European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Although surgeries have been performed for the treatment of lumbar disc herniation (LDH) or lumbar spinal stenosis (LSS), not all patients who undergo surgery are satisfied with the outcome. Electrodiagnostic study (EDX) can assess the physiological functions of nerve roots with higher specificity and relate better with clinical manifestations. The purpose of this study was to examine how EDX can predict surgical outcomes in patients with LDH and LSS and to compare the predicted values of EDX with other clinical factors and MRI findings. ⋯ EDX detected functional abnormalities of nerve roots that did not show clinical manifestation and did not appear compressed on MRI. These abnormalities are important predictive factors for surgical outcomes in patients with LDH or LSS. Therefore, pre-operative EDX is a clinically useful method to predict surgical prognosis.
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Spinal intradural extramedullary (IDEM) schwannoma diagnosed by magnetic resonance (MR) imaging is sometimes detected incidentally. Because the natural history of spinal IDEM schwannoma has not been established well, questions remain regarding whether small and asymptomatic tumour has to be removed. We aimed to assess the natural history of spinal schwannoma diagnosed by MR imaging using an accurate and reliable method. ⋯ Spinal probable IDEM schwannoma grew 5.45% of the tumour volume annually and can be divided into growing and stable tumours. The tumour that grows≥2.5% of volume per year needs a careful inspection because it may be not benign schwannoma and keep growing continuously.
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En bloc sacrectomy is a demanding surgical procedure to remove tumors from the sacrum. Comprehensive data on readmissions for complications endured months to years after initial discharge are scant. The purpose of this study is to present the long-term complications, readmissions and secondary interventions for patients having undergone en bloc sacrectomy. ⋯ En bloc sacrectomy is a procedure with a high rate of major complications, regardless of tumor histology, often necessitating readmissions and secondary interventions. Long-term survival is associated with considerable morbidity and extensive preoperative counseling should be conducted to discuss the risks and outcome of the procedure.
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Technical note. ⋯ The reported technique can be applied for chest wall reconstruction in cases of total or subtotal vertebrectomy accomplished with the resection extending towards rib cage. It appears to be straightforward, safe and effective allowing good cosmetic and functional outcome.
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Despite being commonly affected by degenerative disorders, there are few data on normal thoracic intervertebral disc dimensions. A morphometric analysis of adult thoracic intervertebral discs was, therefore, undertaken. ⋯ Thoracic disc morphometry varies significantly and consistently with disc level, sex and age. This study provides unique reference data on adult thoracic intervertebral disc morphometry, which may be useful when interpreting pathological changes and for future biomechanical and functional studies.