✓Spinal echinococcosis is a rare entity, accounting for 1% of all cases of hydatid disease. The authors report the case of a 60-year-old man whom they treated for recurrent nerve root compression due to disseminated intraspinal echinococcosis (hydatid disease). Six years previously he had undergone surgery on an emergency basis at another institution after presenting with acute paraplegia due to a primary extradural hydatid cyst of the thoracic spine. Unfortunately, during surgical removal of the cysts, the echinococcosis disseminated into the spinal canal. This complication was documented by magnetic resonance (MR) imaging. In the 4 years before the authors treated him, he was hospitalized 4 times for 4 recurrences of nerve root compression. The authors treated the disseminated disease successfully with total T7–8 corpectomy, grafting with titanium cage and Texas Scottish Rite Hospital instrumentation, and long-term administration of albendazole (400 mg daily). Early diagnosis, proper utilization of MR imaging, and radical resection of diseased vertebrae and soft tissues followed by anthelmintic treatment are essential to control disseminated spinal hydatidosis and prevent recurrence.

We conclude that drill-generated noise during craniotomy has been incriminated as a cause of SNHL. Possible noise disturbance to the inner ear can only be avoided by minimizing the number of burr holes and the duration of harmful noise exposure to the cochlear structures.

Background:Back pain is one of the most prevalent health problems for which physicians are consulted. Back pain has many economic impacts, such as sickness absences and long-term disability. The prevalence of major depression in patients with chronic low back pain is approximately 3 to 4 times greater than the prevalence rate reported in the general population.Objectives:This study was designed to evaluate the depression and disability improvement after lumbar discectomy compared with presurgery levels in patients with chronic low back pain and radicular leg pain.Patients and Methods:One hundred forty-eight patients with chronic low back pain and radicular leg pain were included in this analytic observational study. The study evaluated several main variables, including age; sex; educational level; job; height; weight; and patient history of abortion, leg pain, back pain, smoking, trauma, number of previous pregnancies, driving, long-term sitting, lifting heavy bodies, and disability and depression before and 6 and 12 months after laminectomy.Results:The depression and disability scores of patients before lumbar discectomy significantly decreased after surgery.Conclusions:Our results indicate that lumbar discectomy surgery significantly improved depression and disability in patients with chronic herniated discs.

Background:Back pain is one of the most common health problems for which physicians are consulted, and it can considerably decrease the quality of life of patients during a great part of their lives.Objectives:Our study was designed for assessing the improvement in the quality of life of patients undergoing lumbar discectomy for chronic low back pain.Patients and Methods:We included 148 patients with chronic low back pain in the analytic observational study. Using the 36-Item Short-Form Health Survey (SF-36), we evaluated the quality of life before and 6 and 12 months after lumbar discectomy.Results:Physical and mental health scores of patients significantly improved after 6 and 12 months of lumbar discectomy. The mean improvement in physical health scores was significantly higher in female patients than in male patients. However, the improvement in mental health scores was not significantly difference between the 2 sexes and the educational and body mass index (BMI) groups.Conclusions:Lumbar discectomy improves both the physical and mental health subscale of the quality of life in patients with chronic disc herniation.

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Background: Back pain is one of the most prevalent health problems for which physicians are consulted. Back pain has many economic impacts, such as sickness absences and long-term disability. The prevalence of major depression in patients with chronic low back pain is approximately 3 to 4 times greater than the prevalence rate reported in the general population. Objectives: This study was designed to evaluate the depression and disability improvement after lumbar discectomy compared with presurgery levels in patients with chronic low back pain and radicular leg pain. Patients and Methods: One hundred forty-eight patients with chronic low back pain and radicular leg pain were included in this analytic observational study. The study evaluated several main variables, including age; sex; educational level; job; height; weight; and patient history of abortion, leg pain, back pain, smoking, trauma, number of previous pregnancies, driving, long-term sitting, lifting heavy bodies, and disability and depression before and 6 and 12 months after laminectomy. Results: The depression and disability scores of patients before lumbar discectomy significantly decreased after surgery. Conclusions: Our results indicate that lumbar discectomy surgery significantly improved depression and disability in patients with chronic herniated discs.

Background: Blood loss during spinal decompression and fusion is high and at times more than the patient's total estimated blood. Increased blood loss may increase the risks of morbidity and eventually length of hospital stay (LOS). Objectives: The aim of this study was to identify predictor factors of blood transfusion requirements and the length of hospital stay in adult patients who underwent lumbosacral surgery. Materials and Methods:This was a multicenter cross-sectional study to predict factors of hospital length of stay (LOS) and intraoperative red cell transfusion in patients undergoing major posterior lumbar spinal surgeries. In this study, 298 patients who needed spinal surgery were enrolled. Results: Multiple linear regression results revealed the following information. Among variables that had significant association with the volume of intraoperative blood loss, considerable predictors were the number of level fused (R 2 = 0.42), mean intraoperative SBP (R 2 = 0.22), length of operation (R 2 = 0.31) and increasing age (R 2 = 0.37). Significant predictors for the length of hospital stay were increasing age (R 2 = 0.22), much more comorbid conditions (R 2 = 0.30), operation length (R 2 = 0.27), the number of level fused (R 2 = 0.21) and the volume of intraoperative blood loss (R 2 = O.29). The results of logistic regression revealed that length of operation, preoperative Hb value, number of level fused and mean intraoperative SBP considerably predicted the need for intraoperative blood transfusion. Conclusions: Diminishing intraoperative SBP could decrease intraoperative blood loss and eventually less red cell transfusion and shorter LOS. Besides, correcting preoperative anemia in female patients before elective surgeries could decrease a need for red cell transfusions and ultimately decreased red cell transfusion complication rate and shorter hospital LOS.

This study aimed to evaluate the safety and efficacy of topical tranexamic acid (TXA) on intraoperative blood loss (IBL) in patients that have degenerative lumbar canal stenosis and undergo posterior lumbar laminectomy and discectomy. Overview of Literature: The volume of IBL is directly proportional to potential surgical complications. Recent reports have shown that the topical use of antifibrinolytic drugs, such as TXA, during surgery might decrease IBL and improve patient outcomes. Methods: A total of 104 patients with lumbar canal stenosis were enrolled in this randomized, double blinded clinical trial. Participants were randomized and divided into two groups: TXA (54 cases) and control (50 cases). In the TXA group, a TXA solution was used for washing and soaking, whereas, in the control group, irrigation of wound was with normal saline. IBL, pre-and postoperative coagulative studies, operation time, conventional hemostatic agent usage, systemic complications, and length of hospitalization were consecutively recorded. All participants were followed for an additional two months to gather data on their recovery status and time to return to work (RTW). Results: At baseline, there was no difference in clinical or lab findings, between the groups. IBL and use of hemostatic agents were significantly decreased in TXA group, as compared to the control group (p=0.001 and p=0.011, respectively). Systemic complications, length of hospitalization, and RTW were not significantly different between groups (p=0. 47, p=0.38, and p=0.08, respectively). Conclusions: This study showed that topical use of TXA during surgery may decrease IBL and minimize the use of hemostatic materials during posterior midline-approach laminectomy and discectomy, without increasing the potential for complications seen with intravenous TXA usage.