Antibiotic-loaded bone cement treatment reduces the dead space and achieves the targeted drug delivery simultaneously. Treatment using antibiotic-loaded bone cement is an effective treatment option for complex spinal SSI.

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Background Microendoscopic discectomy for lumbar disc herniation has been shown to be as effective as traditional microdiscectomy or open discectomy in terms of clinical outcomes such as pain relief, and it is less invasive. Nevertheless, the reoperation rate for microendoscopic discectomy compared with microdiscectomy or open discectomy remains unclear, possibly due to difficulties in conducting follow-up of sufficient duration and in obtaining information about reoperation in other facilities.Questions/purposes (1) What is the rate of reoperation after microendoscopic discectomy for primary lumbar disc herniation on a large scale at a median of 4 years postoperatively? (2) Is there any difference in revision rate at a median of 4 years and within 90 days postoperatively based on surgical method? Methods We conducted a retrospective, comparative study of adult patients who underwent microendoscopic discectomy or microdiscectomy or open discectomy for One of the authors (KK) certifies receipt of personal payments or benefits, during the study period, in an amount of USD 100,001 to USD

Introduction: Symptomatic postoperative hematoma after spine surgery is a rare but serious complication. The objective of this study was to investigate the incidence and clinical features of symptomatic postoperative hematoma after spine surgery. Methods: We retrospectively identified 10,680 patients who underwent spine surgery between 2002 and 2012 in nine hospitals. We reviewed the incidence of postoperative hematoma and its clinical features, including time before onset, main symptoms, and neurological outcomes. Results: The overall incidence of symptomatic postoperative hematoma after spine surgery was 0.4% (45/10,680). Postoperative hematoma was more frequent after thoracic spine surgery than after cervical or lumbar surgery. The onset of postoperative hematoma occurred at an average of 2.6 days (range 0-14 days) postoperatively. The chief symptoms caused by postoperative hematoma after spine surgery were tetra/paraplegia in 30 patients, hemiplegia in eight patients, intractable pain in five patients, and airway dysfunction in two patients. Surgical evacuation of the spinal epidural hematoma resulted in improvement of at least one grade in 35 patients, while four patients had complete motor paralysis even after evacuation surgery. Conclusions: We report the clinical details of 45 patients with postoperative hematoma after spine surgery. This information could assist surgeons to make a prompt diagnosis and perform early evacuation surgery for postoperative hematoma following spine surgery.

Study Design: Retrospective clinical series. Objective: To investigate the prognostic factors for the improvement of drop foot caused by degenerative lumbar disease after surgery. Summary of Background Data: Drop foot may be caused by lumbar spinal diseases and may affect daily life. There are limited data regarding predictors of drop foot, especially surgical timing. Methods: We retrospectively reviewed data from 87 patients with drop foot. Prognostic factors and precise timing of surgery affecting drop foot improvement were examined by multivariate logistic regression analysis. Results: Forty patients (46.0%) recovered from drop foot after surgery. Age [odds ratio (OR)=0.93; 95% confidence interval (CI), 0.87−0.98; P=0.01], preoperative anterior tibialis muscle strength (OR=12.0; 95% CI, 2.41−59.9; P=0.002), and duration of drop foot before surgery (OR=3.59; 95% CI, 1.09−11.8; P=0.04) were significant prognostic factors. Two months was the most appropriate cutoff for surgery after appearance of symptoms. Conclusions: Age, preoperative tibialis anterior muscle strength, and duration of drop foot were statistically significant prognostic factors of recovery from drop foot. Surgery within 2 months after the onset of drop foot may improve postoperative outcome.