Spine
-
This study describes recent United States trends and regional variations in the management of low back pain. ⋯ Rapidly increasing surgical rates and wide geographic variations suggest the need for a more consistent approach to back problems.
-
Comparative Study
Comparison of same-day sequential anterior and posterior spinal fusion with delayed two-stage anterior and posterior spinal fusion.
This was a retrospective review. Short-term outcomes were compared based on two different surgical techniques. ⋯ In selected patients with pediatric spinal deformity, experienced spinal surgeons can reduce blood loss, hospital stay, and costs by performing anterior and posterior spinal fusions sequentially under one anesthetic.
-
Case Reports
Transient paraplegia from intraoperative intercostal nerve block after transthoracic discectomy.
To present two patients with transient paraplegia from intercostal nerve blocks after transthoracic discectomy. ⋯ Because of the inherent risk of neurologic injury after thoracic discectomy, the authors discourage the use of intercostal nerve blocks for relieving postoperative pain after transthoracic discectomy.
-
Patients with intradural herniation of an intervertebral disc were identified and managed surgically. ⋯ This entity should be suspected when a calcified disc within the spinal canal is being treated. The optimal exposure is a posterolateral extracavitary costotransversectomy with a hemilaminotomy. Alternative approaches to a typical thoracic disc would be problematic in managing these patients.