DVT assessment using ultrasonography is important for proper management of VTE during the perioperative period of spinal surgery, especially for high-risk patients, such as those with advanced age or neurological deficit. The institutional protocol for VTE using pneumatic sequential compression device and compression stockings is effective, although the administration of chemoprophylaxis should be considered for high-risk patients, such as those with spinal tumors and spinal trauma.

We have reported a rare case of lumbar metastasis of choriocarcinoma after a normal-term pregnancy. This is the first report of lumbar metastasis of choriocarcinoma treated by spinal surgery. Because surgical resection of a lumbar metastasis of choriocarcinoma involves a substantial risk of profuse hemorrhage, local recurrence and the spread of metastasis, multiagent chemotherapy in combination with radiotherapy should be preformed before surgical resection.

We report a case of Ewing sarcoma that mimicked a psoas abscess secondary to spinal infection. Abnormal magnetic resonance imaging images, as well as a confusing clinical course, made diagnosis difficult. When enlargement of the iliopsoas with a vertebral lesion is detected in a child with low back pain, Ewing sarcoma should be included in the differential diagnosis.

We have reported for the first time, that an alkaptonuria patient showed thoracic myelopathy caused by rupture of a thoracic intervertebral disc. Decompression followed by the instrumented fusion of the thoracic spine was effective for improving the neurologic symptoms.

Background: Obesity is likewise becoming more prevalent in patients with lumbar spinal canal stenosis, but few studies have examined relationships between obesity levels and surgical outcomes for this condition. The purpose of the present study is to determine the influence of body-mass index (BMI) on outcomes of surgery for lumbar spinal canal stenosis. Materials and Methods: The subjects comprised 118 patients who had underwent posterolateral fusion in a single intervertebral disc space with spinal instrumentation using a pedicle screw and rod system. Obesity levels were classified into three groups according to BMI: 35, severely obese group (n=12); 25 to <35, obese (n=38); and <25, non-obese (n=68). Investigated items including operative time, volume of intraoperative bleeding, distance from skin surface to the posterior margin of the vertebral body, improvement rate of the Japanese Orthopaedic Association (JOA) scoring system for lumbar spinal disorders and intra-and postoperative complications were all compared between the three groups. Results: Longer operative time, increased intraoperative bleeding, longer distance from the skin surface to the posterior margin of the vertebral body, poor postoperative outcomes and higher incidences of intra-and postoperative complications were observed with surgery for lumbar spinal canal stenosis in severely obese patients (BMI 35), compared to patients with BMI <35. Conclusions: Severely obese patients and their family members should thus receive sufficient explanation of the risks associated with surgery when obtaining informed consent.