Comparison of cervical kinematics between patients with cervical artificial disc replacement and anterior cervical discectomy and fusion for cervical disc herniation.

Background Context: Although anterior cervical discectomy and fusion (ACDF) is an effective treatment option for patients with cervical disc herniation, it limits cervical range of motion, which sometimes causes discomfort and leads to biomechanical stress at neighboring segments. In contrast, cervical artificial disc replacement (ADR) is supposed to preserve normal cervical range of motion than ACDF. A biomechanical measurement is necessary to identify the advantages and clinical implications of ADR.

Anterior dislodgement of a fusion cage after transforaminal lumbar interbody fusion for the treatment of isthmic spondylolisthesis.

Transforaminal lumbar interbody fusion (TLIF) is commonly used procedure for spinal fusion. However, there are no reports describing anterior cage dislodgement after surgery. This report is a rare case of anterior dislodgement of fusion cage after TLIF for the treatment of isthmic spondylolisthesis with lumbosacral transitional vertebra (LSTV).

Microscopic anterior foraminal decompression combined with anterior lumbar interbody fusion.

Background Context: Anterior lumbar interbody fusion (ALIF) with percutaneous pedicle screw fixation (PPF) provides successful surgical outcomes to isthmic spondylolisthesis patients with indirect decompression through foraminal volume expansion. However, indirect decompression through ALIF followed by PPF may not obtain a successful surgical outcome in patients with isthmic spondylolisthesis accompanied by foraminal stenosis caused by a posterior osteophyte or foraminal sequestrated disc herniation. Thus far, there has been no report of foraminal decompression through anterior direct access in the lumbar spine.

Echocardiographic predictor of acute heart failure after spine surgery: a novel tissue Doppler index associated with a potentially fatal complication of the operation.

Background Context: Acute heart failure (HF) is a potentially fatal complication after spine surgery.

Purpose: We sought to identify clinical and echocardiographic predictors of postoperative HF in spine surgery patients.

Study Design: Retrospective observational study.

Changes in the adjacent segment 10 years after anterior lumbar interbody fusion for low-grade isthmic spondylolisthesis.

Background: Adjacent segment degeneration is a long-term complication of arthrodesis. However, the incidence of adjacent segment degeneration varies widely depending on the patient's age and underlying disease and the fusion techniques and diagnostic methods used.

Questions/purposes: We determined (1) the frequency of adjacent segment degeneration and increased lordosis on imaging tests, (2) the frequency and severity of clinical sequelae of these findings, including revision surgery, and (3) the sequence of degeneration and risk factors for degeneration.

Effective cervical decompression by the posterior cervical foraminotomy without discectomy.

Study Design: A retrospective review.

Objective: To compare the effectiveness of the posterior cervical foraminotomy (PCF) with and without discectomy for the treatment of cervical disk herniation.

Summary Of Background Data: Although PCF is effective and does not require a fusion procedure, it has certain disadvantages, including a narrow operating field, the need for cervical nerve root retraction, and the obstacle of epidural venous bleeding.

Biomechanical comparison of anterior lumbar interbody fusion: stand-alone interbody cage versus interbody cage with pedicle screw fixation -- a finite element analysis.

Background: Anterior lumbar interbody fusion (ALIF) followed by pedicle screw fixation (PSF) is used to restore the height of the intervertebral disc and provide stability. Recently, stand-alone interbody cage with anterior fixation has been introduced, which eliminates the need for posterior surgery. We compared the biomechanics of the stand-alone interbody cage to that of the interbody cage with additional PSF in ALIF.

Solid fusion after lumbosacral arthroplasty.

A 55-year-old female was diagnosed with L5-S1 degenerative disc disease (DDD). Initial scores by the visual analogue scale (VAS) were 5 (back) and 9 (leg) and the Oswestry disability index (ODI) was 32. Arthroplasty was performed.

Preliminary results of the clinical effectiveness of percutaneous adhesiolysis using a Racz catheter in the management of chronic pain due to cervical central stenosis.

Background: Cervical central stenosis (CCS) is a narrowing of the spinal canal that can cause mechanical compression of the spinal nerve and roots, leading to neck pain and/or radicular pain. Cervical epidural steroid injections are commonly used in the treatment of CCS. After failure of epidural steroid injections, the next sequential step is percutaneous adhesiolysis with a targeted drug delivery.

Comparison of morphine and tramadol in transforaminal epidural injections for lumbar radicular pain.

Background: Transforaminal epidural steroid injections are known to reduce inflammation by inhibiting synthesis of various proinflammatory mediators and have been used increasingly. The anti-inflammatory properties of opioids are not as fully understood but apparently involve antagonism sensory neuron excitability and pro-inflammatory neuropeptide release. To date, no studies have addressed the efficacy of transforaminal epidural morphine in patients with radicular pain, and none have directly compared morphine with a tramadol for this indication.

Intraoperative discography for detecting concealed lumbar discal cysts.

Lumbar discal cyst is a rare cause of radiculopathy. Their exact pathogenesis and the optimal treatment modality remain unidentified. Depending on their location, discal cysts cannot always be easily identified intraoperatively.

Clinical effectiveness of percutaneous adhesiolysis and predictive factors of treatment efficacy in patients with lumbosacral spinal stenosis.

Objective: Patients with lumbosacral spinal stenosis (LSS) do not always obtain satisfactory pain relief from transforaminal epidural steroid injection (TFESI) because perineural/epidural adhesions prevent the spread of injectate into the epidural space. Percutaneous adhesiolysis (PA) can eliminate the deleterious effects of adhesion. This study was to evaluate the effectiveness of PA among patients with LSS refractory to TFESI and to ascertain the prognostic factors determining PA efficacy.

Percutaneous endoscopic lumbar discectomy and annuloplasty for lumbar disc herniation at the low two contiguous levels: single-portal, double surgeries.

Study Design: Technical case report.

Objective: The authors report surgical experience of treating contained or noncontained lumbar disc herniation (LDH) at the L3-L4 and L4-L5 or L4-L5 and L5-S1 levels by transforaminal percutaneous endoscopic lumbar discectomy and annuloplasty (PELDA) through the single entry point.

Summary Of Background Data: When there are concurrent LDHs involving lower two levels simultaneously, PELDA has not been performed.

Clinical results of XMR-assisted percutaneous transforaminal endoscopic lumbar discectomy.

Background: Although percutaneous endoscopic lumbar discectomy (PELD) has shown favorable outcomes in the majority of lumbar discectomy cases, there were also some failures. The most common cause of failure is the incomplete removal of disc fragments. The skin entry point for the guide-needle trajectory and the optimal placement of the working sleeve are largely blind, which might lead to the inadequate removal of disc fragments.

Comparison between the accuracy of percutaneous and open pedicle screw fixations in lumbosacral fusion.

Background Context: In pedicle screw fixation, accurate insertion is essential to avoid neurological injury or weak stability. The percutaneous pedicle screw system was developed for minimally invasive spine surgery, and its safety has already been reported. However, the accuracy of percutaneous pedicle screw fixation (PPF) has not been compared with that of the open system to date.

Effect of relative injectate pressures on the efficacy of lumbar transforaminal epidural steroid injection in patients with lumbar foraminal stenosis.

Objective: Transforaminal epidural steroid injections (TFESIs) are often used to treat lumbar foraminal stenosis. Injectate pressure (of contrast) was monitored during fluoroscopically guided TFESI to assess the effect on short-term pain reduction.

Design: A total of 40 patients underwent single-level lumbar TFESI for unilateral lumbar radicular pain ascribed to foraminal stenosis.

Cervical spinal epidural hematoma following cervical posterior laminoforaminotomy.

A 65-year-old man who had lateral cervical disc herniation underwent cervical posterior laminoforaminotomy at C5-6 and C6-7 level right side. During the operation, there was no serious surgical bleeding event. After operation, he complained persistent right shoulder pain and neck pain.

Transdural Nerve Rootlet Entrapment in the Intervertebral Disc Space through Minimal Dural Tear : Report of 4 Cases.

Four patients underwent lumbar surgery. In all four patients, the dura was minimally torn during the operation. However, none exhibited signs of postoperative cerebrospinal fluid leakage.

Clinical and radiological comparison of femur and fibular allografts for the treatment of cervical degenerative disc diseases.

Objective: This consecutive retrospective study was designed to analyze and to compare the efficacy and outcomes of anterior cervical discectomy and fusion (ACDF) using a fibular and femur allograft with anterior cervical plating.

Methods: A total of 88 consecutive patients suffering from cervical degenerative disc disease (DDD) who were treated with ACDF from September 2007 to August 2010 were enrolled in this study. Thirty-seven patients (58 segments) underwent anterior interbody fusion with a femur allograft, and 51 patients (64 segments) were treated with a fibular allograft.

Effectiveness of percutaneous transforaminal adhesiolysis in patients with lumbar neuroforaminal spinal stenosis.

Background: Lumbar foraminal spinal stenosis (LFSS) is a narrowing of the bony exit of a nerve root, which causes mechanical compression of spinal nerve roots. Low back pain and/or leg pain, and possibly neurogenic claudication, may result due to mechanical neural compression. Transforaminal epidural steroid injections (TFESIs) are commonly used for treating LFSS.

Radiological analysis of lumbar degenerative kyphosis in relation to pelvic incidence.

Background Context: Lumbar degenerative kyphosis (LDK) is characterized by sagittal imbalance resulting from a loss of lumbar lordosis (LL). The pelvic incidence (PI) regulates the sagittal alignment of the spine and pelvis.

Purpose: The purpose of this study is to evaluate the spinopelvic parameters in patients with LDK and to compare them with those of a normal population.

The accuracy of 3D image navigation with a cutaneously fixed dynamic reference frame in minimally invasive transforaminal lumbar interbody fusion.

Objective: In contrast to preoperative image-based 3D navigation systems, which require surgeon-dependent registration, an intraoperative cone-beam computed tomography (cb-CT) image-based 3D navigation system allows automatic registration during the acquisition of 3D images intraoperatively. Thus, the need for spinal exposure for point matching is obviated, making a cb-CT image-based navigation system ideal for use in minimally invasive spinal procedures. Conventionally, the dynamic reference frame (DRF) is mounted to an adjacent spinous process or iliac bone through a separate incision.

Instrumented Minimally Invasive Spinal-Transforaminal Lumbar Interbody Fusion (MIS-TLIF): Minimum 5-Year Follow-Up With Clinical and Radiologic Outcomes.

Study Design: A retrospective study.

Objective: To determine the clinical and radiologic outcomes of the long-term results of instrumented minimally invasive spinal-transforaminal lumbar interbody fusion (MIS-TLIF) in unstable, single-level, low-grade, isthmic spondylolisthesis (IS) or degenerative spondylosis (DS) including degenerative spondylolisthesis, foraminal stenosis with central stenosis, degenerative disk disease, and recurrent disk herniation.

Summary Of Background Data: MIS-TLIF is a common surgical procedure to treat lumbar spondylolisthesis.

Radiation exposure to the surgeon during percutaneous endoscopic lumbar discectomy: a prospective study.

Study Design: A prospective study.

Objective: The purpose of this study was to determine the radiation dose to which the surgeons are exposed during percutaneous endoscopic lumbar discectomy (PELD) and to calculate the allowable number of cases per year.

Summary Of Background Data: Transforaminal PELD is a minimally invasive technique for soft disc herniation.

Delayed neurological deficits induced by an epidural hematoma associated with a thoracic osteoporotic compression fracture.

A 79-year-old woman developed neurological deficits 6 weeks after the onset of a thoracic osteoporotic compression fracture. Magnetic resonance (MR) imaging of the thoracic spine revealed an epidural hematoma at the T10-L2 levels. Acute decompressive laminectomy and percutaneous vertebroplasty were performed.