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J Neurol Surg A Cent Eur Neurosurg 2020 Jun 22. Epub 2020 Jun 22.

Department of Neurosurgery, Nanoori Hospital Gangnam, Seoul, Republic of Korea.

Background:  With advances in techniques and instruments, percutaneous endoscopic transforaminal lumbar diskectomy (PETLD) is now widely used for lumbar disk herniation. Although the indication for PETLD is expanding, the technique still has limitations. To overcome them, we performed the epidural catheter-assisted PETLD described here. Read More

Surg Neurol Int 2020 9;11:104. Epub 2020 May 9.

Department of Neurosurgery, University of California San Diego School of Medicine, San Diego, California, United States.

Background: An engorged venous plexus may mimic nerve compression from a herniated disk on the magnetic resonance (MR) studies as they both have similar signal intensities. During a laminectomy, if an engorged venous plexus is encountered instead of a disk herniation, there may be marked unanticipated bleeding.

Case Description: A 58-year-old female who had a prior anterior lumbar interbody fusion later returned with recurrent radiculopathy. Read More

World Neurosurg 2020 May 18. Epub 2020 May 18.

Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands.

Background: Intracranial hypotension (IH) has a widely variable clinical and radiologic presentation. Secondary IH may be caused by degenerative spine disorders and in particular by thoracic disk herniations (TDHs).

Methods: We present 2 patients with a transdural TDH, a secondary IH, and superficial siderosis in 1. Read More

Clin Spine Surg 2020 Mar 6. Epub 2020 Mar 6.

Department of Orthopaedics, Harvard Medical School, Massachusetts General Hospital, Boston, MA.

Study Design: Retrospective study.

Objective: The goal of this study is to identify and validate the reliability and accuracy of 2 methods used to assess lumbar disk herniations (LDHs): anteroposterior length and cross-sectional area.

Background: Many clinicians characterize LDHs through the measurement of the anteroposterior length in the axial plane. Read More

Skeletal Radiol 2020 Jul 26;49(7):1141-1147. Epub 2020 Feb 26.

Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, 808 Route de Lennik, 1070, Brussels, Belgium.

Objective: To prospectively compare the prevalence and frequency of subchondral bone marrow edema (BME) in the lumbar facet joints of low back pain patients and healthy subjects.

Materials And Methods: Lumbar magnetic resonance imaging (MRI) examinations were performed on 55 asymptomatic participants (18 men; age range 21-63; mean 36 ± 12 years; body mass index (BMI) range 16-31; mean 22.6 ± 3. Read More

Eur Spine J 2020 Jul 18;29(7):1702-1708. Epub 2020 Feb 18.

Department of Neurosurgery, Bergman Clinics, Amsterdam, The Netherlands.

Objective: The five-repetition sit-to-stand (5R-STS) test was designed to capture objective functional impairment and thus provided an adjunctive dimension in patient assessment. The clinical interpretability and confounders of the 5R-STS remain poorly understood. In clinical use, it became apparent that 5R-STS performance may differ between patients with lumbar disk herniation (LDH), lumbar spinal stenosis (LSS) with or without low-grade spondylolisthesis, and chronic low back pain (CLBP). Read More

J Neurol Surg A Cent Eur Neurosurg 2020 Feb 11. Epub 2020 Feb 11.

Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.

Background And Study Aims:  Technically and anatomically, accessing a high-grade migrated lumbar disk herniation (LDH) using traditional full endoscopic lumbar diskectomy (FELD) approaches (either transforaminal or interlaminar) is challenging. The objective of this study was to present an effective and safe surgical approach for high-grade up-migrated LDH by translaminar FELD.

Patients And Methods:  Thirteen patients with soft high-grade up-migrated LDH treated with a translaminar FELD between May 2015 and July 2018 were reviewed in this study. Read More

Radiol Med 2020 Jun 10;125(6):569-577. Epub 2020 Feb 10.

Unità Operativa di Radiologia, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.

Aim: To compare clinical success and patient satisfaction of percutaneous cervical nucleoplasty (PCN) and percutaneous cervical discectomy (PCD) in contained cervical disc herniation treatment.

Materials And Methods: We retrospectively identified 50 consecutive patients in our institution: 24 underwent the PCD treatment and 26 patients were treated by the PCN procedure. All patients complained of radicular pain with or without neck pain; diagnosis of contained cervical disc herniation was obtained by MRI; all patients had received conservative therapy which did not result in symptom improvement. Read More

World Neurosurg 2020 May 3;137:e336-e342. Epub 2020 Feb 3.

Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

Background: Percutaneous transforaminal endoscopic diskectomy has been a major treatment for lumbar disk herniation. However, damage to exiting nerve roots is one of the most severe complications in this surgery. In this paper, the relationship of the exiting nerve root and the superior articular process in Kambin's triangle of the lumbar intervertebral foramen was assessed using cadavers and computed tomography (CT) imaging. Read More

J Am Vet Med Assoc 2020 01;256(2):210-219

Objective: To determine the accuracy of the surgeon's perception versus postoperative MRI findings in assessing the effectiveness of spinal cord decompression achieved in dogs surgically treated for intervertebral disk extrusion (IVDE) and whether postoperative MRI findings were more likely to be associated with various outcomes.

Animals: 68 dogs surgically treated for cervical or thoracolumbar IVDE.

Procedures: Data on clinical, neurologic, pre- and postoperative MRI, and intraoperative findings as well as outcomes and recovery times (6-month follow-up period) were prospectively collected and compared between various groups. Read More

World Neurosurg 2020 Feb 28;134:540-543. Epub 2019 Nov 28.

Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences, Gwangju, Korea. Electronic address:

Background: Intradural disk herniation (IDH) is defined as the displacement of the intervertebral disk nucleus pulposus into the dural sac. In this lumbar lesion, the affected level differs from that of a traditional extradural herniation: 55% of cases occur at the level of L4-5, 16% at L3-4, and 10% at L5-S1. Upper lumbar IDH is extremely rare. Read More

Front Vet Sci 2019 8;6:383. Epub 2019 Nov 8.

Postgraduate Program in Animal Science, Pontifical Catholic University of Paraná, Curitiba, Brazil.

Paraparesis and paraplegia are common conditions in dogs, most often caused by a disc herniation in the thoracolumbar spinal segments (T3-L3), which is a neurological emergency. Surgical decompression should be performed as soon as possible when spinal compression is revealed by myelography, computed tomography, or magnetic resonance imaging. Mesenchymal stem-cell therapy is a promising adjunct treatment for spinal cord injury. Read More

World Neurosurg 2020 Feb 4;134:182-186. Epub 2019 Nov 4.

Department of Neurosurgery, Koç University Hospital, Istanbul, Turkey. Electronic address:

Background: Percutaneous endoscopic surgery is a common technique used for the treatment of disk herniation and spinal stenosis. In this report, we present a patient who underwent percutaneous endoscopic decompression due to spinal metastasis.

Case Description: A 72-year-old female patient with a known diagnosis of lung cancer presented to our clinic with a 10-day history of severe pain in the left leg and a 5-day history of muscle weakness in the left thigh. Read More

World Neurosurg 2019 Dec 12;132:273-281. Epub 2019 Sep 12.

Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P. R. China. Electronic address:

Objective: Although many risk factors for cage retropulsion (CR) after lumbar interbody fusion (LIF) have been described in the literature, they still remain controversial. The purpose of this study is to investigate the risk factors for CR after LIF.

Methods: The literature was searched in PubMed, Cochrane library, and Embase from October 2000 to October 2018. Read More

World Neurosurg 2020 Jan 7;133:135-141. Epub 2019 Sep 7.

Joint Orthopaedic Research Center of Zunyi Medical University & University of Rochester Medical Center, Zunyi Medical University, Zunyi, Guizhou, China. Electronic address:

Background: The occurrence rate of thoracic spinal stenosis caused by ossification of the ligamentum flavum combined with disk herniation is lower than that of ossified ligamentum flavum in the thoracic spine, and the treatment method has rarely been reported. In this paper, we applied an endoscopic technique to a patient with thoracic spinal stenosis caused by ossification of the ligamentum flavum combined with disk herniation at the T10-11 level.

Methods: We performed surgical decompression of the thoracic spinal cord for a patient diagnosed with thoracic spinal stenosis at the T10-11 level caused by ossification of the ligamentum flavum combined with disk herniation using percutaneous endoscopic surgery via the bilateral translaminar osseous channel approach. Read More

J Vet Intern Med 2019 Sep 30;33(5):2160-2166. Epub 2019 Aug 30.

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon Tharp St., Columbus, Ohio.

Background: Cervical spondylomyelopathy (CSM) occurs because of compression of the cervical spinal cord, nerve roots, or both, usually affecting young adult to older large and giant breed dogs. Juvenile dogs are affected infrequently.

Objective: To describe clinical and magnetic resonance imaging (MRI) findings in juvenile dogs (≤ 12 months) with cervical spondylomyelopathy. Read More

J Neurol Surg A Cent Eur Neurosurg 2020 Jan 29;81(1):17-27. Epub 2019 Aug 29.

Department of Neurosurgery, Universitatsklinikum Giessen und Marburg, Giessen, Germany.

Objective:  Microsurgical diskectomy/sequestrectomy is the standard procedure for the surgical treatment of lumbar disk herniations. The transforaminal endoscopic sequestrectomy technique is a minimally invasive alternative with potential advantages such as minimal blood loss and tissue damage, as well as early mobilization of the patient. We report the implementation of this technique in a German university hospital setting. Read More

Clin Rehabil 2020 Jan 28;34(1):13-22. Epub 2019 Aug 28.

Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei.

Objective: To evaluate the effectiveness of traction in improving low back pain, functional outcome, and disk morphology in patients with herniated intervertebral disks.

Data Source: PubMed, Scopus, Embase, and the Cochrane Library were searched from the earliest record to July 2019.

Review Methods: We included randomized control trials which (1) involved adult patients with low back pain associated with herniated disk confirmed by magnetic resonance imaging or computed tomography, (2) compared lumbar traction to sham or no traction, and (3) provided quantitative measurements of pain and function before and after intervention. Read More

World Neurosurg 2019 Dec 20;132:47-52. Epub 2019 Aug 20.

Department of Spine Surgery, Affiliated Hospital of Zunyi Medical University, Huichuan District, Zunyi City, Guizhou Province, China.

Background: With the continuous advancement of the spinal endoscopic technique in recent years, full-endoscopic operations provide a new approach for the treatment of migrated cervical disk herniation.

Case Description: A 42-year-old man presented with nuchal pain and limb numbness for 2 months, with recently developed symptoms of unstable walking. Physical examination revealed a diminished skin sensitivity to pain and temperature, beginning at the C4 dermatome. Read More

Asian Spine J 2019 Dec 20;13(6):913-919. Epub 2019 Aug 20.

Fulya Orthopedics and Spine Center, İstanbul, Turkey.

Study Design: Retrospective clinical study.

Purpose: To evaluate clinical results of the M6 cervical prosthesis.

Overview Of Literature: Cervical disk prostheses have been developed to preserve motion and reduce degeneration in adjacent segments in degenerative disk diseases. Read More

Pain 2019 12;160(12):2829-2840

China-USA Neuroimaging Research Institute, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.

Brain functional network properties are globally disrupted in multiple musculoskeletal chronic pain conditions. Back pain with lumbar disk herniation (LDH) is highly prevalent and a major route for progression to chronic back pain. However, brain functional network properties remain unknown in such patients. Read More

World Neurosurg 2019 Nov 2;131:112-115. Epub 2019 Aug 2.

Department of Materials and Textiles, Oriental Institute of Technology, New Taipei, Taiwan; Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan. Electronic address:

Background: Pneumocephalus is a rare complication after an elective lumbar spine surgery. Full endoscopic lumbar diskectomy (FELD) is an evolving minimally invasive surgical procedure gaining its popularity in the past decade. Although seizure was recognized as a possible complication, organic injury to the central nervous system such as pneumocephalus has not yet been reported after FELD. Read More

Cureus 2019 May 11;11(5):e4645. Epub 2019 May 11.

Surgery, The University of Toledo Medical Center, Toledo, USA.

Epidural disc extrusion is extremely rare and may cause cauda equina syndrome. This is a surgical emergency and needs rapid decompression. Although cauda equina is commonly caused by disc herniation, this is an unusual presentation with epidural disc extrusion. Read More

World Neurosurg 2019 Sep 15;129:e857-e865. Epub 2019 Jun 15.

Department of Neurosurgery, St. Barbara-Hospital, Academic Hospital of Westfälische Wilhelms-Universität Münster, Hamm, Germany.

Background: Foraminal cervical nerve root compression can be caused by lateral disk herniation or osteophyte formation of the vertebrae. Improved diagnosis and evaluation can be achieved using different imaging techniques: radiographs, computed tomography (CT), and magnetic resonance imaging. We retrospectively evaluated the potential influence of a virtual reality (VR) visualization technique on surgery planning and evaluation of postoperative results in patients with monosegmental, unilateral osseous cervical neuroforaminal stenosis. Read More

Medicine (Baltimore) 2019 Jun;98(24):e15912

Hematology Department.

Rationale: The differential diagnosis of conditions manifesting as bone and joint pain is complex. Although many individuals with acute leukemia experience bone pain, lumbosacral pain as an early feature of acute lymphoblastic leukemia (ALL) is rare.

Patient Concerns: Here we report a case of an adult who presented with a 7-month history of persistent lumbosacral pain which had become more severe during the previous month. Read More

Brain Sci 2019 May 29;9(6). Epub 2019 May 29.

Department of Emergency Medicine, Loma Linda University Medical Center, Loma Lind 92354, CA, USA.

The authors report a case in which a 38-year-old male who presented himself to the emergency department with a chief complaint of cervical neck pain and paresthesia radiating from the right pectoral region down his distal right arm following self-manipulation of the patient's own cervical vertebrae. Initial emergency department imaging via cervical x-ray and magnetic resonance imaging (MRI) without contrast revealed no cervical fractures; however, there was evidence of an acute cervical disc herniation (C3-C7) with severe herniation and spinal stenosis located at C5-C6. Immediate discectomy at C5-C6 and anterior arthrodesis was conducted in order to decompress the cervical spinal cord. Read More

BMC Vet Res 2019 May 14;15(1):148. Epub 2019 May 14.

Division of Neurological Sciences, Division of Clinical Veterinary Neurology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Laenggassstrasse 128, 3012, Bern, Switzerland.

Background: Hemorrhage in the spinal canal leads to further damage of the spinal cord influencing outcome in dogs with intervertebral disk (IVD) extrusion. The aim of the study was to evaluate blood degradation products and ferritin in the cerebrospinal fluid (CSF) of dogs with thoracolumbar IVD extrusion, and their association to clinical parameters and MRI findings.

Results: In the CSF of dogs with IVD extrusion, both net oxyhemoglobin absorption (NOA) and net bilirubin absorption (NBA) were significantly higher compared to the control groups of dogs with steroid responsive meningitis arteritis (SRMA) and idiopathic epilepsy (IE) (P < 0. Read More

World Neurosurg 2019 Aug 25;128:e315-e321. Epub 2019 Apr 25.

Division of Spine Surgery, Department of Orthopedic Surgery, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, Fujian, P.R. China.

Objective: To describe the operative methods and to investigate the efficacy of ventral neural decompression under microscopic vision with oblique lumbar interbody fusion (OLIF).

Methods: Twelve patients with extruded or sequestered disk were treated with ventral neural decompression under microscopic vision via the working corridor of routine OLIF. Their clinical data were gathered and analyzed retrospectively. Read More

J Stroke Cerebrovasc Dis 2019 Jun 28;28(6):e66-e67. Epub 2019 Mar 28.

Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois. Electronic address:

Fibrocartilaginous embolism (FCE) is an uncommon cause of spinal cord infarction often misdiagnosed as transverse myelitis. The mechanism of ischemia is suspected to be due to retrograde embolization of nucleus pulposus material originating from Schmorl's nodes to the spinal vessels following acute disk herniation. We describe the clinical and imaging findings of FCE in 3 healthy young women with history of trivial spinal cord trauma, and recommend that FCE should be considered in the differential diagnosis of acute myelopathy. Read More

J Pediatr Orthop 2019 Nov/Dec;39(10):e791-e795

Texas Scottish Rite Hospital for Children, Dallas, TX.

Background: Lumbar herniated nucleus pulposis (HNP) occurs infrequently in the pediatric/adolescent population. A minority of patients with radicular symptoms fail to improve with conservative management and require discectomy. The authors hypothesize that children who ultimately require surgical intervention have an underlying lumbar stenosis predisposing them to continued symptoms. Read More

Zhongguo Gu Shang 2019 Mar;32(3):239-243

Suzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, Suzhou 215009, Jiangsu, China.

Objective: To explore the clinical effect of conservative treatment for giant lumbar intervertebral disc herniation and analyze the factors affecting its resorption.

Methods: From January 2013 to December 2016, the clinical data of 130 patients with giant lumbar intervertebral disc herniation were collected. The patients were classified according to the characteristics of Iwabuchi displacement and "bull eye sign", Xiaosui Huahe decoction of traditional Chinese medicine conservative treatment was used in the patients. Read More

Oper Neurosurg (Hagerstown) 2020 Jan;18(1):E8

Department of Neurosurgery, Nanoori Incheon Hospital, Incheon, Republic of Korea.

The conventional surgical approach to far lateral lumbar disk herniations is a paraspinal Wiltse approach. During the Wiltse approach, it is sometimes necessary to resect some of the facet or pars interarticularis to achieve an adequate exposure. The endoscopic transforaminal route can be of benefit in far lateral disk herniations due to direct access to the epidural space through Kambin's triangle, without the need for any bony removal or nerve retraction. Read More

J Neurol Surg A Cent Eur Neurosurg 2019 May 1;80(3):169-173. Epub 2019 Feb 1.

Department of Neurosurgery, Okmeydanı Training and Research Hospital, Istanbul, Turkey.

Purpose: Thoracic disk herniation (TDH) is relatively uncommon. The surgical approach differs from lumbar or cervical disk herniations because serious complications are associated with the posterior approach in TDH. Various different approaches have been tried for the surgical removal of TDH, but most of them are cumbersome surgeries such as thoracotomy or thoracoscopic or anterior approaches with or without instrumentation. Read More

World Neurosurg 2019 Jun 29;126:e33-e40. Epub 2019 Jan 29.

The Atkinson Morley Neurosurgical Department, St. George's Hospital, Tooting, England.

Background: Symptomatic spinal epidural lipomatosis (SSEL) is characterized by hypertrophy of adipose tissue within the spinal canal and consequent neural compromise. The exact pathogenesis remains enigmatic. The authors describe a retrospective case series, define the full clinical spectrum, and discuss possible pathogenetic mechanisms. Read More

World Neurosurg 2019 05 28;125:1-2. Epub 2019 Jan 28.

Department of Neurological Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA.

Calcified disk herniation of the thoracic spine is by no means a rare clinical entity in neurosurgery. We present a 63-year-old woman with a long-standing giant calcified disk in the thoracic spine. Initial imaging studies indicated a differential diagnosis of calcified disk versus meningioma. Read More

PM R 2019 08 28;11(8):807-814. Epub 2019 Mar 28.

Department of Physical Medicine and Rehabilitation, Moss Rehab, Elkins Park, PA.

Background: The clinical course of motor deficits from lumbosacral radiculopathy appears to improve with or without surgery. Strength measurements have been confined to manual muscle testing (MMT) and have not been extensively followed and quantified in prior studies.

Objective: To determine if motor weakness and patient-reported outcomes related to lumbosacral radiculopathy improve without surgical intervention over the course of 12 months. Read More

PM R 2019 09 1;11(9):934-938. Epub 2019 Apr 1.

New England Baptist Hospital, Boston, MA.

Background: Cervical radiculopathy (CR) is a clinical diagnosis defined as a combination of neck, shoulder, and arm pain, often accompanied by sensory and motor symptoms. CR is often caused by degenerative spine pathology associated with impingement of a cervical nerve root, and this pathology can be visualized using magnetic resonance imaging (MRI) or computed tomography (CT). [Correction added September 4, 2019, after online publication: 'computer tomography' corrected to 'computed tomography'] Factors that are associated with the onset of CR have not been explored. Read More

Ophthalmic Plast Reconstr Surg 2019 May/Jun;35(3):e85

Departments of Oculoplastics and Reconstructive surgery.

Eur Spine J 2019 04 17;28(4):849-854. Epub 2019 Jan 17.

Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan.

Introduction: Abnormalities of the lumbar nerve tract caused by congenital variations or high nerve root take-off angles are difficult to visualize. Diffusion-weighted magnetic resonance neurography (DW-MRN) has recently been introduced for imaging of the lumbosacral region. The aims of this study were to identify lumbar nerve tract abnormalities caused by congenital variation or a high nerve root take-off angle using DW-MRN and to assess the diagnostic value of this imaging modality. Read More

Neurosurg Rev 2019 Dec 8;42(4):885-894. Epub 2019 Jan 8.

Department of Orthopaedic Surgery, University of California, 500 Parnassus Avenue, MU 320W, San Francisco, CA, 94143-0728, USA.

Although symptomatic thoracic disk herniation (TDH) is relatively rare, its treatment is quite difficult. Our aim is to present the outcomes and complications in patients with thoracic disk herniation treated with minimally invasive lateral transthoracic approach (LTTA). Fifty-nine consecutive patients with 69 symptomatic disk herniations that underwent minimally invasive LTTA to treat TDH between 2007 and 2016 were enrolled. Read More

Radiology 2019 02 4;290(2):446-455. Epub 2018 Dec 4.

From the Division of Experimental and Translational Imaging (C.B., J.N., S.S.M., M.H.A., I.Y., L.L., T.D., J.L.W.) and Department of Diagnostic and Interventional Radiology (T.G.R., K.E., T.J.V.), University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; and Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy (T.D.).

Purpose To assess the diagnostic performance of dual-energy CT with reconstruction of virtual noncalcium (VNCa) images for the detection of lumbar disk herniation compared with standard CT image reconstruction. Materials and Methods For this retrospective study, 41 patients (243 intervertebral disks; overall mean age, 68 years; 24 women [mean age, 68 years] and 17 men [mean age, 68 years]) underwent clinically indicated third-generation, dual-source, dual-energy CT and 3.0-T MRI within 2 weeks between March 2017 and January 2018. Read More

Cardiovasc Intervent Radiol 2019 May 2;42(5):775-778. Epub 2019 Jan 2.

MGH Harvard Medical School, Boston, USA.

We describe the case of a 30-year-old patient who was referred for lumbar epidural corticosteroid injection due to right L5 radiculopathy. Two months earlier, MRI demonstrated a right large paracentral L4-L5 disk extrusion causing disabling L5 radiculopathy. The L4-L5 level was selected for interlaminar injection, using fluoroscopic guidance. Read More

J Med Case Rep 2018 Dec 28;12(1):391. Epub 2018 Dec 28.

Biruni University Hospital, Istanbul, Turkey.

Background: Projectile foreign bodies are known to cause chronic heavy metal toxicity due to the release of metal into the bloodstream. However, the local effect around the metallic object has not been investigated and the main goal of our study is to examine the influence of the object in close proximity of the object.

Case Presentation: A 36-year-old Caucasian woman with one metallic pellet close to her sciatic nerve due to a previous shotgun injury at the gluteal area presented with a diagnosis of recurrent lumbar disk herniation at L4-5 level. Read More

J Neurol Surg A Cent Eur Neurosurg 2019 Mar 24;80(2):88-95. Epub 2018 Dec 24.

Department of Orthopaedic and Spine Surgery, Seikei-kai Chiba Medical Center, Chiba, Japan.

Background:  With effective preoperative planning, percutaneous endoscopic diskectomy (PED) via an interlaminar approach (PED-IL) can reduce the need for partial laminectomy. Our aim was to assess the clinical outcomes of PED-IL, planned using three-dimensional fusion of computed tomography and magnetic resonance (3D CT/MR) images.

Material And Methods:  Our retrospective analysis was based on data from 102 patients (66 were men) treated by PED-IL. Read More

J Am Acad Orthop Surg 2019 Jul;27(14):e633-e640

From the Department of Orthopaedics, Beaumont Health System, Royal Oak, MI.

Cutibacterium acnes, long thought to be skin flora of pathological insignificance, has seen a surge in interest for its role in spine pathology. C acnes has been identified as a pathogen in native spine infection and osteomyelitis, which has implications in the management compared with more commonly recognized pathogens. In addition, It has also been recognized as a pathogen in postoperative and implant-associated infections. Read More

Eurasian J Med 2018 Oct;50(3):178-181

Department of Neurosurgery, Atatürk University School of Medicine, Erzurum, Turkey.

Objective: The aim of this study was to evaluate the outcomes of patients with lumbar disk hernia operated between 2012 January and 2017 August and to compare the differences between open discectomy (OD) and microdiscectomy (MD).

Materials And Methods: Files of 519 patients who presented at our neurosurgical department with lumbar disk herniation were retrospectively reviewed and recorded. Preoperatively, all patients routinely underwent spinal lumbar magnetic resonance imaging (MRI) and anteroposterior as well as lateral lumbar vertebrae X-rays. Read More

World Neurosurg 2019 Feb 23;122:505-507. Epub 2018 Nov 23.

Department of Neurosurgery, Nanoori Hospital, Gangnam-gu, Seoul, Republic of Korea.

Background: Double crush of a nerve at the root level is not common. We describe here a double crush of the right L4 nerve with foramina to far lateral disk (ventral) and extraforaminal (dorsal) compression. The double crush was managed by endoscopy with a contralateral uniportal approach from the left interlaminar space. Read More

Spine (Phila Pa 1976) 2019 Jun;44(11):E640-E649

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ.

Study Design: Case-control whole-genome sequencing analysis of a highly select, young cohort with symptomatic lumbar disk herniation (LDH) compared with the standard variation in a large reference population.

Objective: To assess genetic influences predisposing pediatric and young adult patients to symptomatic LDH.

Summary Of Background Data: LDH has traditionally been attributed to natural weakening or mechanical insult, but recent literature supports a potential genetic influence. Read More

World Neurosurg 2019 Feb 15;122:e1345-e1353. Epub 2018 Nov 15.

Department of Orthopaedics, The Second Affiliated Hospital, Chongqing Medical University, District Yuzhong, Chongqing, China. Electronic address:

Objective: To examine the effects of anterior transcorporeal percutaneous endoscopic cervical diskectomy (ATPECD) for the treatment of single-level cervical intervertebral disk herniation (CIDH) with a focus on its safety, feasibility, clinical efficacy, and specific possible complications.

Methods: A series of 35 patients with symptomatic single-level CIDH were enrolled to be treated with ATPECD. Neck and arm pain was measured using the visual analog scale. Read More

J Ultrasound Med 2019 Jul 13;38(7):1695-1703. Epub 2018 Nov 13.

Department of Radiology, Istanbul University, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.

Objectives: To assess lumbar multifidus muscle stiffness in patients with unilateral lumbar disk herniation (LDH) causing nerve root compression using shear wave elastography (SWE).

Methods: Thirty-three patients with unilateral subarticular LDH (L3-L4, L4-L5, and L5-S1) causing nerve root compression, diagnosed by magnetic resonance imaging, were enrolled in the study. Exclusion criteria were bilateral or multilevel LDH confirmed on magnetic resonance imaging, bilateral leg symptoms, and patients with a history of any spinal operation, malignancy, trauma, infection, spondylolisthesis, severe lateral recess stenosis, spinal canal stenosis, and substantial comorbidities. Read More