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
-
Lumbar disc herniation (LDH) with radiculopathy is associated with greater pain, disability, healthcare use, and costs compared with nonspecific low back pain. Reliable information about its incidence and risk factors were lacking. ⋯ Incidence of LDH varies in different populations and according to case definition. Risk factors include individual, behavioural, and work-related variables. Our findings support the need to develop standardised case definitions that validly classify the clinical spectrum of LDH and for future low risk of bias studies examining causal relationships for LDH with radiculopathy in adults.
-
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).
-
Review Case Reports
Expanded application of unilateral biportal endoscopy in adult thoracic disease: report of three cases and literature review.
Traditional surgery for degenerative thoracic disorder can be extremely invasive and accompanied by complications. Unilateral biportal endoscopy (UBE), a newly developed technique in the field of spin surgery, is minimally invasive and its popularity and indications have been increasing. In this study, we report three cases of different thoracic diseases treated using UBE. ⋯ Although UBE surgery is limited in completely replacing traditional treatments for degenerative thoracic disease, it offers the advantages of rapid rehabilitation and short-term hospitalization and can be a good surgical treatment option.