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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Conjoined twins are a rare complication of 9 monozygotic twins and are associated with high perinatal mortality. Pygopagus are one of the rare types of conjoined twins with only a handful of cases reported in the literature. We present the case of one-and-half month-old male pygopagus conjoined twins, who were joined together dorsally in lower lumbar and sacral region and had spina bifida and shared a single thecal sac with combined weight of 6.14 kg. Spinal cord was separated at the level of the conus followed by duraplasty. They had uneventful recovery with normal 15 months follow-up. ⋯ Separation of conjoined twins is recommended in where this is feasible with the anticipated survival of both or one infant.
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Case Reports
Intractable hiccups caused by syringobulbia and syringomyelia associated with intramedullary spinal hemangioblastoma.
Hiccups caused by a neoplasm in the spinal cord are rare. ⋯ Intractable hiccups can be caused by syringobulbia associated with an intramedullary cord tumor in the cervical area and possible mechanisms of hiccups were reviewed.
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Comparative Study
Fusion in degenerative spondylolisthesis: comparison of osteoconductive and osteoinductive bone graft substitutes.
The emergent widespread options of bone graft substitutes for spinal fusion procedures vary in their osteobiologic activity. A majority of current literature focuses on the comparison of osteoinductive (OI) or osteoconductive (OC) bone graft substitutes individually against ICBG. These studies have demonstrated the legitimacy of bone graft substitutes, but despite the widespread use in spinal fusion procedures there is a dearth in the current literature in the direct comparison of OC and OI substitutes. This retrospective comparative analysis compares the efficacy of OI vs. solely OC agents in producing radiographic fusion on patients with DS. ⋯ With the vastly growing market for OI and OC materials commonly used in lumbar spinal fusions, the options for surgical treatment for degenerative spondylolisthesis are ever expanding. No significant difference was found when comparing fusion rates between the two types of materials in this retrospective analysis. Interestingly, TLIF procedures provided lower fusion rates than posterolateral fusion procedures. This may be due to a small sample size but the association with a minimally invasive technique warrants investigation. Due to the substantial difference in price between the OI and OC materials and the lack of evidence supporting higher fusion rates with more expensive OI agents, it is incumbent on the spine community to consider and reassess the products that are routinely used.
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Case Reports
Failure of a polyether-ether-ketone expandable interbody cage following transforaminal lumbar interbody fusion.
Expandable cages are a more recent option for maintaining or restoring disc height and segmental lordosis with transforaminal lumbar interbody fusion (TLIF). Complications associated with expandable cages have not yet been widely reported. We report a case of postoperative failure of a polyether-ether-ketone (PEEK) expandable interbody device used during TLIF. ⋯ Expandable cages are a recent innovation; as such, efficacy and complication data are limited. As with any new device, there exists potential for mechanical failure, as occurred in the case presented.
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Traumatic spinal cord injuries (TSCI) are among the most devastating conditions in developed and developing countries, which can be prevented. The situation of TSCI around the world is not well understood which complicates the preventive policy decision making in fight against TSCI. This study was aimed to gather the available information about incidence of TSCI around the world. ⋯ Data of epidemiologic information in TSCI are available for 41 countries of the world, which are mostly European and high-income countries. Researches and efforts should be made to gather information in developing and low-income countries to plan appropriate cost-effective preventive strategies in fight against TSCI.