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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Lumbar nerve root entrapment syndromes cause radicular signs and symptoms in the affected leg. The applicability of diffusion-weighted imaging (DWI) for the assessment of lower lumbar nerves (L4-S1) has been demonstrated. The purpose of this pilot study was to establish DWI reference data for the all lumbosacral nerve roots (L1-S1) in a healthy, asymptomatic study population and to determine its potential as a diagnostic tool for patients with lumbar radicular syndromes. ⋯ For the first time, we have established data for the DRG and DSN in human lumbosacral spinal nerves (L1-S1), using diffusion-weighted magnetic resonance imaging techniques. 3 T ADC maps have a higher signal to noise ratio, thus offering better image quality. Results from this study suggest that DWI has added value as new diagnostic tools for patients with symptomatic lumbar nerve root entrapment syndromes as well.
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Symptomatic foraminal stenosis has been observed in patients with degenerative disc disease, scoliosis, asymmetrical disc degeneration and spondylolisthesis. Nevertheless not all patients with the above pathologies will develop symptomatic foraminal stenosis. We hypothesised that symptomatic patients have anatomical predisposition to foraminal stenosis, namely a larger pedicle height (PH) to vertebral body height (VH) ratio, leaving less room below the pedicle for the exiting nerve root compared to asymptomatic patients. ⋯ Symptomatic patients with foraminal stenosis have smaller VH leading to lesser space beneath the pedicle and putting the exiting nerve root at risk in cases of spondylolisthesis or disc degeneration.
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Postoperative symptomatic epidural hematoma (SEH) is a serious complication of lumbar spine surgery. Despite its rarity, this uncommon complication may result in devastating neurological sequelae, including lower limb weakness. ⋯ The findings suggest that preoperative diastolic blood pressure, intraoperative use of gelfoam for dura coverage and postoperative drain output are risk factors for symptomatic epidural hematoma after lumbar decompression surgery. Major blood loss and multilevel surgical procedure could result in poor recovery of muscle power. After spine decompression surgery, early detection and evacuation of hematoma are the key to avoid neurologic deterioration and have better clinical outcomes.
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Fenestration is the gold standard surgery for lumbar spinal canal stenosis in Japan. Several previous studies have analyzed the reoperation rates in large numbers of patients undergoing several surgical procedures such as laminectomy with or without instrumented spinal fusion; however, there have been few studies focusing solely on fenestration. The purpose of this study was to calculate the reoperation rates after fenestration using the survival function method. ⋯ Fenestration can be performed at low cost using standard spinal surgery equipments. The reoperation rates of this procedure were lower than previously reported for several other surgical procedures.
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One single factor cannot by itself predict curve progression accurately. The aim of this study is to determine multiple related factors in predicting the progression of scoliosis in girls with adolescent idiopathic scoliosis (AIS) treated with bracing. ⋯ This study suggests that Risser sign, the magnitude of the major curve at pre-brace, apical vertebral rotation, and the spinal length increasing velocity are important factors to predict progression in the girls with AIS. Risser sign cannot predict the progression of scoliosis accurately unless combined with other related parameters.