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Lumbar spinal stenosis (LSS) is a common and debilitating pathology globally. Conservative and surgical treatment options exist for patients. Recently, minimally invasive lumbar decompression (MILD) has been described as a less invasive technique for the treatment of early spinal stenosis ≥2.5mm ligamentum thickening or in patients at high risk for general anesthesia. Often, MILD is performed by interventional pain providers and shows low complication rates. We describe a 76-year-old woman who presented to the emergency department immediately after undergoing a MILD procedure at an outside surgery center with lower back/sacral pain resulting from an acute epidural hematoma extending from T12-L3. Early recognition and surgical evacuation resulted in a good outcome with no complications. Our goal is to increase awareness of this rare complication and encourage multidisciplinary approaches to managing LSS between spine surgeons and pain providers.
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http://dx.doi.org/10.7759/cureus.51083 | DOI Listing |
Front Neurol
August 2025
Department of Mini-invasive Spinal Surgery, The Third People's Hospital of Henan Province, Zhengzhou, Henan, China.
Background: This study aimed to develop and validate the first nomogram model for predicting postoperative complications in thoracic spinal stenosis (TSS) patients undergoing unilateral biportal endoscopy (UBE), integrating multidimensional risk factors to provide a quantitative basis for preoperative risk evaluation and individualized treatment planning.
Methods: Patients were divided into a retrospective training cohort ( = 375) and a prospective validation cohort ( = 100). Baseline clinical data [age, diabetes, preoperative Japanese Orthopaedic Association (JOA) score], radiographic parameters (Spinal cord/canal area (SC/ECA) ratio, intramedullary high signal, thoracic kyphosis (TK) angle), and surgical variables (intraoperative blood loss, number of lesion segments, dural adhesion, etc.
World Neurosurg
September 2025
Department of Neurosurgery, Independent Public Specialist Western Hospital John Paul II in Grodzisk Mazowiecki, Daleka 11, 05-825, Grodzisk Mazowiecki, PL. Electronic address:
Introduction: Anterior cervical discectomy and fusion (ACDF) is a common surgical procedure used to treat herniated discs, degenerative disc disease, and nerve root compression in the cervical spine. This systematic literature review aims to analyze the available literature on the incidence, risk factors, clinical considerations, and available therapies for spinal epidural hematoma (SEH) following ACDF.
Methods: A systematic search was conducted in PubMed, Google Scholar, and Embase from database inception to June 18, 2025, following the PRISMA guidelines.
J Neurotrauma
September 2025
The Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor, Michigan, USA.
Cerebrovascular autoregulation (CA) is a protective mechanism against brain injury. We present an ultrasound-based volumetric blood flow indices to monitor CA. Swine were instrumented under general anesthesia to monitor mean arterial blood pressure (MAP), intracranial pressure (ICP), and blood flow in the internal carotid artery (ICA) and femoral artery (FA) and flow velocity and volumetric flow in the middle cerebral artery (MCA) using transcranial Doppler.
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September 2025
Health Science University Istanbul Kanuni Sultan Süleyman Education and Training Hospital, Department of Anesthesiology and Reanimation, Istanbul, Turkey.
Background: Opioid-free analgesia is critical in pediatric patients with complex comorbidities to avoid adverse effects, such as respiratory depression. Patients with tethered cord syndrome (TCS), often presenting with conditions like spina bifida, renal impairment, and musculoskeletal deformities, pose unique perioperative challenges that demand alternative pain management strategies.
Case: We present the case of an 11-year-old male with spina bifida and chronic kidney disease (CKD) undergoing tethered cord release surgery.
Medicina (Kaunas)
August 2025
Department of Pain Medicine, Kok Pain Clinic, Seongnam-si 13615, Gyeonggi-do, Republic of Korea.
: Percutaneous epidural neuroplasty (PEN) and related adhesiolysis procedures are widely used for managing chronic spinal pain. Although generally safe, complications-ranging from minor to life-threatening-have been reported. This review aimed to estimate the incidence and characteristics of complications following PEN and to evaluate the medical rationale for post-procedural inpatient monitoring.
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