Spine
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A retrospective case series. ⋯ Delayed surgical site infections after spinal instrumentation for deformity need to be treated with implant removal to clear the surgical site infection. Patients may require to undergo repeat instrumentation and fusion at a later date if they develop progressive deformity or symptomatic pseudarthrosis after implant removal.
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A case report of 3 patients with posterior migration of bullet-shaped fusion cages after transforaminal lumbar interbody fusion (TLIF). One patient required emergency revision surgery; the other 2 patients are being observed during conservative treatment. ⋯ Revision surgery after TLIF appears relatively safe because the migrated cage tends to locate more laterally than in patients with cage migration after posterior lumbar interbody fusion. Cage migration subsequent to TLIF may not cause compression of neural tissues, so conservative treatment may suffice for these patients. Unilateral pedicle screw fixation may not provide sufficient stability to prevent cage migration in patients with degenerative scoliosis. Further study is needed to clarify surgical indications for unilateral pedicle screw fixation in TLIF.
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This is a retrospective review of 129 consecutive anterior lumbar revision surgeries in 108 patients. It is a single-center, multi-surgeon study. ⋯ Complication rates for revision lumbar surgery in this series were 3 to 5 times higher than reported for primary lumbar exposures. Complication rates were significantly higher for revision anterior lumbar fusions at the same segment, which were typically in the lower lumbar spine, compared with cases involving extensions, which were typically in the upper lumbar spine.
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Consecutive case series cohort. ⋯ For patients presenting to a spine surgeon's clinic for LBP, up to 25% of patients may have significant pain contribution from the hip or SI joints, and an additional 10% will still have an undefined pain source even after diagnostic workup. This underscores the need for clinicians to be aware of nonspinal pain generators and to appropriately pursue alternative diagnoses.
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Radiographic review. ⋯ Dynamic cervical curvature changes based on a central apex, stems from vertebral rotation and displacement in the sagittal plane. Our study reveals variation patterns of dynamic cervical spine sagittal alignment and curvature, providing vertebral spatial alignment value as reference for orthopedic cervical kyphosis corrective surgery.