Spine

STUDY DESIGN: Retrospective multicenter cohort study. OBJECTIVE: Recurrent lumbar disc herniation (ReLDH) is a common condition requiring surgical intervention in a large proportion of cases. Evidence regarding the appropriate choice between repeat microdiscectomy (RD) and instrumented surgery (IS) is lacking. To understand the indications for either of the procedures and compare the results, we aimed to provide an overview of spine surgeon practice in France. METHODS: This retrospective, multicenter analysis included adults who underwent surgery for ReLDHs between December 2020 and May 2021...

Intervertebral disc degeneration is characterized by deterioration in structural support that is potentially followed by stimulated neuronal ingrowth, and dysfunction of cellular physiology in the disc. Discogenic low back pain originates from nociceptors within the intervertebral disc or the cartilage endplate. This narrative review examines the mechanisms of disc degeneration, the association between degeneration and pain, and the current diagnosis and treatment of discogenic low back pain. Mechanisms of disc degeneration include dysregulated homeostasis of the extracellular matrix of the disc, altered spine mechanics, DNA damage, oxidative stress, perturbed cell signaling pathways, and cellular senescence...

INTRODUCTION: Current treatment of spinal metastases (SM) aims on preserving spinal stability, neurological status, and functional status as well as achieving local control. It consists of spinal surgery followed by radiotherapy and/or systemic treatment. Adjuvant therapy usually starts with a delay of a few weeks to prevent wound healing issues. Intraoperative radiotherapy (IORT) has previously been successfully applied during brain tumor, breast and colorectal carcinoma surgery but not in SM, including unstable one, to date...

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BACKGROUND: The least significant change (LSC) threshold of 0.03 g/cm² is used to interpret bone mineral density (BMD) scans in the general population. Our working hypothesis was that the current LSC threshold would not be applicable in obese populations. AIMS: The aim of this study was to calculate the LSC in an obese population. METHODS: We performed an interventional study among 120 obesity patients, in whom two measurements of BMD were performed at 3 sites...

PURPOSE: The aim of the study was to determine the effect of trauma etiology on the management, functional outcomes and psychiatric characteristics of suicide jumpers and patients who accidentally fall from height. METHODS: 89 patients (48 accidental falls and 41 suicidal jumpers) who had undergone spinal surgery were included in the study. The patients were evaluated clinically and radiologically. Visual Analog Scale (VAS), Roland Morris Disability Questionnaire (RMDQ) and McGill Pain Questionnaire (MPQ) were performed for functional evaluation...

Traumatic heterotopic ossification (HO) of the lower extremity is relatively rare but is of major importance in clinical practice. They are defined as posttraumatic abnormal formations of bone within soft tissue outside of the skeletal system. This article describes the clinical case of a 31-year-old male patient who suffered 2 traumatic events within 12 months-a gunshot wound in the lumbar spine/gluteal region followed by a severe traumatic brain injury with intracranial hemorrhage in a traffic accident as a pedestrian...

Although the measurements of the lumbar spine and pelvic flexion have shown that subjects with radiculopathy exhibited greater decreases of motion when compared with subjects with low back pain, there is still a lack of evidence regarding the changes in flexion relaxation ratio in patients with radiculopathy. The aims of this study were to investigate the flexion relaxation ratio and flexion of the lumbar spine and pelvis in subjects with low back pain (LBP) and LBP with radiculopathy (LBPR) in comparison with healthy subjects (CG-control group)...

Teachers usually present work-related pain such as neck pain. Their posture could be the cause of these problems; indeed, it is often a sway-back posture. Furthermore, teachers can also experience problems with their voice such as dysphonia, specifically muscle tension dysphonia (MTD). This scoping review aims to find the correlation between teachers' posture and MTD. It also studies how a posture-based treatment can influence this disorder. Randomized controlled trials, controlled clinical trials, prospective cohort studies, and cross-sectional studies that considered the relationship between posture and MTD and that included teachers in their sample...

BACKGROUND: We aimed to establish a novel model using a radiomics analysis of magnetic resonance (MR) images for predicting osteoporosis. PURPOSE: To investigate the effectiveness of a radiomics approach utilizing magnetic resonance imaging (MRI) of the lumbar spine in identifying osteoporosis. MATERIAL AND METHODS: In this retrospective study, a total of 291 patients who underwent MRI were analyzed. Radiomics features were extracted from the MRI scans of all 1455 lumbar vertebrae, and build the radiomics model based on T2-weighted (T2W), T1-weighted (T1W), and T2W + T1W imaging...

INTRODUCTION: Recently, an entity known as salivary duct carcinoma with rhabdoid features (SDC-RF) has been associated with somatic CDH1 mutations. Here we present the first known case report of conventional SDC occurring in the setting of a germline CDH1 pathogenic variant accompanied by a somatic loss of heterozygosity at the CDH1 locus. CASE DISCUSSION: A 67-year-old man presented with chest and back pain and was found to have osteolytic lesions in the sternum and lumbar spine...

Intra-operative navigation has revolutionized spinal instrumentation. The O-arm (a mobile X-ray system; Medtronic, Minneapolis, MN) is uniquely capable of enabling visualization of the spine in axial planes. The application of this technology is wide yet underutilized in terms of its capacity to image spinal vascular anatomy. We completed a retrospective chart review of the following case studies. A 24-year-old neurologically intact female presented with a Jefferson fracture without vertebral artery dissection after a motor vehicle accident...

Cerebral palsy (CP) is a neurodevelopmental disorder that affects motor function and is often accompanied by secondary musculoskeletal issues. Severe scoliosis, a lateral curvature of the spine over 40 degrees, poses a significant challenge for individuals with CP, impacting their mobility and overall well-being. While the association between scoliosis and gastrointestinal complications is acknowledged, the occurrence of colonic volvulus with necrosis in the context of CP and severe scoliosis is rare and complex...

Objective Anterior cervical discectomy with fusion (ACDF) is the treatment of choice for cervical radiculopathy/myelopathy; however, it presents various complications. Endoscopic procedures may provide similar results and minimize adverse events. This review aimed to assess and compare the efficacy of anterior endoscopic cervical discectomy (AECD) and ACDF. Methods Major databases, registries, and other relevant material were screened for prospective trials directly comparing AECD and ACDF. No restrictions were imposed...

AIM: Postural kyphosis (PK) is a poor postural habit in which a patient\'s back appears abnormally rounded. This study aimed to evaluate the quality of life of patients with PK compared with those with adolescent idiopathic scoliosis (AIS) and Scheuermann kyphosis (SK) patients. MATERIAL AND METHODS: Health-related quality of life (HRQoL) of adolescents with PK who were admitted to our clinic between January 2020 and June 2022 was compared with that of patients with AIS and SK who were admitted during the same period by using the Scoliosis Research Society-22 (SRS-22) questionnaire...

This retrospective case series of prospective data aims to describe the transaxillary approach for the treatment of upper thoracic spine pathology. Various surgical techniques and approaches have been reported across the literature to address upper thoracic spine pathology, including the cervicothoracic approach, anterior transsternal approach, posterolateral approach, supraclavicular approach, and lateral parascapular approaches. These techniques are invasive. A minimally invasive, less morbid, and direct access approach to the pathology of the upper thoracic spine has not been reported in the literature...

STUDY DESIGN: Basic research. PURPOSE: This finite element (FE) analysis (FEA) aimed to compare the biomechanical parameters in multilevel posterior cervical fixation with the C7 vertebra instrumented by two techniques: lateral mass screw (LMS) vs. transpedicular screw (TPS). OVERVIEW OF LITERATURE: Very few studies have compared the biomechanics of different multilevel posterior cervical fixation constructs. METHODS: Four FE models of multilevel posterior cervical fixation were created and tested by FEA in various permutations and combinations...

STUDY DESIGN: A retrospective study at a single academic institution. PURPOSE: This study aimed to identify imaging risk factors for stenosis in extended neck positions undetectable in preoperative neutral magnetic resonance imaging (MRI) and improving decompression strategies for cervical spine disorders. OVERVIEW OF LITERATURE: Cervical disorders are influenced by various dynamic factors, with spinal stenosis appearing during neck extension...

STUDY DESIGN: This was a retrospective study. PURPOSE: This study aimed to assess the value of the Spinal Infection Treatment Evaluation (SITE) score, Brighton Spondylodiscitis Score (BSDS), and Pola classification to predict the need for surgical intervention in patients with spondylodiscitis. OVERVIEW OF LITERATURE: Spondylodiscitis is a rare disease, and the prediction of its outcome is crucial in the decision-making process. METHODS: All case records were assessed to extract information on the American Spinal Injury Association (ASIA), Visual Analog Scale (VAS), and Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) scores before and after surgery...

STUDY DESIGN: A retrospective observational study. PURPOSE: This study aimed to determine an accurate and convenient screening method for predicting proximal junctional fractures (PJFr) following surgery for adult spinal deformity (ASD) using computed tomography (CT)-based measurement of Hounsfield units (HUs). OVERVIEW OF LITERATURE: CT-based measurement of HUs is an alternative tool for assessing bone mineral density. However, the optimal method for predicting adjacent vertebral fractures following spinal fusion using HUs remains unclear...