Menu
Menu
19 Harley St, London, W1G 9QJ, UK

Day: December 25, 2016

[Radicular pain caused by Schmörl’s node: a case report].

By London Spine

[Radicular pain caused by Schmörl’s node: a case report].

Rev Bras Anestesiol. 2017 Oct 04;:

Authors: Kim S, Jang S

Abstract
Schmörl’s node is focal herniation of intervertebral disc through the end plate into the vertebral body. Most of the established Schmörl’s nodes are quiescent. However, disc herniation into the vertebral marrow can cause low back pain by irritating a nociceptive system. Schmörl’s node induced radicular pain is very rare condition. Some cases of Schmörl’s node which generated low back pain or radicular pain were treated by surgical methods. In this article, authors reported a rare case of a patient with radicular pain cause by Schmörl’s node located inferior surface of the 5th lumbar spine. The radicular pain was alleviated by serial 5th lumbar transforamnial epidural blocks. Transforamnial epidural block is suggested as first conservative option to treat radicular pain due to herniation of intervertebral disc. Therefore, non-surgical treatment such as transforamnial epidural block can be considered first treatment option of radicular pain caused by Schmörl’s node.

PMID: 28987417 [PubMed – as supplied by publisher]

Efficacy and outcomes of dynamic-plated single-level anterior diskectomy/fusion with additional analysis of comparative costs.

By London Spine

Efficacy and outcomes of dynamic-plated single-level anterior diskectomy/fusion with additional analysis of comparative costs.

Surg Neurol Int. 2011;2:9

Authors: Epstein NE

Few studies focus on the fusion rates and outcomes for single-level anterior cervical diskectomy/fusion (1-ACDF) utilizing iliac autograft and dynamic plates.

PMID: 21297931 [PubMed]

Prospective evaluation of 1-year outcomes in single-level percutaneous lumbar transfacet screw fixation in the lateral decubitus position following lateral transpsoas interbody fusion.

By London Spine
Related Articles

Prospective evaluation of 1-year outcomes in single-level percutaneous lumbar transfacet screw fixation in the lateral decubitus position following lateral transpsoas interbody fusion.

Eur Spine J. 2015 Apr 18;

Authors: Rhee JW, Petteys RJ, Anaizi AN, Sandhu FA, Voyadzis JM

Abstract
PURPOSE: Lateral transpsoas lumbar interbody fusion (LTIF) is an accepted treatment for degenerative lumbar disc disease. Bilateral percutaneous transfacet (TF) fixation is a promising option for stabilization following LTIF. Here, we describe our experience with this technique and assess the clinical outcomes and efficacy.
METHODS: Thirty-eight consecutive patients were identified who underwent LTIF followed by bilateral percutaneous transfacet fixation in the lateral position. Preoperative and 1-year postoperative VAS scores, and operative data were prospectively recorded. One-year outcomes were also assessed according to the MacNab criteria. Fusion was assessed at 1 year via computed tomography and dynamic radiography. Two-tailed Student’s t test was used to compare VAS scores.
RESULTS: Twenty-six patients underwent fusion at L4-5, 11 at L3-4, and one at L2-3; two patients were lost to follow-up. Mean operative time was 148.0 ± 47.9 min; mean blood loss was 33.0 ± 26.1 ml; mean hospital stay was 53.5 ± 51.2 h. Mean preoperative VAS scores for back and leg pain were 7.4 ± 3.0 and 7.0 ± 2.9, respectively; mean postoperative VAS scores for back and leg pain were 1.9 ± 2.4 (p < 0.0001) and 2.0 ± 3.0 (p < 0.0001), respectively. Most (89 %) patients had some relief, 72 % good to excellent and 17 % fair outcomes; eleven percent had little to no relief. There was one postoperative complication (pulmonary embolus). All patients had evidence of solid bony fusion.
CONCLUSIONS: Percutaneous transfacet fixation in the lateral position is a safe and effective alternative for fixation after LTIF and may be associated with shorter operative time and less blood loss than other posterior fixation techniques.

PMID: 25893335 [PubMed – as supplied by publisher]

To the Editor.

By London Spine
Related Articles

To the Editor.

Spine (Phila Pa 1976). 2013 Oct 1;38(21):1901

Authors: Kovacs FM, Urrútia G, Arana E, Álvarez-Galovich L, Olabe J

PMID: 23846504 [PubMed – indexed for MEDLINE]

Analysis of complications and perioperative data after open or percutaneous dorsal instrumentation following traumatic spinal fracture of the thoracic and lumbar spine: a retrospective cohort study including 491 patients.

By London Spine
Related Articles

Analysis of complications and perioperative data after open or percutaneous dorsal instrumentation following traumatic spinal fracture of the thoracic and lumbar spine: a retrospective cohort study including 491 patients.

Eur Spine J. 2016 Dec 15;

Authors: Kreinest M, Rillig J, Grützner PA, Küffer M, Tinelli M, Matschke S

Abstract
PURPOSE: The aim of the current study is to analyze perioperative data and complications of open vs. percutaneous dorsal instrumentation after dorsal stabilization in patients suffering from fractures of the thoracic or lumbar spine.
METHODS: In the time period from 01/2007 to 06/2009, open surgical approach was used for dorsal stabilization. The percutaneous surgical approach was used from 05/2009 to 03/2014. In every time period, all types of fractures were treated only by open or by percutaneous approach, respectively, to avoid any selection bias. Retrospectively, epidemiological data, complications and perioperative data were documented and statistically analyzed.
RESULTS: A total of 491 patients met the inclusion criteria. Open surgery procedure was carried out on 169 patients, and percutaneous surgery procedure was carried out on 322 patients. Fracture level ranged from T1 to L5, and fractures were classified types A, B, and C. In 91.4% of all patients, no complication occured following dorsal stabilization after traumatic spine fracture during their hospital stay. However, 42 complications related to dorsal stabilization have been documented during the hospital stay. The complication rate was 14.8% if open surgical approach has been used and was significantly reduced to 5.3% using percutaneous surgical approach. Post-operative hospital stay was also reduced significantly using the percutaneous surgical approach.
CONCLUSIONS: According to the current study, percutaneous dorsal stabilization of the spine could also be safely used in trauma cases and is not restricted to degenerative spinal surgery.

PMID: 27981452 [PubMed – as supplied by publisher]

Dynamic transpedicular stabilisation and decompression in single-level degenerative anterolisthesis and stenosis.

By London Spine
Related Articles

Dynamic transpedicular stabilisation and decompression in single-level degenerative anterolisthesis and stenosis.

Acta Neurochir (Wien). 2013 Dec 19;

Authors: Payer M, Nicolas S, Oezkan N, Tessitore E

Abstract
BACKGROUND: Different treatment options exist for symptomatic single-level degenerative anterolisthesis and stenosis. While simple micro-decompression has been advocated lately, most authors recommend posterior decompression with fusion. In recent years, decompression and dynamic transpedicular stabilisation has been introduced for this indication. The aim of this study was to evaluate the safety and efficacy of decompression and dynamic transpedicular stabilisation with the Dynesys® system in single-level degenerative anterolisthesis and stenosis.
METHODS: Thirty consecutive patients with symptomatic single-level degenerative anterolisthesis and stenosis without scoliosis underwent decompression and single-level Dynesys stabilisation at the level of degenerative anterolisthesis. Patients were followed prospectively for 24 months with radiographs, Oswestry Disability Index scores, visual analogue scale (VAS) for back and leg pain, and estimated pain-free walking distance.
RESULTS: At the 2-year follow-up, back pain was reduced from 6.5 preoperatively to 2.5, leg pain from 5.4 to 0.6. The pain-free walking distance was estimated at 500 m preoperatively and at over 2 km after 2 years, while the ODI decreased from 54 % to 18 %. Screw loosening was found in 2/30 cases. Symptomatic adjacent segment disease was found in 3/30 patients between 12 and 24 months postoperatively.
CONCLUSIONS: Single-level Dynesys stabilisation combined with single- or multi-level decompression seems to be a safe and efficient treatment option in single-level degenerative anterolisthesis and stenosis over an observation period of 2 years, avoiding iliac crest or local bone grafting required by fusion procedures. However, it does not seem to avoid adjacent segment disease.

PMID: 24352372 [PubMed – as supplied by publisher]