Sexual activity after spine surgery: a systematic review
ConclusionDespite limited evidence from high-quality articles, there is a general trend towards improvement of sexual activity and function after spine surgery. Future studies incorporating specific assessments of sexual activity will be required to address this important determinant of quality of life so that appropriate pre-operative counselling can be done by providers.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - May 23, 2018 Category: Orthopaedics Source Type: research

Intervertebral disc damage models in organ culture: a comparison of annulus fibrosus cross-incision versus punch model under complex loading
ConclusionCompressional stiffness, GAG and DNA contents, did not differ between injury models under complex load. This behaviour was partially attributed to the positive influence of complex loading on matrix regeneration and cell viability. However, disc height was reduced for the cross-incision. Relative gene expression changes of the inflammatory and anabolic genes for the biopsy punch approach might indicate that induced damage was too intense to trigger any inflammatory or repair response.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - May 22, 2018 Category: Orthopaedics Source Type: research

Iatrogenic dural tear in endoscopic lumbar spinal surgery: full endoscopic dural suture repair (Youn ’s technique)
AbstractBackgroundWith the advancement of minimally invasive spinal surgery, endoscopic lumbar decompression has been widely used for the treatment of degenerative lumbar spinal diseases. Iatrogenic dural tear is a relatively common complication in endoscopic lumbar spinal surgery. The golden standard of treatment for iatrogenic dural tear is immediate open conversion and direct repair under microscopic visualization. Recently, most of endoscopic spinal surgery is performed under local anesthesia. So, conversion to open surgery is very embarrassing situation because of the need of additional general anesthesia. But, direct...
Source: European Spine Journal - May 22, 2018 Category: Orthopaedics Source Type: research

The relevance of the Hippocratic Oath to the ethical and moral values of contemporary medicine. Part II: interpretation of the Hippocratic Oath —today’s perspective
The objective is to prove that theOath has established the general context of medical ethics of the physician –patient relationship, which reflects long-lasting moral values that still define the medical profession. TheOath has exemplified the fundamental modern ethical principles of beneficence, non-maleficence and confidentiality. Its foremost message focuses on patients ’ best interests and not on the prohibition of surgery, euthanasia or abortion, as is generally believed. Furthermore, theOath as a code of professional identity has had a powerful impact on modem judicial opinions regarding medical ethics. I...
Source: European Spine Journal - May 21, 2018 Category: Orthopaedics Source Type: research

Posterior-only versus combined anterior/posterior fusion in Scheuermann disease: a large retrospective study
ConclusionSurgery for Scheuermann ’s kyphosis gives good and stable functional and radiological results. Given the fact that the two surgical strategies give the same results, it appears that the anterior/posterior fusion technique to treat Scheuermann’s kyphosis should be reserved for major deformations.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - May 19, 2018 Category: Orthopaedics Source Type: research

Hybrid constructs pedicle screw with apical sublaminar bands versus pedicle screws only for surgical correction of adolescent idiopathic scoliosis
ConclusionThe two groups offer similar curve correction without neurologic complications in the surgical treatment of AIS (Lenke 1). The use of sublaminar bands on the apex (concave side) can be a valid fixation in the presence of hypoplastic pedicle, can reduce the thoracic hypokyphosis and derotate the vertebra but had more blood loss comparing to pedicle screws alone.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - May 17, 2018 Category: Orthopaedics Source Type: research

Announcements
(Source: European Spine Journal)
Source: European Spine Journal - May 17, 2018 Category: Orthopaedics Source Type: research

Different pedicle osteosynthesis for thoracolumbar vertebral fractures in elderly patients
ConclusionAll stabilization methods showed good clinical results, but cannulated screws augmented with PMMA seem to provide better implant stability with the lowest rate of loosening.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - May 14, 2018 Category: Orthopaedics Source Type: research

Minimally invasive surgery procedure in isthmic spondylolisthesis
ConclusionThe study showed that the extreme lateral approach to the lumbar spine in case of isthmic spondylolisthesis is a reliable and safe option to the most common open procedures. In the authors ’ opinion, XLIF procedures allow a good correction of the listhesis associated with good clinical and radiographic results.Graphical abstractThese slides can be retrieved under Electronic supplementary material. (Source: European Spine Journal)
Source: European Spine Journal - May 11, 2018 Category: Orthopaedics Source Type: research

Sagittal classification in adolescent idiopathic scoliosis: original description and therapeutic implications
DiscussionThis new classification summarizes all the pathological scenarios of the sagittal alignment of AIS into four patterns. A specific surgical planning can be extrapolated for each pattern. In type 1, the objective is to preserve the sagittal shape. In type 2, the objective is to restore thoracic kyphosis. In type 2b, TL junction should be straightened. In type 3, the objective is to reshape the lower arc of thoracic sagittal angle and straighten the TL junction.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - May 10, 2018 Category: Orthopaedics Source Type: research

Biomechanical advantages of supplemental accessory and satellite rods with and without interbody cages implantation for the stabilization of pedicle subtraction osteotomy
ConclusionsThe study supports the current clinical practice providing a strong biomechanical rationale to recommend 4-rod constructs based on accessory rods combined with cages adjacent to PSO site. Although weaker, the usage of accessory rods without cages and of a central satellite rod with hooks in combination with interbody spacers may also be justified.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - May 8, 2018 Category: Orthopaedics Source Type: research

Management of aortic injury during minimally invasive lateral lumbar interbody fusion
ConclusionsThis case highlights the importance of immediate recognition and imaging of any potential vascular injury during minimally invasive lateral interbody fusion. Given the poor outcomes associated with attempted open repair, endovascular techniques provide a valuable tool for the treatment of these complex injuries with significantly less morbidity. (Source: European Spine Journal)
Source: European Spine Journal - May 7, 2018 Category: Orthopaedics Source Type: research

Titanium granules pre-treated with hydrogen peroxide inhibit growth of bacteria associated with post-operative infections in spine surgery
ConclusionsOur findings suggest that the Ti-peroxy is a promising perioperative antimicrobial strategy that may be highly effective for prevention of post-operative infections. We therefore suggest application of hydrogen peroxide to implants prior to implantation.Graphical abstractThese slides can be retrieved under Electronic supplementary material. (Source: European Spine Journal)
Source: European Spine Journal - May 7, 2018 Category: Orthopaedics Source Type: research

C haracteristic morphological patterns within adolescent idiopathic scoliosis may be explained by mechanical loading
ConclusionsThis study identified a certain morphological pattern along the spine, which reveals a distinct load path prevalent within AIS. The data suggested that the spine adapts to the asymmetric load conditions and the spine is not deformed by asymmetric growth  disturbance.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - May 5, 2018 Category: Orthopaedics Source Type: research

The impact of deep surgical site infection on surgical outcomes after posterior adult spinal deformity surgery: a matched control study
ConclusionSSI significantly affects the first postoperative year after posterior ASD surgery. It is associated with more complications, unrelated revisions, and worst quality of life. However it ’s negative impact seems to be diluted by the second postoperative year as differences in HRQoL scores between the two groups decrease.Graphical abstractThese slides can be retrieved under Electronic Supplementary material. (Source: European Spine Journal)
Source: European Spine Journal - May 4, 2018 Category: Orthopaedics Source Type: research

Association between polymorphisms in vitamin D receptor gene and adolescent idiopathic scoliosis: a meta-analysis
ConclusionsMeta-analysis of existing data suggested thatBsmI was associated with increased risk of AIS in Asian populations. Nevertheless, further studies with rigorous design and more ethnic groups are encouraged to validate our findings.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - May 4, 2018 Category: Orthopaedics Source Type: research

Esophageal perforation caused by a thoracic pedicle screw
We report a case of anterior cortical perforation by a T4 pedicle screw complicated by an esophageal perforation in a 15-year-old girl with convulsive encephalopathy. She was operated for a severe neurological scoliosis (Rett syndrome). Her neurological condition deteriorated 3  years after the posterior spinal surgery, requiring a percutaneous gastrostomy. An intra-esophageal screw was discovered incidentally during an endoscopy. We decided not to remove this screw, because the patient’s health status presented a surgical contraindication. The patient showed no apparen t discomfort at the 10-year follow-up exam...
Source: European Spine Journal - May 3, 2018 Category: Orthopaedics Source Type: research

Lumbar epidural lipomatosis is associated with visceral fat and metabolic disorders
ConclusionsLEL patients had significantly more visceral fat and increased levels of insulin, UA and ferritin, which are closely related with metabolic disorders. This study indicates that the increased epidural fat in the spinal canal seen in the LEL patients is associated with metabolic syndrome.Graphical abstractThese slides can be retrieved under Electronic Supplementary material. (Source: European Spine Journal)
Source: European Spine Journal - May 2, 2018 Category: Orthopaedics Source Type: research

Correction to: Cervical pedicle screw instrumentation is more reliable with O-arm-based 3D navigation: analysis of cervical pedicle screw placement accuracy with O-arm-based 3D navigation
Unfortunately, the second author name of the above-mentioned article was incorrectly published in original publication. The complete correct name is given below: Hamid Rahmatullah Bin Abd Razak. The original article has been corrected. (Source: European Spine Journal)
Source: European Spine Journal - May 2, 2018 Category: Orthopaedics Source Type: research

Letter to the Editor concerning “Relationship between preoperative serum rapid turnover proteins and early-stage surgical wound infection after spine surgery” by D. Kudo et al. (Eur Spine J; 2016: DOI 10.1007/s00586-016-4855-z)
(Source: European Spine Journal)
Source: European Spine Journal - May 1, 2018 Category: Orthopaedics Source Type: research

Expert ’s comment concerning Grand Rounds case entitled “Low energy chronic traumatic spondylolisthesis of the axis” by C. J. Dunn, S. Mease, K. Issa, K. Sinha, A. Emami (Eur Spine J; 2017: DOI 10.1007/s00586-017-5206-4)
(Source: European Spine Journal)
Source: European Spine Journal - April 28, 2018 Category: Orthopaedics Source Type: research

Analysis of radiological parameters associated with decreased fractional anisotropy values on diffusion tensor imaging in patients with lumbar spinal stenosis
AbstractPurposePrevious studies have indicated that decreased fractional anisotropy (FA) values on diffusion tensor imaging (DTI) are well correlated with the symptoms of nerve root compression. The aim of our study is to determine primary radiological parameters associated with decreased FA values in patients with lumbar spinal stenosis involving single L5 nerve root.MethodsPatients confirmed with single L5 nerve root compression by transforaminal nerve root blocks were included in this study. FA values of L5 nerve roots on both symptomatic and asymptomatic side were obtained. Conventional radiological parameters, such as...
Source: European Spine Journal - April 26, 2018 Category: Orthopaedics Source Type: research

Announcements
(Source: European Spine Journal)
Source: European Spine Journal - April 26, 2018 Category: Orthopaedics Source Type: research

The use of vacuum-assisted closure in spinal wound infections with or without exposed dura
ConclusionsThis is one of the largest studies which confirms the safety and efficacy of VAC dressings in patients with spinal wound infections, even when the dura is exposed.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - April 25, 2018 Category: Orthopaedics Source Type: research

Preliminary experience with SpineEOS, a new software for 3D planning in AIS surgery
ConclusionIn this preliminary study, the software based on 3D stereoradiography low-dose system used to plan AIS surgery seems reliable for preoperative planning and precontoured rods. It is an interesting tool to improve surgeons ’ practice, since 3D planning is expected to reduce complications such as iatrogenic malalignment and to help for a better understanding of the complications, choosing the location of the transitional vertebra. However, further work is needed to improve thoracic kyphosis planning.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - April 24, 2018 Category: Orthopaedics Source Type: research

Expert ’s comment concerning Grand Rounds case entitled “Aneurysmal bone cyst of C2 treated with novel anterior reconstruction and stabilization” by S. Rajasekaran et al. (Eur Spine J; 2016: DOI 10.1007/s00586-016-4518-0)
(Source: European Spine Journal)
Source: European Spine Journal - April 23, 2018 Category: Orthopaedics Source Type: research

Extremely high preoperative C7 slope limits compensatory cervical lordosis after muscle-preserving selective laminectomy
This study evaluated the effect of an extremely high C7 slope on C2–C7 lordotic compensation following SL.MethodsThis study enrolled 151 cervical compressive myelopathy patients who underwent SL. Lateral cervical spine radiographs were taken before surgery and during final follow-up. Patients were divided into extremely high C7 slope ( ≥ 30°) (EH) and non-high C7 slope (
Source: European Spine Journal - April 23, 2018 Category: Orthopaedics Source Type: research

The pedicle instrumentation and percutaneous elevation (Pi.Pe): a new cementless surgical technique in type A post-traumatic vertebral fractures
AbstractPurposeTo investigate if bone substitutes are strictly necessary to restore the vertebral body height and improve the clinical outcome, in patients with thoracolumbar or lumbar AO type A post-traumatic vertebral fractures, managed with balloon kyphoplasty combined with posterior screw and rod system.Methods105 patients with post-traumatic thoracolumbar spine fracture were recruited. At baseline, the patients underwent a CT and an MRI of the spine. Clinical evaluation was performed, using the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI), at baseline, 48  h after surgery, at 3-month follow-u...
Source: European Spine Journal - April 20, 2018 Category: Orthopaedics Source Type: research

Expert ’s Comment concerning Grand Rounds case entitled “Hirayama disease” by D. C. Kieser, P. J. Cox, S. C. J. Kieser (Eur Spine J; 2018: doi:10.1007/s00586-018-5545-9)
(Source: European Spine Journal)
Source: European Spine Journal - April 20, 2018 Category: Orthopaedics Source Type: research

Systematic review of the complications associated with magnetically controlled growing rods for the treatment of early onset scoliosis
ConclusionsMCGRs improve coronal deformity and maintain spinal growth, but carry a 44.5% complication and 33% unplanned revision rate. Conversion procedures do not increase this risk. Single rods should be avoided.Graphical abstractThese slides can be retrieved under Electronic Supplementary material. (Source: European Spine Journal)
Source: European Spine Journal - April 19, 2018 Category: Orthopaedics Source Type: research

Low virulence bacterial infections in cervical intervertebral discs: a prospective case series
ConclusionsOur data show thatCNS is more prevalent thanP. acnes in degenerative cervical discs. The infection route in cervical discs may be predominantly through an annulus fissure. Correlation between these infections and clinical symptoms is uncertain; therefore, their clinical significance needs to be investigated in the future.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - April 19, 2018 Category: Orthopaedics Source Type: research

Adolescent idiopathic scoliosis correction by instrumented vertebral arthrodesis with autologous bone graft from local harvesting without bone substitute use: results with mean 3  year follow-up
ConclusionBone substitutes are a further cost in arthrodesis surgery and suboptimal integration leaves foreign bodies on vertebras. Our experience shows that all pedicle screw instrumentation and bracing after surgery obtain stable correction showing in time a solid arthrodesis with autologous bone only, harvested at local site, without bone substitutes or further bone graft.Graphical abstract (Source: European Spine Journal)
Source: European Spine Journal - April 19, 2018 Category: Orthopaedics Source Type: research

Osteoporotic thoracolumbar compression fractures: long-term retrospective comparison between vertebroplasty and conservative treatment
ConclusionsPercutaneous vertebroplasty represents a safe treatment for osteoporotic vertebral compression fractures, although it may be associated with a higher incidence of adjacent fractures and therefore worse thoracolumbar kyphosis and long-term follow-up than conservative treatment.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - April 19, 2018 Category: Orthopaedics Source Type: research

Expert ’s Comment concerning Grand Rounds case entitled “Idiopathic spinal cord herniation: consideration of its pathogenesis based on the histopathology of the dura mater’’ by S. Shimizu et al. (Eur Spine J; 2017. DOI 10.1007/s00586-017-5147-y)
(Source: European Spine Journal)
Source: European Spine Journal - April 19, 2018 Category: Orthopaedics Source Type: research

Expert ’s comment concerning Grand Rounds case entitled & quot;Malignant triton tumor: Grand Round presentation of a rare aggressive case thoracolumbar spine tumor & quot; by S. Ghailane et al. (Eur Spine J; 2017: DOI 10.1007/s00586-017-5277-2)
(Source: European Spine Journal)
Source: European Spine Journal - April 18, 2018 Category: Orthopaedics Source Type: research

Comparison of pure lateral and oblique lateral inter-body fusion for treatment of lumbar degenerative disk disease: a multicentric cohort study
ConclusionsLLIF and OLIF represent safe and effective MIS procedures for the treatment of lumbar DDD. LLIF had some risks of motor deficit and monitoring is mandatory, though it addressed more the coronal deformities. OLIF did not imply risks for motor deficits, but attention should be paid to vascular anatomy. It was more effective in kyphotic segmental deformities.Graphical abstractThese slides can be retrieved under Electronic Supplementary material. (Source: European Spine Journal)
Source: European Spine Journal - April 18, 2018 Category: Orthopaedics Source Type: research

The etiology of congenital scoliosis: genetic vs. environmental —a report of three monozygotic twin cases
ConclusionThe variable presentation of congenital scoliosis in a genetically unique population serves as testament to the complexity associated with its development, likely involving both environmental factors and a genetic predisposition. (Source: European Spine Journal)
Source: European Spine Journal - April 18, 2018 Category: Orthopaedics Source Type: research

Pulmonary cement embolism following cement-augmented fenestrated pedicle screw fixation in adult spinal deformity patients with severe osteoporosis (analysis of 2978 fenestrated screws)
ConclusionThis study showed an overall 16.3% radiological PCE and 1.4% symptomatic PCE incidence when CAFPS were used due to severe osteoporosis. The symptomatic PCE risk was significant when CAFPS were  >  7 levels; >  14 fenestrated screws; and >  20–25 cc cement volume is used and this may cause PAP increase and right ventricular dilatation.Graphical Abstract (Source: European Spine Journal)
Source: European Spine Journal - April 18, 2018 Category: Orthopaedics Source Type: research

The use of STarT BACK Screening Tool in emergency departments for patients with acute low back pain: a prospective inception cohort study
ConclusionMost of patients seeking care in emergency departments with a new episode of acute LBP improved after 6  weeks. The use of SBST to guide initial treatment and to predict clinical outcomes are most indicated when the instrument is applied after 6 weeks after presentation to emergency care.Graphical abstractThese slides can be retrieved under Electronic Supplementary material. (Source: European Spine Journal)
Source: European Spine Journal - April 18, 2018 Category: Orthopaedics Source Type: research

Pulmonary cement embolism is not associated with the cause of death in a post-mortem cohort of cement-augmented interventions in the spine
ConclusionsThe presented data reveal a high frequency of PCE making it a notable finding —especially since not only single but also branch-like embolisms were detected. Thus, it is of great importance that none of the causes of death were related to the impact of PCE. Nevertheless, it is crucial to consider the underlying diseases for increased PCE risk and to apply latest surgical te chniques and preventive measures.Graphical abstract These slides can be retrieved under Electronic Supplementary material. (Source: European Spine Journal)
Source: European Spine Journal - April 17, 2018 Category: Orthopaedics Source Type: research

Triplanar correction of adolescent idiopathic scoliosis by asymmetrically shaped and simultaneously applied rods associated with direct vertebral rotation: clinical and radiological analysis of 36 patients
AbstractPurposeAim of this study was to investigate the effectiveness of a new surgical corrective manoeuvre for adolescent idiopathic scoliosis (AIS) by asymmetrically shaped and simultaneously applied rods and in combination with direct vertebral rotation, to control both the triplanar deformity and the kyphosis apex location.MethodsWe retrospectively reviewed 36 patients who undergo surgical treatment using simultaneous translation on two differently contoured rods, in combination with direct vertebral rotation. Patients were divided into three main groups according to the scoliotic curve type.ResultsThe average follow-...
Source: European Spine Journal - April 17, 2018 Category: Orthopaedics Source Type: research

Multidisciplinary management of pyogenic spondylodiscitis: epidemiological and clinical features, prognostic factors and long-term outcomes in 207 patients
ConclusionThe microbiological diagnosis is the main predictive factor for successful treatment. Early diagnosis and multidisciplinary management are also needed to identify underlying aggressive conditions and to avoid neurological complications associated with poorer long-term outcomes. Despite high healing rates, PS may lead to major disabilities still representing a difficult challenge.Graphical abstractThese slides can be retrieved under Electronic Supplementary material. (Source: European Spine Journal)
Source: European Spine Journal - April 17, 2018 Category: Orthopaedics Source Type: research

Spinal navigation for minimally invasive thoracic and lumbosacral spine fixation: implications for radiation exposure, operative time, and accuracy of pedicle screw placement
ConclusionsO-Arm navigation provides greater accuracy of percutaneous instrumentation placement with an acceptable procedural radiation dose delivered to the patients and comparable operative times.Graphical abstractThese slides can be retrieved under Electronic Supplementary material. (Source: European Spine Journal)
Source: European Spine Journal - April 17, 2018 Category: Orthopaedics Source Type: research

Is it statistically significant?
(Source: European Spine Journal)
Source: European Spine Journal - April 17, 2018 Category: Orthopaedics Source Type: research

Reviewer ’s Comments on the Letter to the Editor entitled “Generalising the results: how can we improve our reports?” by Saltychev M, Eskola M (2018). Eur Spine J; doi:10.1007/s00586-018-5558-4
(Source: European Spine Journal)
Source: European Spine Journal - April 17, 2018 Category: Orthopaedics Source Type: research

Comments on the Letter to the Editor of Jie Weng et al. concerning “Relationship between preoperative serum rapid turnover proteins and early-stage surgical wound infection after spine surgery” by D. Kudo et al. (Eur Spine J; 2016: doi:10.1007/s00586-016-4855-z) as well as the Reply of D. Kudo et al. (Eur Spine J; 2018: doi:10.1007/s00586-018-5560-x)
(Source: European Spine Journal)
Source: European Spine Journal - April 17, 2018 Category: Orthopaedics Source Type: research

Thoraco-lumbar fractures with blunt traumatic aortic injury in adult patients: correlations and management
ConclusionRelationship between thoraco-lumbar fracture and vascular lesion is rare, but potentially fatal. Comprehension of spinal biomechanics and vascular damages could be crucial to avoid poor results or decrease mortality. Frequently, traction of the aorta and its vessels is realized by C-dislocated fractures. CT and angio-CT are recommended. Spine stabilization should always follow the vascular repair. Early severe deficits worse the prognosis related to neurological recovery and survival.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - April 16, 2018 Category: Orthopaedics Source Type: research

Cortical bone trajectory screws for circumferential arthrodesis in lumbar degenerative spine: clinical and radiological outcomes of 101 cases
ConclusionsThis is to our knowledge that the largest available study regarding CBT for circumferential arthrodesis. Results underlined the safety of this technique and the promising clinical and radiological outcomes that will need a longer follow-up.Graphical abstractThese slides can be retrieved under Electronic Supplementary material. (Source: European Spine Journal)
Source: European Spine Journal - April 16, 2018 Category: Orthopaedics Source Type: research

Successful treatment of a diffuse type tenosynovial giant cell tumor in the thoracic spine mimicking spinal metastasis by frozen recapping laminoplasty in a patient with thyroid cancer
ConclusionsTGCT-D can mimic metastasis in PET/CT and should be included in the differential diagnosis if a lytic lesion affecting the posterior elements of the vertebrae involves the facet joints. CT-guided biopsy is recommended for accurate diagnosis when an occult tumor, such as TGCT, is incidentally detected on PET-CT, even in patients with a history of malignant neoplasm. Frozen recapping laminoplasty is useful for complete resection of a spinal tumor, preventing local recurrence, and preservation of the posterior spinal elements. (Source: European Spine Journal)
Source: European Spine Journal - April 16, 2018 Category: Orthopaedics Source Type: research

Vertebral body osteonecrosis: proposal of a treatment-oriented classification system
ConclusionsThe classification allows a systematic staging of this disease and can help establish a proper and patient-oriented treatment plan. Further researches are advocated to fully validate the proposed classification system.Graphical abstract These slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - April 16, 2018 Category: Orthopaedics Source Type: research