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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The purpose of this study is to justify a new concept of the pathogenesis of secondary changes in the cervical spinal cord, and its correlation with the depth of development of neurological disorders in spinal injury. ⋯ Collateral circulation is a significant factor that limits the damage to the cervical spinal cord. Impaired circulation in the artery of cervical enlargement is significant in extension of perifocal ischemia. The appearance of early arteriovenous shunting in the region of a primary spinal cord injury (contusion focus) by angiography is pathognomonic. The data obtained open a perspective for the endovascular treatment of spinal cord injury.
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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.
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This retrospective study analyzes long-term outcomes (15 years) of circumferential lumbar fusion (CF) for degenerative spine disease using instrumented PLIF. The occurrence of adjacent segment degeneration (ASD) and the reintervention rate was specially focused. ⋯ Circumferential lumbar fusion provides good clinical results at short-term follow-up. From 2- to 15-year follow-up, outcome worsened significantly. The high rate of ASD occurrence and reintervention questions the reliability of this technique for lumbar fusion.
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Case Reports
Extension type fracture of the ankylotic thoracic spine with gross displacement causing esophageal rupture.
This study aimed at discussing the relevance of the type B3 fracture of the new AOSpine classification. ⋯ The B3 typification raised a lot of discussion during the development of the new classification system and may be controversial. This case, however, nicely illustrates the relevance of an intact posterior hinge as compared to C-type injuries where complete dissociation is present with inherent spinal cord damage.
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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.