Minimally Invasive Approach for Diffuse Idiopathic Skeletal Hyperostosis (DISH)-Related Vertebral Fractures: A Case Report on Combining Vertebral Cement Augmentation and Cement-Augmented Pedicle Screw Instrumentation.

Diffuse idiopathic skeletal hyperostosis (DISH)-related vertebral fractures often require surgical intervention due to associated spinal instability and neurological deficits. This study presents a minimally invasive approach that utilizes vertebral cement augmentation and cement-augmented pedicle screw (PS) instrumentation to manage DISH-related vertebral fractures. We present an 87-year-old male patient with a T11 vertebral fracture associated with DISH. Despite the patient's advanced age and comorbidities, he underwent a successful surgical procedure, achieving relatively short-segment fixation by combining vertebral cement augmentation and cement-augmented PS instrumentation. After the surgery, the patient's lower back pain subsided, facilitating a return to normal activities. Radiographic evaluation at the six-month postoperative stage confirmed the maintenance of vertebral body reduction with no indications of implant failure. In DISH-associated vertebral fractures, the combined application of vertebral cement augmentation and cement-augmented PS instrumentation offers a minimally invasive solution that expedites fracture stabilization and enhances patient outcomes. This approach offers the potential for effective fracture stabilization and a significant reduction in postoperative complications, holding promise for managing challenging cases in this patient population.

A case of hip joint septic arthritis due to haematogenous infection, which was misdiagnosed sternoclavicular joint septic arthritis as SAPHO syndrome.

Anterior chest pain associated with sternoclavicular arthritis has been considered a symptom specific to SAPHO syndrome. Differentiating aseptic arthritis of the SAPHO syndrome from infectious sternoclavicular joint (SCJ) arthritis is often difficult. We reported a 55-year-old woman with left hip joint and right SCJ pain. Diagnosis and treatment were delayed because she was misdiagnosed with SAPHO syndrome, and haematogenous infection spread to the hip joint septic arthritis. She was diagnosed promptly after presenting to our hospital and underwent early debridement, and her hip joint and SCJ was found to have almost no dysfunction. Differentiation between sternoclavicular arthritis of the SAPHO syndrome and sternoclavicular septic arthritis is clinically important and requires careful attention.

Perioperative Complications in 155 Patients Who Underwent Oblique Lateral Interbody Fusion Surgery: Perspectives and Indications From a Retrospective, Multicenter Survey.

STUDY DESIGN: A retrospective multicenter survey. OBJECTIVE: To investigate the perioperative complications of oblique lateral interbody fusion (OLIF) surgery. SUMMARY OF BACKGROUND DATA: OLIF has been widely performed to achieve minimally invasive, rigid lumbar lateral interbody fusion. The associated perioperative complications are not yet well described. METHODS: The participants were patients who underwent OLIF surgery under the diagnosis of degenerative lumbar diseases between April 2013 and May 2015 at 11 affiliated medical institutions. The collected data were classified into intraoperative and early-stage postoperative (≤1 mo) complications. The intraoperative complications were then subcategorized into organ damage (neural, vertebral, vascular, and others) and other complications, mainly related to instrumental failure. The collected data were also divided and analyzed based on whether the surgeon was certified to perform the surgery and the incidence of complications in the early (April 2013-March 2014) and late stages (April 2014-May 2015) of OLIF introduction. RESULTS: In the 155 included patients, 75 complications were reported (incidence rate, 48.3%). The most common complication was endplate fracture/subsidence (18.7%), followed by transient psoas weakness and thigh numbness (13.5%) and segmental artery injury (2.6%). Almost all these complications were transient, except for three patients who had permanent damage: one had ureteral injury and two had neurological injury. Postoperative complications included surgical site infection (1.9%) and reoperation (1.9%). Whether the primary operator was experienced did not affect the incidence of complications. Regarding the introductory stage, the incidence of complications was 50% in the early stage and 38% in the late stage. CONCLUSION: The overall incidence of perioperative complications of OLIF surgery reached 48.3%, of which only 1.9% resulted in permanent damage. Our analysis based on surgeon experience indicated that the OLIF procedure could be performed without increasing incidence of complications, under the guidance of experienced supervisors. LEVEL OF EVIDENCE: 3.