Type 2 odontoid fractures are notorious for non-union. if not treated in a timely fashion, patients may develop irreducible atlantoaxial dislocation. Odontoidectomy or release of the dens via transoral approach with posterior instrumented fusion is generally employed for treating such cases. However, transoral approach is usually undesirable due to its high rate of complications.
Approximately 10% of patients with oncologic disease develop spinal metastases. One third of patients with spinal metastases develop symptoms such as pain, neurological impairment, or biomechanical instability. Various techniques have been described, however the latest advances in minimally invasive approach have transformed oncological surgery, offering advantages like reductions in muscle damage, wound site infection, intraoperative blood loss, postoperative pain and length of stay
The objective of this study is to determine if there is a significant relationship between the duration of preoperative pain and the time to return to work in patients operated on for lumbar disc herniation in a social security hospital of Lima, Perú from 2016 to 2018.
Due to the changing landscape of surgical management for atlanto-axial instability after the advent of a posterior joint manipulation technique, standard transoral odontoidectomy seems to have fallen out of favor. Indications, however, exist favoring transoral approach. We report a series of 21 cases performed at our unit without the use of navigation systems.
Ewing's sarcoma is a primary malignant bone tumor, mainly affecting children and adolescents. It represents an undifferentiated form of primary peripheral neuroectodermal tumors (PNET). Vertebral location are rare.
Spinal dermoid cysts are rare congenital lesions. MRI can often diagnose dermoid cysts in their typical form, but superinfected cysts may be source of misdiagnosis due to their clinical particularities and unspecific radiological features.
Surgery for patients with gunshot wounds (GSWs) to the cervical spine remains controversial, however, the presence of neurologic damage, CSF leakage or signs of instability are surgical indications. C-spine instability is difficult to rule out in patients with GSW. We present a case of a patient with an extensive C2-C3 disc damage treated by operative management in order to prevent late spine instability.
Finite element analysis (FEA) is a mathematical method which has applications in biologic processes. The objective of this study was to develop a novel FEA model with trabecular-to-cortical bone proportion of the lumbosacral spine.
Traumatic injuries in the thoracolumbar region are common, with high functional loss rate, representing high costs for health systems from a surgical and rehabilitation point of view. The classification "Thoracolumbar Injury Classification and Severity" (TLICS), evaluating three items, fracture morphology, neurological status and subsequent ligament complex commitment; has become an excellent guide to defining behavior for patients who benefit from a surgical vs. medical proposal.
Conventional posterior cervical foraminotomy is a surgical technique developed to treat cervical radiculopathy that involves important retraction and trauma in the adjacent tissues which is why minimally invasive techniques have been described to achieve better surgical outcomes. The objective is this article is to review the anatomy and surgical technique needed for a minimally invasive posterior cervical foraminotomy and to evaluate clinical and imagenologic outcomes in a series of patients who underwent surgery using this technique.
Cervical spondylodiscitis represents 3-6% of cases of vertebral osteomyelitis. However frequent complications with a negative impact on neurologic function and quality of life from this condition impose an uphill battle to the surgeon and prompt for early and accurate treatment decisions.
Spinal erector plane (PEE) block at the dorsolumbar level under ultrasound guidance is a technique that has been used in recent years for the management of postoperative pain in various surgical procedures, including patients treated by arthrodesis in the dorsal and lumbar spine. The results have been promising, as some authors have shown that the intensity of pain and the requirement for postoperative opioid use decrease. In this work, the results obtained with the use of the spinal erector plane block under direct vision in patients undergoing spinal surgery are reported.
Mesenchymal chondrosarcoma (MCS) is a rare malignant variant of chondrosarcoma with a high tendency of recurrence and metastasis. Intracranial chondrosarcomas are primary cartilaginous neoplasms that represent 6% of all skull base tumors. Intracranial extraskeletal chondrosarcomas are more rare, often arising from the meninges at the falx, tentorium, or cerebral convexity. They are generally characterized as classical or mesenchymal, with the latter associated with worse outcomes.
Neurological deterioration is a feared complication of closed reduction of cervical spine fractures. Frequently this is due to a prolapsed disc, cord oedema, and mechanical factors – but rarely an epidural haematoma.In this case report we described a patient who initially had a normal cervical spine MRI following closed reduction. However, he quickly deteriorated neurologically, and his repeat MRI revealed a large dorsal epidural haematoma. After an urgent decompression and laminectomy, his neurological function improved.Considering this case, we reviewed the different aetiologies of neurological decline during closed reduction with traction and highlighted the importance of serial neurological examinations during the process. The incidence of epidural haematomas during traction is also discussed, as there is only one documented case of an epidural haematoma following traction.
The Degenerative lumbar Spondylolisthesis Instability Classification (DSIC) system categorizes three different types of spondylolisthesis (stable, potentially unstable, and unstable) based on surgeon impression. It does not contain objective criteria. Objective-1: Develop a quantitative DSIC system from predetermined radiographic and clinical variables. Objective-2: Compare qualitative (surgeon-assigned) DSIC Types to quantitative (objective) DSIC Types. Objective-3: Determine proportion of patients receiving more invasive surgery than warranted based on the quantitative DSIC system.
Sublaminar bands is a new system of stabilization of the spine, in order to favor an arthrodesis or the consolidation of a vertebral fracture. This system was designed for a posterior approach. It can be used in the following indications: surgery of spinal injuries, reconstructive surgery of the spine, incorporated in fixtures of correction of the spinal deformities like scoliosis, kyphosis and the degenerative surgery of the rachis, as a support to fusion. The aim of our study is to evaluate the efficacy and the safety of sublaminar bands in the correction of the deviations of the spine on a series of 07 patients operated in the department of neurosurgery of the ARRAZI Hospital of Mohamed VI University Hospital of Marrakech.