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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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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Does lumbar fusion lead to accelerated adjacent segment disc degeneration (ASDD) or is it explained by genetics and aging? The influence of genetics on ASDD remains to be explored. This study assesses whether the disc space height adjacent to a fused segment is associated with candidate gene single nucleotide polymorphisms (SNPs). ⋯ Age was the most significant determinant of adjacent segment disc space height followed by genetic factors, specifically inflammatory genes. Fusion explained a statistically significant but small proportion of the total variance. Much of the variance remained to be explained.
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Modic changes (MC) are associated with low back pain (LBP). Inflammation is considered as a key factor that triggers symptoms in especially type I MC, but so far of the potential inflammatory candidates only TNFα has been linked to MC. The objective of the study was to analyze a set of inflammatory mediators in human surgical disk samples and quantify their association with MC in the adjacent vertebral bodies. ⋯ Since these cytokines are related to differentiation and proliferation of osteoclasts, our data suggest that the stimulation of vertebral osteoclasts by factors secreted by disk tissue is involved in the pathophysiology of MC.
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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.
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Many authors favor conservative treatment options in oligo-symptomatic non-dislocated cervical fractures. This is mainly because of adverse events, anesthesia times and blood loss associated with surgical treatment of these injuries. We, therefore, sought to minimize the invasiveness of the surgical treatment of simple cervical fractures using image-guidance and a percutaneous approach. ⋯ The technique presented here was found to be a feasible minimally invasive treatment option for uncomplicated cervical fractures. Besides to our best knowledge, we here present the first percutaneous implantation of lateral mass screws.