European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
-
Review Case Reports
Hepatic myelopathy with spastic paraparesis: report of two cases and review of the literature.
The present report illustrates two men aged for 59 and 43 years, respectively, who presented with slowly progressive spastic paraparesis. ⋯ Hepatic myelopathy remains a default diagnosis assigned only after the exclusion of other causes of spastic paraparesis and partial transverse myelopathy. An accurate history, along with appropriate imaging and laboratory findings, is crucial.
-
Review Case Reports
A novel case of "ambulatory" cervical spondyloptosis: case report with literature review.
Cervical spondyloptosis is an extreme variant of cervical spinal injury where patients usually present with disabling neurological deficits. Presentation of these patients without significant morbidity is very rare and we could only find sporadic case reports in literature involving traumatic cervical spondyloptosis without neurological deficits. Usually such patients get spared due to expansion of spinal canal after fracture of posterior vertebral elements. We report a case of traumatic C5/C6 spondyloptosis in an ambulatory patient despite having an intact posterior vertebral arch. This patient was managed successfully with anterior cervical fusion. ⋯ To the best of our knowledge, this is the first case report of its kind as it exemplifies the rarity of such an occurrence and underlines the importance of timely management to maintain such preserved neurological status.
-
Randomized Controlled Trial
Transforaminal lumbar interbody fusion vs. posterolateral instrumented fusion: cost-utility evaluation along side an RCT with a 2-year follow-up.
Long-lasting low back pain is an increasing problem, and for some patients surgery is the final option for improvement. Several techniques for spinal fusion are available and the optimal technique remains uncertain. The objective of this study was to assess the cost-effectiveness and cost-utility of transforaminal lumbar interbody fusion (TLIF) compared to posterolateral instrumented fusion (PLF) from the societal perspective. ⋯ TLIF does not seem to be a relevant alternative to PLF from a socioeconomic, societal point of view.
-
Comparative Study
Sacropelvic fixation versus fusion to the sacrum for spondylodesis in multilevel degenerative spine disease.
Retrospective study. ⋯ The surgical treatment of multilevel degenerative spine disease carries a significant risk for pseudarthrosis and screw loosening, mandating a rigid sacropelvic fixation. The use of an iliosacral plate resulted in an inferior surgical and clinical outcome when compared to iliac screws.