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Introduction Spinal surgery necessitates the peeling of soft tissues such as muscles from around the vertebral bodies, while fusion surgery also necessitates the opening of the laminae and removal of the intervertebral discs from the affected
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recommendations for spine surgeons (including those in orthopedics and brain or neurosurgery). Any intraspinal misuse of TXA into the cerebrospinal fluid or topical application of TXA during spinal surgery is likely to result in seriously adverse consequences once
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herniated disc from inside the spinal canal. Evidence supporting minimally invasive approaches and transforaminal endoscopic spinal surgery (TESS) in particular has grown exponentially over the last ten years. In this review, the authors describe the
Centre for Spinal Surgery, Queens Medical Centre, Nottingham University NHS Trust, Nottingham, UK
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In all levels of disc herniations the absolute surgical indications include deteriorating neurological deficits with myelopathy or cauda equina syndrome. However, this review summarized the relative indications for surgery in each level.
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In cervical disc herniation (CDH), the indications for surgery consist of six months of persisting symptoms, not responding to conservative treatment. However, high-quality studies are lacking, and a randomized controlled trial is now underway to clarify the indications.
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In thoracic disc herniation (TDH), the indications for surgery comprise failure of conservative measures and/or worsening neurological symptoms. Moreover, giant calcified thoracic disc herniations or myelopathy signs on magnetic resonance imaging, even in the absence of neurological symptoms, may benefit from surgical treatment as a preventive measure.
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In lumbar disc herniation (LDH), the indications for surgery include imaging confirmation of LDH, consistent with clinical findings, and failure to improve after six weeks of conservative care.
Cite this article: EFORT Open Rev 2021;6:526-530. DOI: 10.1302/2058-5241.6.210020
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symptoms, compression location, and cord priority, non-spinal factors also determine the surgical strategy of TSS. With the exacerbation of the aging society, the elderly account for a large proportion of patients who undergo spinal surgery ( 97 ). The high
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group of 1121 MEP/SSEP-monitored scoliosis surgeries, although the relevant signal changes were noted in 3.4% surgeries. 39 IONM significantly decreases risk in spinal surgeries, and today it is the standard of care in the US and many other
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mechanism of action is to reduce bleeding by inhibiting the production and activity of plasmin, thereby preventing the dissolution of fibrin. Previous meta-analyses have evaluated the safety and efficacy of tranexamic acid in spinal surgery. Based on a
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Life and Health Science Research Institute, University of Minho, Portugal
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Life and Health Science Research Institute, University of Minho, Portugal
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shunt of blood flow through the epidural and paravertebral veins, which increases the pressure in the epidural venous circuit, augmenting the bleeding in the surgical field during spinal surgery. Abdominal compartment syndrome is also a potential
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-thoracotomy or a retropleural approach have both been recommended, 64 modern advancements in imaging, coupled with laser resection, may now allow surgeons to consider full endoscopy for even these difficult pathologies. During any spinal surgery
These authors contributed equally to this work and should be considered co-first authors
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These authors contributed equally to this work and should be considered co-first authors
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cervical arthrodesis Hilibrand, AS 975 44.3 IV 4 A critical review of recombinant human bone morphogenetic protein-2 trials in spinal surgery: emerging safety concerns and lessons learned Carragee, EJ 898 89.8 NA 5 Donor site
