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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We report on a 72-year-old male patient who developed a nontraumatic spinal subdural hematoma (SSDH) during rivaroxaban therapy, a relatively new orally administered direct factor Xa inhibitor. ⋯ Determining the time of safe surgery remains challenging when hemorrhagic complications happen with direct factor Xa inhibitor, especially when neurological prognosis is engaged. Spinal subdural hematoma has not previously been reported following rivaroxaban therapy.
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To investigate volumetric changes in lumbar disc herniation (LDH) using three-dimensional measurements obtained by magnetic resonance imaging (MRI) and to identify possible factors affecting such changes. ⋯ We observed that LDH is a dynamic disease and that a herniated disc is not always spontaneously resorbed, in contrast to what has been reported previously. Alleviation of clinical symptoms can be achieved via conservative treatment even if the volume of the herniated disc changes. Spinal surgeons should not only present an option of initial non-surgical treatment to LDH patients but should also inform them that the LDH may change in size during daily activity or exercise.
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Traumatic bilateral locked facet joints occur with extreme rarity in the lumbar spine. A careful review of the literature revealed only three case reports. ⋯ The existing literature and a biomechanics review of the lumbar spine are described in the context of the presented case in addition to a proposed mechanism for such dislocations.
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Caring for pediatric spine trauma patients places spine surgeons in situations that require unique solutions for complex problems. Recent case reports have highlighted a specific injury pattern to the lower cervical spine in very young children that is frequently associated with complete spinal cord injury. ⋯ Familiarity with the challenges and solutions presented in the case may be useful to surgeons who could face a similar challenge in the future.
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This retrospective study analyzes long-term outcomes (15 years) of circumferential lumbar fusion (CF) for degenerative spine disease using instrumented PLIF. The occurrence of adjacent segment degeneration (ASD) and the reintervention rate was specially focused. ⋯ Circumferential lumbar fusion provides good clinical results at short-term follow-up. From 2- to 15-year follow-up, outcome worsened significantly. The high rate of ASD occurrence and reintervention questions the reliability of this technique for lumbar fusion.