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Recent literature has associated pseudarthrosis and pedicle screw loosening with subchronic infection at the pedicle of the vertebra. The positive culture results of a previous retrieval analysis show that such patients have a high frequency of bacterial contamination. The objective of this study is to visually capture the architecture of these undiagnosed infections, which have been described in other studies as biofilms on supposedly "aseptic" screw loosening.

Explants from 10 consecutive patients undergoing revision spine surgery for pseudarthrosis were collected and fixed in glutaraldehyde solution. Each of these implants was imaged thoroughly by using scanning electron microscopy and x-ray spectroscopy to evaluate the architecture of the biofilm. Additionally, eight patient swabs from tissues around the implants were sent for cultures to assess bacterial infiltration in tissues beyond the biofilm. The implants were also analyzed using energy dispersive x-ray spectroscopy. The exclusion criteria inclutly present in "aseptic" pseudarthrosis cases.
Posterior lumbar interbody fusion (PLIF) is a widely used effective, safe, and established treatment for degenerative spinal disorders. Adjacent segment disease (ASD) is one of the serious concerns governing the clinical results following spinal fusion surgery. Cortical bone trajectory (CBT) is an alternative and less-invasive technique for lumbar pedicle screw placement. Its unique medial and caudal entry point has the potential to prevent an iatrogenic facet joint violence leading to the ASD; however, the incidence of ASD following PLIF using the CBT technique (CBT-PLIF) remains unknown.

Among patients surgically treated with CBT-PLIF in our institute, 52 consecutive patients (13 males, 39 females) with single-level degenerative lumbar spondylolisthesis (DLS) who were followed up for at least 24 months were exclusively enrolled. Their clinical and radiological features, including the incidence of radiographical and symptomatic ASD and significantly associated factor for the developing radiographical ASDlow-up studies are required to elucidate the clinical output of CBT-PLIF.
The present study, even though it is preliminary, revealed that CBT-PLIF can achieve a neurological improvement and an effective reduction of spondylolisthesis for the treatment of single-level DLS. The CBT technique is capable of reducing the incidence of ASD compared with the traditional technique; however, we must keep in mind that appropriate postoperative lumbar lordosis should be achieved. Larger, longer-term follow-up studies are required to elucidate the clinical output of CBT-PLIF.
Despite technical developments in decompression without fusion, many studies still assert that instability could be increased in patients with spinal stenosis and lumbar degenerative spondylolisthesis after spinal decompression surgery without fusion. selleck chemicals llc Thus, this study aimed to describe and assess the clinical outcomes of the semi-circumferential decompression (SCD) technique used for microsurgical en-bloc total ligamentum flavectomy with preservation of the facet joint in treating patients who have lumbar spinal stenosis with two-level degenerative spondylolisthesis.

We retrospectively analyzed the clinical and radiologic outcomes of 14 patients who had spinal stenosis with two-level Meyerding grade I degenerative spondylolisthesis. We evaluated improvements in back pain and radiating pain using a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). We have also examined the occurrence of spinal instability on a radiological exam using slip percentage and slip angle.

The mean VAS score of back pain and radiating pain has been determined to decrease significantly from 6.7 to 3.3 and from 8.6 to 2.7, respectively. Meanwhile, the ODI score significantly improved from 27.3 preoperatively to 9.8 postoperatively. Statistically significant change was not observed in the slip percentage in both upper and lower levels. Dynamic slip percentage, which is defined as the difference in the slip percentage between flexion and extension, also did not significantly change. No statistically significant change was found in the slip angle and dynamic slip angle.

SCD is a recommendable procedure that can improve clinical results. This procedure does not cause spinal instability when treating patients who have spinal stenosis with two-level degenerative spondylolisthesis.
SCD is a recommendable procedure that can improve clinical results. This procedure does not cause spinal instability when treating patients who have spinal stenosis with two-level degenerative spondylolisthesis.
Transpsoas lumbar spine surgery is minimally invasive and has very good corrective effects. However, approach-side nerve complications delay post-operative rehabilitation. We anatomically investigated the localization of the lumbar plexus running in the psoas muscle.

We examined 27 formalin-fixed cadavers. The left-sided psoas muscle was extracted and cut parallel to the intervertebral disc at the L2/3, L3/4, and L4/5 disc levels. Using digitized photographs, we calculated the ratio of the distance from the front edge of the psoas muscle to the center of the lumbar plexus in the anteroposterior diameter of the psoas muscle (%). Then, we calculated the ratio of the distance from the lateral edge of the psoas muscle to the center of the lumbar plexus in the lateral diameter of the psoas muscle (%).

The anterior-posterior lumbar plexus localization was 74.5 at L2/3, 74.7 at L3/4, and 81.2 at L4/5. There was a significant difference between L2/3 and L4/5 and between L3/4 and L4/5, but not between L2/3 and L plexus localization in the psoas muscle when looking directly at this muscle to enter the pricking point or route with a lower risk of nerve damage.
The revised Tokuhashi scoring system has been used to predict survival in patients with metastatic spinal tumors. Because of the rapid progress of cancer therapy, the original criteria of the revised Tokuhashi scoring system became in recent years unsuitable. The study aim was to evaluate the validity of the revised Tokuhashi scoring system in patients who underwent spinal surgery and to establish new prognostic criteria.

The study enrolled 85 patients with metastatic spinal tumors who underwent spinal surgery. The patients' survival outcomes in October 2019 were as follows 57 patients died; 10 were alive; and 18 had unknown prognoses. The study evaluated the validity of the Tokuhashi scoring system, and established and validated the new prognostic criteria.

The accuracies of the Tokuhashi scoring system were 66.7% in the short-term group, 60% in the midterm group, and 100% in the long-term group. Among the patients who died, the survival period and total score were significantly correlated. Total score cutoff point was six points in the patients whose predicted survival was <6 months.
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