We present a case series of symptomatic post-operative spinal subdural extra-arachnoid collections that displace the cauda equina roots anteriorly. This is described as the "rising root sign".

Background: The literature on total en bloc spondylectomy (TES) of bone tumors of the lumbar spine is sparse and heterogeneous. Therefore, the aim was to systematically pool the data from the published studies to quantitatively summarize the morbidity and mortality and to identify factors associated with favorable outcomes and complications.Method: A systematic literature search for studies with individual patient-level data was conducted using specific medical subject heading(MeSH) terms. The outcome measures assessed included complications, tumor recurrence, survival, and function. Individual patient data were pooled from all the studies and quantitatively analyzed to assess the association of different factors with outcomes and complications.Results: Twelve studies were included in this review with a total of 145 TES cases. Of all patients, 50% had at least 1 reported complication post surgery and this was associated with advancing age (OR 1.04, P < 0.001), metastatic disease (OR 5.61, P < 0.001), and adjuvant chemo and/or radiotherapy (OR 20.3, P = 0.001). Intralesional excision (OR 5.2, P = 0.01) and primary malignant tumors (OR 3.3, P = 0.02) were associated with a high recurrence rate. However, the surgical approach was not associated with differences in survival (P = 0.874) or recurrence (P = 0.525) rates. L5 tumor resection was associated with excessive bleeding. Postoperatively, there was an overall improvement in the Frankel grades in most patients.Conclusion: TES is associated with high rates of complications especially in association with primary malignant and metastatic diseases. However, the number of publications on this topic remain scarce and heterogeneous. Hence, there is a need for standardization in the reporting of the outcomes and complications to help with decision-making and consenting for this procedure.

Peripheral venous cannulation is one of the most commonly performed medical procedures in hospital medicine. The dorsal metacarpal veins are typically used for cannulation as they are easily accessible. We present the first case of an iatrogenic intratendinous ganglion cyst of the extensor digitorum tendon of the middle finger following intravenous cannulation.

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Dorsal minimally invasive hook of hamate fixation was performed by a single operator on ten hands. The anterior dissection revealed the absence of vascular, nerve or tendon injury in all cases. The screw length and position were correct in all cases with bicortical fixation in the tip of the hook. Mean fluoroscopy duration was 3 minutes, 23 seconds. The dorsal incision was always less than 10 mm long.Our cadaveric study confirms that the dorsal percutaneous approach is a reliable method and provides safe fixation of non-displaced fractures of the hook of hamate. Knowing that, we recommend that primary surgical fixation should be considered over excision in order to allow early return to activities with decreased risk of complications related to the ulnar neurovascular pedicle. However, careful evaluation of clinical outcomes is needed to confirm this approach. ReferencesBansal A, Carlan D, Moley J, Goodson H, Goldfarb CA. Return to play and complications after hook of the hamate fracture surgery.