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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Paralysis subsequent to spinal cord decompression in the cervical or thoracic region is infrequent, with White Cord Syndrome (WCS) being among its several causes. Due to WCS's infrequency, there exists a paucity of high-level evidence concerning its manifestations. Our primary objective is to systematically collate all documented WCS cases, discern prevalent risk and prognostic factors, appraise available treatment modalities, and evaluate patient outcomes. ⋯ WCS is a rare cause of postoperative neurological deficit following spinal cord decompression surgery. Risk factors for WCS include advanced age, extensive surgery, posterior approach for decompression, and the presence of OPLL. Treatment includes high-dose steroids, posterior cervical decompression, maintaining MAP over 85mmHg, rehabilitation, and sometimes neurotrophic drugs. Most patients can walk with or without assistance during follow-up, but around a quarter never regain neurological function. The only preoperative factor impacting outcomes is the preoperative neurological status (Nurick Grade).
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Randomized Controlled Trial
Efficacy and safety of multidrug cocktail injections in postoperative pain management for lumbar microendoscopic decompression surgery: a prospective randomized controlled trial.
This study aimed to evaluate the analgesic effects and safety of multidrug cocktail injections for postoperative pain management in patients undergoing lumbar microendoscopic decompression surgery. ⋯ Multidrug cocktail injections are effective and safe for postoperative pain management in lumbar microendoscopic decompression surgery, significantly reducing pain, analgesic use, CRP levels, and hospital stay. These findings suggest that incorporating multidrug cocktail injections into postoperative care protocols can enhance patient recovery and outcomes.
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Comparative Study
Comparison of clinical and radiographic outcomes in unilateral transforaminal lumbar interbody fusion: a retrospective analysis of three surgical approaches.
The primary objective of this study is to evaluate and compare the clinical and radiographic outcomes of the combined spinous process-splitting approach with a Wiltse (SPSW) approach, the combined conventional approach with a Wiltse (CW) approach, and the conventional open (CO) approach in unilateral transforaminal lumbar interbody fusion (TLIF). ⋯ All the SPSW, CW, and CO approach TLIF procedures achieved overall satisfactory effects of decompression and fusion for lumbar degenerative diseases. The SPSW approach procedure appears to be associated with the smallest surgical trauma and highest satisfaction because of reducing iatrogenic injury of the paraspinal muscles.
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Clinicians monitor scoliosis progression using radiographs during growth. Three standing positions were assessed because the arms must be elevated to visualize all vertebrae on radiographs, possibly affecting sagittal parameters. 3D Ultrasound (3DUS) is safe to assess positions without radiation, but its test-retest reliability has not been established for common radiograph positions. The aim was to determine the test-retest reliability of frontal, sagittal, and transverse measurements obtained from three positions using 3DUS imaging. ⋯ 3DUS produces reliable frontal, sagittal, and transverse measurements for research use in three standing positions. Hands on wall produces reliable measurements for clinical practice.
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This study aimed to explore associations between ABO blood type and postoperative adjacent segment degeneration/disease (ASD) following lumbar spine fusion, as well as evaluate differences in spinopelvic alignment, perioperative care, postoperative complications, and patient-reported outcome measures (PROMs). ⋯ This is the first large-scale study to address and demonstrate proof-of-principle that ABO blood type, a non-modifiable risk factor, is associated with ASD following lumbar spine fusion.