Interlaminar lumbar device implantation in treatment of Baastrup disease (kissing spine)

Background: Baastrup disease (BD) is characterized by the degenerative changes of spinous processes and interspinous soft tissues. It is more common among aged persons. This disorder is a relatively common cause of low back pain. Its incidence is underestimated. A few studies have investigated BD epidemiology and proposed treatment efficacy. The aim of this paper is to establish impact and outcome evaluations of managing the patients with Baastrup disease who have been treated by implementing of floating interlaminar device (FID). Materials and Methods: Between January 2015 and September 2017, 47 patients have been operated by implementing of FID for BD in our Department of Neurosurgery. Results: Of the 47 patients, 20 were female and 27 were male with an average age of 51.78. On average, we followed the cases up to 11 months. The most frequent level of disorder was L4–L5 followed by L3–L4 level. The condition of 45 patients improved after surgery according to Oswestry low back pain score and 39 patients could return to their work. Conclusion: The results from our study corroborate that implementing of FID is a good alternative treatment for patient chronic low back pain due to BD This technique contributes to improving a better living situation for the patients given the correct indications

Late appearance of low back pain relating to modic change after lumbar discectomy

Background: In practice of neurosurgery, we find that a wide number of patients referred for refractory low back pain have a history of lumbar discectomy. In a large number of them, magnetic resonance imaging (MRI) studies detect Modic changes (MCs). The aim of this study is to determine the relationship between emergence of MC and low back after lumbar discectomy. Materials and Methods: Three hundred and fifty-eight patients with a medical history of discectomy had a MC at the level of the operated disc without any other discopathy. They have been selected from among the 1154 patients operated for lumbar disc herniation over 5 years. Results: Two hundred and fourteen patients (67.30%) had not presented MCs on preoperative MRI. Conclusion: Our study awakens a strong presumption about the relationship between emergence of MC after lumbar discectomy

Preliminary results of anterior cervical arthroplasty by porous alumina ceramic cage for cervical disc herniation surgery

Objective: Anterior cervical arthroplasty (ACA) is the gold standard surgery in severe or unresponsive cases of cervical disc herniation, uncarthrosis, and foraminal stenosis. The aim of this study is to establish the impact and outcome evaluations of managing the patients operated for cervical arthroplasty by the intersomatic porous alumina ceramic cervical cages (PACC). The authors describe their experience in the area to allow the comparison of effectiveness of ceramic cages versus other interbody fusion cages. Materials and Methods: Between April 2015 and September 2018, we operated 118 for ACA by using PACC. Among them, 52 were female and 66 were male, with an average age of 46.78 years. Results: The mean symptoms duration was 14.1 months. The most frequent level of the disorder was C5–C6 followed by C6–C7 level. Mean follow-up was 3.3 years. The Neck Disability Index (NDI) and the visual analog scale (VAS) were used to evaluate the patients status. No significant differences were observed between our results and literature data regarding operative time, duration of hospitalization, and NDI; however, we observed a shorter period and higher rate of bony fusion. Conclusion: The results from the present study corroborate that implementing of PACC is a good alternative treatment for the patient operated by ACA for cervical disc herniation or foraminal cervical stenosis

Lumbar disk herniation: How far should efforts go to minimally invasive procedure?

Background: Minimally invasive surgery (MIS) of lumbar disk herniation allows avoiding less of a mess in crossing structures, reducing muscular and cutaneous scarring, postoperative pain, lengthy recovery times, and the rate of infection. The aim of this study is to explain our experience in MIS of disc herniation. We compare the outcome of three different surgical techniques used for the treatment of lumbar disc herniation. Materials and Methods: A total of 1147 patients have been operated from July 2008 to December 2015 for lumbar disk herniation by posterior endoscopic approach. Three hundred and seventy-nine patients underwent discectomy and herniectomy (DH), 557 patients have been operated by herniectomy (H), and 211 patients underwent only bone decompression (BD). Results: The results show 80.10%, 82.06%, and 84.02% excellent outcome, respectively, in BD, DH, and BD techniques. Conclusion: Analysis of the data demonstrates that the results obtained are equivalent and comparable in different used techniques for the treatment of disc herniation, we do not need to perform discectomy in all cases in a systematic way

Proposal of a new anatomical landmark to identify the disc space in endoscopic lumbar discectomy

Introduction: In endoscopic lumbar discectomy for posterolateral disc herniation, we determined some anatomical landmarks for improved disc space access. These landmarks are based on the beginning of the insertion of the ligamentum flavum (LF) to vertebral lamina. Materials and Methods: In 978 patients operated by posterolateral disc herniation, we measured prospectively the distance between the beginning of the insertion of the LF and space disc rostrally. Results: The distance between the beginning of the insertion of the LF and space disc was broader at the level of L3–L4, with an average of 14 mm. At L4–L5, the average distance was 13.5. At L5–S1, the average distance was 12 mm. Conclusion: Knowing the accurate distance between the insertion of LF and disc space contributes to reducing the average duration of the surgical procedure to avoid empirical search of disc space by a surgeon and avoiding unnecessary and excessive LF and bone removal

Dolomitization and burial history of lower triassic carbonate reservoir-rocks in the Persian Gulf (Salman offshore field)

International audienceShallow marine carbonate sedimentation prevailed during the Early Triassic in the northern part of the Persian Gulf (Kangan Formation; offshore Iran). Associated near surface and (to a lesser extent) burial diagenesis had significant impacts on the evolution of reservoir properties of the Kangan Formation. In some Iranian offshore fields such as Salman, pervasive, early dolomitization of the Kangan carbonate rocks is believed to have played an important role in improving the reservoir characteristics of this unit. Detailed petrographic and geochemical analyses indicate that such dolomitization could be explained by means of the sabkha/seepage-reflux model. Furthermore, three types of dolomites, found in Kangan rocks in the Salman Field, have been described: (1) fabric-retentive, (2) fabric-destructive, and (3) cement. Fabric-retentive dolomites are the most frequent commonly found in the studied field, with respect to the other types. Oxygen and carbon-stable isotopic analyses confirm that the fabric-retentive dolomites and associated anhydrites formed at surface and near-surface conditions, whereas the fabric-destructive dolomite formed at temperatures above 50 °C. The burial history of the Salman Field is divided into three major phases (tectonic quiescence and low subsidence rates, and two active phases with high subsidence rates). The fabric-retentive dolomites are mostly related to the first phase, while the fabric-destructive and dolomite cements are related to the second and third phases including shallow and deep burial, respectively