Spine surgery and related research
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Spine Surg Relat Res · Jan 2020
The Surgical Outcomes of Spinal Fusion for Osteoporotic Vertebral Fractures in the Lower Lumbar Spine with a Neurological Deficit.
Osteoporotic vertebral fracture (OVF) is the most common osteoporotic fracture, and some patients require surgical intervention to improve their impaired activities of daily living with neurological deficits. However, many previous reports have focused on OVF around the thoracolumbar junction, and the surgical outcomes of lumbar OVF have not been thoroughly discussed. We aimed to investigate the surgical outcomes for lumbar OVF with a neurological deficit. ⋯ Level III.
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Spine Surg Relat Res · Jan 2019
Surgical Treatment of Osteoporotic Vertebral Fracture with Neurological Deficit-A Nationwide Multicenter Study in Japan.
The prevalence of patients with osteoporosis continues to increase in aging societies, including Japan. The first choice for managing osteoporotic vertebral compression fracture (OVF) is conservative treatment. Failure in conservative treatment for OVF may lead to non-union or vertebral collapse, resulting in neurological deficit and subsequently requiring surgical intervention. This multicenter nationwide study in Japan was conducted to comprehensively understand the outcomes of surgical treatments for OVF non-union. ⋯ This study demonstrated that substantial improvement in activity of daily living (ADL) was achieved by fusion surgery. Although there was a considerable rate of complications, fusion surgery is beneficial for elderly OVF patients with non-union.
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Spine Surg Relat Res · Oct 2018
Fixed Neck Position in Multilevel Cervical Posterior Decompression and Fusion to Reduce Postoperative Disturbances of Cervical Spine Function.
Difficulties with neck mobility often interfere with patients' activities of daily living (ADL) after cervical posterior spine surgery. The range of motion of the cervical spine decreases markedly after multilevel cervical posterior decompression and fusion (PDF). However, details regarding the limitations of cervical spine function due to postoperative reduced neck mobility after multilevel PDF are as yet unclarified. The present study aimed to clarify the quality of life and its related factors after PDF, and the optimal fixed neck position in multilevel PDF that minimizes the limitations of ADL accompanying markedly reduced postoperative neck mobility. ⋯ The optimal fixed neck position in C2-T1 PDF to reduce postoperative limitations of ADL involving neck mobility is a C2-C7 lordotic angle of less than 6°, or a C2-T1 tilt angle (°) of greater than 1.8 × the C2-C7 lordotic angle (°).
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Spine Surg Relat Res · Jan 2018
ReviewSensory nerve ingrowth, cytokines, and instability of discogenic low back pain: A review.
Many patients suffer from discogenic low back pain. However, the mechanisms, diagnosistic strategy, and treatment of discogenic low back pain all remain controversial. The purpose of this paper was to review the pathological mechanisms of discogenic low back pain. ⋯ Pathological mechanisms of discogenic low back pain include sensory nerve ingrowth into inner layers of the intervertebral disc, upregulation of neurotrophic factors and cytokines, and instability. Inhibition of these mechanisms is important in the treatment of discogenic low back pain.
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Spine Surg Relat Res · Jan 2018
Case ReportsPyogenic arthritis of a lumbar facet joint, a rare cause of retroperitoneal abscess: a case report.
Pyogenic arthritis in the spinal facet joint is rare, although the wide availability of magnetic resonance imaging (MRI) has increased the detection rate. Pyogenic arthritis of a lumbar facet joint is often combined with abscesses in the paraspinal muscles and epidural space. However, there is no report of pyogenic arthritis of a lumbar facet joint causing a retroperitoneal abscess. We report on a patient with pyogenic lumbar facet arthritis, which caused a huge retroperitoneal abscess. ⋯ Pyogenic arthritis of a lumbar facet joint can cause a retroperitoneal abscess through the vertebral foramen as well as the more common abscesses in the paravertebral muscles and epidural space, and the finding of MRI is characteristic. The clinician should suspect of pyogenic arthritis of a lumbar facet joint in a patient presenting with retroperitoneal abscesses that are not secondary to diseases of kidney or gastrointestinal tract.