E506 CMAJ, July 9, 2013, 185(10) © 2013 Canadian Medical Association or its licensors A76-year-old woman with a 20-year history of chronic pain in her back and legs caused by degenerative spondylo listhesis, spinal stenosis, morbid obesity, ven ous insufficiency and osteoarthritis presented to our chronic pain clinic. She had previously undergone a laminectomy at L4–L5/ L5–S1 and, 2 years later...

Cervical radiculopathy is typically caused by posterolateral disc herniation or spondylotic foraminal stenosis. Standard surgical treatment for cervical degenerative disc disease has been either direct anterior excision necessitating fusion or indirect posterior decompression. Anterior decompression has now become more widely used. It can be achieved using different techniques. Anterior fusion ...

Background & Aim: Although most patients experience severe pain after major spinal fixation surgery, little attention has been paid to control it with a multi-modal approach. The aim of this study is to select appropriate method of pain management after spinal surgery. Methods & Materials/Patients: This study was a randomized clinically controlled trial in candidates of spondylolisthesis and...

STuDY DeSign: Prospective study. ObJeCTive: To study the validity of Hybrid construction (Anterior Lumbar Interbody Fusion) ALIF at one level and (Total Disc Arthroplasty) TDA at the adjacent level for two levels disc disease in the lumbar spine as an alternative surgical strategy compared to two levels disc arthroplasties. SuMMARY OF bACkgROunD DATA: With growing evidence that fusion construct...

The object of this paper is to show that the so-called “ primary “ instability of lumbar vertebrae is perhaps the commonest cause of low back pain (Table I). It records our experience of the pathological anatomy, clinical features and radiological signs of this malady ; and also the results of treatment, including thirty spinal fusions. This is the form of lumbar vertebral listhesis that Jungha...

Lumbar spinal stenosis is a common cause of lowback pain and neurogenic claudication in the adult population. Moreover, degenerative spondylolisthesis ac c ounts for a substantial proportion of lumbar spinal stenosis in this age group. Spinal fusion has become the established operative treatment for unstable degenerative spondylolisthesis.2 However, there are several disadvantages and issues re...

Plasma exchange in a patient with factor XI deficiency allowed the determination of the factor XI disappearance time. The decay curve showed a biphasic pattern with a t1⁄2 of 12.3 h during the first 3 days, followed by a slower decay with a t1⁄2 of 121 h. After a loading dose by means of plasma exchange with fresh frozen plasma (FFP) up to a factor XI level of 65%, administration of 0.5 liter F...