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
Surgical treatment of an atlantoaxial fracture after a delayed diagnosis in a comatose patient.
Case report. ⋯ To avoid unnecessary surgery, surgeons should recognize the possibility of cervical fractures that cannot be detected without CT, especially in patients who are comatose at injury. Atlantoaxial fixation with a hook and lamina screw in C2 is an option for old upper cervical fractures in cases where a pedicle screw cannot be inserted into C2.
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Review Meta Analysis
Minimally invasive versus open transforaminal lumbar interbody fusion for treatment of degenerative lumbar disease: systematic review and meta-analysis.
While open TLIF (O-TLIF) remains the mainstay approach, minimally invasive TLIF (MI-TLIF) may offer potential advantages of reduced trauma to paraspinal muscles, minimized perioperative blood loss, quicker recovery and reduced risk of infection at surgical sites. This meta-analysis was conducted to provide an updated assessment of the relative benefits and risks of MI-TLIF versus O-TLIF. ⋯ In summary, the present systematic review and meta-analysis demonstrated that MI-TLIF appears to be a safe and efficacious approach compared to O-TLIF. MI-TLIF is associated with lower blood loss and infection rates in patients, albeit at the risk of higher radiation exposure for the surgical team. The long-term relative merits require further validation in prospective, randomized studies.
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We performed a phase I/IIa clinical trial and confirmed the safety and feasibility of granulocyte colony-stimulating factor (G-CSF) as neuroprotective therapy in patients with acute spinal cord injury (SCI). In this study, we retrospectively analyzed the clinical outcome in SCI patients treated with G-CSF and compared these results to a historical cohort of SCI patients treated with high-dose methylprednisolone sodium succinate (MPSS). ⋯ These results suggest that G-CSF administration is safe and effective, but a prospective randomized controlled clinical trial is needed to compare the efficacy of MPSS versus G-CSF treatment in patients with SCI.
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Review Case Reports
C1-C2 pigmented villonodular synovitis and clear cell carcinoma: unexpected presentation of a rare disease and a review of the literature.
Pigmented Villonodular synovitis (PVNS) is a rare vertebral pathology--around 50 reports, only 3 concerning C1-C2 location. ⋯ A large differential diagnosis should be made when the typical findings for metastatic disease are absent precluding the iatrogenic consequences of empirical treatments based on clinical diagnosis with no histopathological support.
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Review Case Reports
Vertebroplasty in a 10-year-old boy with Gorham-Stout syndrome.
To describe our experience using balloon vertebroplasty with polymethylmethacrylate filler in a 10-year-old boy with Gorham-Stout syndrome. Gorham-Stout syndrome is a rare disorder of unknown etiology characterized by intraosseous proliferation of fibrovascular or lymphatic tissue that results in progressive osteolysis and bone destruction. It can affect any part of the skeleton and lead to pathological fractures and muscular weakness or atrophy. The literature contains few reports on the surgical management of vertebral osteolysis with risk of fracture in children. Spinal fusion is the treatment of choice. ⋯ We report the only application to date of vertebroplasty to treat vertebral osteolysis in a pediatric patient. The outcome and possible complications of this technique remain unknown in children. The patient in the present report underwent vertebroplasty at two levels, and his progress remains satisfactory 4 years after surgery. He has not developed technical complications or changes in spinal growth. Therefore, we propose vertebroplasty for the treatment of vertebral osteolysis in pediatric patients at risk of pathological fracture.