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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Paralysis subsequent to spinal cord decompression in the cervical or thoracic region is infrequent, with White Cord Syndrome (WCS) being among its several causes. Due to WCS's infrequency, there exists a paucity of high-level evidence concerning its manifestations. Our primary objective is to systematically collate all documented WCS cases, discern prevalent risk and prognostic factors, appraise available treatment modalities, and evaluate patient outcomes. ⋯ WCS is a rare cause of postoperative neurological deficit following spinal cord decompression surgery. Risk factors for WCS include advanced age, extensive surgery, posterior approach for decompression, and the presence of OPLL. Treatment includes high-dose steroids, posterior cervical decompression, maintaining MAP over 85mmHg, rehabilitation, and sometimes neurotrophic drugs. Most patients can walk with or without assistance during follow-up, but around a quarter never regain neurological function. The only preoperative factor impacting outcomes is the preoperative neurological status (Nurick Grade).
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Randomized Controlled Trial
Efficacy and safety of multidrug cocktail injections in postoperative pain management for lumbar microendoscopic decompression surgery: a prospective randomized controlled trial.
This study aimed to evaluate the analgesic effects and safety of multidrug cocktail injections for postoperative pain management in patients undergoing lumbar microendoscopic decompression surgery. ⋯ Multidrug cocktail injections are effective and safe for postoperative pain management in lumbar microendoscopic decompression surgery, significantly reducing pain, analgesic use, CRP levels, and hospital stay. These findings suggest that incorporating multidrug cocktail injections into postoperative care protocols can enhance patient recovery and outcomes.
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Comparative Study
Open vs tubular rate of re-operation for incidental durotomies after lumbar microdiscectomies: a propensity matched analysis.
Incidental durotomy (ID) is a common complication in spine surgery and can lead to increase in length of stay, decreased satisfaction with surgery and pseudomeningocele formation. Here, we describe a retrospective study comparing ID occurrences and repairs between patients receiving traditional open versus tubular minimally invasive spine (MIS) microdiscectomy. ⋯ Pseudomeningocele formation after ID is rare. The rates of ID were similar between cohorts. We found no significant difference between re-operation rate for pseudomeningocele between the two cohorts. Larger, cohort-matched, prospective studies are needed to determine the true difference between rates of re-operation for pseudomeningocele formation after lumbar microdiscectomies.