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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Case Reports
Neurogenic intermittent claudication caused by vasculitis in the cauda equina: an autopsy case report.
Intermittent claudication (IC) refers to leg pain that is induced by walking and relieved by rest. Neurogenic IC is usually associated with lumbar canal stenosis (LCS). We present rare findings from an autopsied patient who had neurogenic IC caused by vasculitis in the cauda equina. ⋯ MPA is a rare cause of neurogenic IC when the symptom is acute and multimodal. Small-vessel vasculitis affecting the cauda equina may underlie MPA-associated IC.
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S1 alar iliac (S1AI) trajectory has gained popularity as a salvage technique for revision surgeries and failed constructs in the lumbopelvic region. This study aims to investigate the morphometry of this new trajectory based on 3D models. The possible role of gender, ethnicity and view angle (surgeon's vs. radiologist's) was investigated. ⋯ Preoperative 3D modeling would be an invaluable adjunct to increase the accuracy of S1AI screw placement. Surgeon's perspective of the trajectory differs from standard CT sections and should be considered in preoperative planning.
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Posterior spinal fusion (PSF) at skeletal maturity is still the gold standard in children with neuromuscular scoliosis (NMS) who underwent fusionless surgery. The aim of this computed tomography (CT) study was to quantify the spontaneous bone fusion at the end of a lengthening program by minimally invasive fusionless bipolar fixation (MIFBF), that could avoid PSF. ⋯ This first computed quantitative study showed MIFBF in NMS preserved spinal growth, while it induced 93% of facet joints fusion. This could be is an additional argument when questionning the real need for PSF at skeletal maturity.
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Allogeneic blood transfusion (ABT) is current standard of blood replenishment despite known complications. Salvaged blood transfusion (SBT) addresses majority of such complications. Surgeons remain reluctant to employ SBT in metastatic spine tumour surgery (MSTS), despite ample laboratory evidence. This prompted us to conduct a prospective clinical study to ascertain safety of intraoperative cell salvage (IOCS), in MSTS. ⋯ Patients of SBT had OS and tumour progression better than ABT/NBT groups. This is the first prospective study to report of SBT in comparison with control groups in MSTS.
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The objective was to analyze the role of the thoracolumbar sagittal flexibility on the outcome after posterior spinal fusion of Lenke 1 and 2 adolescent idiopathic scoliosis with last touched vertebra as the lowest instrumented vertebra. ⋯ The flexibility of the thoracolumbar junction is a determining factor in the surgical outcome after posterior spinal fusion for AIS and should be considered in correlation with the frontal and sagittal alignment of the spine.