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INTRODUCTION: Pedicle screw fixation has been the gold standard because this technique allows solid arthrodesis and provides a degree of stiffness that immediately diminishes mechanical back pain. Although the translaminar screw technique is considered inferior to the pedicle screw technique due to the thought that it is minimally invasive, studies proved that both fixation systems had significantly greater stiffness and reduced range of motion compared with the normal vertebrae. The purpose of this study is to determine the fusion rate, the clinical outcome of translaminar screw fixation of the lumbar and lumbosacral for the long term. CASE PRESENTATION: We evaluate six patients with a degenerative lumbar disorder and performed posterior lumbar fixation and fusion with the translaminar screw. The translaminar screw was performed monosegmentally (3 patients), across two segments (1 patient), and across three segments (2 patients). We then evaluate Oswestry Disability Index (ODI) score one week, three months, and one year postoperatively. DISCUSSION: When lumbosacral spine fusion procedures are performed without supplemental internal fixation, a 10% pseudoarthrosis rate can be expected for single-level fusions, and the percentage can reach 30% if more than two levels are fused. Compared to the pedicle screw technique, the translaminar technique provides a limited profile and less bony invasion that will minimize the risk of failure. CONCLUSION: Translaminar screw offers immediate postoperative stability, seen in postoperatively, patients experienced better quality of life than preoperatively. It also represents a useful and inexpensive technique for short segment fusion of the non-traumatic lumbar and lumbosacral spine.
RESUMO
BACKGROUND Osteosarcoma is the most common type of malignant bone tumor arising from mesenchymal stem cell. When occurring on the proximal humerus, it is associated with poor outcomes; there are numerous neurovascular structures around proximal humerus. Unfortunately, the degree of vascular involvement in osteosarcoma is rarely evaluated and reported. Thus, we would like to highlight our case. CASE REPORT We reported a case of left proximal humerus osteosarcoma causing dead limb in a 14-year-old boy. The dead limb progressed in the span of 3 weeks. An emergency forequarter amputation (FQA) was conducted to prevent further complications such as septicemia and mortality. Two months after the surgery, the patient had improved quality of life. One year after, the patient had no local recurrence. However, there was a lung metastasis detected 9 months after the surgery. The patient died 13 months after the surgery. CONCLUSIONS Osteosarcoma of the proximal humerus can potentially compromise vascular structures. Early diagnosis and treatment are mandatory to prevent such complications.
