The spine journal : official journal of the North American Spine Society
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Case Reports
Aseptic meningitis after microdiscectomy: description of a case and review of the literature.
Aseptic meningitis has rarely been described after spinal surgery. No reports of aseptic meningitis exist after microdiscectomy in the literature. ⋯ Presentation of aseptic meningitis after microdiscectomy is a rare but important diagnosis to consider. Examination of CSF is an important procedure to rule out the more dangerous diagnosis of bacterial meningitis.
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Spinal instrumentation is accompanied by various problems, including screw malpositioning. One way of preventing this is the employment of intraoperative biplanar fluoroscopy. However, screw malpositioning despite the use of fluoroscopy has been reported, and exposure to radiation is another burden of this method. Therefore, the purpose of this article was to compare the results of instrumentation applications without using scopy versus the harmful effects of radiation exposed during spinal instrumentation. ⋯ Screw application without fluoroscopy is performed with calculation of all essential anatomic details, and because of the reduction of surgery time, the absence of exposure to radiation, and very low infection rates as a consequence of reduced surgery time, it is a method recommendable for surgeons experienced with screw placement. Besides, its malpositioning rates are within acceptable limits. Because screw malpositioning is also found after biplanar fluoroscopy, the prevention of screw malpositioning requires knowing the anatomic landmarks accurately.
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Case Reports
Pseudoaneurysm of the thoracoabdominal aorta caused by a severe migration of an anterior spinal device.
Case report. ⋯ The pseudoaneurysm of the aorta can occur secondary to a migrated anterior spinal fixation device and can be successfully treated by revision anterior surgery with vascular repair and implant removal.
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Compared with the cervical spine, little attention has been paid to rheumatoid arthritis (RA)-related lumbar disorders. Only a few articles have described the status of the lumbar spine affected by RA based on plain X-ray films and magnetic resonance imaging (MRI). ⋯ Of 104 patients, 47 (45.2%) exhibited abnormalities on X-ray films and MRI. There were two types of disorders, disc narrowing and disc ballooning. Both the Lansbury index and Ochi's classification reflected the severity of lumbar lesions in RA patients.
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Magnetic stimulation (MS), which is used to evaluate motor pathways, is helpful in evaluating cervical spinal cord compression (cervical myelopathy [CM]). Previous studies have shown that the central motor conduction time (CMCT), which is the time taken for the nerve impulses to reach the cervical spinal roots after the stimulation of the motor cortex, is prolonged in CM. However, the duration of motor-evoked potentials (MEPs) in CM has not been studied in detail. ⋯ This study shows that in addition to the CMCT, the duration of MEPs is also useful in evaluating patients with CM using MS.