Journal of neurosurgery. Spine
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Review Case Reports
Dysphagia following combined anterior-posterior cervical spine surgeries.
This study was undertaken to evaluate the incidence of and risk factors associated with the development of dysphagia following same-day combined anterior-posterior cervical spine surgeries. ⋯ The incidence of dysphagia following combined anterior-posterior cervical surgery in this study was comparable to that of previous reports. The risk factors for dysphagia that were identified in this study were increased number of anterior levels exposed, anterior surgery that extended above C-4, and increased surgical correction of C2-7 lordosis.
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Lumbosacropelvic pseudarthrosis after long spinal fusions for treatment of adult degenerative scoliosis remains a challenging condition. Moreover, although pelvic fixation with iliac screws is widely used in deformity surgery to provide a biomechanically strong distal anchor for long thoracolumbar constructs, there are very few options available after failed pelvic fixation with iliac screws. The authors conducted a retrospective review of the surgical charts and imaging findings of patients subjected to revision surgery for lumbosacropelvic pseudarthrosis from August 2011 to August 2012. ⋯ The discussion is illustrated with a surgical case in which this technique was used to treat a patient with pseudarthrosis that had developed after fixation with classic iliac screws. In conclusion, although S-2 SAI screws have previously been reported as an interesting alternative to classic iliac wing screws, this report is the first on the use of combined S-1 and S-2 SAI screws for pelvic fixation as a salvage technique for lumbosacropelvic instability. According to the reported experience, this technique provides a biomechanically robust construct for definitive pelvic fixation during revision surgeries in the challenging scenarios of pseudarthrosis and instability of the lumbosacropelvic region.
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Cervical spine osteotomies are powerful techniques to correct rigid cervical spine deformity. Many variations exist, however, and there is no current standardized system with which to describe and classify cervical osteotomies. This complicates the ability to compare outcomes across procedures and studies. The authors' objective was to establish a universal nomenclature for cervical spine osteotomies to provide a common language among spine surgeons. ⋯ The proposed cervical spine osteotomy nomenclature provides the surgeon with a simple, standard description of the various cervical osteotomies. The reliability analysis demonstrated that this system is consistent and directly applicable. Future work will evaluate the relationship between this system and health-related quality of life metrics.
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In this study the authors report on the clinical outcomes, safety, and efficacy of lateral retroperitoneal transpsoas minimally invasive surgery-lumbar interbody fusion (MIS-LIF) at the L4-5 disc space in patients with spondylolisthesis. This approach has become an increasingly popular means of fusion. Its most frequent complication is lumbar plexus injury. Reported complication rates at the L4-5 disc space vary widely in the literature, bringing into question the safety of MIS-LIF for the L4-5 region, especially in patients with spondylolisthesis. ⋯ With its established surgical corridors through the retroperitoneum and psoas muscle, the MIS-LIF combined with posterior percutaneous pedicle screw fixation/reduction is a safe, reproducible, and effective technique for patients with symptomatic degenerative spondylolisthesis at the L4-5 vertebral segment.
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The authors undertook this study to investigate the relationships between low-back pain (LBP) and spinal bone density. Low-back pain is a major health issue and contributes to increases in medical and economic costs. Epidemiological studies have identified individual, sociodemographic, psychosocial, and occupational risk factors for LBP. However, there have been limited studies addressing the relationships between LBP and spinal bone density. ⋯ Higher bone density in the lumbar spine is associated with LBP, independent of confounding factors such as sociodemographic status, education, and medical-psychiatric disorders. Cause and effect relationship between higher bone density and LBP, such as degenerative changes in spine, requires further investigation.