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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Observational Study
Similar result after non-elective and elective surgery for lumbar disc herniation: an observational study based on the SweSpine register.
Surgery for lumbar disc herniation (LDH) is most often elective, but intense pain may require more urgent, non-elective, treatment. It was hypothesized that non-elective treatment could be associated with a less favourable outcome than elective surgery. The aim of this study was to compare 1-2-year outcome after non-elective and elective surgery for treatment of para-median LDH using data from the Swedish Spine register (SweSpine). ⋯ Even if non-elective patients preoperatively had substantially more pain, higher disability and poorer quality of life than elective patients, postoperative differences were clinically small. Patient satisfaction did not differ.
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Total en bloc spondylectomy (TES) is a surgical procedure performed to achieve complete resection of an aggressive benign spinal tumor or a malignant spinal tumor. When reconstructing the spine after resection, we have been using liquid nitrogen-frozen resected spine bearing tumor as a bone graft, expecting an immunological response to tumor-specific antigen(s). The purpose of this article is to report a successful treatment case of lung adenocarcinoma metastasis with TES and this cryotherapy. ⋯ TES with a liquid nitrogen-frozen tumor specimen could be a promising therapeutic option for cancer patients with spine metastasis.
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Instrumented spinal fixations are an important tool in the management of traumatic conditions and delayed complications are rare. ⋯ To our knowledge, this is the first report of an intradural rod migration distant to the initial surgery in a patient without posterior decompression. This highlights the need for long-term follow-up of patients with spinal instrumentation.
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Case Reports
Use of PET/CT in the early diagnosis of implant related wound infection and avoidance of wound debridement.
Delayed infections after spinal instrumentation typically require complete implant removal and extensive wound debridement due to the difficulties in establishing an early diagnosis. We report a case of occult late infection after posterior spinal instrumentation that was detected early using PET/CT and therefore was successfully treated with antibiotics alone. ⋯ PET/CT provides detailed diagnostic information for occult infections in the absence of morphological changes and thus, is valuable for an early diagnosis of late infection after spinal instrumentation. It is possible to retain the instrumentation in the case of late infection, if early detection and efficacious treatment can be achieved timely.
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This case series describes a novel condition characterized by familial pseudotail associated with scoliosis, and synpolydactyly that has not been previously reported in literature. ⋯ The described cases represent a novel condition that has not been previously reported in the literature. Familial pseudotail scoliosis synpolydactyly syndrome is a newly recognized form of familial pseudotail.