Perioperative Safety of Lumbar Decompression Surgery Performed Under Continuous Low-Dose Aspirin Administration.

Study Design: Retrospective clinical analysis.

Objective: To investigate the changes in perioperative bleeding and overall safety associated with the use of low-dose aspirin (LDA) in spinal surgery.

Summary Of Background Data: There is no consensus on whether to continue the use of LDA in patients requiring spinal surgery.

Lumbar Spinal Stenosis: Pathophysiology, Biomechanics, and Innovations in Diagnosis and Management.

Lumbar spinal stenosis (LSS) is a common condition caused by the narrowing of the spinal canal, resulting in compression of neural and vascular structures. This compression leads to symptoms such as claudication, paresthesia, and lower extremity weakness. LSS is the leading cause of low back pain and functional limitations, affecting over 103 million people worldwide.

Otolaryngology-Assisted Approach for Anterior Cervical Discectomy and Fusion.

First introduced by Robinson & Smith in 1955, the anterior cervical discectomy and fusion (ACDF) surgery has seen minimal changes over the years. Its reproducibility, impressive long-term results, and minimal complication rates have established it as one of the most frequently performed cervical spinal fusion surgeries. Yet, post-operative dysphagia remains a concern with a 60% incidence rate.

Imaging of Craniovertebral Junction Instability, Fixation, and Stenosis in Children.

Craniovertebral junction (CVJ) instability, fixation, and stenosis in children are closely related conditions that are often challenging to diagnose and are associated with significant morbidity. Groups at higher risk for CVJ abnormalities include children with trisomy 21, juvenile idiopathic arthritis, upper respiratory infection or other inflammatory conditions of the head and neck, and certain skeletal dysplasias. Radiography, CT, and MRI play complementary roles in the evaluation of pathologic conditions of the CVJ.

Multivariable Analysis of the Association Between Lumbar and Lumbosacral MRI-Diagnosed Spinal Pathologies and Pain in Dogs.

Lumbar and lumbosacral pain in dogs often involves multiple concurrent spinal pathologies, complicating the identification of primary pain generators. This study assessed the associations between MRI-diagnosed spinal pathologies and pain to provide clinically relevant insights for their diagnosis and management. MRI scans and clinical records of 518 client-owned dogs were retrospectively reviewed, documenting demographic data, pain status, and MRI findings.

MRI underestimates lumbar spinal canal cross-sectional area compared to CT in patients with lumbar spinal stenosis.

Objectives: Lumbar spinal stenosis (LSS) is a common condition characterized by the narrowing of the spinal canal, often leading to neural compression. Accurate imaging is crucial for diagnosis and surgical planning, with MRI and CT being the primary modalities. While MRI excels in soft tissue visualization, CT is superior for assessing bony structures.

Spontaneous psoas hematoma following posterior lumbar fusion surgery: a mini literature review.

Background: Spontaneous psoas hematoma is a very rare clinical entity, and the pathogenesis and pathologic mechanisms of spontaneous psoas hematoma remain unclear, thus, it is of great value to explore.

Case Presentation: We encountered a patient who developed femoral nerve paralysis due to psoas muscle hematoma following posterior lumbar fusion surgery. A 69-year-old female with lumbar spinal canal stenosis underwent posterior lumbar fusion at the L3-4 and L4-5 levels.

Transthyretin amyloid deposition in the ligamentum flavum of an Italian cohort of patients with lumbar spinal stenosis.

Transthyretin amyloidosis (ATTR amyloidosis) is a rare systemic disorder characterized by the extracellular deposition of amyloid fibrils, which can affect multiple tissues. Lumbar spinal stenosis (LSS), a condition involving narrowing of the lumbar spinal canal, has been frequently associated with amyloid deposition in the ligamentum flavum (LF). This study aimed to evaluate the prevalence of ATTR deposits in LF samples obtained from patients undergoing LSS surgery at two Italian centers.

Factors associated with improved outcomes after lumbar transforaminal epidural steroid injections for radicular pain: A systematic review.

Purpose: Despite numerous studies, the factors contributing to clinical success after a lumbar transforaminal epidural steroid injection (LTFESI) for radicular pain remain unclear. The aim of this study was to systematically review literature evaluating preprocedural predictive factors for improved outcomes in patients receiving a LTFESI.

Methods: We searched databases including PubMed/MEDLINE, Cochrane Library, and Scopus for studies published from 2006 through 2023.

How to prevent preoperative adjacent segment degeneration L5/S1 segment occuring postoperative adjacent segment disease? A retrospective study of risk factor analysis.

Objective: L5/S1 segment is one of the most common lumbar degenerative segments with high clinical failure rate. When the clinically responsible segment consists of one or more segments including L4/L5 segment, whether to merge the severely degraded L5/S1 segment together is a common problem plaguing clinicians. Therefore, the purpose of this study was to explore the risk factors for preoperative adjacent segment degeneration L5/S1 segment occuring Postoperative adjacent segment disease(ASDis), analyze the correlation between the high risk factors and the occurrence of adjacent segment disease, clarify the preventive measures and direction, and provide references for clinical selection of personalized treatment.

Diagnostic efficacy of nerve root sedimentation sign in post-lumbar interbody fusion patients: an imaging evaluation and modification.

Background: The sedimentation sign offers an efficient method for evaluating lumbar spinal stenosis. However, limited research exists regarding its applicability to post-operative MRI scans. This study aims to assess the viability of utilizing the nerve root sedimentation sign (NRSS) and Schizas classification (SC) in the evaluation of post-operative lumbar stenosis.

Percutaneous transforaminal endoscopic decompression versus posterior short-segment fusion for treating degenerative lumbar scoliosis with lumbar spinal stenosis: a cohort study with a minimum five year followup.

Purpose: This retrospective cohort study aimed to compare the clinical outcomes of percutaneous transforaminal endoscopic decompression (PTED) with those of posterior lumbar interbody fusion (PLIF) for the treatment of degenerative lumbar scoliosis (DLS) with lumbar spinal stenosis (LSS).

Methods: In this study, 143 DLS patients who met the inclusion criteria from January 2016 to March 2019 were retrospectively analyzed and divided into the PTED and PLIF groups. The propensity score matching (PSM) method was used to adjust for imbalanced confounding variables between the groups.

Pregnancy in ACHD women: crucial role of multidisciplinary clinical roadmap.

Purpose: Pregnancy in women with adult congenital heart disease (ACHD), whether in its natural history or after surgical correction, represents a unique pathophysiological model that requires careful, multidisciplinary management to ensure favorable maternal, fetal and neonatal outcomes. Investigating the impact of congenital cardiac conditions on maternal and feto-neonatal health, the effect of pregnancy-related cardiovascular changes on maternal cardiac health, and the outcomes for offspring born from ACHD mothers is highly relevant, due to the increasing number of ACHD women reaching adulthood and the significant burden these pregnancies can pose. The aim of this article is to provide food for thought to those who have always been involved in ACHD and pregnancy, but also to provide a training tool for young doctors who are approaching at this wonderful world for the first time.

Efficacy of Navigation Systems With Smart Delivery Tools in Enhancing the Accuracy of Percutaneous Pedicle Screw Insertion.

Purpose Minimally invasive surgical techniques are advancing in spinal surgery, creating a need for the development of surgical support systems. This study evaluates the efficacy of a compact navigation system with smart delivery tools in percutaneous pedicle screw insertion. Methods This retrospective observational study included consecutive thoracic or lumbar spinal fusion patients with percutaneous pedicle screw placement treated from November 2022 to July 2023 in a Japanese private hospital.

DeVa (Decay Variance): A Novel Score Calculated via Postprocessing the Changes in Signal Intensity of an Intervertebral Disc in a T2* Multi-Echo Magnetic Resonance Image Can Quantify Painful and Degenerate Lumbar Vertebral Discs.

Introduction: Low back pain (LBP), a global disability leader, is often linked to intervertebral disc (IVD) degeneration. Traditional diagnostics like T2-weighted MRI provide qualitative but imprecise evaluations. A novel post-processing MRI technique, Decay Variance (DeVa), has shown promise in differentiating degenerate from healthy discs in animal studies.

Efficacy and Safety of Unilateral Biportal Endoscopy Compared With Transforaminal Route Percutaneous Endoscopic Lumbar Decompression in the Treatment of Lumbar Spinal stenosis: Minimum 1-year Follow-up.

Objective: This study compared the efficacy and safety of unilateral biportal endoscopic (UBE) decompression and transforaminal route percutaneous endoscopic lumbar decompression (PELD) for lumbar spinal stenosis (LSS), assessing 1-year clinical outcomes.

Methods: A total of 120 patients (64 UBE, 56 PELD) diagnosed with LSS in 2021 were evaluated. Perioperative outcomes included overall operation time, extracanal operative time, intracanal decompression time, incision length, fluoroscopy time, estimated blood loss, preoperative and postoperative day 3 hb levels, length of post-operative hospital stays, total expenses, postoperative complications.

Incidence and long-term patient reported outcome measures of patients with radiological cauda equina compression but without clinical features of cauda equina syndrome.

Background: Cauda equina syndrome (CES) is a rare spinal emergency. Paradoxically, in the British NHS, suspected CES requiring an emergency magnetic resonance imaging constitutes one of the commonest reasons for acute referrals to neurosurgery/spine surgery. Further acute referrals also occur with the reverse scenario, when radiological evidence of cauda equina compression is not accompanied by the clinical red flags of the syndrome.

Modified minimally invasive transforaminal microscope-assisted fusion to treat lumbar foraminal stenosis combined with severe lumbar degenerative diseases.

Purpose: Lumbar foraminal stenosis combined with severe lumbar degenerative disease causing instability, radiculopathy and claudication may require surgery. The surgical treatment goals are decompression, restoration of the height of the disc and foramina and stabilize the spine. We used a modified minimally invasive transforaminal lumbar interbody fusion (TLIF) approach in those patients and evaluated its clinical efficacy.

Percutaneous endoscopic transforaminal lumbar interbody fusion with an expandable cage for the treatment of degenerative lumbar spinal stenosis with instability.

Purpose: To evaluate the safety and efficacy of percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) with an expandable cage for the treatment of single-level degenerative lumbar spinal stenosis (LSS) with instability.

Methods: The clinical data of 42 patients (14 males and 28 females) with single-level LSS with instability who underwent PE-TLIF from September 2019 to April 2023 were retrospectively reviewed. All the patients underwent a minimum follow-up of 12 months.

Comparison of postoperative outcomes, satisfaction, and complications between bilateral 3-portal endoscopy and unilateral biportal endoscopy in patients with lumbar spinal stenosis: A multicenter, retrospective, cohort study.

Background: Bilateral 3-portal endoscopy is a novel minimally decompression surgery based on the modification of unilateral biportal endoscopy, which achieves complete decompression through a bilateral approach for patients with lumbar spinal stenosis. This study tested the hypothesis that bilateral 3-portal endoscopy could improve clinical outcomes and satisfaction versus unilateral biportal endoscopy in these patients.

Methods: In this multicenter, retrospective, cohort study, 87 patients with lumbar spinal stenosis who received bilateral 3-portal endoscopy or unilateral biportal endoscopy were divided into bilateral 3-portal endoscopy (N = 35) and unilateral biportal endoscopy (N = 52) groups, respectively.

Association between lumbar spine kinematics and falls in patients with lumbar spinal stenosis: a cross-sectional study.

Purpose: The purpose of the present study was to quantitatively assess the characteristics of lumbar spine motor function in patients with lumbar spinal stenosis (LSS) who experienced falls and to determine the association between falls and lumbar spine motion.

Methods: This cross-sectional study enrolled consecutive patients with clinically and radiologically defined LSS indicated for surgical treatment at a single center. The lumbar motion task consisted of bending forward to the maximum range of motion of the lumbar spine in the standing position, followed by a return to the upright position.

Clinical and Radiologic Outcomes of Unilateral Biportal Endoscopic Lumbar Interbody Fusion Compared With Conventional Posterior Lumbar Interbody Fusion on the Treatment of Single-segment Lumbar Spinal Stenosis With Instability, a 2-year Follow-up Study.

Study Design: Retrospective cohort study.

Objective: To investigate the clinical and radiologic outcomes of unilateral biportal endoscopic lumbar interbody fusion (ULIF) for single-segment lumbar spinal stenosis with instability.

Background: Unilateral biportal endoscopic technology has developed rapidly, and ULIF is a new type of minimally invasive fusion surgery.

Early Clinical and Radiologic Evaluation of Endoscopic Unilateral Laminectomy for Bilateral Decompression in Degenerative Lumbar Spinal Stenosis: A Retrospective Study.

Background: Endoscopic unilateral laminectomy for bilateral decompression (ULBD) is gaining attention as a minimally invasive procedure for treating spinal stenosis. However, comprehensive studies on its outcomes remain limited.

Purpose: This study aims to evaluate the changes in radiologic parameters and clinical outcomes associated with endoscopic ULBD for treating spinal stenosis.

Interlaminar Endoscopic Treatment of Adjacent Segment Disease After Posterior Instrumented Lumbar Fusion.

Purpose: This study aimed to investigate the feasibility of interlaminar endoscopic surgery for the treatment of adjacent segment disease (ASD) after posterior instrumented lumbar fusion.

Materials And Methods: Between January 2019 and March 2023, the data of 22 patients with ASD who underwent revision interlaminar technique (R-ILT) endoscopic surgery after posterior instrumented lumbar fusion were retrospectively analyzed. For comparison, the data of 30 patients with single segment lumbar spinal stenosis who underwent primary interlaminar technique (P-ILT) endoscopic surgery were collected.

Web-based machine learning application for interpretable prediction of prolonged length of stay after lumbar spinal stenosis surgery: a retrospective cohort study with explainable AI.

Objectives: Lumbar spinal stenosis (LSS) is an increasingly important issue related to back pain in elderly patients, resulting in significant socioeconomic burdens. Postoperative complications and socioeconomic effects are evaluated using the clinical parameter of hospital length of stay (LOS). This study aimed to develop a machine learning-based tool that can calculate the risk of prolonged length of stay (PLOS) after surgery and interpret the results.