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[Comparison of treatment with microendoscopic discectomy and posterior lumbar interbody fusion using single and double B-Twin expandable spinal spacer].

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[Comparison of treatment with microendoscopic discectomy and posterior lumbar interbody fusion using single and double B-Twin expandable spinal spacer].

Zhonghua Wai Ke Za Zhi. 2010 Nov 1;48(21):1637-41

Authors: Zhang DQ, Yang Q, Jiang CM, Wu CM, Ma K, Tang K, Liu Y, Wang B

To compare the therapeutic effect of posterior lumbar interbody fusion by single and double B-Twin expandable spinal spacer with microendoscopic discectomy (MED) for lumbar intervertebral disc protrusion accompanying degenerative instability.

PMID: 21211259 [PubMed – in process]

Odontoid Peg Fracture Non-Union

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Os odontoideumAn oval or round well-corticated ossicle of variable size, found in the expected position of the odontoid process.Current opinion considers os odontoideum  to represent the result of prior, often unrecognised, trauma. Atlanto-axial instability occurs in 83% of cases of os odontoideum. Therefore, when an os odontoideum is noted, flexion/extension radiographs should be obtained to exclude…

Lower Back Pain with Sciatic Disorder Following L5 Dermatome Caused by Herpes Zoster Infection.

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Lower Back Pain with Sciatic Disorder Following L5 Dermatome Caused by Herpes Zoster Infection.

Orthop Rev (Pavia). 2015 Sep 28;7(3):6046

Authors: Hackenberg RK, von den Driesch A, König DP

Abstract
We report the case of a 62-year-old patient with lower back pain radiating into the right leg accompanied by numbness. The pain had an acute onset and was resistant to conservative pain treatment. A magnetic resonance imaging (MRI) scan of the lumbar spine showed no degenerative discovertebral lesions, but a swelling of the nerve root supplying the affected dermatome. For pain treatment the patient received lumbar epidural infiltrations. During this treatment the patient suddenly developed a skin rash with grouped vesicular blisters on an erythematous ground. After the diagnosis of a lumbar herpes zoster and an acyclovir treatment, the patient could be discharged in an ameliorated condition. This case demonstrates the importance to consider rare causes of lumbosciatic pain and disorders and to acknowledge unspecific changes in a MRI scan.

PMID: 26605030 [PubMed – as supplied by publisher]

Modified Mini-Open Transforaminal Lumbar Interbody Fusion (MOTLIF): Description of Surgical Technique and Assessment of Free-Hand Pedicle Screw Insertion.

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Modified Mini-Open Transforaminal Lumbar Interbody Fusion (MOTLIF): Description of Surgical Technique and Assessment of Free-Hand Pedicle Screw Insertion.

Spine (Phila Pa 1976). 2016 Feb 23;

Authors: Pakzaban P

Abstract
STUDY DESIGN: Retrospective case series OBJECTIVE.: To describe a modified technique for miniopen transforaminal lumbar interbody fusion (TLIF) which improves visualization for decompression, fusion and free-hand pedicle screw insertion. Accuracy of free-hand pedicle screw placement with this technique was assessed.
SUMMARY OF BACKGROUND DATA: Mini-open TLIF is a minimally invasive technique that allows limited visualization of the boney and neural anatomy via an expandable tubular retractor inserted through the Wiltse plane. No significant modification that of this technique has been described in detail.
METHODS: 92 consecutive patients underwent one-level modified mini-open TLIF (MOTLIF). MOTLIF modifications consisted of: trans-muscular dissection through the multifidus muscle rather than inter-muscular dissection in the Wiltse plane; microsurgical detachment of multifidus from the facet rather than muscle dilation; en bloc total facetectomy (unilateral or bilateral, as needed for decompression); facet autograft used for interbody fusion; solid pedicle screws placed bilaterally by a free-hand technique under direct vision.
RESULTS: The mean age was 53 years. Mean follow-up was 35 months (minimum 2 years). By 6 months, mean VAS for back and leg pain had improved from 51 to 19 and from 58 to 17, respectively, and mean ODI improved from 53 to 16. These improvements persisted at 2 years. Solid fusion, defined by computed tomography (CT) at 1 year, was achieved in 88.1%, while satisfactory fusion was achieved in 95.2% of patients. Pedicle screws were accurately placed in 335 of 336 imaged pedicles (pedicle breach grades: 91.1% Grade 1; 8.6% Grade 2; 0.3% Grade 3). Mean fluoroscopy time was 29.3 seconds.
CONCLUSION: MOTLIF is a safe and effective minimally invasive technique with a high fusion rate. It allows accurate pedicle screw placement by a free-hand technique. By eliminating bi-planar fluoroscopy, it helps reduce radiation exposure. This is the largest published report of mini-open TLIF to date.
LEVEL OF EVIDENCE: 4Supplemental Digital Content is available in the textThis is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives 4.0 License, where it is permissible to download and share the work, provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0.

PMID: 26909829 [PubMed – as supplied by publisher]