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 review a series of patients > 60 years affected by primary spine bone tumors, who have undergone surgery, and to describe their clinical presentation, results and complications associated with surgical treatment. ⋯ Primary malignant or locally aggressive bone tumors of the spine should be treated with wide surgery also in the older age, although the complications rate and the risk of patient survival can be considered high. These slides can be retrieved under Electronic Supplementary Material.
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The conventional posterior approach is mostly advocated for excision of sacral tumours below S2. We describe an operative technique of single-stage en bloc resection of sacral tumours, extending up to S1, through an extended posterior approach. ⋯ The reported technique allows en bloc resection of sacral tumours up to S1, through a posterior-only approach. It is less invasive with minimal morbidity. The functional and oncological outcomes are similar to those reported by other investigators. These slides can be retrieved from electronic supplementary material.
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The aim of this study was to evaluate the prevalence and risk factors for postoperative pulmonary complications (PPC) after posterior instrumentation and fusion (PIF) in patients with non-degenerative scoliosis. ⋯ A prevalence of 11.7% PPC was observed after PIF. Risk factors were preoperative Cobb angle of main curve > 75°, preoperative respiratory disease, revision surgery and thoracoplasty. Surgeons should recognize and pay attention to these risk factors and take appropriate preventive measures to prevent severe pulmonary complications. These slides can be retrieved under Electronic Supplementary Material.
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Postoperative standing radiographs are usually performed before hospital discharge after AIS fusion. However, patients are often still painful and have not recovered yet their physiological balance. The aim of this study was therefore to evaluate the relevance of such early radiographs and more specifically investigate whether postoperative alignment could be analyzed. ⋯ There is no need for additional immediate postoperative radiographs in AIS, if an intraoperative radiograph has already been taken. This finding could help reducing radiation exposure in immature patients and should be further studied in other etiologies. These slides can be retrieved under Electronic Supplementary Material.
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Review Practice Guideline
Danish national clinical guidelines for surgical and nonsurgical treatment of patients with lumbar spinal stenosis.
To summarize the recommendations from the national clinical guideline published by the Danish Health Authority regarding surgical and nonsurgical interventions in treatment of lumbar spinal stenosis in patients above the age of 65 years. ⋯ The recommendations are based on low to very low quality of evidence or professional consensus as well as patient preferences and positive or harmful effects of the intervention. The true treatment effect may therefore be different from the estimated effects, which is why the results should be interpreted with caution. The working group recommends intensified research in relation to all aspects of management of lumbar spinal stenosis. These slides can be retrieved under Electronic Supplementary Material.