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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We report on a 72-year-old male patient who developed a nontraumatic spinal subdural hematoma (SSDH) during rivaroxaban therapy, a relatively new orally administered direct factor Xa inhibitor. ⋯ Determining the time of safe surgery remains challenging when hemorrhagic complications happen with direct factor Xa inhibitor, especially when neurological prognosis is engaged. Spinal subdural hematoma has not previously been reported following rivaroxaban therapy.
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Comparative Study
Analysis of a performance-based functional test in comparison with the visual analog scale for postoperative outcome assessment after lumbar spondylodesis.
Prospective, non-blinded, non-randomization. ⋯ In summary, the TUG appeared to be significantly more sensitive for describing the course after spine surgery. The TUG represents an appropriate performance-based functional test that is not time-consuming. Assessment of both pain and functionality is, therefore, needed to evaluate patients adequately.
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Case Reports
Complete fracture of the lamina of the sixth cervical vertebra with hemiplegia: a case report.
We report the rare case of a 27-year-old man who presented a right sided complete hemiplegia after a neck trauma due to a road traffic accident. ⋯ This is the first paper, in the literature, to describe a complete laminar fracture at the cervical spine level with hemiplegia. Early surgical intervention probably provides the better neurological outcome.
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We report the case of a 44-year-old man who was found to have metastatic thymoma to his lumbar spine presenting as a spontaneous epidural haematoma. The man presented with back pain and cauda equina like symptoms in the absence of trauma, antiplatelet or anticoagulant agents. ⋯ To the best of our knowledge, this is the first such case of metastatic thymoma to the lumbar spine presenting as a spontaneous epidural collection. We believe, in all patients with spontaneous spinal epidural haematoma and a background of malignancy, histopathological analysis should be sought.
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To investigate whether obesity is associated with worse patient-reported outcomes following surgery for degenerative lumbar conditions. ⋯ Body mass index ≥35 is associated with worse baseline and 12-month PROs, however, there was no difference in change scores across BMI groups. Controlling for important co-variables, BMI greater than 35 was not an independent predictor of worse PROs at 12 months.