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
-
The management of implant-associated surgical site infections (SSI) in patients with posterior instrumentation is challenging. Evidence regarding the most appropriate treatment and the need for removal of implants is equivocal. We sought to evaluate the management and outcome of such patients at our institution. ⋯ Patients with SSI after posterior (thoraco-)lumbo(-sacral) instrumentation can be successfully treated in most cases with surgical and specific antibiotic treatment. An interdisciplinary approach is recommended. Loose implants should be replaced. In some cases, multiple revisions may be necessary. Patient outcomes were satisfactory.
-
Degenerative cervical myelopathy (DCM) is the most common non-traumatic cause of spinal cord dysfunction. Prediction of the neurological outcome after surgery is important. The aim of this study was to analyze the relationship between first symptoms of DCM and the neurological outcome after surgery. ⋯ Motor deficits and gait disturbances as the first symptom of DCM are negative predictors for postoperative neurological outcome. Nevertheless, patients with motor deficits and gait disturbance significantly profit from the surgical treatment despite poor preoperative mJOA Score.
-
To evaluate the validity of the Roussouly classification system for assessing distal junctional problems (DJP) after long instrumented spinal fusion in degenerative scoliosis. ⋯ If the postoperative sagittal profile can be restored to match the patient's own PI value, use of the Roussouly classification can greatly reduce the possibility of postoperative DJP.
-
To investigate the normal values of the sagittal spinal parameters and analyze the distribution of the global spinal profiles in a Chinese population with age over 75. ⋯ The normal values of the sagittal parameters were presented in the elderly Chinese asymptomatic population (≥ 75 years). Ethnic, age, and sex displayed significant effects on the behaviors of the sagittal spinal balance and profiles. These results could be served as physiological references for the planning of surgical strategies in elderly Chinese patients over 75 years.