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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Case Reports
Neurogenic intermittent claudication caused by vasculitis in the cauda equina: an autopsy case report.
Intermittent claudication (IC) refers to leg pain that is induced by walking and relieved by rest. Neurogenic IC is usually associated with lumbar canal stenosis (LCS). We present rare findings from an autopsied patient who had neurogenic IC caused by vasculitis in the cauda equina. ⋯ MPA is a rare cause of neurogenic IC when the symptom is acute and multimodal. Small-vessel vasculitis affecting the cauda equina may underlie MPA-associated IC.
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Using ultrashort echo time (UTE) MRI, we determined prevalence of abnormal cartilaginous endplate (CEP), and the relationship between CEP and disc degeneration in human lumbar spines. ⋯ These results suggest that abnormal CEPs are frequently found, and it associates significantly with disc degeneration, suggesting an insight into pathoetiology of disc degeneration.
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The objective was to analyze the role of the thoracolumbar sagittal flexibility on the outcome after posterior spinal fusion of Lenke 1 and 2 adolescent idiopathic scoliosis with last touched vertebra as the lowest instrumented vertebra. ⋯ The flexibility of the thoracolumbar junction is a determining factor in the surgical outcome after posterior spinal fusion for AIS and should be considered in correlation with the frontal and sagittal alignment of the spine.
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The impact of pre-existing degeneration of a disc underlying a lumbar arthrodesis via lateral approach on long-term clinical outcome has, to our knowledge, not been studied. When performing arthrodesis between L2 and L5, its extension to L5S1 is challenging because it imposes a different surgical approach. Therefore, surgeon's temptation is to not include L5S1 in the fusion even in case of discopathy. Our objective was to study the influence of the preoperative L5S1 status on the clinical outcome of lumbar lateral interbody fusion (LLIF) using a pre-psoatic approach between L2 and L5 with a minimum follow-up of 2 years. ⋯ A preop L5S1 disc degeneration does not seem to impact the final clinical outcomes after lumbar lateral interbody fusion at a minimal two years F.U. It should not be systematically involved in an overlying fusion.
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Current decision-making in multilevel cervical fusion weighs the potential to protect adjacent levels and reduce reoperation risk by crossing the cervicothoracic junction (C7/T1) against increased operative time and risk of complication. Careful planning is required, and the planned distal and adjacent levels should be assessed for degenerative disc disease (DDD). This study assessed whether DDD at the cervicothoracic junction was associated with DDD, disc height, translational motion, or angular variation in the adjacent superior (C6/C7) or inferior (T1/T2) levels. ⋯ The association of DDD at the cervicothoracic junction with DDD at the adjacent levels emphasizes the necessity for careful selection of the distal level in multilevel fusion in the distal cervical spine.