Journal of spinal disorders & techniques
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J Spinal Disord Tech · Jul 2007
The frequency and etiology of intraoperative dural tears in 110 predominantly geriatric patients undergoing multilevel laminectomy with noninstrumented fusions.
A retrospective analysis of the frequency and etiology of dural tears (DT), defined as an unintended incidental intraoperative durotomy, occurring in 110 predominantly geriatric patients undergoing multilevel laminectomies with noninstrumented fusions. ⋯ Ten of 110 patients undergoing multilevel laminectomies and noninstrumented fusions developed unintended incidental DT attributed to OYL extending to/through the dura (3 patients), postoperative scar/marked OYL (2 patients), and synovial cysts/marked OYL (5 patients).
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J Spinal Disord Tech · Jul 2007
Case ReportsUsing intraoperative electrophysiologic monitoring as a diagnostic tool for determining levels to decompress in the cervical spine: a case report.
This report describes the clinical usefulness of using intraoperative electrophysiologic monitoring as a diagnostic tool for determining levels to decompress in the cervical spine. ⋯ Intraoperative, continuous free-running electromyography proved clinically effective in determining the course of surgery.
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J Spinal Disord Tech · Jun 2007
Spinal surgery and ophthalmic complications: a French survey with review of 17 cases.
Ocular complications after spine surgery are incompletely understood and are not as rare as implied by recent publications. In 13 out of 15 published case reports, ocular complications are attributed mainly to compression. But in 66 cases reported in 4 series in the literature, compression seems to play a role in less than 10 cases. However, 3 out of the 4 series lack sufficient detail to support this mechanism clearly. Our objectives were to identify the mechanisms and specific risk factors associated with this devastating complication, to help in prevention. ⋯ The authors propose 2 preventive measures: modification of horseshoe-shaped headrest and precautions with lateral rotation of the head in patients with carotid atheroma.
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J Spinal Disord Tech · Jun 2007
Safety and efficacy of implant removal for patients with recurrent back pain after a failed degenerative lumbar spine surgery.
The etiology of failed degenerative lumbar spine surgery may include a wide array of conditions. There is a group of patients who have recurrence of back pain despite a solid fusion in the absence of any obvious pain generator. Implant removal in those patients is a controversial optional treatment. ⋯ One patient developed a superficial infection managed successfully. Bivariate analysis showed that percent VAS change after injection, months free of pain after the index operation, and provocation of pain by palpation were significant predictors for pain relief (P<0.05). Removal of the implant may be an efficient and safe procedure for carefully selected patients and the most consistent predictor of its efficacy is the percent pain relief after the diagnostic injection of the painful operative side.
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J Spinal Disord Tech · Jun 2007
Case ReportsRepeated meningitis as a delayed complication of scoliosis surgery.
Case report. ⋯ Delayed meningitis can be a late complication of spinal instrumentation for scoliosis. A high index of suspicion is necessary.