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
-
Review Case Reports
A comprehensive review of adult onset spinal teratomas: analysis of factors related to outcomes and recurrences.
Spinal teratomas are rare tumours noted in adults and are commonly located in the thoracolumbar region. Currently, there appears to be a lack of clear consensus regarding the management and prognosis of these lesions. A comprehensive review along with an illustrative case managed at the author's institute has been presented. ⋯ Total surgical resection is the standard treatment and appears to be beneficial both in terms of outcomes and recurrences. Overall, recurrences are rare and may be managed by re-surgery. In addition, the present report is the eighth case of adult spinal teratoma with an acute onset presentation. These slides can be retrieved under Electronic Supplementary Material.
-
Opposed to proximal junctional kyphosis and proximal junctional failure, their distal equivalents, distal junctional kyphosis and failure (DJK/DJF) have received less attention in the literature. The aim of this article is to provide an overview of the problem of DJK-DJF in different clinical scenarios such as adolescent idiopathic scoliosis (AIS), Scheuermann's kyphosis (SK) and adult deformity surgery and to suggest a strategy for prevention and treatment. ⋯ The proposed strategy of treatment includes restoration of normal sagittal alignment, choice of a distal fixation point stable in the sagittal, coronal and transverse planes, balancing the fusion mass over the distal fixation point and providing solid fixation at the distal end of the construct. These slides can be retrieved under Electronic Supplementary Material.
-
As adult spinal deformity surgery is performed more and more, the spine surgeon is faced with the challenge to treat pseudoarthrosis. The presentation may vary, from asymptomatic patients, who should be observed in most of the cases, to patients with acute episode of broken rods, and or chronic pain with often trunk imbalance. In some instances, patients will present with neurologic symptoms. ⋯ Despite the extent of these surgeries and the potential for immediate postoperative complications, the outcome is in most cases satisfactory if these goals are achieved. In this review, the authors explore different scenarios for pseudoarthrosis in the adult spine deformity patient and the preferred treatment method to obtain the best outcome for every individual patient. These slides can be retrieved under Electronic Supplementary Material.
-
To compare surgical outcomes between seven different approaches for thoracolumbar corpectomy/spondylectomy in the setting of spinal metastasis. ⋯ Less invasive approaches (mini-open retropleural/retroperitoneal and thoracoscopic) not only had superior outcome in terms of blood loss and operating time, but also were shown to be safe techniques in cancer patients with low rates of procedure-related complications. These slides can be retrieved under Electronic Supplementary Material.
-
Revision surgery in spine tumor surgery can offer peculiar challenges given the severity of the majority of these lesions and the complexity of surgical procedures that are required. ⋯ The aim of this study is to evaluate the most frequent complications that can lead to revision in spine tumor patients, to provide suggestions on how to prevent these events and to offer reasonable strategies to properly plan and perform a revision surgery. These slides can be retrieved under Electronic Supplementary Material.