The spine journal : official journal of the North American Spine Society
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Review Case Reports
Giant cell tumor of fifth lumbar vertebrae: two case reports and review of the literature.
complete or total en bloc spondylectomy has been recommended for giant cell tumors of the spine. Wide local resection of the fifth lumbar vertebra carries potential risks of major complications because of its anatomical features. Only nine cases of the giant cell tumors involving the fifth lumbar vertebra have been reported in the literature. ⋯ There was no recurrence of the tumor after the combined single-stage anterior and posterior tumor resection and adjuvant radiotherapy for the second case for over 7 years follow-up. However, complete resection of the vertebra and tumor at the fifth lumbar vertebra is still challenging to accomplish.
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Review Case Reports
Minimally invasive far lateral microendoscopic discectomy for extraforaminal disc herniation at the lumbosacral junction: cadaveric dissection and technical case report.
Extraforaminal lumbar disc herniations (ELDHs) at the lumbosacral junction are an uncommon cause of L5 radiculopathy. The surgical anatomy of the extraforaminal space at L5-S1 is uniquely challenging for the various open surgical approaches that have been described for ELDHs in general. Reports specifically describing minimally invasive surgical approaches to lumbosacral ELDHs are lacking. ⋯ FLMED offers a safe and efficacious approach to ELDHs at the lumbosacral junction by combining satisfactory visualization for adequate resection of the sacral ala with the benefits of reduced tissue injury and faster recovery times that accompany minimally invasive techniques.
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The currently accepted surgical treatments for compressive cervical myelopathy include both anterior and posterior decompression. Anterior approaches including multilevel discectomy with fusion or vertebral corpectomy with strut grafting, both with and without instrumentation, have enjoyed successful outcomes, but have been associated with select postoperative complications. Laminoplasty has been developed to decompress the spine posteriorly while avoiding the spinal destabilization seen after laminectomy. ⋯ Cervical laminoplasty remains a reliable procedure for posterior decompression of the spine, but the optimal approach to cervical myelopathy must take into account both patient and disease characteristics, as well as the capabilities and experience of the surgeon.
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Review Case Reports
Ossified posterior longitudinal ligament: management strategies and outcomes.
This study was designed to determine the management strategies and outcomes of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. ⋯ One- or two-level OPLL can be resected by an anterior approach with partial corpectomy, whereas expansive laminoplasty is indicated for multilevel compressive myelopathy due to OPLL. EOPLL and HPLL should be carefully examined with radiological workups because they are a prestage form of OPLL.
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Cervical myelopathy is a group of closely related disorders usually caused by spondylosis or by ossification of the posterior longitudinal ligament and is characterized by compression of the cervical spinal cord or nerve roots by varying degrees and number of levels. The decrease in diameter of the vertebral canal secondary to disc degeneration and osteophytic spurs compresses the spinal cord and nerve roots at one or several levels, producing direct damage and often secondary ischemic changes. ⋯ This review summarizes some of the significant pathophysiological processes involved in cervical myelopathy.