Lateral lumbar and thoracic interbody fusion (LLIF) for thoracolumbar spine trauma (Trauma LLIF): A single-center, retrospective observational cohort study.

Background: Pain, disability and progressive kyphosis is a common problem after traumatic injury of the thoracolumbar (TL-) junction. Surgical treatment may include long-segment posterior or short-segment anterior-posterior fusion. We aim to report our experience with the application of short-segment posterior instrumented fusion with anterior column support using lateral lumbar or thoracic interbody (LLIF) cages. Methods: In this retrospective, single-center observational cohort study we included consecutive patients treated surgically for traumatic injury of the TL-junction (Th10/11-L2/3) by posterior instrumentation/fusion and LLIF. We measured segmental kyphosis, complications, and outcomes until last follow-up (about 3 years postoperative). Results: We identified 61 patients (mean age 39.0 years [SD 13.3]; 23 females [37.7%]) with A3 fractures without (n=48; 78.7%) or with additional sagittal split component n=11; 18.0%. Additional posterior tension band injury was present in n=26 (42.6%). The affected levels of injury were Th12/L1 in n=25 (41.0%) and Th11/12 in n=22 (36.1%). The segmental kyphotic angle was 14.6° (6.7°) preoperative and remained significantly reduced at all times of follow-up at discharge (5.4°±5.5°; p<.001), at 90 days (7.2°±5.5°; p<.001), after partial hardware removal (7.2°±6.0°; p<.001) and at last follow-up (8.1°±6.3°; p<.001). We noticed a tendency for less progression of kyphosis in the group with 2-staged, compared to single-staged bisegmental surgery (mean difference (MD) 3.1° after partial hardware removal, p=.064). During follow-up, n=11 experienced complications (18%), n=58 (95.1%) had an excellent or good outcome and solid fusion was noticed in n=60 (98.4%). Conclusions: "Trauma LLIF" should be considered as possibility for short-segment anterior-posterior fusion for injuries of the TL- junction. We observed most reproducible and long-lasting kyphosis reduction with a temporary bisegmental, 2-staged procedure resulting in monosegmental fusion (posterior instrumentation/fusion with delayed LLIF and partial hardware removal to release the noninjured caudal motion segment).

Comparison between recreational male Ironman triathletes and marathon runners.

Recent investigations described a personal best marathon time as a predictor variable for an Ironman race time in recreational male Ironman triathletes. Similarities and differences in anthropometry and training were investigated between 83 recreational male Ironman triathletes and 81 recreational male marathoners. Ironman triathletes were significantly taller and had a higher body mass and a higher skin-fold thickness of the calf compared to the marathoners. Weekly training volume in hours was higher in Ironman triathletes. In the Ironman triathletes, percent body fat was related to overall race time and both the split time in cycling and running. The weekly swim kilometres were related to the split time in swimming, and the speed in cycling was related to the bike split time. For the marathoners, the calf skin-fold thickness and running speed during training were related to marathon race time. Although personal best marathon time was a predictor of Ironman race time in male triathletes, anthropometric and training characteristics of male marathoners were different from those of male Ironman triathletes, probably due to training of different muscle groups and metabolic endurance beyond marathon running, as the triathletes are also training for high-level performance in swimming and cycling. Future studies should compare Olympic distance triathletes and road cyclists with Ironman triathletes.

Spondylodiscitis due to anaerobic bacteria Veillonella parvula: Case report and literature review.

BACKGROUND: While pyogenic spondylodiscitis due to Gram-positive aerobic bacteria and its treatment is well known, spondylodiscitis caused by anaerobic Gram-negative pathogen is rare. In particular, the spondylodiscitis caused by Veillonella species is an absolute rarity. Thus no established management recommendations exist. CASE DESCRIPTION: A case report of a 79-year-old man with spondylodiscitis caused by Veillonella parvula with intramuscular abscess collection managed conservatively with stand-alone antibiotic therapy without a spinal stabilization procedure. A review of literature of all reported spondylodiscitis caused by Veillonella species was performed. After 3 week-intravenous therapy with the ceftriaxone in combination with the metronidazole followed by 3 weeks per oral therapy with amoxicillin/clavulanate, the complete recovery of the patient with the V. parvula infection was achieved. CONCLUSION: Treatment of the spondylodiscitis caused by Veillonella species should contain a beta-lactam with beta-lactamase inhibitor or third-generation cephalosporine. Six weeks of treatment seem to be sufficient for the complete recovery of the patient.