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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To optimize intraoperative neuromonitoring during extreme lateral interbody fusion (XLIF) by adding transcranial electrical stimulation with motor evoked potential (TESMEP) to previously described monitoring using spontaneous EMG (sEMG) and peripheral stimulation (triggered EMG: tEMG). ⋯ Monitoring the complete nervous system during an XLIF procedure is found to be helpful since nerve roots, lumbar plexus as well as the intradural neural structures may be at risk. TESMEP has additional value to sEMG and tEMG during XLIF procedure: (1) it informed about otherwise unnoticed events, and (2) it confirmed and added information to events measured using sEMG.
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Pain management following posterior spinal fusion surgeries is a challenging topic. Continuous epidural analgesia (CEA) technique has been invented to resolve some deleterious effects related with conventional intravenous patient-controlled analgesia (IV-PCA) method. However, studies for effectiveness and safety of CEA are scarce in adult population. Our aim was to compare effectiveness and safety of patient-controlled CEA with conventional IV-PCA method in adult patient population. ⋯ Patient-controlled CEA method is as safe as IV-PCA method and is even more effective than that in controlling immediate post-operative pain in patients treated with posterior spinal fusion.
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We determined the incidence of and risk factors for clinical adjacent segment pathology (C-ASP) requiring additional surgeries among patients previously treated with one-segment lumbar decompression and fusion surgery. ⋯ Pre-existing spinal stenosis, greater facet tropism, and higher BMI significantly increased C-ASP risk. Myelography is a more accurate method for detecting latent spinal canal stenosis as a risk factor for C-ASP.
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This case series describes a novel condition characterized by familial pseudotail associated with scoliosis, and synpolydactyly that has not been previously reported in literature. ⋯ The described cases represent a novel condition that has not been previously reported in the literature. Familial pseudotail scoliosis synpolydactyly syndrome is a newly recognized form of familial pseudotail.
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To determine the content of current Dutch expert hospital physiotherapy practice for patients undergoing lumbar spinal fusion (LSF), to gain insight into expert-based clinical practice. ⋯ Dutch perioperative expert physiotherapy for patients undergoing LSF is variable and lacks structural outcome assessment. Studies evaluating the effectiveness of best-practice physiotherapy are warranted.