The spine journal : official journal of the North American Spine Society
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Symptomatic epidural hematomas after spinal surgery are uncommon and are usually diagnosed within 24 hours after surgery. ⋯ Delayed spinal epidural hematomas are an uncommon cause of delayed deterioration after spinal surgery. Previous surgery with attendant scarring that results in impairment of clot resorption may be a contributing factor in the development of the condition.
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Review Historical Article
A surgical revisitation of Pott distemper of the spine.
Pott disease and tuberculosis have been with humans for countless millennia. Before the mid-twentieth century, the treatment of tuberculous spondylitis was primarily supportive and typically resulted in dismal neurological, functional and cosmetic outcomes. The contemporary development of effective antituberculous medications, imaging modalities, anesthesia, operative techniques and spinal instrumentation resulted in quantum improvements in the diagnosis, management and outcome of spinal tuberculosis. With the successful treatment of tuberculosis worldwide, interest in Pott disease has faded from the surgical forefront over the last 20 years. With the recent unchecked global pandemic of human immunodeficiency virus, the number of tuberculosis and secondary spondylitis cases is again increasing at an alarming rate. A surgical revisitation of Pott disease is thus essential to prepare spinal surgeons for this impending resurgence of tuberculosis. ⋯ Unlike historical times, effective medical and surgical management of tuberculous spondyitis is now possible. Proper selection of drug therapy and operative modalities, however, is needed to optimize functional outcomes for each individual case of Pott disease.
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Threaded lumbar cages have been used as a safe and effective surgical fusion method for a decade. Smaller versions have now been developed for the cervical spine to obviate the need for allograft use or iliac autograft harvest and to provide initial stability before fusion. ⋯ In this study, the BAK/C cage group had the lowest graft requirements/risks, generally required fewer hospital resources, achieved similar patient outcomes and fused at a higher rate than ACDF and plate groups.