Endospine Surgery Complications in Lumbar Herniated Disc.

BACKGROUND AND OBJECTIVE: Spine surgery is entering a new era of evolution, with minimally invasive spine surgery to decompress the neural structures without affecting the stability of the spine. However, complications may occur. The surgeon must have these in mind in order to prevent them. We report on the main intraoperative and postoperative complications of endospine surgery of lumbar disc herniation. METHODS: It was a retrospective study spread over 22 years (January 1993-December 2015) concerning 10,433 patients who underwent treatment for lumbar disc herniation at the Endospine Surgery Center Bordeaux France. Among them 1189 patients had 1 intraoperative or postoperative complication. RESULTS: This study comprised 10,433 patients, among whom 1189 had various complications, which represented 11.39%. The average age of this sample was 46 years, and the eldest were 91 years. A male predominance was noted in 6502 of cases with a sex ratio of 6502/3931 = 1.65. The complications were recurrences (6.77%) followed by dural tears (1.91%), facet resection (1.14%), two-level approach instead of one (1.09%), radicular lesion (0.17%) that remained with motor or pain symptoms, wrong level and infections such as spondylodiscitis and wound infection, respectively (0.08%) each, deep vein thrombosis (0.04%), and gauze (0.03%). CONCLUSIONS: Twenty-two years of follow-up on endospine treatment for lumbar disc herniation showed a low complication rate. An early and efficient management will nevertheless allow a good outcome in the majority of patients operated.

Rheumatologic and neurological events in an elderly patient with tricho-rhino-phalangeal syndrome type I.

Sparse scalp hair, a peculiar shape of the nose, and cone-shaped epiphyses of the phalanges are the hallmarks of the tricho-rhino-phalangeal syndromes (TRPS). Short stature, hip dysplasia, and malformations of inner organs including mitral valve prolpase have also often been described for these conditions. Here, we described a 64-year-old woman with molecularly proved TRPS I and several atypical late-onset rheumatologic and neurological symptoms.

Brain tumors and hormonal factors: review of the epidemiological literature.

BACKGROUND: To date, the etiology of primary tumors of the central nervous system (mainly gliomas and meningiomas) is poorly understood. The role of sex hormones has been suggested, based on clinical, experimental, biological, and epidemiological data. OBJECTIVE: To review the epidemiological studies on the relation between hormonal factors and the occurrence of glioma and meningioma, in order to identify new research developments. METHODS: Articles published until September 2010 were selected by considering exogenous and endogenous exposures and specific brain tumors. Standardized information was collected from 20 articles: 15 concerning gliomas and 13 meningiomas. RESULTS: An increased glioma risk was observed with later menarche and menopause, while a reduced glioma risk was observed with hormone replacement therapy (HRT) and oral contraceptive use, despite duration of use had no effect on risk. Meningioma risk increased after menopause and with HRT use. No clear association was found with pregnancy and breastfeeding. CONCLUSION: Results are globally concordant with the biologic hypothesis assuming that female sex hormones are protective against glioma and may increase the risk of meningioma. However, new epidemiological studies should be conducted in order to confirm these associations and to refine the role of hormonal factors in brain etiology.