Minimally invasive surgery for spinal fractures due to multiple myeloma

Background: Multiple myeloma (MM) presents with spinal lesions in 60% of cases. The combination of osteolytic lesions with multifactorial osteopenia raises specific surgical treatment challenges. Minimally invasive spine surgery (MISS) could be a potential option for MM spinal lesions treatment. Objective: The objective of this study is to evaluate MISS techniques to treat patients presenting with spine fractures due to MM. Methods: Retrospective analysis of consecutive patients with histology-proven pathological fractures caused by MM treated with MISS between 2009 and 2018. We collected the data from the clinical records on epidemiology, topography of spine lesions, surgical techniques, blood loss, operation time, complications, mean in-hospital time, and clinical evolution. Results: Twenty-one patients were studied - 13 males and 8 females, with a mean age of 64 years (range 43-83). Mean preoperative spinal instability neoplastic score was 9.8 ± 6 (range 5-16). All cases had a thoracolumbar location - 15 patients underwent kyphoplasty (KP) or vertebroplasty (VP) and 6 were treated with other more complex procedures. All patients had a reduction of pain and/or analgesic load. Vertebral body height increased by a mean of 2.9 mm after VP/KP. Mean hospital stay was 1.3 days for KP/VP and 5.0 days for other MISS procedures. Three patients had complications. Conclusions: The heterogeneity of techniques used reflected the variety of spine involvement by MM. KP and VP led to shorter hospital stays and less complications, being adequate for lesions without major instability. More complex MISS techniques offer an effective treatment with short delay for starting MM adjuvant treatment.info:eu-repo/semantics/publishedVersio

Multilevel cervical arthroplasty-clinical and radiological outcomes

Cervical disc arthroplasty (CDA) is a valid option for single-level cervical disc disease (CDD) as an alternative to fusion. However, the use in 3- and 4-level disc disease is under scrutiny with scarce data published so far. Our aim was to study clinical and radiological outcomes of arthroplasty in patients with multilevel CDD.info:eu-repo/semantics/publishedVersio

The 2019 Cervical Spine Research Society (CSRS) Asia Pacific Traveling Fellowship

The Cervical Spine Research Society (CSRS) is dedicated to advancing the care of patients with cervical spine pathology. The authors present here highlights of the 2019 CSRS-Asia Pacific Traveling Fellowship.Scientific Assessment and Innovation in Neurosurgical Treatment Strategie

The 2019 Cervical Spine Research Society (CSRS) Asia Pacific Traveling Fellowship

The Cervical Spine Research Society (CSRS) is dedicated to advancing the care of patients with cervical spine pathology. The authors present here highlights of the 2019 CSRS-Asia Pacific Traveling Fellowship.Scientific Assessment and Innovation in Neurosurgical Treatment Strategie

Cervical Spondylotic Myelopathy: Natural Course and the Value of Diagnostic Techniques -WFNS Spine Committee Recommendations

2-s2.0-85073778650Objective: This study presents the results of a systematic literature review conducted to determine most up-to-date information on the natural outcome of cervical spondylotic myelopathy (CSM) and the most reliable diagnostic techniques. Methods: A literature search was performed for articles published during the last 10 years. Results: The natural course of patients with cervical stenosis and signs of myelopathy is quite variable. In patients with no symptoms, but significant stenosis, the risk of developing myelopathy with cervical stenosis is approximately 3% per year. Myelopathic signs are useful for the clinical diagnosis of CSM. However, they are not highly sensitive and may be absent in approximately one-fifth of patients with myelopathy. The electrophysiological tests to be used in CSM patients are motor evoked potential (MEP), spinal cord evoked potential, somatosensory evoked potential, and electromyography (EMG). The differential diagnosis of CSM from other neurological conditions can be accomplished by those tests. MEP and EMG monitoring are useful to reduce C5 root palsy during CSM surgery. Notable spinal cord T2 hyperintensity on cervical magnetic resonance imaging (MRI) is correlated with a worse outcome, whereas lighter signal changes may predict better outcomes. T1 hypointensity should be considered a sign of more advanced disease. Conclusion: The natural course of CSM is quite variable. Signal changes on MRI and some electrophysiological tests are valuable adjuncts to diagnosis. © 2019 by the Korean Spinal Neurosurgery Society

Cervical spine pathology and treatment: A global overview

10.21037/jss.2020.01.12Journal of Spine Surgery61340-35

Migration Phenomenon in Food Packaging. Food-Package Interactions, Mechanisms, Types of Migrants, Testing and Relative Legislation-A Review

The development of convenient and low-cost packages, together with the increased consumer demands for safer products, have resulted in the conduction of extensive research and the publication of numerous studies related to the phenomenon of migration. The large number of synthetic materials used for the manufacture of packages makes the evaluation of the food-package interactions quite complicated. Different parameters such as the nature of the food of interest, the type of food-package contact, the time and temperature of contact, the packaging materials used, the properties of the migrating substances, as well as the amount of potential migrants contained in the packaging materials, can drastically affect the migration rate and extent. Due to the extreme variety of foods used, several food simulants have been suggested and applied for testing the migration phenomenon under various laboratory conditions. The use of many of those simulants is defined by national and international legislation. This review article covers the main migration phenomena, which are related to the most commonly used packaging materials. It is clearly demonstrated that the complexity of the migration phenomena requires more research to establish internationally accepted risk management procedures and standardised testing methods