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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Explore the relationships between preoperative findings and clinical outcome following lumbar disc surgery, and investigate the prognostic value of physical examination findings after accounting for information acquired from the clinical history. ⋯ Information gleaned from the clinical history and physical examination helps to identify patients more likely to succeed with lumbar disc surgery. While this study helps to inform clinical practice, additional research confirming these results is required prior to confident clinical implementation.
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The state of adjacent level discs and its impact on surgical outcomes following single-level lumbar discectomy have not been previously investigated. The purpose of the present study was to determine if a significant relationship exists between the degree of preoperative adjacent level disc degeneration and post-operative clinical outcomes following lumbar discectomy. ⋯ The degree of preoperative adjacent level degeneration does not significantly affect functional or pain relief outcomes following lumbar discectomy up to 1 year after surgery.
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To describe the effect of the C1 bursting fracture on the location of the internal carotid artery (ICA) around the atlas. ⋯ Lateral displacement of the bony structure of C1 bursting fracture changes the relative location of the ICA medially, which increase the injury risk during the bicortical C1 screw insertion. These data suggest that CT angiography or enhanced CT scans can give critical information to choose the ideal fixation technique and the proper trajectory of the screws for C1 bursting fracture.
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Resection of calcified thoracic disc herniations carries significant risks of neurological worsening, particularly in case of concomitant central location. Transthoracic approaches are a first-choice option to avoid spinal cord manipulation but entail drawbacks such as postoperative pain and the risk of bronchopulmonary complications. The purpose of this report is to describe a novel approach to resect calcified herniations, even centrally located, from a posterior perspective. ⋯ The endoscope-assisted posterior approach afforded safe and complete resection of calcified discs. The technique is particularly useful for central disc herniations, where transthoracic approaches are normally deemed mandatory.
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The objective of this study is to present the paid expenditures and productivity costs of disability pensions (DP) due to spinal disorders (SD) in Finland during 1990-2010. ⋯ Despite a significant decrease in DP-associated expenditures due to SDs after 1993, the annual expenditures have stayed on a high level in Finland.