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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Removal of hardware procedures following posterior spinal fusion is most commonly performed for hardware irritation without overt infection. It is imperative that surgeons realize that serious complications may arise from this procedure. The purpose of this report is to report a case of a pneumothorax that developed in a thoracolumbar removal of hardware case that resulted in a patient death. ⋯ This case report highlights one of the rare but potential complications of spinal removal of hardware surgery. It is essential that surgeons are aware of the possibility of pulmonary complications during thoracolumbar removal of hardware cases so that they may fully counsel their patients on the potential risks.
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The American Society of Anaesthesiologists' Physical Status Score (ASA) is a key variable in predictor models of surgical outcome and "appropriate use criteria". However, at the time when such tools are being used in decision-making, the ASA rating is typically unknown. We evaluated whether the ASA class could be predicted statistically from Charlson Comorbidy Index (CCI) scores and simple demographic variables. ⋯ It was possible to predict ASA from CCI. In a simple model, CCI ≥ 1 best distinguished between ASA ≥ 3 and < 3. For a more precise prediction, regression algorithms were created based on CCI and simple demographic variables obtainable from patient interview. The availability of such algorithms may widen the utility of decision aids that rely on the ASA, where the latter is not readily available.
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Dislocation is one of the remaining challenges after total hip arthroplasty. The spinopelvic mobility is considered to be the key to solve this problem and is of interest both to arthroplasty and spine surgeons. The purpose of this letter is to discuss the spinopelvic mobility and spinal stiffness described in the paper titled "Impact of spinal alignment and stiffness on impingement after total hip arthroplasty: a radiographic study of pre‑ and post‑operative spinopelvic alignment." by Hagiwara S, et al. METHODS: Examining the consistency between this paper and previously published papers on spinopelvic mobility. ⋯ The conclusions and titles are overstated from the results, but this paper is highly valuable in reminding spinal surgeons of the importance of spinopelvic alignment and mobility in THA.