Ankylosing spondylitis: special considerations and clinical outcomes in surgical management of spinal fractures, case series and analysis of twenty patients.

Ankylosing Spondylitis (AS) is a systemic inflammatory disease that involves the axial skeleton the most. It causes ascending inflammation and, thus, rigidity in the spinal column, from the sacroiliac joint to the cervical region. Spinal column deformities, besides vulnerability to trauma, alter the patients' quality of life and put their neural elements a great risk.

Basilar invagination and atlantoaxial dislocation as a complication of severe dystrophic cervical kyphosis correction in neurofibromatosis type 1: Report of a rare case and review of literature.

Introduction And Importance: Neurofibromatosis type 1 (NF1) affects the musculoskeletal system as well as the cervical spine. It is associated with severe, progressive cervical kyphosis. Surgical intervention is the treatment of choice to avoid neurological impairment and malalignment.

Microsurgical treatment of ophthalmic artery aneurysm, a case series of 55 patients with long-term follow-up.

Background: Ophthalmic artery aneurysm (OAA) can be secured in endovascular or microsurgical approaches. Still there are controversies in technique selection and their long term outcomes.

Methods: All the patients with OAA were treated microsurgically and followed.

Traumatic atlantoaxial rotatory fixation in adults: a systematic review of published cases.

Atlantoaxial rotatory fixation (AARF) in adults is a rare and clinically challenging condition characterized by a spectrum of etiological factors, predominantly attributed to traumatic and inflammatory pathologies within the craniovertebral region. Trauma is the most frequently identified cause within the adult population, with the first case report published in 1907. This study aims to conduct a systematic review that addresses the clinical presentations and management strategies relating to traumatic atlantoaxial rotatory fixation in adults.

Assessment of Analgesic Efficacy of Bilateral Lumbar Erector Spinae Plane Block for Postoperative Pain following Lumbar Laminectomy: A Single-Blind, Randomized Clinical Trial.

Background: The erector spinae plane (ESP) block is a novel approach to minimizing postoperative pain. We investigated the efficacy and side effects of the ultrasonography-guided bilateral ESP block in reducing pain in the first 24 hours after lumbar laminectomy.

Materials And Methods: We conducted a single-blind (statistical analyst and those responsible for recording patient information postoperation were unaware of the study groups) randomized clinical trial on 50 patients aged 18 to 65 with American Society of Anesthesiology (ASA) class I or II physical status scheduled for lumbar laminectomy surgery at Shahid Chamran Hospital, Shiraz, Iran.

Posterior-only approach for treatment of irreducible traumatic Atlanto-axial dislocation, secondary to type-II odontoid fracture; report of a missed case, its management and review of literature.

Introduction And Importance: Odontoid fracture (OF) is among the most common and challenging cervical spine fractures in regards to the treatment and surgical approach. Atlanto-axial dislocation (AAD) is considered a significant complication after failed non-surgical treatment of OF. Traditionally, it requires anterior odontoidectomy followed by posterior C1-C2 reduction and fusion.

Surgical Management of Adult Traumatic Atlantoaxial Rotatory Fixation with Hangman Fracture: Case Report and Literature Review.

Atlantoaxial rotatory fixation (AARF) is a rare type of adult cervical spine injury. The classic symptoms are painful torticollis and limited neck range of motion. To avoid catastrophic consequences, early diagnosis is necessary.

Dorsal intradural spinal arteriovenous fistula associated with giant intradural spinal aneurysm, a case report.

Arteriovenous fistula and spinal aneurysms like other vascular malformations can mimic radiculopathy and low back pain. Precise imaging work combined with a hybrid endovascular-microsurgical approach is the key element for the best clinical outcome.

Spontaneous idiopathic spinal subdural hemorrhage in a 16-year-old boy: A rare case in pediatrics and review of literature.

Idiopathic spinal subdural hematoma (SSDH) is a rare phenomenon. Here, we present a 16-year-old-boy who presented with acute sudden onset weakness and brown squared syndrome; the cervical MRI findings showed acute subdural hematoma from C2 to C6. Emergent surgical intervention was performed, and significant improvement was seen in follow-ups.

Multilevel anterior cervical fusion with standalone cage or cage-and-plate after cervical discectomy: Benefits and drawbacks.

Purpose: Multilevel anterior cervical discectomy and fusion (ACDF), especially two-level ACDF, has been usually performed in the cervical degenerative disease, and the incidence rate of complications is controversial. This study aimed to compare the outcomes of ACDF approach with cage alone and with plate fixation in multilevel discectomy.

Methods: Patients who had undergone multilevel ACDF by the Smith-Robinson methods were included from 2018 to 2020.

The impact of physical and psychological pain management training on pain intensity, anxiety and disability in patients undergoing lumbar surgeries.

Background/context: Lumbar surgery is one of the interventions performed for patients with degenerative conditions.

Purpose: This study aimed to investigate the effect of pain management education on pain intensity, anxiety, and disability after the lumbar surgery.

Study Design/setting: This randomized controlled trial was performed on 70 30-65-year-old patients with lumbar canal stenosis and lumbar disc herniation from 2018 to 2019.

Clinical Outcome of Pedicle-Sparing Transfacet Diskectomy and Fusion with Segmental Instrumentation for Thoracic Disc Herniation.

Background:  Thoracic disk herniations (TDHs) are relatively rare compared with their cervical and lumbar counterparts. Posterior approaches allow for a simpler and less invasive surgery than anterior and lateral approaches. A pedicle-sparing transfacet approach was initially described in 1995, and modified in 2010.

Surgical Outcome of Pediatric Posterior Fossa Tumors in Shiraz, Southern Iran: A Brief Report.

Posterior fossa tumors (PFTs) are prevalent in children, and about half of all childhood brain tumors arise from the structures of the posterior fossa. Studies on PFTs in Iranian children have mainly focused on epidemiological characteristics. This study aimed to evaluate surgical outcomes and predictive factors for survival in children with PFTs in Shiraz, Iran.

Traumatic Cervical Vertical Translational Injury: A Case Report.

Traumatic cervical translational injury is a notably rare and highly unstable subtype of type C sub-axial cervical spine injury with high morbidity and mortality rates. Hereby, we report a 41-years-old man who was a case of multiple trauma due to car rollover. He was completely conscious, complaining of cervical pain, with a GCS score of 15/15.

Metastatic thoracic and lumbar intramedullary and extramedullary Ewing's sarcoma: a rare case report and literature review.

Ewing sarcoma (ES) is a highly aggressive bone and soft tissue tumor that occurs mainly in young children and adolescents and is associated with primary and metastatic disease. Intramedullary ES (either primary or secondary) is rare, and the ideal management remains inconclusive. We herein report intramedullary and extramedullary metastatic ES in a single patient.

Alternative approach to treatment of unusual site giant cell tumor at cervical spine: A case report and review of literature.

Giant cell tumor (GCT) is an intermediate malignant bone tumor which mostly involves long extremity bones, less commonly involving the spine with sacral predominance. Cervical spine involvement is rare. According to literature, the selective approach for the treatment of GCT is en bloc resection with spinal reconstruction.

Odontoid fracture complicating ankylosing spondylitis presenting with cervical canal stenosis and quadriparesis: A case report with 5-year follow-up and review of the literature.

Introduction And Importance: Spinal fractures, especially cervical fractures, are more common in patients with ankylosing spondylitis in comparison with unaffected patients. However, odontoid fractures are relatively rare in these patients. Also, neurological symptoms are not common in odontoid fractures due to the larger diameter of the spinal canal at this level.

Evaluation of Serum Interleukin-1β (IL-1β) Levels in Patients with Intracranial Aneurysms Compared to a Control Group.

Aim: To examine the screening value of the serum level of interleukin-1β (IL-1β) in aneurysmal subarachnoid hemorrhage (SAH), and to evaluate its association with the severity of initial bleeding.

Material And Methods: This case-control study was performed in Namazi Hospital, affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. The study population included patients referred to Namazi Hospital with a diagnosis of SAH, whose symptoms had emerged within less than 48 hours.

Effect of continuous intra-incisional bupivacaine on postoperative pain in non-traumatic spinal fixation surgeries: a randomized controlled trial.

Background: Continuous injection of local anesthetics by using surgical wound catheters for postoperative pain relief has gained acceptance in recent years. However, whether this method can be alternatively used instead of systemic opioids in different surgical procedures has not yet been elucidated.

Objectives: The aim was to investigate the effect of continuous injection of bupivacaine through a catheter inside the surgical wound on reducing the postoperative pain of lumbar spine fusion surgeries.

Reconstruction of C1 lateral mass with an expandable cage in addition to vertebral artery preservation: presenting two cases.

Purpose: C1 lateral mass reconstruction is recommended, in cases of instability caused by tumor involvement or extensive C1 lateral mass resection. However, because of the anatomical complexity of the area and, most importantly, the proximity to vertebral arteries, few cases of reconstruction have been reported to date. The purpose of this report is to present technical details of C1 lateral mass reconstruction in conjunction with vertebral artery preservation from a posterior approach.

A Randomized Controlled Trial of Early versus Late Surgical Decompression for Thoracic and Thoracolumbar Spinal Cord Injury in 73 Patients.

Convincing clinical evidence exists to support early surgical decompression in the setting of cervical spinal cord injury (SCI). However, clinical evidence on the effect of early surgery in patients with thoracic and thoracolumbar (from T1 to L1 [T1-L1]) SCI is lacking and a critical knowledge gap remains. This randomized controlled trial (RCT) sought to evaluate the safety and efficacy of early (<24 h) compared with late (24-72 h) decompressive surgery after T1-L1 SCI.

Clinical, Functional, and Radiologic Outcome of Single- and Double-Level Transforaminal Lumbar Interbody Fusion in Patients with Low-Grade Spondylolisthesis.

Objective: The main objective is to determine the functional, clinical, and radiological outcome of patients with low-grade spondylolisthesis undergoing single- or double-level transforaminal lumbar interbody fusion (TLIF).

Materials And Methods: This quasi-interventional study was conducted during a 2-year period from 2016 to 2018 in Shiraz, Southern Iran. We included all the adult (≥18 years) patients with low-grade spondylolisthesis (Meyerding Grade I and II) who underwent single- or double-level TLIF in our center.

Surgical Management of Adult Traumatic Atlantoaxial Rotatory Subluxation with Unilateral Locked Facet; Case Report and Literature Review.

Atlantoaxial rotatory subluxation (AARS) is rarely occurred in adults with trauma as the most common cause. In type A and B it is usually managed with close reduction and external brace; however, in nonresponsive cases, surgical interventions might be needed. Our patient is a 21-year-old man with neck pain and torticollis after a car turn- over.