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
-
Cervical total disc arthroplasty (TDA) is a motion-preserving alternative to anterior cervical discectomy and fusion that has gained popularity among spine surgeons. Although generally effective, TDA has been associated with rare cases of progressive osteolysis, a complication whose natural history and impact on clinical outcomes are not well understood. This case report aims to present a case of progressive osteolysis following cervical TDA with the SpinalKinetics® M6-C Artificial Cervical Disc and to discuss the clinical approach and implications for patient management. ⋯ This case highlights the potential for progressive osteolysis as a complication following cervical TDA, emphasizing the importance of ongoing surveillance and increased awareness among spine surgeons. Early identification and monitoring of osteolysis may mitigate the risk of severe outcomes and guide timely intervention.
-
To reduce the amount of radiation that patients receive during surgery, surgeons can evaluate the quality of the bone prior to surgery using computed tomography (CT) or dual-energy X-ray absorptiometry. Recently, lumbar spine vertebral bone quality has been evaluated using an MRI-based scoring system. However, few studies have investigated the connection between cage subsidence in patients following cervical interbody fusion and site-specific MRI bone evaluation. It is unknown how cage subsidence following anterior cervical corpectomy decompression and fusion is related to MRI-based endplate bone quality assessment. ⋯ After ACCF, cage subsidence was strongly correlated with higher C-EBQ scores on preoperative MRI. Assessing C-EBQ before ACCF may be a useful way to estimate the likelihood of postoperative subsidence.
-
To evaluate effects of spinal and rib osteotomies on the resulting spinal flexibility for surgical correction of thoracic scoliosis and to explore effects of posterior fixation on thoracolumbar segmental range of motion and lumbar intervertebral disc loading. ⋯ Low effects of Schwab grade 1 and 2 osteotomies question the impact of isolated posterior spinal releases for surgical correction maneuvers in adolescent idiopathic scoliosis, in contrast to additional concave rib osteotomies. High effects of posterior fixation potentially explain frequently reported complications such as adjacent segment disease or proximal junctional kyphosis.
-
To present two cases of life-threatening hemorrhage related to lumbar artery injury in adult spinal deformity (ASD) patients following S2‑alar‑iliac (S2AI) fixation and asymmetrical pedicle subtraction osteotomy (PSO), and discuss the possible reasons for postoperative hemorrhage in these patients. ⋯ For patients with severe kyphoscoliosis, asymmetrical PSO increases the risk of lumbar artery injury on the convex side, and postoperative ST may further contribute to this risk. In cases where a sudden increase in drainage is observed postoperatively, it is crucial to consider the possibility of lumbar artery injury, particularly on the convex side of the osteotomized vertebra.
-
We aimed to validate and cross-culturally adapt the Core Outcome Measures Index (COMI) neck for use in Portuguese patients with cervical spine degenerative disease and define the minimal clinically important change score (MCIC) for this questionnaire and population. ⋯ The COMI (neck) psychometric qualities were confirmed, such that it can be considered a valid and reliable questionnaire to be applied in the European Portuguese population with surgical cervical spine degenerative disease, with an MCIC of 2 points.