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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To investigate the relationship between lumbar facet fluid and dynamic instability in degenerative spondylolisthesis (DS), as well as the relationship between facet fluid and patient-reported outcomes following a posterior lumbar fusion. ⋯ Facet joint fluid is associated with the presence of dynamic instability in DS. The presence of facet fluid and dynamic instability may predict increased likelihood of achieving MCID for improvement in back pain following posterior lumbar fusion.
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Three-column lumbar spinal resection osteotomies including pedicle subtraction osteotomy (PSO), vertebral column resection (VCR), and total en bloc spondylectomy (TES) can potentially lead to dorsal root ganglion (DRG) injury which may cause postoperative dysesthesia (POD). The purpose of retrospective study was to describe the uncommon complication of POD in lumbar spinal resection osteotomies. ⋯ Although POD is a unique and rare complication and maybe misdiagnosed as nerve root injury in lumbar spinal resection osteotomies, combination drug therapy and DRG block have an effective result of pain relief. The appearance of a gradual pain moving to distal end of a proper DRG innervated region during recovering may be used as a sign for the good prognosis.
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Pedicle subtraction osteotomy (PSO) is widely used to treat severe fixed sagittal imbalance. However, the effect of PSO on balance has not been fully documented. The aim of this study was to assess dynamic walking balance after PSO to treat fixed sagittal imbalance. ⋯ Despite a mild residual spinal-pelvic malalignment, PSO restored sagittal alignment and balance satisfactorily and has improved the gait pattern.
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Pedicle subtraction osteotomy (PSO) is one of the surgical options for treating alignment disorders of the fused spine (due to post-surgical fusion or related to arthritis). It enables satisfactory sagittal realignment and improved function due to economic sagittal balance. The aim of this study was to analyze clinical and radiological results of PSO after a minimum follow-up of 2 years and demonstrate the benefit of sub-group analysis as a function of pelvic incidence (PI). ⋯ PSO is a surgical procedure enabling correction of multiplane rigid spinal deformities that require major sagittal correction. It was seen to be highly effective in patients with a small or moderate pelvic incidence (PI <60°) but was sometimes less effective in patients with large pelvic incidence due to insufficient lordosis correction. Clinical results were highly correlated with the value of the FBI index.
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Great vessel injury during posterior 3-column osteotomy is rare, but potentially fatal. Literature review revealed limited data guiding spine surgeons during this major catastrophe. In this study our aim was first, to present our case of mortality; second, to discuss a novel technique that can be performed to temporize hemorrhage in a life-threatening situation where an iatrogenic great vessel injury occurs and hemodynamic stability cannot be achieved through usual means of hemostasis; third, a cadaveric study to determine if this novel technique is feasible. ⋯ The posterior peri-vertebral approach can potentially be used by a spine surgeon during a life-threatening situation to temporarily occlude great vessel hemorrhage while waiting for the assistance of a vascular/trauma team.