulting club were questioned monthly from November 2014 until October 2015.

Posterior Lumbar Interbody Fusion versus Dynamic Hybrid Instrumentation: A Prospective Randomized Clinical Trial.

Objective: The purpose of this study was to assess the radiologic and clinical outcomes after lumbar fusion intervention and to compare the established posterior lumbar interbody fusion (PLIF) technique and dynamic hybrid instrumentation (topping off).

Methods: In this prospective randomized trial, all patients who presented with degenerative changes to the lumbar spine (L2-S1) were included and randomized in 2 groups: patients who underwent the 360°-fusion procedure in PLIF (group 1: control group) and those patients who underwent fusion surgery with additional hybrid instrumentation (Dynesys-Transition-Optima [Zimmer Spine Inc., Denver, Colorado, USA]) cranial to the rigid fixed segment (group 2: intervention group).

Evaluation of Absorbent Versus Conventional Wound Dressing.

Background: Lower-limb endoprosthetic operations and spinal operations are among the more common types of orthopedic procedures. Postoperative woundhealing disturbances and infections can lead to longer periods of hospital stay and recovery as well as to higher morbidity and mortality.

Methods: 209 patients who had been judged to have an indication for a primary knee or hip endoprosthesis or for a primary spinal operation were included in this randomized trial (ClinicalTrials.

Radiofrequency-Targeted Vertebral Augmentation: Case Report of a Patient with 7 Osteoporotic Vertebral Fractures in a Variant of Osteogenesis Imperfecta.

Introduction: Radiofrequency-targeted vertebral augmentation (RF-TVA) is a recognized treatment for painful compression fractures. RF-TVA in a patient with multiple compression fractures due to type I osteogenesis imperfecta (OI) has not been previously reported.

Case Presentation: A 54-year-old patient with type I OI is presented with a segmental thoracic hyperkyphosis and 7 recent vertebral compression fractures.

The Influence of Parkinson Disease on Lumbar Decompression Surgery: A Retrospective Case Control Study.

Background: Parkinson disease (PD) is a major risk factor during spine surgery, and its frequency is increasing as the population ages. The study aim was to examine the influence of PD specifically on lumbar decompression surgery.

Methods: A retrospective review was performed of all patients with PD who underwent elective lumbar decompression surgery at 2 university hospital departments between December 2003 and July 2016.

[Surgery for Pulmonary Metastases in Patients with Advanced Soft Tissue and Osteosarcomas].

Advanced soft tissue or osteosarcoma is often associated with lung metastases. Curative pulmonary metastasectomy is appropriate for patients with successfully resected primary cancer who show no evidence of extrapulmonary metastases, with proven functional operability and completely resectable metastases. Systematic literature research and qualitative analysis of studies on patients undergoing lung metastasectomy after resection of primary sarcoma published since 01.

[Quality of Life and Functional Outcome after Microsurgical Decompression in Lumbar Spinal Stenosis: a Register Study].

Because of recent increases in life expectancy, lumbar spinal stenosis (LSS) has become one of the most common degenerative changes in the spine. In patients not responding to conservative therapy, microsurgical decompression is the gold standard of operative treatment for degenerative LSS. The goal of the current study is to evaluate quality of life after microsurgical decompression for LSS, using data from the DWG Register (previously Spine Tango).