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
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Case Reports
Posterior lumbar fixation in a kidney transplant recipient: logistics and perioperative challenges.
Kidney transplantation has become the ideal and successful treatment for medically suitable patients with established kidney disease. This results in increased likelihood of these patients developing unrelated conditions requiring surgery, including spinal surgery. There are only a few publications available regarding spinal patients with renal transplants. ⋯ The key to success was a multidisciplinary approach and detailed planning regarding pre-, intra- and postoperative care. The presented scheme of care might be useful when considering the posterior approach and prone positioning in kidney transplant recipients with spinal pathologies requiring surgical treatment.
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Redundant nerve roots of the cauda equina in lumbar spinal canal stenosis, an MR study on 500 cases.
The purpose of this study was to evaluate magnetic resonance (MR)-detected redundant nerve roots (RNRs) of the cauda equina in patients with lumbar spinal canal stenosis. ⋯ With an occurrence rate of 15%, RNRs of the cauda equina are not uncommon in cases with lumbar spinal canal stenosis. Advanced age, a canal stenosis at L2-4, and the presence of a sharp intracanal protuberance in the site of the stenosis are the related risk factors. Patients' age and the location of RNRs may be of prognostic value.
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The preoperative identification of lumbar foraminal stenosis (LSFS) is important because a lack of recognition of this clinical entity is often associated with failed back surgery syndrome. Although magnetic resonance imaging (MRI) is widely used, and is considered by many as an appropriate tool for studying spine pathologies, there is limited data to suggest that MRI examinations are sufficiently sensitive or specific for the diagnosis of LSFS. There is a paucity of literature on the diagnostic performance of the combination of conventional diagnostic imaging methods. The purpose of this study is to determine the characteristics of conventional diagnostic imaging for symptomatic lumbar foraminal stenosis. ⋯ Our study demonstrates combination of conventional imaging techniques, to improve the detection of symptomatic foraminal stenosis.