Neurospine

Minimally Invasive Spine Surgery

Endoscopic Decompression Combined With Percutaneous Pedicle Screw Fixation for AOSpine A3 or A4 Thoracolumbar Fractures With Neurological Deficits: A Retrospective Cohort Study: Huiming Yang, Junxian Miao, Jiangtao Wang, Dan Han, Yuhang Wang, Liang Yan, Biao Wang, Dingjun Hao; Neurospine 2025;22(2):571-582. Published online April 30, 2025; DOI: https://doi.org/10.14245/ns.2449212.606

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Endoscopic Decompression Combined With Percutaneous Pedicle Screw Fixation for AOSpine A3 or A4 Thoracolumbar Fractures With Neurological Deficits: A Retrospective Cohort Study

Neurospine. 2025;22(2):571-582. Published online April 30, 2025

DOI: https://doi.org/10.14245/ns.2449212.606

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Endoscopic Decompression Combined With Percutaneous Pedicle Screw Fixation for AOSpine A3 or A4 Thoracolumbar Fractures With Neurological Deficits: A Retrospective Cohort Study

Neurospine. 2025;22(2):571-582. Published online April 30, 2025

DOI: https://doi.org/10.14245/ns.2449212.606

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Objective
This study aimed to compare the clinical outcomes of patients with AOSpine A3 or A4 thoracolumbar fractures presenting with neurological deficits treated with endoscopic decompression combined with percutaneous pedicle screws fixation (endoscopic minimally invasive surgery, EMIS) or conventional open surgery (OS).
Methods
Data of patients with AOSpine A3 or A4 thoracolumbar fractures with neurological deficits who were treated with EMIS or OS between June 2019 and July 2021 were extracted from the electronic database. Various clinical outcomes were compared between the 2 cohorts.
Results
Among the 231 patients who were followed up for more than 2 years, 107 were in the EMIS cohort and 124 were in the OS cohort. Compared with the OS cohort, the EMIS cohort had longer operative time (p<0.05), but the intraoperative blood loss, incision length and hospital stay were significantly reduced (p<0.05). At both postoperative and final follow-up assessments, the EMIS cohort demonstrated significantly better visual analogue scale and Oswestry Disability Index outcomes compared to the OS cohort (p<0.05). Both cohorts maintained similar correction of spinal canal erosion rate, percentage of anterior vertebral height and sagittal Cobb angle after surgery and at the last follow-up (p>0.05). According to American Spinal Injury Association classification, the 2 cohorts had similar neurological recovery at the last follow-up (p>0.05).
Conclusion
In comparison to OS, EMIS treatment for AOSpine A3 or A4 thoracolumbar fractures with neurological deficits has shown comparable clinical efficacy while significantly reducing surgical trauma.

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Severe trauma care: advances and future directions in diagnostic and therapeutic techniques and information technology support
Feifei Jin, Shu li, Xuemin Zhang, Wei Huang, Jing Zhou, Zhongdi Liu, Pan Hu, Yanqiu Wu, Zixiao Zhang, Lijun Hou, Xiangjun Bai, Tianbing Wang
Medical Review.2026; 6(3): 175. CrossRef

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Spine and Spinal Cord Tumors DSPN-Neurospine Special Issue

Steroids in the Management of Preoperative Neurological Deficits in Metastatic Spine Disease: Results From the EPOSO Study: Anne L. Versteeg, Lior M. Elkaim, Arjun Sahgal, Laurence D. Rhines, Daniel M. Sciubba, James M. Schuster, Michael G. Fehlings, Aron Lazary, Michelle J. Clarke, Paul M. Arnold, Chetan Bettegowda, Stefano Boriani, Ziya L. Gokaslan, Charles G. Fisher, Michael H. Weber, AO Spine Knowledge Forum Tumor; Neurospine 2022;19(1):43-50. Published online January 30, 2022; DOI: https://doi.org/10.14245/ns.2142768.384

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Steroids in the Management of Preoperative Neurological Deficits in Metastatic Spine Disease: Results From the EPOSO Study

Neurospine. 2022;19(1):43-50. Published online January 30, 2022

DOI: https://doi.org/10.14245/ns.2142768.384

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Steroids in the Management of Preoperative Neurological Deficits in Metastatic Spine Disease: Results From the EPOSO Study

Neurospine. 2022;19(1):43-50. Published online January 30, 2022

DOI: https://doi.org/10.14245/ns.2142768.384

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Objective
Patients presenting with neurological deficit secondary to metastatic epidural spinal cord compression (MESCC) are often treated with surgery in combination with high-dose corticosteroids. Despite steroids being commonly used, the evidence regarding the effect of corticosteroids on patient outcomes is limited. The objective of this study was to describe the effect of corticosteroid use on preoperative neurological function in patients with MESCC.
Methods
Patients who underwent surgery between August 2013 and February 2017 for the treatment of spinal metastases and received steroids to prevent neurologic deficits were included. Data regarding demographics, diagnosis, treatment, neurological function, adverse events, health-related quality of life, and survival were extracted from an international multicenter prospective cohort.
Results
A total of 30 patients treated surgically and receiving steroids at baseline were identified. Patients had a mean age of 58.2 years (standard deviation, 11.2 years) at time of surgery. Preoperatively, 50% of the patients experienced deterioration of neurological function, while in 30% neurological function was stable and 20% improved in neurological function. Lengthier steroid use did not correlate with improved or stabilized neurological function. Postoperative adverse events were observed in 18 patients (60%). Patients that stabilized or improved neurologically after steroid use showed a trend towards improved survival at 3- and 24-month postsurgery.
Conclusion
This study described the effect of steroids on preoperative neurological function in patients with MESCC. Stabilization or improvement of preoperative neurological function occurred in 50% of the patients.

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Perioperative Management of Spinal Tumour Surgeries: A Narrative Review
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Nature Reviews Clinical Oncology.2026;[Epub] CrossRef
Advancing Metastatic Spine Tumor Research: A Review of AO Spine Knowledge Forum Tumor’s Scientific Contributions Derived From the EPOSO Network, 2014-2024
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Biotechnology and Genetic Engineering Reviews.2024; 40(2): 765. CrossRef
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Kristine N. Kim, Michael LaRiviere, Emily Macduffie, Caitlin A. White, Mary M. Jordan-Luft, Eleanor Anderson, Matthew Ziegler, Jacob A. Radcliff, Joshua Jones
Practical Radiation Oncology.2023; 13(1): 28. CrossRef
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Obada T. Alhalabi, Stefan Heene, Vincent Landré, Jan-Oliver Neumann, Moritz Scherer, Basem Ishak, Karl Kiening, Klaus Zweckberger, Andreas W. Unterberg, Alexander Younsi
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Siravich Suvithayasiri, Young-Jin Kim, Yanting Liu, Warayos Trathitephun, Akarawit Asawasaksaku, Javier Quillo-Olvera, Vit Kotheeranurak, Haroldo Chagas, Cristian Correa Valencia, Marcus Vinicius Serra, Facundo Van Isseldyk, Lung-Hsing Lee, Chien-Min Chen
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Spontaneous Spinal Epidural Hematoma: A Retrospective Study on Prognostic Factors and Review of the Literature: Mark Fedor, Eric S. Kim, Kai Ding, J. Paul Muizelaar, Kee D. Kim; Korean J Spine 2011;8(4):272-282. Published online December 31, 2011; DOI: https://doi.org/10.14245/kjs.2011.8.4.272

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Spontaneous Spinal Epidural Hematoma: A Retrospective Study on Prognostic Factors and Review of the Literature

Korean J Spine. 2011;8(4):272-282. Published online December 31, 2011

DOI: https://doi.org/10.14245/kjs.2011.8.4.272

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Spontaneous Spinal Epidural Hematoma: A Retrospective Study on Prognostic Factors and Review of the Literature

Korean J Spine. 2011;8(4):272-282. Published online December 31, 2011

DOI: https://doi.org/10.14245/kjs.2011.8.4.272

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Objectives

The spontaneous spinal epidural hematoma (SSEH) is a rare clinical entity. Patients typically present with sudden onset back pain followed by neurological deficits.

Methods

Diagnosis of SSEH is usually made with MRI and standard treatment is surgical evacuation. In 1996, Groen published the most comprehensive review on the SSEH in which he analyzed 333 cases. We review 104 cases of SSEH presented in the English literature since the last major review and add three of our own cases, for a total of 107 cases.

Results

Our patients presented with back pain and neurologic deficits. Two made excellent functional recovery with prompt surgical decompression while one continued to have significant deficits despite evacuation. Better postoperative outcome was associated with less initial neurological dysfunction, shorter time to operation from symptom onset and male patients.

Conclusion

We discuss the etiology of SSEH and report current trends in diagnosis, treatment, and outcome.

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Extent of spinal canal obliteration as prognostic factor for functional outcome in patients with spontaneous spinal epidural hematoma: a retrospective study
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Acta Neurochirurgica.2021; 163(12): 3279. CrossRef
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The American Journal of Medicine.2019; 132(3): 300. CrossRef
Consecutive images of conservatively treated cervical spontaneous spinal epidural hematoma
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Journal of Clinical Neuroscience.2019; 59: 270. CrossRef
A brief review of literature of spontaneous spinal epidural hematoma in the context of an idiopathic spinal epidural hematoma
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Egyptian Journal of Neurosurgery.2019;[Epub] CrossRef
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Clinical Practice and Cases in Emergency Medicine.2018; 2(2): 151. CrossRef
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JBJS Case Connector.2018; 8(3): e59. CrossRef
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World Neurosurgery.2017; 98: 546. CrossRef
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Hang Xian, Li-Wei Xu, Cong-Han Li, Jian-Ming Hao, Wei-Xia Wan, Guo-Dong Feng, Ke-Jian Lian, Lin Li
Medicine.2017; 96(44): e8473. CrossRef
Acute spontaneous thoracic epidural hematoma, triggered by weight-lifting training, in a retired sportsman: case report and literature review
Aurelian Anghelescu, Alin Rasina
Spinal Cord Series and Cases.2017;[Epub] CrossRef
Spontaneous spinal epidural hematoma as a possible complication of anticoagulant therapy
Karel Brabec, Lenka Jelínková, Ivana Štětkářová
Neurologie pro praxi.2017; 18(6): 389. CrossRef
Successful Recovery from Spontaneous Spinal Epidural Hematoma in a Patient Undergoing Hemodialysis
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American Journal of Case Reports.2017; 18: 1357. CrossRef
Acute Cervical Spontaneous Spinal Epidural Hematoma Presenting with Minimal Neurological Deficits: A Case Report
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Orthopedics & Traumatology.2016; 65(4): 845. CrossRef
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Romanian Neurosurgery.2015;[Epub] CrossRef
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Korean Journal of Spine.2012; 9(3): 297. CrossRef