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 rate and predictive factors of post-operative neurological deterioration in ossified yellow ligament (OYL) surgery. ⋯ A total of 26 patients were included in this study. Most patients (92.3%) had Frankel grade D pre-operatively. The rate of neurological deterioration was 15.4% and was correlated with the presence of dural tear, extra-dural hematoma and spinal cord injury. Pre-operative walking score was prognostic of patients' walking ability in the post-operative period. Intra-operative monitoring of Somatosensory Evoked Potentials (SSEP) was found to be useful for monitoring spinal cord injury in OYL surgery, with a positive predictive value of 100% and a negative predictive value of 92.3%. The false negative rate of a SSEP signal drop was only 7.7% CONCLUSIONS: This is the first study exploring risk factors for post-operative neurological deterioration after surgery for thoracic OYL. The rate of neurological deficit is not small and prognostic factors for poor outcome include poor pre-operative walking score, presence of intra-operative dural tear, extra-dural hematoma and spinal cord injury, and intra-operative drop of SSEP signal.
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Aim of the study was to evaluate the role of the mechanical properties of the rod and of the characteristics of the patients (age, skeletal maturity, BMI, and Lenke type) in determining the deformity correction, its maintenance over time and the risk of mechanical failure of the instrumentation. ⋯ Rod diameter and material as well as patient characteristics such as BMI, age, and Risser grade play an important role in deformity correction and its maintenance over time.
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Tandem spinal stenosis (TSS) is a condition of combined spinal stenosis in the cervical and lumbar regions. The purpose of this study was to determine the prevalence of radiographic TSS and its association with developmental canal stenosis (DCS). The second purpose was to investigate the extent to which radiographic TSS is associated with cervical myelopathy and symptomatic LSS. ⋯ The present study is the first population-based study to clarify TSS characteristic using whole-spine MRI.
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Spondylodiscitis refers to infections of the intervertebral disc and the adjacent vertebral body. Although it is still considered a rare condition, its rate is projected to increase. Mortality rate is considered to be low, but an estimated one third of the survivors experience residual disabilities. Literature shows that uncomplicated spondylodiscitis can be adequately treated by early antibiotic therapy and immobilization. The aim of the study is to evaluate the outcome of conservative treatment in patients with haematogenous spondylodiscitis. ⋯ Conservative approaches are safe and effective for patients without complications. A delayed diagnosis and MRSA infections are related to poor clinical outcome among patients treated by conservative treatment; this must be carried out scrupulously with close patient monitoring.
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The investigation was based on finite-element simulations. ⋯ The use of cages is crucial to ensure anterior support and decrease loads and stresses on the posterior instrumentation.