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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Cauda Equina Syndrome (CES) is a rare surgical emergency. The implications for loss of quality of life through delayed management are high, though no clinical symptom is pathognomonic in its diagnosis. We describe how machine learning based algorithms can be used in triaging patients with suspected CES (CES-S). ⋯ With our dataset, the trained algorithm demonstrated the potential for safely reducing the number of emergency MRI scans by over 95%. Prior to the wide clinical application, large volume prospective data is needed for continuous training of the algorithm, in order to improve accuracy and confidence of prediction.
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Cervical total disc arthroplasty (TDA) is a motion-preserving alternative to anterior cervical discectomy and fusion that has gained popularity among spine surgeons. Although generally effective, TDA has been associated with rare cases of progressive osteolysis, a complication whose natural history and impact on clinical outcomes are not well understood. This case report aims to present a case of progressive osteolysis following cervical TDA with the SpinalKinetics® M6-C Artificial Cervical Disc and to discuss the clinical approach and implications for patient management. ⋯ This case highlights the potential for progressive osteolysis as a complication following cervical TDA, emphasizing the importance of ongoing surveillance and increased awareness among spine surgeons. Early identification and monitoring of osteolysis may mitigate the risk of severe outcomes and guide timely intervention.
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A standard 6-12-week course of antibiotics is recommended for pyogenic spondylitis. Recent evidence supports early minimally invasive posterior fixation surgery; however, its effect on antibiotic treatment duration is unclear. This study aims to identify factors associated with prolonged antibiotic treatment in thoracolumbar pyogenic spondylitis patients resistant to conservative treatment and assess whether early surgery can reduce treatment duration. ⋯ Early surgery (within three weeks) with minimally invasive posterior fixation for thoracolumbar pyogenic spondylitis is associated with reduced antibiotic duration and overall treatment duration regardless of the presence of prolonging factors like iliopsoas abscess and elevated CRP levels.
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The Core Outcome Measures Index (COMI) is a short, multidimensional instrument translated into several languages that covers five domains recommended in the assessment of outcome in patients with low-back and neck pain. The purpose of this study was to cross-culturally adapt the COMI from English to Czech language and to test the face and construct validity and reproducibility of its results in patients with low-back and neck pain. ⋯ The Czech COMI shows acceptable properties and is thus suitable to use as a short instrument for measuring important domains in patients with low-back and neck pain.