Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
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Aggressive vertebral hemangiomas causing spinal compression are rare, and there is controversy with regard to treatment. The purpose of this study was to evaluate the clinical results of patients with aggressive vertebral hemangiomas at a mean follow-up of more than 10 years after total excision and discuss the treatment options for the tumors. ⋯ We performed a combination of preoperative transarterial embolization and total excision for aggressive vertebral hemangiomas with extraosseous extension that were causing spinal cord compression in all five cases. The results in the long-term follow-up have proved satisfactory.
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Comparative Study
Ipsilateral basicervical femoral neck and shaft fractures treated with long proximal femoral nail antirotation or various plate combinations: comparative study.
Although many treatment methods have been developed, controversy exists regarding the optimal management of ipsilateral femoral neck and shaft fractures. The purpose of this retrospective study was to compare the results of long proximal femoral nail antirotation (PFNA-long) and various plate combinations in the treatment of ipsilateral basicervical femoral neck and shaft fractures. ⋯ Both treatment methods achieved satisfactory functional outcomes in patients with ipsilateral basicervical femoral neck and shaft fractures. PFNA-long was a good option for the treatment of complex fractures, with the advantages of closed antegrade nailing with minimal exposure, reduced perioperative blood loss, and biological fixation of both fractures with a single implant.
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Clinically, the origin of low back pain is unknown. The pain may originate from the lumbar muscles directly, or it may be referred pain from the spine. Dorsal root ganglion (DRG) neurons with dichotomizing axons have been reported in several species and are thought to be related to referred pain. However, these neurons, which have dichotomizing axons to the lumbar facet joints and to the lumbar muscle, have not been fully investigated. ⋯ This finding provides a possible neuroanatomical explanation for referred low back muscle pain from the lower facet joints.
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Comparative Study
Comparison of early and late surgical intervention for lumbar disc herniation: is earlier better?
The optimal timing for surgical intervention in cases of lumbar disc herniation is debatable. This retrospective study sought to determine whether early surgical intervention resulted in greater improvement in clinical outcomes. ⋯ Early surgical intervention did not result in greater improvement of clinical outcomes for patients with lumbar disc herniation. Later surgical intervention resulted in significant improvement of psychological disorders.
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Surgical treatment of massive rotator cuff tears is challenging for shoulder surgeons. The purpose of this study was to investigate both clinical outcomes and cuff integrity after tendon patch grafting using the long head of the biceps (LHB) tendon for irreparable massive rotator cuff tears. ⋯ The LHB tendon is available in case tenodesis or tenotomy is needed. The resected tendon may be used as a graft for rotator cuff repair without any additional skin incision, which could reduce both the surgical invasion and the risk of infection. The LHB tendon patch grafting may be one of the useful options for surgical treatment of irreparable massive rotator cuff tears.