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Medicine (Baltimore) 2019 Jan;98(1):e13970

Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka.

Prospective case-control study.This study used a prospective multicenter database to investigate whether dural tear (DT) is associated with an increased rate of other perioperative complications.Few studies have had sufficient data accuracy and statistical power to evaluate the association between DT and other complications owing to a low incidence of occurrence. Read More

J Biomech Eng 2018 Dec 5. Epub 2018 Dec 5.

ASME Fellow, Mechanical and Aerospace Engineering Department, Biomedical Engineering Department, University of California, Davis, 2132 Bainer Drive, Davis, CA 95616-5294.

Mathematical models of the human spine can be used to investigate spinal biomechanics without the difficulties, limitations and ethical concerns associated with physical experimentation. Validation of such models is necessary to ensure the modeled system behavior accurately represents the physics of the actual system. The goal of this work was to validate a medical image-based nonlinear lumbosacral spine finite element model of a healthy 20-year-old female subject under physiological moments. Read More

World Neurosurg 2019 Feb 1;122:e790-e794. Epub 2018 Nov 1.

Department of Neurosurgery, Harvard Medical School, Boston, Massachusetts, USA. Electronic address:

Objective: Lumbar spondylolisthesis can be related to facet arthropathy and disc degeneration or to a fracture of the pars interarticularis, but the mechanistic underpinnings of spondylolisthesis remain unclear. We posit that high sacral slope and body weight increase sacral inclination vector forces, which leads to pars fractures and exacerbates risk for spondylolisthesis.

Methods: To investigate this hypothesis, we measured the sacral slope, body weight, and S1 endplate vector forces for patients who underwent L5-S1 fusion for grade I spondylolisthesis. Read More

World Neurosurg 2018 11 21;119:304-305. Epub 2018 Aug 21.

Department of Neurosurgery, Avicenne Military Hospital, Marrakech, Morocco; Mohammed V University, Rabat, Morocco.

The pathogenesis of spinal posterior ring apophysis separation (PRAS) remains controversial, and spontaneous regression of PRAS has not been established previously. This is a case report about a 33-year-old man with a PRAS of the posterior superior end plate of S1 who presented with spontaneous low back pain followed by right leg pain. The patient was managed conservatively. Read More

World Neurosurg 2018 Nov 12;119:494-499. Epub 2018 Jun 12.

Department of Neurosurgery, Saarland University Medical Center and Faculty of Saarland University, Homburg-Saar, Germany. Electronic address:

Objective: The incidental dural tear is a common complication in lumbar spine surgery. It has been reported that the incidence of dural tears is much greater in endoscopic procedures. Primary closure via suturing remains challenging in endoscopic procedures. Read More

Pediatr Neurosurg 2018 30;53(4):263-269. Epub 2018 May 30.

Department of Neurosurgery, School of Medicine, University of São Paulo, São Paulo, Brazil.

A 4-year-old girl was admitted to the emergency department after having been buried beneath a wall. A computed tomography scan revealed anterior grade V L5-S1 spondylolisthesis, and magnetic resonance imaging showed a traumatic rupture of the fibrous annulus of the L5-S1 intervertebral disc and lesion of the anterior longitudinal and yellow ligaments. The patient underwent anterior and posterior fixation. Read More

Can Vet J 2018 04;59(4):388-392

Dick White Referrals, Six Mile Bottom, Cambridgeshire CB8 0UH, United Kingdom.

One cat was presented for investigation of urinary retention and constipation and a second cat was presented with decreased appetite, reluctance to jump, reduced level of activity, and constipation. Magnetic resonance imaging revealed dorsal bulging of the hypo-intense intervertebral disc at S3-Cd1 on fast spin echo T2. Dorsal laminectomy was performed and both cats recovered with resolution of neurological signs. Read More

Cureus 2017 Dec 22;9(12):e1980. Epub 2017 Dec 22.

None, Miller Scientific Consulting.

Introduction Oblique lumbar interbody fusion (OLIF) is a newer procedure that avoids the psoas and lumbosacral plexus due to its oblique trajectory into the retroperitoneal space. While early experience with OLIF is reassuring, the longer-term clinical efficacy has not been well established. The purpose of this study was to describe two-year clinical outcomes with OLIF performed by a single surgeon during the learning curve without the aid of the neuromonitoring. Read More

Vet Clin North Am Small Anim Pract 2018 Jan 23;48(1):169-186. Epub 2017 Oct 23.

Department of Small Animal Clinical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843, USA.

Once decompressive surgery has been elected, the approach that maximizes the likelihood of gaining access to the herniated material for complete removal should be chosen. In most cases, a procedure that optimizes access to the ventrolateral aspect of the spinal cord will be advantageous but it is important to tailor the details of the surgical procedure to suit individual patients. Decompressive surgery for chronic (type II) herniations will frequently demand a ventral approach with partial corpectomy. Read More

Spine J 2018 01 28;18(1):7-14. Epub 2017 Sep 28.

Department of Orthopaedic Surgery, University of California, San Francisco, 513 Parnassus Ave, S1157, San Francisco, CA, 94143-0514, USA. Electronic address:

Background Context: Prolonged microgravity exposure is associated with localized low back pain and an elevated risk of post-flight disc herniation. Although the mechanisms by which microgravity impairs the spine are unclear, they should be foundational for developing in-flight countermeasures for maintaining astronaut spine health. Because human spine anatomy has adapted to upright posture on Earth, observations of how spaceflight affects the spine should also provide new and potentially important information on spine biomechanics that benefit the general population. Read More

Br J Neurosurg 2018 Oct 13;32(5):579-581. Epub 2017 Jul 13.

a Department of Orthopaedics , Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College , Hangzhou , Zhejiang , China.

A 23 year-old female was diagnosed with lumbar idiopathic intervertebral disc calcification associated with ossification of OLF. The patient underwent posterior decompression and posterolateral fusion with pedicle screw fixation, which achieved excellent clinical improvement. Surgical intervention of a posterior approach for decompression and instrumented fusion is indicated in cases that the spinal cord compression with neurologic deficits was involved. Read More

Orthopedics 2017 May 31;40(3):e520-e525. Epub 2017 Mar 31.

Concomitant spine and hip disease in patients undergoing total hip arthroplasty (THA) presents a management challenge. Degenerative lumbar spine conditions are known to decrease lumbar lordosis and limit lumbar flexion and extension, leading to altered pelvic mechanics and increased demand for hip motion. In this study, the effect of lumbar spine disease on complications after primary THA was assessed. Read More

World Neurosurg 2017 Jun 6;102:91-96. Epub 2017 Mar 6.

Seattle Science Foundation, Seattle, Washington, USA.

Background: Scattered reports exist in the medical literature regarding facet tropism. However, this finding has had mixed conclusions regarding its origin and impact on the normal spine.

Methods: We performed a literature review of the anatomy, embryology, biomechanics, and pathology related to lumbar facet tropism. Read More

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2017 Feb;42(2):189-194

Department of Spine Surgery, Second Xiangya Hospital of Central South University, Changsha 410011, China.

Objective: To evaluate the efficacy and safety of combined anterior and posterior short segment fixation and fusion for lumbar sagittal split fracture.
 Methods: From March, 2005 to May, 2013, 13 patients of lumbar sagittal split fracture underwent short segment posterior fixation and anterior fusion. Preoperative and postoperative kyphotic Cobb's angle, visual analogue scale (VAS) score of back pain, Oswestry disability index (ODI), as well as the incidence of complication were accessed. Read More

Musculoskelet Sci Pract 2017 01 11;27 Suppl 1:S5-S14. Epub 2016 Dec 11.

Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK. Electronic address:

Background: No studies have been published on an astronaut population to assess the effectiveness of countermeasures for limiting physiological changes in the lumbopelvic region caused by microgravity exposure during spaceflight. However, several studies in this area have been done using spaceflight simulation via bed-rest. The purpose of this systematic review was to evaluate the effectiveness of countermeasures designed to limit physiological changes to the lumbopelvic region caused by spaceflight simulation by means of bed-rest. Read More

Ergonomics 2017 Aug 28;60(8):1055-1063. Epub 2016 Nov 28.

a Department of Bioengineering , University of California , San Diego , CA , USA.

Military training aims to improve load carriage performance and reduce risk of injuries. Data describing the lumbar spine (LS) postural response to load carriage throughout training are limited. We hypothesised that training would reduce the LS postural response to load. Read More

Clin Spine Surg 2017 Jul;30(6):E839-E844

Department of Orthopedic Surgery, Spinal Injuries Center, Iizuka, Japan.

Study Design: The prospective cohort study.

Objective Of The Study: The objective was to evaluate the relationships between local pressure changes of the intervertebral foramen during lumbar spine extension and lumbar foraminal morphology.

Summary Of Background Data: The physiological states of lumbosacral nerve roots in the vertebral foramen remain controversial. Read More

Eur Spine J 2016 12 6;25(12):4195-4198. Epub 2016 Aug 6.

Department of Orthopaedic Surgery, Juntendo University, Tokyo, Japan.

Purpose: Bleeding from the lumbar artery is a potential complication during the transpsoas approach to the lower lumbar intervertebral discs. In this anatomic study, the morphological relationships between the branches of the lumbar artery and the lower intervertebral disc were investigated to assess the risk of injury to the branches of the lumbar segmental arteries.

Methods: We studied 88 sites (86 lumbar arteries) at the third and fourth lumbar vertebrae bilaterally in 22 formalin-fixed cadavers. Read More

Eur Spine J 2016 Aug 2. Epub 2016 Aug 2.

Indian Spinal Injuries Centre, Sector C, Vasant Kunj, Delhi, India.

Hyperextension injuries of lumbar spine resulting in lumbosacral dislocation are a rare entity. We report a case of a 60-year-old male who presented to us in outpatient department with history of trivial fall from bicycle with fracture through the pedicles extending from L2 to L5 with lumbosacral dislocation with free floating posterior elements with intact neurology. This is the first case report of 4 level extension compression injury with lumbosacral dislocation leading to floating lumbar spine to the best of author's knowledge. Read More

Spine (Phila Pa 1976) 2017 Mar;42(5):345-351

*Departments of Bioengineering, University of California, San Diego, CA †Departments of Radiology, University of California, San Diego, CA ‡Departments of Orthopedic Surgery, University of California, San Diego, CA §Warfighter Performance Department, Naval Health Research Center, San Diego, CA ¶Department of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA.

Study Design: Repeated measures.

Objective: The purpose of this study was to quantify the effect of operationally relevant loads and distributions on lumbar spine (LS) in a group of active-duty Marines.

Summary Of Background Data: Low-back pain has been associated with heavy load carriage among military personnel. Read More

Spine (Phila Pa 1976) 2017 Feb;42(3):135-142

*Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan †Department of Orthopaedic Surgery, East Chiba Medical Center, Togane, Japan ‡Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan §Department of Orthopaedic Surgery, Shimoshizu National Hospital, Yotsukaido, Japan ¶Kitachiba Spine and Sports Clinic, Chiba, Japan.

Study Design: A retrospective radiological study on vascular anatomy.

Objective: The aim of this study was to evaluate the anatomical and radiological features of lumbar segmental arteries with respect to the surgical field of the oblique lateral interbody fusion (OLIF) approach by using magnetic resonance imaging (MRI).

Summary Of Background Data: OLIF surgery restores disc height and enables indirect decompression of narrowed spinal canals through an oblique lateral approach to the spine, by using a specially designed retractor. Read More

Leg Med (Tokyo) 2016 May 22;20:44-8. Epub 2016 Apr 22.

Center of Legal Medicine Lausanne-Geneva, University of Lausanne, Chemin de la Vulliette 4, CH-1000 Lausanne 25, Switzerland.

Lumbar surgery is regularly applied in cases of discal hernia and acquired lumbar stenosis. In this report, we present a case of a laceration in the left common iliac artery and iliac vein during a lumbar surgery and discuss the literature concerning this kind of event. In the present case, the surgical procedure was followed by a sudden decrease in blood pressure, and the surgeon discovered an intra-abdominal haemorrhage that led to the patient's death. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2015 Dec;29(12):1500-3

Objective: To explore the effectiveness of posterior lumbar interbody fusion in the treatment of double-segmental bilateral isthmic lumbar spondylolisthesis.

Methods: Between February 2008 and December 2013, 17 patients with double-segmental bilateral isthmic lumbar spondylolisthesis were treated with posterior lumbar interbody fusion. There were 12 males and 5 females, with an age ranged 48-69 years (mean, 55. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2015 Sep;29(9):1104-8

Objective: To evaluate the medium-term effectiveness of Waveflex system in the treatment of multiple lumbar degenerative diseases.

Methods: Between May 2010 and July 2012, 26 patients with multiple lumbar degenerative diseases underwent posterior decompression, transforaminal lumbar interbody fusion (TLIF), and internal fixation with Waveflex system. There were 15 males and 11 females, aged 23-65 years (mean, 34. Read More

World Neurosurg 2016 Mar 14;87:455-62. Epub 2015 Dec 14.

Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland; Department of Spine Surgery, University Hospital of Basel, Basel, Switzerland.

Objective: Incidental durotomy (ID) during lumbar spine surgery is a frequent complication of growing clinical relevance as the number and complexity of spinal procedures increases. Yet, there is still a lack of guidelines for the treatment of ID with a large heterogeneity of established surgical techniques. The aim of this study was to investigate the efficacy of dural suturing in patients having ID during degenerative lumbar spine surgery, compared with other dural closure techniques. Read More

Cells Tissues Organs 2016 9;201(1):38-50. Epub 2015 Oct 9.

Department of Orthopaedic Surgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, PR China.

The intervertebral disc (IVD) is a fibrocartilaginous joint between two vertebral bodies. An IVD unit consists of a gelatinous central nucleus pulposus, encased by the annulus fibrosus, which is sandwiched between cartilaginous endplates (EPs). The IVD homeostasis can be disrupted by injuries, ageing and/or genetic predispositions, leading to degenerative disc disorders and subsequent lower back pain. Read More

JBI Database System Rev Implement Rep 2015 01;13(1):3-13

1 The Witwatersrand Centre for Evidence-based Practice: a Collaborating Centre of the Joanna Briggs Institute, South Africa2 Neuromusculoskeletal Physiotherapy, South Africa3 Sports Medicine, La Trobe University, Melbourne; Cricket Australia4 School of Public Health, University of Sydney, Australia5 Cricket South Africa6 Faculty of Health Sciences, University of Southampton, Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, United Kingdom7 School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, South Africa.

Review Question/objective: Review question: which extrinsic and intrinsic factors are associated with non-contact injury in adult cricket pace bowlers?Review objective: the objective of this review is to determine the extrinsic and intrinsic factors associated with non-contact injury in adult pace bowlers.

Background: Cricket is generally considered to be a sport of low injury risk compared to other sports. In cricket, the pace bowler strives towards the adoption of a bowling technique with a relatively low injury threat that will, at the same time, allow for a fast (>120km/hr) and accurate delivery to the opposing batsman. Read More

Sports Med 2016 Jan;46(1):79-101

School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa.

Background: The high prevalence of injury amongst cricket fast bowlers exposes a great need for research into the risk factors associated with injury. Both extrinsic (environment-related) and intrinsic (person-related) risk factors are likely to be implicated within the high prevalence of non-contact injury amongst fast bowlers in cricket. Identifying and defining the relative importance of these risk factors is necessary in order to optimize injury prevention efforts. Read More

Acta Orthop Belg 2014 Dec;80(4):545-50

Purpose: To confirm the validity of postoperative creatine kinase (CK) values as an indicator of muscle lesion, assess the relationship of CK with variables indicating surgical invasiveness and investigate an association between CK values and excessive postoperative pain.

Material And Methods: The study included 96 patients (mean age 62.8 years) who underwent instrumented spine fusion for degenerative lumbosacral disease. Read More

J Spinal Disord Tech 2015 Jul;28(6):222-5

Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.

Minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) is performed via tubular dilators thereby preserving the integrity of the paraspinal musculature. The decreased soft tissue disruption in the MIS technique has been associated with significantly decreased blood loss, shorter length of hospitalization, and an expedited return to work while maintaining comparable arthrodesis rates when compared with the open technique particularly in the setting of spondylolisthesis (isthmic and degenerative), recurrent symptomatic disk herniation, spinal stenosis, pseudoarthrosis, iatrogenic instability, and spinal trauma. The purpose of this article and the accompanying video wass to demonstrate the techniques for a primary, single-level MIS TLIF. Read More

Eur Spine J 2016 Mar 13;25(3):774-82. Epub 2015 May 13.

Department of Mechanical Engineering, Sharif University of Technology, 11155-9567, Tehran, Iran.

Purpose: Iatrogenic injuries to paraspinal muscles during the posterior lumbar surgery (PLS) cause a reduction in their cross-sectional areas (CSAs) and contractile densities over time post-surgery. This study aims to quantify such alterations.

Method: Pre- and postoperative CSAs (~6 months interval) of all paraspinal muscles were measured in six patients undergoing PLS using a 3-T magnetic resonance (MR) scanner to quantify the alterations in geometrical and tissue effective contractile (non-fatty) CSAs of these muscles at all lumbar levels. Read More

Spine (Phila Pa 1976) 2015 Jun;40(12):942-7

*Department of Orthopedics, Spine and Scoliosis Surgery, Hospital for Special Surgery, New York, NY; and †Department of Neuroradiology, Weill Cornell Medical Center New York-Presbyterian Hospital, New York, NY.

Study Design: Observational study.

Objective: To demonstrate use of magnetic resonance (MR) neurography to visualize the course of the lumbar plexus at the L4-L5 disc space.

Summary Of Background Data: Risk of injury to the lumbar plexus during lateral transpsoas approach for lumbar interbody fusion (LLIF) is significant. Read More

Spine (Phila Pa 1976) 2015 Jun;40(11):E634-9

*Department of Orthopaedics, University of Utah, Salt Lake City, UT; and †Department of Orthopaedics, University of Nevada, Las Vegas, NV.

Study Design: Retrospective comparative case series.

Objective: Evaluate L5-S1 fusion rates when lower dose of bone morphogenic protein-2 (BMP-2) (average 3.2 mg) and pelvic fixation were used, with or without interbody fusion. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2014 Nov;28(11):1353-7

Objective: To investigate the feasibility and short-term effectiveness of percutaneous endoscopic spine surgery for treatment of lumbar disc herniation with posterior ring apophysis separation.

Methods: Between July 2008 and January 2013, 57 patients with lumbar disc herniation and posterior ring apophysis separation were treated. There were 39 males and 18 females, aged from 13 to 46 years (mean, 26. Read More

Asian Spine J 2014 Dec 17;8(6):813-9. Epub 2014 Dec 17.

Brain and Spinal Cord Injuries Repair Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran. ; Department of Neurosurgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Study Design: A cross-sectional case-control study was designed to compare the sagittal alignment of lumbosacral regions in two groups of patients suffering from low back pain, one with intervertebral disc pathologies and one without.

Purpose: To evaluate the correlation between lumbosacral sagittal alignment and disc degeneration.

Overview Of Literature: Changes in lumbar lordosis and pelvic parameters in degenerative disc lesions have been assessed in few studies. Read More

Interv Neuroradiol 2014 Oct 17;20(5):547-54. Epub 2014 Oct 17.

Neuroradiology Unit, IRCCS Institute of Neurological Sciences; Bologna, Italy - DIMES, Department of Specialty, Diagnostic and Experimental Medicine, University of Bologna; Bologna, Italy.

Intradiscal oxygen-ozone (O2-O3) chemonucleolysis is a well-known effective treatment for pain caused by protruding disc disease and nerve root compression due to bulging or herniated disc. The most widely used therapeutic combination is intradiscal injection of an O2-O3 mixture (chemonucleolysis), followed by periradicular injection of O2-O3, steroid and local anaesthetic to enhance the anti-inflammatory and analgesic effect. The treatment is designed to resolve pain and is administered to patients without motor weakness, whereas patients with acute paralysis caused by nerve root compression undergo surgery 24-48h after the onset of neurological deficit. Read More

Eur Spine J 2015 Nov 1;24(11):2514-9. Epub 2014 Oct 1.

Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Kyoto, Japan.

Purpose: To elucidate the effect of diffuse idiopathic skeletal hyperostosis (DISH) on the clinical results of short-segment lumbar interbody fusion (LIF) for the treatment of degenerative lumbar spinal diseases.

Methods: The 208 patients who underwent one- or two-level LIF were selected as the subjects of this study. Patients with prior lumbar fusion surgery or follow-up <1 year were excluded. Read More

Equine Vet J 2015 Sep 9;47(5):573-9. Epub 2014 Oct 9.

J.D. Wheat Veterinary Orthopedic Research Laboratory, School of Veterinary Medicine, University of California, Davis, USA.

Reasons For Performing Study: To gain insight into the pathophysiology of equine lumbar vertebral fractures in racehorses.

Objectives: To characterise equine lumbar vertebral fractures in California racehorses.

Study Design: Retrospective case series and prospective case-control study. Read More

Spine (Phila Pa 1976) 2014 Oct;39(21):E1256-60

*Department of Orthopedic Surgery, Spinal Injuries Center, Iizuka, Japan; and †Department of Orthopedic Surgery, Fukuoka University, Fukuoka, Japan.

Study Design: Measurement of local pressure of the intervertebral foramina.

Objective: To evaluate the pathophysiological effects of lumbar instrumentation surgery on lumbosacral nerve roots in the vertebral foramen.

Summary Of Background Data: The physiological states of lumbosacral nerve roots in the vertebral foramen remain controversial. Read More

J Anesth 2015 Feb 1;29(1):138-42. Epub 2014 Jul 1.

Department of Anesthesiology and Critical Care Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.

Ventral disc protrusions have been neglected because they are asymptomatic. Lumbar sympathetic nerve block (LSNB) is one of the clinical choices for refractory low back pain treatment. Leakage of the contrast medium may occur and lead to complications, especially when using a neurolytic agent. Read More

PLoS One 2014 14;9(5):e97275. Epub 2014 May 14.

Department of Spine Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, P. R. China.

Objectives: To identify the negative effect on treatment results of reserving damaged intervertebral discs when treating type B and type C spinal fracture-dislocations through a one-stage posterior approach.

Methods: This is a retrospective review of 53 consecutive patients who were treated in our spine surgery center from January 2005 to May 2012 due to severe thoracolumbar spinal fracture-dislocation. The patients in Group A (24 patients) underwent long-segment instrumentation laminectomy with pedicle screw-rod fixators for neural decompression. Read More

J Neurosurg Spine 2014 Aug 25;21(2):203-9. Epub 2014 Apr 25.

Department of Orthopaedic Surgery, National Defense Medical College, Tokorozawa, Saitama; and.

Object: A cortical bone trajectory (CBT) is a new pedicle screw trajectory that maximizes the thread contact with cortical bone surface, providing enhanced screw purchase. Despite the increased use of the CBT in the lumbar spine, little is known about the insertion technique for the sacral CBT. The aim of this study was to introduce a novel sacral pedicle screw trajectory. Read More

BMJ Support Palliat Care 2013 Jun;3(2):200-2

Barnsley Hospice, Barnsley, UK.

Malignant spinal cord compression (MSCC) is an oncological emergency requiring rapid diagnosis and treatment to prevent irreversible spinal cord injury and disability. A case is described in a 45-year-old male with renal cell carcinoma in which the presentation of the MSCC was atypical with principally proximal left leg weakness with no evidence of bone metastasis. This was due to an unusual aetiology of the MSCC as the renal carcinoma had metastasised to his left psoas muscle causing a lumbosacral plexopathy and infiltrated through the intervertebral disc spaces, initially causing left lateral cauda equina and upper lumbar cord compression, before complete spinal cord compression. Read More

Spine J 2014 Sep 18;14(9):2102-11. Epub 2014 Jan 18.

Department of Neurosurgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224, USA.

Background Context: Achieving a posterolateral fusion in conjunction with performing decompressive laminectomies can prevent recurrence of stenosis or worsening of spondylolisthesis. Facet bone dowels have been introduced and marketed as a less invasive alternative to pedicle screws. Surgeons have been placing them during lumbar laminectomy surgery and coding for intervertebral biomechanical device and posterolateral fusion. Read More

Spine J 2014 Aug 3;14(8):1460-5. Epub 2013 Oct 3.

Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St, Suite 400, Chicago, IL 60612, USA. Electronic address:

Background Context: The published literature has not characterized the surgeon's learning curve with the technically demanding technique of a minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).

Purpose: To characterize based on intra- and perioperative parameters, the learning curve for one spine surgeon during his initial phases of performing an MIS TLIF.

Study Design/setting: Retrospective analysis of a single institution and single surgeon experience with the unilateral MIS TLIF technique between July 2008 and April 2011. Read More

Clin Orthop Relat Res 2014 Jun;472(6):1769-75

Spine Center, Cedars-Sinai Medical Center, 444 S San Vicente Blvd, Suite 800, Los Angeles, CA, 90048, USA,

Background: Spinal fusion to the sacrum, especially in the setting of deformity and long constructs, is associated with high complication and pseudarthrosis rates. Transsacral discectomy, fusion, and fixation is a minimally invasive spine surgery technique that provides very rigid fixation. To date, this has been minimally studied in the setting of spinal deformity correction. Read More

J Orthop Sci 2013 Nov 5;18(6):878-84. Epub 2013 Sep 5.

Department of Orthopedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan,

Background: The presence of lumbosacral transitional vertebrae (LSTV) may affect the variation of the termination level of conus medullaris (TLCM). However, there have been few studies examining the association between the distribution of the TLCM and LSTV, especially in young patients. The purpose of this investigation was therefore to assess the relationship between the TLCM and LSTV in young patients. Read More

Clin Interv Aging 2013 12;8:1063-9. Epub 2013 Aug 12.

Bergman Clinics, Naarden and NedSpine, Ede, The Netherlands.

Introduction: The aim of this study is to report our 6-year single-center experience with L5-S1 axial lumbar interbody fusion (AxiaLIF).

Methods: A total of 131 patients with symptomatic degenerative disc disease refractory to nonsurgical treatment were treated with AxiaLIF at L5-S1, and were followed for a minimum of 1 year (mean: 21 months). Main outcomes included back and leg pain severity, Oswestry Disability Index score, working status, analgesic medication use, patient satisfaction, and complications. Read More