Key Predictors of Treatment Failure in Conservatively Managed Spondylodiscitis: A Long-Term Retrospective Cohort Study.

: Conservative treatment of patients with pyogenic spinal infection is a well-established therapy. Nevertheless, treatment failure is often seen despite adequate antibiotic therapy. The aim of this study was to evaluate predictors of treatment failure facilitating individualized, patient-specific therapy and thus increasing the success of therapy.

Minimal Invasive Pre-Op CT-Guided Gold-Fiducials in Local Anesthesia for Easy Level Localization in Thoracic Spine Surgery.

The accurate identification of intraoperative levels is of paramount importance in spinal surgery, particularly in cases of obesity or anatomical anomalies affecting the thoracic spine. The aim of this work was to clarify whether the preoperative percutaneous placement of fiducial markers under local anesthesia only, with minimal discomfort to the patient, can be performed safely and efficiently. Patients treated at our institution between June 2019 and June 2020 for thoracic intraspinal lesions with preoperative percutaneous gold fiducial placement were analyzed.

Return to Work Following Anterior Lumbar Interbody Fusion with Percutaneous Posterior Pedicle Fixation: A Retrospective Analysis from Two Academic Centers in Germany.

Return to work after spinal surgery is a crucial factor in the recovery process. It can contribute not only to physical rehabilitation but also to psychological well-being. This study aims to evaluate the rate of return to work following elective lumbar spine surgery and identify predictors that predict failure of return to work.

Comparison of head positioning using the Mayfield skull clamp versus padded headrest in anterior cervical discectomy and fusion surgery.

Background: Anterior cervical discectomy and fusion (ACDF) is a commonly implemented surgical intervention for a variety of pathologies affecting the cervical spine. The current literature and daily practice reveal variations on patient head positioning for this procedure with both rigid fixations in the Mayfield skull clamp as well as use of a padded headrest being used. In this study, we therefore examine whether patients undergoing surgery using head positioning in the Mayfield skull clamp versus a padded headrest differ in regard to adverse events, surgical parameters and clinical outcome.

From the Oral Cavity to the Spine: Prevalence of Oral Cavity Infections in Patients with Pyogenic Spinal Infection.

Background incidence of pyogenic spinal infections has increased in recent years. In addition to treating the spinal infection, optimal care also includes identifying the source of the pyogenic spinal infection and the presence of other infections. The aim of this study is to elucidate the prevalence of oral cavity infection (OCI) within this patient cohort.

Effectiveness of outpatient parenteral antimicrobial therapy (OPAT) for patients with cranial infection.

Objective: Outpatient parenteral antimicrobial therapy (OPAT) is a well-established and cost-effective method for improving the efficient use of healthcare resources. However, only a few centres in Germany perform it. Here we analysed OPAT for the treatment of patients with cranial infections in our neurosurgical department.

Surgical management and clinical outcome of cervical, thoracic and thoracolumbar spinal tuberculosis in a middle-European adult population.

Spinal tuberculosis is due to globalization no longer a disease limited to developing nations. It remains in Germany a rarity and still a difficult diagnosis. Here we analyzed patients with spinal tuberculosis treated at our neurosurgical department.

The Beneficial Effect of Preoperative Exercise on Postoperative Clinical Outcome, Quality of Life and Return to Work after Microsurgical Resection of Spinal Meningiomas.

Objective: While outcomes of surgical treatment for spinal meningiomas are well-described within the literature, factors affecting early return to work as well as long-term health related quality of life remain unclear.

Methods: In this retrospective study, patients with spinal meningioma and surgical treatment from two university-level neurosurgical institutions between 2008 and 2021 were analyzed. Time to return to work, physical activities and long-term health related quality of life (assessed by telephone interviews using the EQ-5D-5L health status measure and visual analogue scale (EQ VAS) were analyzed.

Safety and feasibility of outpatient parenteral antimicrobial therapy for patients with spinal infection.

Outpatient parenteral antimicrobial therapy (OPAT) is a cost-effective method of administering intravenous antimicrobial therapy. Although OPAT is well established in the UK and US healthcare systems, few centres in Europe perform it. Here we analysed OPAT for the treatment of patients with spinal infections at our institution.

Resection of Lumbar Spinal Facet Joint Cysts and Cerebrospinal Fluid Leakage: Incidence, Prognostic Parameters, and Outcome in a Single-center Series.

Study Design: Single-center series.

Objective: Intraspinal facet joint cysts can lead to nerve root compression symptoms with severe discomfort and disability. Permanent improvement can be achieved by surgical resection of the cyst.

The Added Value of Cerebral Imaging in Patients With Pyogenic Spinal Infection.

The incidence of pyogenic spinal infection has increased in recent years. In addition to treatment of the spinal infection, early diagnosis and therapy of coexisting infections, especially of secondary brain infection, are important. The aim of this study is to elucidate the added value of routine cerebral imaging in the management of these patients.

Functional outcome and morbidity after microsurgical resection of spinal meningiomas.

Objective: The aim of this study was to evaluate functional outcome, surgical morbidity, and factors that affect outcomes of surgically treated patients.

Methods: The authors retrospectively analyzed patients who underwent microsurgical resection for spinal meningiomas between 2009 and 2020. Patient data and potential variables were collected and evaluated consecutively.

Quality of Life Following Surgical and Conservative Therapy of Pyogenic Spinal Infection: A Study of Long-term Outcome in 210 Patients.

Object:  The management and recommendations for treatment strategies of pyogenic spinal infection are still a highly controversial issue. The purpose of this study was to evaluate patient's quality of life (QoL) after surgical and conservative treatment of spinal infection.

Materials And Methods:  We conducted a retrospective, single-center study.

Early versus Delayed Surgery for Spinal Epidural Abscess : Clinical Outcome and Health-Related Quality of Life.

Objective: Spinal epidural abscess (SEA) is a severe and life-threatening disease. Although commonly performed, the effect of timing in surgical treatment on patient outcome is still unclear. With this study, we aim to provide evidence for early surgical treatment in patients with SEA.

Thromboembolic infarction caused by an unknown patent foramen ovale 30 years after VA shunt insertion: a case report and review of the literature.

Background: Ventriculoatrial shunt (VA) insertion is one of the possible surgical procedures to treat hydrocephalus. However, it is also associated with several complications such as obstruction and shunt infection as well as life-threatening complications like intraatrial thrombus or thrombosis on the distal catheter. In this case report, we share a rare case of a patient with a VA shunt, who was admitted to our hospital with a stroke.

Upright MRI after decompression of spinal stenosis and concurrent spondylolisthesis.

OBJECTIVEThe treatment of patients with spinal stenosis and concurrent degenerative spondylolisthesis is controversial. Two large randomized controlled clinical trials reported contradictory results. The authors hypothesized that a substantial number of patients will show evidence of micro-instability after a sole decompression procedure.

Infective endocarditis in patients with pyogenic spondylodiscitis: implications for diagnosis and therapy.

OBJECTIVEThe incidence of patients with pyogenic spinal infection is increasing. In addition to treatment of the spinal infection, early diagnosis of and therapy for coexisting infections, especially infective endocarditis (IE), is an important issue. The aim of this study was to evaluate the proportion of coexisting IE and the value of routine transesophageal echocardiography (TEE) in the management of these patients.

Surgical Treatment of Spinal Synovial Cysts in Elderly Patients: Symptoms, Treatment Course, and Outcome in Patients >75 Years of Age.

Background: With the aging of our society comes a rising number of elderly patients with progressive degeneration of the spine associated with synovial cysts. Surgical treatment may be particularly challenging in elderly patients because of comorbidities.

Methods: Patients treated in our department between 1999 and 2014 for spinal synovial cysts were screened.

Noninvasive Transfontanelle Monitoring of the Intracerebral Pressure in Comparison With an Invasive Intradural Intracranial Pressure Device: A Prospective Study.

Background: We previously introduced a novel noninvasive technique of intracranial pressure (ICP) monitoring in children with open fontanelles.

Objective: To compare the ICP obtained by our new technique to the ICP derived from an intradurally implanted ICP measurement device (external ventricular drain, subdural ICP device).

Methods: Children with open fontanelles and need of intracranial monitoring were included in this study.

Synovial cysts of the spine: long-term follow-up after surgical treatment of 141 cases in a single-center series and comprehensive literature review of 2900 degenerative spinal cysts.

OBJECTIVE Synovial cysts of the spine are rare lesions, predominantly arising in the lumbar region. Despite their generally benign behavior, they can cause severe symptoms due to compression of neural structures in the spinal canal. Treatment strategies are still a matter of discussion.

Natural history of intramedullary spinal cord ependymoma in patients preferring nonoperative treatment.

Surgical resection of intramedullary spinal cord ependymoma still remains the standard of care but is challenging and occasionally associated with poor outcome. The aim of this study is therefore to provide additional information regarding the natural history of conservatively treated symptomatic intramedullary spinal cord ependymoma. Retrospective, single center review of all patients with intramedullary spinal cord ependymoma treated conservatively (wait and see) between 1980 and 2016.

Management of Patients with Primary Intramedullary Spinal Cord Glioblastoma.

Background: Primary intramedullary spinal cord glioblastomas are very rare tumors of the spinal cord. They imply a very poor prognosis because complete surgical resection is not possible as the result of the infiltrative growth of these tumors. The aim of this study is to present our data achieved with an aggressive multimodality treatment.

General Anesthesia Versus Local Anesthesia in Stereotactic Biopsies of Brain Lesions: A Prospective Randomized Study.

Background: Stereotactic biopsy of brain lesions with unknown entities is a common neurosurgical procedure to obtain tumor tissue. Pathologists can then provide an exact diagnosis on which further therapy, such as resection, radiotherapy, or chemotherapy, can be based. These procedures can be performed under local or general anesthesia.