Aims. To identify the incidence and risk factors for five-year same-site recurrent disc herniation (sRDH) after primary single-level lumbar
Aim. To compare outcomes of revision lumbar
Background: The usefulness of open (fenestration/ laminotomy)
Aims: The aim of this study was to compare the results of Micro Endoscopic
Introduction: This study is performed to investigate the efficacy of steroid, local anaesthesia (LA) or combination of both in reducing post operative pain in lumbar
Aims. Open
Introduction. This study was performed to investigate the efficacy of steroid and local anaesthesia (LA) in reducing post-operative pain in lumbar
Aims. Lumbar disc prolapse is a frequent indication for surgery. The few available long-term follow-up studies focus mainly on repeated surgery for recurrent disease. The aim of this study was to analyze all reasons for additional surgery for patients operated on for a primary lumbar disc prolapse. Methods. We retrieved data from the Swedish spine register about 3,291 patients who underwent primary surgery for a lumbar disc prolapse between January 2007 and December 2008. These patients were followed until December 2020 to record all additional lumbar spine operations and the reason for them. Results. In total, 681 of the 3,291 patients (21%) needed one or more additional operations. More than three additional operations was uncommon (2%; 15/906). Overall, 906 additional operations were identified during the time period, with a mean time to the first of these of 3.7 years (SD 3.6). The most common reason for an additional operation was recurrent disc prolapse (47%; 426/906), followed by spinal stenosis or degenerative spondylolisthesis (19%; 176/906), and segmental pain (16%; 145/906). The most common surgical procedures were revision
Although interlaminar endoscopic lumbar
Aims. The escalating demand for medical resources to address spinal diseases as society ages is an issue that requires careful evaluation. However, few studies have examined trends in spinal surgery, especially unscheduled hospitalizations or surgeries performed after hours, through large databases. Our study aimed to determine national trends in the number of spine surgeries in Japan. We also aimed to identify trends in after-hours surgeries and unscheduled hospitalizations and their impact on complications and costs. Methods. We retrospectively investigated data extracted from the Diagnosis Procedure Combination database, a representative inpatient database in Japan. The data from April 2010 to March 2020 were used for this study. We included all patients who had undergone any combination of laminectomy, laminoplasty,
We have studied 180 patients (128 men and 52 women) who had undergone lumbar
Single level
Aims. The aim of the study was to determine if there was a direct correlation between the pain and disability experienced by patients and size of their disc prolapse, measured by the disc’s cross-sectional area on T2 axial MRI scans. Methods. Patients were asked to prospectively complete visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores on the day of their MRI scan. All patients with primary disc herniation were included. Exclusion criteria included recurrent disc herniation, cauda equina syndrome, or any other associated spinal pathology. T2 weighted MRI scans were reviewed on picture archiving and communications software. The T2 axial image showing the disc protrusion with the largest cross sectional area was used for measurements. The area of the disc and canal were measured at this level. The size of the disc was measured as a percentage of the cross-sectional area of the spinal canal on the chosen image. The VAS leg pain and ODI scores were each correlated with the size of the disc using the Pearson correlation coefficient (PCC). Intraobserver reliability for MRI measurement was assessed using the interclass correlation coefficient (ICC). We assessed if the position of the disc prolapse (central, lateral recess, or foraminal) altered the symptoms described by the patient. The VAS and ODI scores from central and lateral recess disc prolapses were compared. Results. A total of 56 patients (mean age 41.1 years (22.8 to 70.3)) were included. A high degree of intraobserver reliability was observed for MRI measurement: single measure ICC was 0.99 (95% confidence interval (CI) from 0.97 to 0.99 (p < 0.001)). The PCC comparing VAS leg scores with canal occupancy for herniated disc was 0.056. The PCC comparing ODI for herniated disc was 0.070. We found 13 disc prolapses centrally and 43 lateral recess prolapses. There were no foraminal prolapses in this group. The position of the prolapse was not found to be related to the mean VAS score or ODI experienced by the patients (VAS, p = 0.251; ODI, p = 0.093). Conclusion. The results of the statistical analysis show that there is no direct correlation between the size or position of the disc prolapse and a patient’s symptoms. The symptoms experienced by patients should be the primary concern in deciding to perform
Objectives: A retrospective study of patients undergoing second operation after initial lumbar
The recent NICE guidelines on management of osteoarthritis outline weight loss as first line treatment in degenerative joint disease in the obese. There is little data surrounding the effects of obesity on the outcomes in spinal surgical interventions. Intervertebral
This paper describes the relationship between post-myelographic symptoms and the timing of a subsequent spinal operation. A prospective study was performed comparing the post-operative symptoms of patients who underwent
Purpose: Persistent radiculopathy secondary to lumbar disc herniation is a common problem that greatly compromises quality of life. In North America, lumbar
Purpose: Since 1990, we have used specific material, presented to us by T. Tajima (Japan) during his visit in 1989 for percutaneous surgical cervical
We performed a prospective study to examine the
influence of the patient’s position on the location of the abdominal
organs, to investigate the possibility of a true lateral approach
for transforaminal endoscopic lumbar
Introduction: Repetitive undertaking of a physical tasks results in an innate memory for that task. Development of this memory is an important component of surgical training and the ease and safety with which these changes are incorporated into a smoothly flowing procedure is represented by the so-called “learning curve”. Changes in equipment and technology may radically alter the paradigm used by surgeons for completing the task of an operation. An example of this is the integration of endoscopy. The hand-eye orientation, field of view, angle of approach, binocularity of vision and skew of the visual field are all altered in lumbar micro-endoscopic
INTRODUCTION: Repetitive undertaking of a physical task results in an innate memory for that task. Development of this memory is an important component of surgical training and the ease and safety with which these changes are incorporated into a smoothly flowing procedure is represented by the so-called “learning curve”. Changes in equipment and technology may radically alter the paradigm used by surgeons for completing the task of an operation. An example of this is the integration of endoscopy. The hand-eye orientation, field of view, angle of approach, binocularity of vision and skew of the visual field are all altered in lumbar microendoscopic
Autologous chondrocyte transplantation is technically feasible and biologically relevant to repairing disc damage and retarding disc degeneration in animal models. Prospective clinical trials with open
Background: Traditionally, lumbar
Aim of the present study was to investigate clinical outcomes and quality of life after standard
The indications for lumbar
The optimum timing of lumbar
Introduction: Following surgical
Study Design: Retrospective review. Objectives: Rugby union has recently become a highly-paid professional sport. Players requiring anterior cervical
Objective: To extend the follow up period of previous studies undertaken by the senior author, looking at the clinical outcome and radiological changes observed in patients with either myelopathy or radiculopathy, following anterior cervical
Recurrence of back or leg pain after discectomy
is a well-recognised problem with an incidence of up to 28%. Once conservative
measures have failed, several surgical options are available and
have been tried with varying degrees of success. In this study,
42 patients with recurrent symptoms after
Introduction. Degeneration of the cervical spine can lead to neurological symptoms that require surgical intervention. Often, an anterior cervical
Objective: To identify risk factors associated with patients that required revision surgery for sciatica. Design: A retrospective study of 580 patients who underwent surgery for intractable sciatica attributable to pro-lapsed lumbar intervertebral disc from 1986 to 2000 inclusive. Subjects: The study included a total of 580 patients. Of these seven patients had an operation at two levels, 25 patients had had a primary operation elsewhere and were therefore excluded; four sets of notes remain missing. The total number of primary operations analysed was therefore 558. Outcome measures: Parameters such as gender, age, level and side of
Introduction Minimally invasive lumbar
Purpose: The advent of lapaoscopic disectomy has made it possible to cure discal herniation with minimal trauma and no limitations on indications. We have adopted the technique described by J. Destandau since June 1998. The purpose of this work was to report our early results. Material and methods: Forty patients were included in a period from June 1998 to August 2000. There were 24 men and 16 women, mean age 43 years (24–78). Eleven patients had an associated stenosis of the spinal canal. Accelerated rehabilitation was employed. Sitting and driving were allowed early. Results: Mean follow-up was 13 months (2–27 months). Mean operative time was 63 minutes (30–150 min). Mean hospital stay was 3.92 days (2–10). There were 29 patients without stenosis of the lumbar canal. In this subgroup, outcome was excellent in 69%, good in 21% (six patients), fair in 3% (one patient), and poor in 7% (two patients). For the PROLO score, three patients were who were retreated were not included in the analysis. Outcome was excellent in 73% (19 patients), good in 12% (three patients), fair in 12% (three patients, and poor in 4% (one patient). In patients with lumbar canal stenosis, (eleven patients), three were reoperated for wider decompression; there was no haematoma. One patient was reoperated for deep infection. For the other patients the WADDELL score was excellent in five and good; in two the PROLO score was excellent in six and poor in one. Discussion: The technique favoured a narrow approach. Shorter exposure preserved the anatomy, but for the three patients with an associated stenosis, reoperation was necessary for decompression. For the cases without complications, we noticed that recovery was very rapid, a finding which is exceptional with the conventional technique. Conclusion: Our early experience with this technique has demonstrated that laparoscopic
Introduction: Anterior cervical
Design of study: Prospective, observational. Purpose of the study: Obese and morbidly obese patients undergoing lumbar surgery can be a challenge to the operating surgeon. Reports on the perioperative data in this group of patients are scarce. The purpose of the study is to prospectively compare the perioperative data in patients with normal and high BMI, undergoing lumbar spine surgery. Method: We conducted a prospective audit of 50 consecutive patients who underwent primary
Introduction Far lateral disc prolapse (also known as foraminal or extreme lateral prolapse) make up 10% of all disc herniations. In addition, far lateral disc prolapses tend to affect more proximal levels more frequently than do prolapses in the posterolateral location and they are often associated with greater radicular symptoms than typical posterolateral herniations, most likely due to involvement of the dorsal root ganglion. Surgery for far lateral disc protrusions has been associated with a less favourable outcome, perhaps due to delays in diagnosis, inadequate preoperative imaging, and postoperative instability as a result of excessive bony and facet resection during the surgical approach. Methods Twelve patients with far lateral disc herniations operated on by the senior author (RPW) fulfilled the criteria of having both pre- and postoperative Oswestry Disability Index (ODI) scores recorded at each clinic visit. Results of these cases and those of a cohort of age and sex matched patients undergoing standard posterolateral
We present a review of 553 patients who underwent surgery for intractable sciatica ascribed to prolapsed lumbar intervertebral disc. One surgeon in one institution undertook or supervised all the operations over a period of 16 years. The total number of primary
Lumbar disc herniations are quite common pathology in orthopedics. Percutaneous
Objective: Anterior cervical
We treated 137 patients with symptomatic lumbar disc prolapse by automated percutaneous lumbar
Microdiscectomy is the most commonly performed spine surgery in the world. Due to its technical simplicity and low complication rate, this was the first spine surgical procedure transitioning for one-day surgery. However, the economic assessment of this outpatient transition was never performed and the question on the real impact in the burden of spine care remains. This economic study aims to access the cost-utility of outpatient lumbar microdiscectomy when compared with the inpatient procedure. To do so, a cost-utility study was performed, adopting the hospital perspective. Direct medical costs were retrieved from the assessment of 20 patients undergoing outpatient lumbar microdiscectomy and 20 undergoing inpatient lumbar microdiscectomy, from a in a Portuguese NHS hospital. Utilities were calculated with quality-adjusted life-years were derived from Oswestry Disability Index values (ODI). ODI was assessed prospectively in outpatients in pre and 3- and 6-month post-operative evaluations. Inpatient ODI data were estimated from a meta-analysis. both probabilistic and deterministic sensitivity analyses were performed and incremental cost-effectiveness ratio (ICER) calculated. A willingness to pay (WTP) threshold of €60000/QALY gained with inpatient procedure was defined. Out results showed that inpatient procedure was cost-saving in all models tested. At 3-month assessment ICER ranged from €135753 to €345755/QALY, higher than the predefined WTP. At 6-month costs were lower and utilities were higher in outpatient, overpowering the inpatient procedure. Probabilistic sensitivity analysis showed that in 65% to 73% of simulations outpatient was the better option. The savings with outpatient were about 55% of inpatient values, with similar utility scores. No 30-day readmissions were recorded in either group. The mean admission time in inpatient group was 2.5 days. Since there is an overall agreement among spine surgeons that an uncomplicated inpatient MD would only need a one-day admission, an analysis reducing inpatient admission time for one day was also performed and outpatient remained cost-effective. In conclusion, as the first economic study on cost-utility of outpatient lumbar microdiscectomy, this study showed a significant reduction in costs, with a similar clinical outcome, proving this outpatient transition as cost-effective
It is recognised that those patients who present sciatica and significant preceding back pain will be disappointed, following
Background. Percutaneous endoscopic interlaminar
The aim of this study was to determine how the short- and medium-
to long-term outcome measures after total disc replacement (TDR)
compare with those of anterior cervical discectomy and fusion (ACDF),
using a systematic review and meta-analysis. Databases including Medline, Embase, and Scopus were searched.
Inclusion criteria involved prospective randomized control trials
(RCTs) reporting the surgical treatment of patients with symptomatic
degenerative cervical disc disease. Two independent investigators
extracted the data. The strength of evidence was assessed using
the Grading of Recommendations, Assessment, Development and Evaluation
(GRADE) criteria. The primary outcome measures were overall and
neurological success, and these were included in the meta-analysis. Standardized
patient-reported outcomes, including the incidence of further surgery
and adjacent segment disease, were summarized and discussed.Aims
Patients and Methods
Introduction Lumbar
We used gadolinium-enhanced fat-suppressed MRI to investigate 67 patients with persistent pain after lumbar
Lumbar
Background: To assess the clinical and radiological results of motion-segment sparing anterior cervical partial
Aim: Evaluate the preoperative prognostic factors of a poor result in conventional surgery of lumbar disc herniation. Methods: From November 1995 to November 2001, we performed 113 standard
We would like to present a rare case report describing a case in which new-onset tonic-clonic seizures occurred following an unintentional durotomy during lumbar
A randomised double-blind study was carried out on 60 patients undergoing elective lumbar
We estimated the long term results of the different methods in chirurgical treatment of lumbar disk herniation in consideration with the presence or absence of degenerative changes and the grade in witch these factors influence the result of this kind of treatment. Seventy eight patents with lumbar disk herniation have been submitted in partial
Objective: To assess the clinical effectiveness of dexamethasone wound infiltration post lumbar
Lumbar
Study design: A prospective comparison of MRI findings with surgical findings in patients presenting to our spinal triage service with a prospective diagnosis of a lumbar disc herniation. Objective: To investigate consistency between Radiologists’ interpretation of MRI scans, and comparison between MRI and surgical findings, in an attempt to identify those patients suitable for percutaneous treatment. Background: MRI has assumed a pre-eminent position in the diagnosis of lumbar disc prolapse. Methods: 87 consecutive patients presenting with signs and symptoms suggestive of a lumbar disc prolapse that underwent an MRI and based on that a
The aim of this study was to evaluate the effect of hyaluronic acid on the stability of the functional spinal unit (FSU) after
Introduction: Lumbar
The purpose of this retrospective study was to investigate the
clinical relevance of increased facet joint distraction as a result
of anterior cervical decompression and fusion (ACDF) for trauma. A total of 155 patients (130 men, 25 women. Mean age 42.7 years;
16 to 87) who had undergone ACDF between 1 January 2001 and 1 January
2016 were included in the study. Outcome measures included the Neck
Disability Index (NDI) and visual analogue scale (VAS) for pain.
Lateral cervical spine radiographs taken in the immediate postoperative
period were reviewed to compare the interfacet distance of the operated
segment with those of the facet joints above and below.Aims
Patients and Methods
Method: We reviewed the hospital notes of 45 patients who underwent a lumbar
Purpose of the study: Evaluate the impact of an information brochure on residual functional incapacity after lumbar
Study design: A prospective comparison of MRI findings with surgical findings in patients presenting to our spinal triage service with a prospective diagnosis of a lumbar disc herniation. Objective: To investigate consistency between radiologists interpretation of MRI scans, and comparison between MRI and surgical findings, in an attempt to identify those patients suitable for percutaneous treatment. Background: MRI has assumed a preeminent position in the diagnosis of lumbar disc prolapse. Methods: 87 consecutive patients presenting with signs and symptoms suggestive of a lumbar disc prolapse that underwent an MRI and based on that a
Aim: The aim is to correlate intra-operative findings such as epidural fibrosis (EF), size and type of disc fragment, lateral recess stenosis and dural tear with postoperative residual radiculopathy (RR) and residual low back pain (RLBP). Material and Methods: 246 revision
The April 2023 Spine Roundup. 360. looks at: Percutaneous transforaminal endoscopic
Prolonged length of stay (LOS) is a significant contributor to the variation in surgical health care costs and resource utilization after elective spine surgery. The primary goal of this study was to identify patient, surgical and institutional variables that influence LOS. The secondary objective is to examine variability in institutional practices among participating centers. This is a retrospective study of a prospectively multicentric followed cohort of patients enrolled in the CSORN between January 2015 and October 2020. A logistic regression model and bootstrapping method was used. A survey was sent to participating centers to assessed institutional level interventions in place to decrease LOS. Centers with LOS shorter than the median were compared to centers with LOS longer than the median. A total of 3734 patients were included (979
Aims. The aim of this study was to investigate whether the type of cervical disc herniation influences the severity of symptoms at the time of presentation, and the outcome after surgical treatment. Methods. The type and extent of disc herniation at the time of presentation in 108 patients who underwent anterior
The February 2023 Spine Roundup. 360. looks at: S2AI screws: At what cost?; Just how good is spinal deformity surgery?; Is 80 years of age too late in the day for spine surgery?; Factors affecting the accuracy of pedicle screw placement in robot-assisted surgery; Factors causing delay in discharge in patients eligible for ambulatory lumbar fusion surgery; Anterior cervical
The outcome of surgery for recurrent lumbar disc
herniation is debatable. Some studies show results that are comparable
with those of primary
Aims. There is evidence that prior lumbar fusion increases the risk of dislocation and revision after total hip arthroplasty (THA). The relationship between prior lumbar fusion and the effect of femoral head diameter on THA dislocation has not been investigated. We examined the relationship between prior lumbar fusion or
Anterior cervical discectomy and fusion (ACDF) is a well-established spinal operation for cervical disc degeneration disease with neurological compromise. The procedure involves an anterior approach to the cervical spine with
Symptomatic lumbar spinal stenosis is a common entity and increasing in prevalence. Limited evidence is available regarding patient reported outcomes comparing primary vs revision surgery for those undergoing lumbar decompression, with or without fusion. Evidence available suggest a lower rate of improvement in the revision group. The aim of this study was to assess patient reported outcomes in patients undergoing revision decompression, with or without fusion, when compared to primary surgery. Patient data was collected from the Canadian Spine Outcomes Research Network (CSORN) database. Patients undergoing lumbar decompression without or without fusion were included. Patients under 18, undergoing
No previous studies have examined the physical
characteristics of patients with cauda equina syndrome (CES). We compared
the anthropometric features of patients who developed CES after
a disc prolapse with those who did not but who had symptoms that
required elective surgery. We recorded the age, gender, height,
weight and body mass index (BMI) of 92 consecutive patients who
underwent elective lumbar
Intervertebral disc degeneration (IDD) affects more than 80% of the population all over the world. Current strategies for the treatment of IDD are based on conservative or surgical procedures with the aim of relieving pain. Mesenchymal stem cell (MSC) transplantation has emerged as a promising therapy in recent decades, but studies showed that the particularly hostile microenvironment in the intervertebral disc (IVD) can compromise cells survival rate. The use of exosomes, extracellular vesicles released by various cell types, possess considerable economic advantages including low immunogenicity and toxicity. Exosomes allow intercellular communication by conveying functional proteins, RNA, miRNA and lipids between cells. The purpose of this study is to assess the therapeutic effects of exosomes derived from Wharton Jelly mesenchymal stromal cells (WJ-MSC) on human nucleuspulposus cells (hNPC) in an in vitro 3D culture model. Exosomes (exos) were isolated by tangential flow filtration of WJ-MSC conditioned media and characterized by: quantification with BCA test; morphological observation with TEM, surface marker expression by WB and size evaluation by NTA. Confocal microscopy has been used to identify exosomes marked with PKH26 and monitor fusion and/or incorporation in hNPC. hNPC were isolated from waste surgical material from patients undergoing
Introduction:. Exercise has showed to reduce pain and improve function in patients with discogenic low back pain (LBP). Although there is currently no biologic evidence that the intervertebral disc (IVD) can respond to physical exercise in humans, a recent study has shown that chronic running exercise is associated with increased IVD hydration and hypertrophy1. Irisin, a myokine released upon muscle contraction, has demonstrated to yield anabolic effects on different cell types, including chondrocytes2. This study aimed to investigate the effect of irisin on human nucleus pulposus cells (hNPCs). Our hypothesis is that irisin may improve hNPCs metabolism and proliferation. METHODS:. The hNPCs, isolated from
Aims. The aim of this study was to use diffusion tensor imaging (DTI) to investigate changes in diffusion metrics in patients with cervical spondylotic myelopathy (CSM) up to five years after decompressive surgery. We correlated these changes with clinical outcomes as scored by the Modified Japanese Orthopedic Association (mJOA) method, Neck Disability Index (NDI), and Visual Analogue Scale (VAS). Methods. We used multi-shot, high-resolution, diffusion tensor imaging (ms-DTI) in patients with cervical spondylotic myelopathy (CSM) to investigate the change in diffusion metrics and clinical outcomes up to five years after anterior cervical interbody
Revision discetomy is a procedure often assumed to give similar results to primary
Purpose: Purpose of the study was to evaluate the incidence of spinal surgery for patients with back pain. Methods and results: During past five years 5145 patients were seen in the back pain screening clinic. 823 patients (16%) were referred to the spine clinic (p<
0.001). 127 patients (2.47%) were operated on (p<
0.001).106 patients (2.1%) had lumbar
Purpose: Back pain is a significant problem in Europe with important socio-economic impact. The purpose of this study was to evaluate the incidence of spinal surgery for patients with back pain. Sudy design: This was a retrospective Level II type study. Patient sample included five thousand and forty five patients with a five year follow up. Methods and results: During past five years 5145 patients were seen in the back pain screening clinic. 823 patients (16%) were referred to the spine clinic (p<
0.001). 127 patients (2.47%) were operated on (p<
0.001). 106 patients (2.1%) had lumbar
In this retrospective study 27 patients who had undergone revision
Introduction: The anatomy and biomechanics of the thoracic spine is different from the cervical and lumbar spine particularly due to the ribs and sternum which contribute to stability and controlling motion. The role of the sternum and costosternal articulation in the biomechanics of thoracic fracture or deformity correction has not been well studied. The effects of releasing each of these structures, whether alone or in combination, is potentially relevant in the surgical correction of thoracic deformities such as severe kyphosis. The purpose of this study was to investigate the relative effects of releasing the intervertebral disc, the costosternal joint, the sternum, and the facet joints on sagittal thoracic motion and the consequences of altering the sequence of the releases. Methods: Eighteen human torsos were tested in three experiments (A, B, and C) to determine the effect on sagittal motion due to three different sequences of three surgical releases. In Experiment A the release sequence was back to front: Total facetectomy, then radical
Purposes of the study and background. The objective of this overview was to evaluate the available evidence from systematic reviews on the effectiveness of surgical interventions for sciatica due to disc herniation. The last search was conducted in 2011. Since then new reviews have been published or existing reviews have been updated. Summary of the methods used and results. A comprehensive search was performed in multiple databases including Cochrane database of systematic reviews (CDSR), Database of Reviews of Effectiveness (DARE) and Pubmed. Included are Cochrane and non-Cochrane systematic reviews on sciatica due to disc herniation published in peer-reviewed journals. We evaluated surgery versus conservative care and different surgical techniques compared to one another. The methodological quality of the systematic reviews was evaluated using AMSTAR by two independent reviewers. Nine, mostly high quality, systematic reviews on surgical interventions for disc herniation were included. Four reviews compared surgery with conservative treatment and concluded consistently that surgery has only short term benefits while the long term results showed no difference in effect. Four reviews compared open
Background. Cauda equina syndrome (CES) is a physical process. There is compression of the cauda equina resulting in arrest of the electrochemical signal from the central nervous system. Previous studies have demonstrated that anthropomorphic features influence nerve conduction properties. Aim. We therefore sought to if there was an association between biophysical parameters and CES. Setting and design. Single centre retrospective comparative study. Method and materials. We analysed consecutive patients who had elective lumbar
Aim. A retrospective review of the management of adjacent level
The volume of spinal procedures have increased over the last two decades (220% in lumbar region). A simultaneous increase in re-operation rates (up to 20%) has been reported. Our aim was to compare with literature the reoperation rates and complications for various spinal procedures from a peripheral unit and to provide this information to the patients. This was a retrospective study of all patients who underwent spinal surgery during the period 1995 to 2005 by one surgeon. Using ICDM-9 codes and private notes patients were identified and medical records were used to gather relevant data. The following information was extracted-demographics, diagnosis, ASA criteria, primary procedure, any complication/s, secondary procedures, duration of follow up and to secondary procedure. The index procedures were grouped into regional and according to indication. Both complications and reoperations were grouped into early (within three months) or delayed (after three months) from the index operation. Reoperation rates and complications were calculated and compared with literature. Four hundred and thirty-nine patients formed the study population. Five patients had inadequate data and were excluded. 23 patients have since died. Demographics showed 22% were smokers and 9% were either unemployed or sickness beneficiary. The commonest diagnosis in the lumbar spine was disc herniation (194). Stenosis and disc degeneration were the next most common surgical indications. In the cervical spine 27 patients had disc herniation and 15 patients were operated for trauma. Lumbar
Aims. We aimed to retrospectively assess the accuracy and safety of
CT navigated pedicle screws and to compare accuracy in the cervical
and thoracic spine (C2-T8) with (COMB) and without (POST) prior
anterior surgery (anterior cervical
Background: A common complication of lumbar spine surgery is incidental tear of the dural sac and subsequent leakage of the cerebrospinal fluid intraoperatively. Studies have reported a wide variation in the rates of dural tears in spine surgery (1%–17%). The rates were higher after revision surgery. Objective: To establish a baseline rate of incidence of dural tears after lumbar surgery in Morriston Hospital Neurosurgical Unit and to compare it with the results reported in the literature. Methods and Results: A prospective review of the operation notes of 65 consecutive patients who had undergone lumbar surgery (Primary lumbar
Aims. Cervical spondylosis is often accompanied by dizziness. It has
recently been shown that the ingrowth of Ruffini corpuscles into
diseased cervical discs may be related to cervicogenic dizziness.
In order to evaluate whether cervicogenic dizziness stems from the
diseased cervical disc, we performed a prospective cohort study
to assess the effectiveness of anterior cervical
Purpose: We present the early results of a pilot study of 10 patients evaluating the basic safety and performance of an in situ polymerising protein hydrogel used in
Background. Recently, some studies have focused attention on the possibility that anaerobic pathogens of low virulence could constitute an etiological factor in disc herniation. There have been isolated such strains, predominantly Propionibacterium acne, between 7 and 53% of patients undergoing surgery for disc pathology. According to these studies, patients with anaerobic infections of the disc are more likely to develop Modic changes in the adjacent vertebrae. The aim of this work was to test this hypothesis by growing in specific media the disc material extracted in a series of lumbar
Introduction Anterior correction of cervical kyphotic deformity in traumatic and degenerative spine is a well established technique. The application of an anterior cervical plate is widely accepted, particularly in multilevel
NHS Patients can wait up to 15 months for non-urgent spine surgery. The intended procedure is determined by the outpatient MRI scan. Do changes occur within the spine during the wait for surgery? Would the changes affect the operative decision?. In a prospective study, 105 patients listed for elective lumbar spine surgery at a district general hospital If the MRI scan is over 6 months old, a second scan is performed prior to surgery. Changes that alter the operative decision are noted. 44%
Objective: NHS Patients can wait up to 18 months for non-urgent spine surgery. The intended procedure is determined by the outpatient MRI scan. Do changes occur within the spine during the wait for surgery? Would the changes affect the operative decision?. Design: A Prospective study. Subjects: 105 patients listed for elective lumbar spine surgery at a district general hospital. Outcome Measures: If the MRI scan is over six months old, a second scan is performed prior to surgery. Changes that alter the operative decision are noted. Results: Forty-four percent
Objective: Measuring outcomes from chronic disease in terms of generic, health-related quality of life (HRQoL) instruments is of increasing importance to allow valid comparison of interventions and to accurately assess efficacy of treatment from the patient’s perspective. In this context we sought to establish the role of the generic SF-36 health survey in measuring outcomes from spinal surgery. Method: A prospective observational study of patients undergoing elective cervical
We analysed prospectively 26 patients who had revision operations for ipsilateral recurrent radicular pain after a period of pain relief of more than six months following primary
Combined anterior/posterior scoliosis surgery is the mainstay of scoliosis surgery in large curves with Cobb angle more than 65°, in stiff curves that correct to above 40° only on the pre-operative bending films and in Steersman’s kyphosis greater than 90°. The combined anterior/posterior scoliosis surgery allows better correction of the curve, saving motion segments in the spine and eliminating the occurrence of the crankshaft phenomenon. Video-assisted spinal surgery (VATS) and Mini open thoracotomy, thoracoscopically assisted (MOT-TA) allow for the performing of multi level