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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The purpose of this study was to examine lumbar segmental mobility using kinetic magnetic resonance imaging (MRI) in patients with minimal lumbar spondylosis. ⋯ In the current study, we evaluated lumbar segmental mobility in patients without significant degenerative disc disease and found that translational motion was greatest in the proximal lumbar levels whereas angular motion was similar in the mid-lumbar levels but decreased at L1-L2 and L5-S1.
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Dynamic stabilization of the spine was developed as an alternative to rigid fusion in chronic back pain to reduce the risk of adjacent segment degeneration. Dynamic neutralization system (Dynesys, Zimmer CH) is one of the most popular systems available, but some midterm studies show revision rates as high as 30 %. Some late infectious complications in our patients prompted us to review them systematically. Propionibacterium recently has been shown to cause subtle infections of prosthetic material. ⋯ The high rate of late infections with low-grade germs and the frequency of screw loosening signs made us suspect a lack of integration at the bone-screw interface. Surgeons should be suspicious if the patient presents a combination of new or increasing pain and signs of screw loosening, and aggressive revision is recommended in these cases.
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The objective of this study was to investigate thoracic myelopathy caused by ossification of the yellow ligament (OYL) in patients with posterior instrumented lumbar fusion. ⋯ We report seven patients who suffered from thoracic myelopathy after instrumented lumbar fusion. Surgeons must be aware of the possibility of thoracic myelopathy caused by OYL at the thoracolumbar junction, especially in patients with a complaint of gait disturbance after long instrumented lumbar fusion.
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To investigate the incidence and risk of stroke after lumbar spinal fusion surgery. ⋯ Three years post-operatively, patients who received lumbar spinal fusion had stroke incidence rates similar to those without surgery. Posterior lumbar spinal fusion surgery is not associated with increased risks for any kind of stroke.
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The natural course of lumbar spinal stenosis (LSS) fluctuates and is not necessarily progressive. The aim of this study was to explore the predictors of clinical outcome in patients with LSS that might eventually help to optimise the therapeutic choices. ⋯ Satisfactory outcomes were disclosed in about 61 % of the patients with mild-to-moderate LSS in a 7-year follow-up. Electrophysiological abnormalities, namely the presence of pluriradicular involvement and abnormalities of the soleus H-reflex, were predictive of deterioration of clinical status in these patients.