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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Review Case Reports
Intercostal lung herniation; a rare complication after mini-transthoracic approach (TTA) for thoracic disc herniation. Two case reports and review of literature.
Lung herniation is a rare condition, most often due to thoracic injury, but has also been described as a complication following cardiothoracic surgery. Here, we report two cases of post-surgical lung herniation following a neurosurgical mini-transthoracic (mini-TTA) for treatment of thoracic herniated discs. With this report we aim to make surgeons aware of this rare complication, review existing literature on surgical repairs and describe our novel correction technique using video assisted thoracic surgery (VATS) and a combination of mesh covering the muscle defect internally and nitinol rib plates for rib approximation on the outside of the thoracic cavity. ⋯ These cases should make surgeons aware of the possibility of post-surgical development of lung herniation and describe successful correction using a combination of mesh material and NiTi-Rib H-plates through a VATS technique.
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Surgical site infection (SSI) is a serious complication after spine surgery. Recently, it has become possible to perform negative pressure wound therapy with instillation and dwell time (NPWTi-d) for postoperative infected wounds. We report the first rare case of symptomatic pneumoencephalopathy following NPWTi-d for methicillin-resistant Staphylococcus aureus (MRSA) infection after spinal deformity surgery. ⋯ Although NPWTi-d is a useful treatment for SSI, it is always necessary to pay attention to the development of pneumoencephalopathy and promptly diagnose and treat it because of the risk of life-threatening complications.
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To describe the process and outcome of vertebral column resection (VCR) at the subapical vertebra for correction of angular kyphosis associated with neurofibromatosis type 1(NF1). ⋯ The novel strategy of performing VCR at the subapical vertebra, with posterior displacement of the distal end, and remodeling of the spinal canal is potentially a safe and efficacious option to correct sharp angular kyphosis.
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This study aimed to investigate how preoperative motion analysis results affect the postoperative clinical outcomes of patients undergoing surgery for adult spinal deformity (ASD). ⋯ The study highlights that a high preoperative Ant-PT angle in motion analyses is associated with poor clinical outcomes after surgery for ASD. Therefore, it is necessary to observe and consider the dynamic gait pattern related to the compensatory mechanism for sagittal imbalance in the decision-making process for ASD surgery.
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The aim of this study is to identify risk factors associated with postoperative DJF in long constructs for ASD. ⋯ Recently, DJF has received recognition as its own entity due to a notable postoperative incidence. Few studies to date have evaluated risk factors for DJF. The results of our study highlight that pedicle subtraction osteotomy, poor correction of lumbar lordosis, and sagittal vertical axis are significantly associated with postoperative occurrence of DJF.