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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Hereditary Multiple Osteochondromas (HMO), previously known as Multiple Hereditary Exostoses (MHE), is a genetic disorder characterized by the formation of multiple, benign, exostoses (osteochondromas) growing from the metaphyseal region of long bones as well as from the axial skeleton. Lesions originating from the lumbar spine region are rare, and are most common growing from the posterior element of the vertebrae. HMO associated osteochondromas are difficult to treat due to continuous and incontrollable growth of these lesions and a lifetime risk for malignant transformation. ⋯ We describe a 360-degree surgical resection with application of a 3D printed model, navigation, and mini-invasive techniques. Our report may be useful and inspire spine surgeons to apply similar techniques to treat complex spine lesions.
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Spinal epidural arachnoid cysts (SEACs) are rare, non-neoplastic pathologies that can cause compressive myelopathy. Preoperative identification of the exact fistula location is crucial for minimally invasive management. ⋯ The "double-needle puncture myelography" technique allows for the swift acquisition of precise anteroposterior and lateral projection dynamic X-ray images during the procedure. As a valuable preoperative diagnostic tool, it accurately pinpoints the location of the fistula, thereby minimizing surgical trauma and preserving spinal stability.
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Adjacent vertebral fracture (AVF) is a frequent complication following percutaneous vertebral augmentation (PVA). While radiomics is widely utilized in the field of spinal medicine, its application for assessing the risk of AVF in post-PVA patients remains limited. ⋯ Radiomics and machine learning modeling using postoperative CT images demonstrate noteworthy capability in assessing the risk of AVF following PVA.
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The letter responds to a study on the role of erector spinae muscle quality in surgical decision-making for lumbar spondylolisthesis. It highlights the potential of paraspinal muscle fatty infiltration as a predictive factor, suggesting that early rehabilitation targeting these muscles may reduce the need for surgery. The authors propose improvements for future research, such as using advanced MRI techniques for better fat infiltration assessment, controlling patient activity levels, and incorporating multidimensional imaging analyses with machine learning. These advancements could support more personalized treatment strategies for lumbar spondylolisthesis.
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Spinal tuberculosis (STB) and Brucella spondylitis (BS) represent two types of granulomatous infections affecting the spine, which exhibit significant similarities that often result in misdiagnosis and overlooked diagnoses during preoperative evaluations. This study aims to identify non-invasive evaluative indicators that facilitate the differentiation between STB and BS. ⋯ Statistically significant differences were observed between STB and BS regarding root symptoms and necrosis formation. In cases where the patient is male, presents with a decreased A/G ratio, does not have thoracic vertebra involvement, number of vertebral body destructions < 2.5, and exhibits straightening of spinal curvature, the likelihood of diagnosing BS is significantly greater than that of STB.