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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Observational Study
Functional neurological outcome of spinal cavernous malformation surgery.
Spinal cavernous malformations (SCM) present a risk for intramedullary hemorrhage (IMH), which can cause severe neurologic deficits. Patient selection and time of surgery have not been clearly defined. ⋯ Removal of symptomatic SCM should be performed within 3 months after IMH when gross total resection is feasible. Patients with ventrally located lesions might be at increased risk for postoperative deficits.
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To compare paraspinal muscle quality between patients with single and multiple osteoporotic vertebral fractures (OVFs) and evaluate the role of the paraspinal muscles in OVFs. ⋯ The pure muscle volumes of the multifidus, psoas major, and quadratus lumborum were lower in patients with multiple OVFs than in those with a single OVF. Furthermore, the inter-correlation among all the paraspinal muscles indicate that the muscle-bone crosstalk profoundly existed in vertebral fracture cascade. Therefore, special attention to paraspinal muscle quality is needed to prevent progression to multiple OVFs.
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Within advances in minimally invasive spine surgery, the implementation of lateral single position (LSP) increases efficiency while limiting complications, avoiding intraoperative repositioning and diminishing surgical time. Most literature describes one-level instrumentation of the lumbar spine; this study includes the use of LSP for multilevel degenerative disease. ⋯ Procedural time and blood loss were similar to those reported in literature. No severe lesions, postoperative infections or reinterventions took place. Although it was a small number of patients and further clinical trials are needed, LSP for multiple levels is apparently safe with adequate outcomes which may improve efficiency in the operating room.
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This paper sets out to analyse mobility changes in segments adjacent to the operated segment. Additionally, it investigates the relationship between the degree of fusion in the operated disc space and mobility changes in the adjacent segments. ⋯ The mobility of the adjacent segment below the implant insertion site was significantly increased at 12 months post-ACDF surgery. The range of this compensatory hypermobility was significantly greater in patients with complete fusion at the ACDF site than in cases of pseudoarthrosis. Implant subsidence was not associated with mobility changes in the segments directly above or directly below the site of ACDF surgery.
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To develop ligamentous vertebral stabilization techniques ("vertebropexy") that can be used after microsurgical decompression (intact posterior structures) and midline decompression (removed posterior structures) and to elaborate their biomechanical characteristics. ⋯ Vertebropexy is a new concept of semi-rigid spinal stabilization based on ligamentous reinforcement of the spinal segment. It is able to reduce motion, especially in flexion-extension. Studies are needed to evaluate its clinical application.