Journal of Spine Surgery (Hong Kong)

Spinal extradural angiolipomas (SEALs) are extremely extraordinary benign extradural lesions. They are infrequently encountered in normal clinical practice although several authors have report single cases or case series. We present two cases of SEAL which we successfully surgical resected with no further neurological deficits. Our cases comprise of a male and a female with ages ranging from 30 to 60 years. Their principal presenting complains were numbness and pain at the lower extremity with associated fecal and urinary incontinence...

The treatment of highly migrated lumbar disc herniation (LDH) is a challenge for percutaneous endoscopic lumbar discectomy (PELD). The purpose of this study was to determine the feasibility and efficacy of PELD for highly migrated LDH via the adjacent interlaminar space. We performed PELD via the adjacent interlaminar space in three patients with radiculopathy caused by highly migrated LDH using a full-endoscopic system (diameter of working channel: 4.1 mm, outer diameter: 6.9 mm). One case had a large interlaminar bone window that did not require enlargement...

Degenerative disc disease (DDD) is highly prevalent. If conservative treatment fails, spinal fusion procedures are commonly performed. Total disc replacement (TDR) might be a surgical option for a distinct subset of patients with DDD. Several prostheses have been or are still available. Despite some promising initial clinical results, there is still limited experience with hardware-related adverse events. This report highlights an unreported complication after TDR with a viscoelastic device. Literature about long-term outcome and safety of this particular TDR is scarce...

In this case series, we describe an infection treatment protocol involving permanent implantation of antibiotic cement that is effective in eradicating deep infection. Surgical site infection (SSI) is a devastating complication of spine surgery. Unlike the gold-standard two-stage revision in North American hip and knee arthroplasty, there exists no standardized, accepted protocol for the management of deep SSI with instrumentation. Because removal of hardware in an unstable, instrumented spine can result in serious neurologic sequelae, retention of instrumentation with elimination of bacterial colonization on implants is the goal...

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No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

This study aimed to describe the perceptions of decision-makers in major orthopedic centers regarding the value, implementation and use of spine surgery registries. A 33-item survey was sent to CEOs and heads of spine surgery of the International Society of Orthopedic Centers (ISOC). ISOC includes 21 hospitals worldwide with a special focus on high-quality musculoskeletal care. Twelve out of 20 member centers (60%) replied to the survey. Seven have working registries; 5 in Europe and 2 in North America. The estimations for the cost/year were distributed more evenly: $10,000 [2], $20,000 [1], $50,000 [1]...

Decompression of lumbar spinal stenosis is the most common spinal surgery in those over 60 years of age. While this procedure has shown immediate and durable benefits, improvements in outcome have not changed significantly. Technical aspects of surgical decompression have evolved significantly. The recently introduced ultrasonic bone cutter allows a precise and safe peri-neural bone resection. The principles of preservation of stability, as described by Getty et al. have remained as relevant as when these were described 40 years ago...

The spinal arachnoid web is an abnormal formation of an arachnoid membrane in the subarachnoid space. It is a rare entity with some degree of uncertainty surrounding its etiology. It can result in a displacement of the spinal cord causing pain and neurological symptoms as well as blockage of cerebrospinal fluid (CSF) flow and subsequent syringomyelia. The syrinx resulting from the altered CSF flow dynamics has been described to assume variable positions relative to the web itself. The "scalpel sign" is regarded as a pathognomonic feature of a spinal arachnoid web...

Spaceflight alters normal physiology of cells and tissues observed on Earth. The effects of spaceflight on the musculoskeletal system have been thoroughly studied, however, the effects on cartilage have not. This area is gaining more relevance as long duration missions, such as Mars, are planned. The impact on intervertebral discs and articular cartilage are of particular interest to astronauts and their physicians. This review surveys the literature and reports on the current body of knowledge regarding the effects of spaceflight on cartilage, and specifically changes to the spine and intervertebral disc integrity and physiology...

Spine pathology afflicts people across the globe and is responsible for a large portion of physician visits and healthcare costs. Imaging such as plain radiographs, CT, MRI, and ultrasound is vital to assess structure, function, and stability of the spine and also provide guidance in therapeutic interventions. Ultrasound utilization in spine conditions is less ubiquitous, but provides benefits in low costs, portability, and dynamic imaging. This study assesses ultrasound efficacy in diagnosis and therapeutic interventions for spine pathology...

Background: There have been many studies that reported various treatment options about recurrent disc herniation, recurrent sciatica, and low back pain following discectomy. However, evaluation and treatment algorithm of post-discectomy pain syndrome (PDPS) could not be standardized. The purpose of this study was to report the results of patients with PDPS who were treated with various treatment options with a minimum 2-year follow-up. Methods: We retrospectively evaluated 54 of 75 patients with PDPS who had no response to 12 weeks of conservative treatment between 2009 and 2014...

Background: Various surgical options for lumbar interbody fusion have been reported. Minimally invasive techniques are widely used to reduce soft tissue damage. Here, we report our novel technique of microendoscope-assisted posterior lumbar interbody fusion (ME-PLIF) using an 18-mm tubular retractor system (METRx, Medtronic Sofamor Danek, Memphis, TN, USA) for lumbar spine degeneration treatment. Methods: Between January 2011 and December 2011, 48 patients underwent one level ME-PLIF by a surgeon in our hospital...

Background: The K-line, which is a virtual line between the midpoints of the antero-posterior canal diameter at C2 and C7, can be useful for determination of surgical procedures for cervical ossification of the posterior longitudinal ligament (OPLL). Although K-line is originally measured with plain radiogram, computed tomography multiplanar reconstruction (CT-MPR) is applied for K-line measurement by several surgeons. The purpose of the present study was to analyze whether there is a difference in K-lines obtained from radiographs of standing patients and those obtained from CT-MPR images of supine patients...

Background: This is a retrospective study on 18 patients affected by thoraco-lumbar junction burst fractures (TLJBF) A3 or A4 at computed tomography (CT) scan who referred to our hospital. To assess the surgical results in terms of pain and quality of life in a series of neurologically intact patients affected by TLJBF who underwent surgery after 3-4 months from the injury. In literature there is controversy if pain could be an indication for surgery in TLJBF and series of patients conservatively managed with success have been reported...

Background: We carried out an observational longitudinal retrospective study between 2000 and 2009 in 28 patients who underwent surgery for unstable vertebral fractures with neurologic deficits. Methods: For the statistical analysis, we used the Chi2 -test to compare proportions in independent groups and the exact Fisher test and the Wilcoxon test for repeated measures, and we compared the mean values using the Mann-Whitney U test at a significance level of P<0...

Background: Tuffier's line (TL) is an anatomical landmark used to identify the L4/5 interspace by palpating inter-cristal level in lumbar spinal surgery. The routine use of pre-operative pre-incision radiographs for level check by spinal surgeons is variable due to reliance on this palpation. The anatomical violation of neighbouring normal levels in microscope assisted lumbar surgery is unknown. The aim of this study was to evaluate the effects of patient-related demographic factors and radiographic parameters on TL in a cohort of patients undergoing lumbar spinal procedures...

Background: Burst fractures of the lumbar vertebrae and laminar fractures associated with dural tears and entrapment of neural elements have been reported in the past as a relatively rare occurrence. To the best of our knowledge, there is no consensus on the approach to repairing these types of fractures. The objective of this study is to describe a method of repair for traumatic burst fractures of the lumbar spine and vertical laminar fractures associated with entrapped neural elements...