The bony spur formation without degenerative change in the lumbar spines in the young age group is quite interesting and not uncommon. This bony spur is different from the degenerative spur in the old age group in shape and mechanism of formation. The authors analyzed 111 patients with such posterior lumbar bony spur for recent 3 years and 9 months. The authors concluded that posterioly located Schmorl's node is a main cause of the bony spur without degenerative change at lumbar region. The authors advocated 'Juvenile spur' as a new disease entity.
Humans ; Lumbosacral Region ; Spine*

Nonunion at the lumbosacral junction is a classic complication of long construct and deformity corrections. Iliac fixations have been extensively studied in the literature and have demonstrated superior biomechanical proprieties and lower complication rates. S2 alar iliac screws address the drawbacks of classical iliac screws but demonstrate similar biomechanical advantage. The main aim of this paper was to describe the S1 alar iliac (S1AI) screw fixation technique while evaluating our early results. S1AI screw fixation technique has the advantage of being able to achieve pelvic fixation without dissection to the S2 pedicle entry and is therefore a viable option for salvage of a failed S1 promontory screw.
Congenital Abnormalities ; Lumbosacral Region ; Pseudarthrosis

STUDY DESIGN: A retrospective case study. PURPOSE: To retrospectively review all incidental dural tears (DTs) that occurred at a single institution, classify them anatomically and evaluate the clinical significance of each subgroup. OVERVIEW OF LITERATURE: Dural tears are considered the most commonly encountered complication during lumbar spine surgery. In contrast to the high frequency of DTs, reports on the characteristic location and mechanism are sparse. METHODS: We retrospectively retrieved all cases of degenerative lumbar spine surgery performed over a 9-year period and classified all identified DTs according to two independent planes. The coronal plane was divided into lower, middle and upper surgical fields, and the sagittal plane into posterior, lateral and ventral occurring tears. Demographic and clinical variables were retrieved and analyzed to search for significant associations. RESULTS: From 2003 to 2011, 1,235 cases of degenerative lumbar spine conditions were treated surgically at our institution. In 84 operations (6.8%), an incidental DT was either identified intraoperatively or suspected retrospectively. The most commonly involved location was the lower surgical field (n=39, 46.4%; p=0.002), followed equally by the middle and upper fields (n=16, 19%). In the sagittal plane, the most commonly involved locations were those in close proximity to the nerve root (n=35, 41.6%), followed by the dorsal aspect of the dural sac (n=24, 28.6%). None of the variables recorded was found to be associated with a particular location. CONCLUSIONS: In our series, incidental DTs were found to occur most commonly in the lower surgical field. We hypothesize that local anatomic feature, such as the lordotic and broadening lumbar dura, may play a role in the observed DT tendency to occur in the lower surgical field. In light of the high frequency and potentially substantial resulting morbidity of incidental DTs, a better characterization of its location and mechanism may optimize both prevention and management.
Humans ; Lumbosacral Region ; Retrospective Studies* ; Spine*

The bony spur formation without degenerative change in the lumbar spines in the young age group is quite interesting and is not uncommon. This bony spur is different from the degenerative spur in the old age group in shape and mechanism of formation. The authors analyzed 25 patients below 29 years old with such posterior lumbar bony spur. We concluded that posterioly located Schmorl's node is main cause of the bony pour in youn age group at lumbar region.
Adult ; Humans ; Lumbosacral Region ; Spine* ; Young Adult*

A rare case of spinal meningeal mesenchymal chondrosarcoma in 3 10/12 year old boy is reported. The tumor was located in lumbosacral region. Osteoplastic laminotomy was performed for total removal of tumor. The postoperative result was good and related literatures were reviewed.
Chondrosarcoma, Mesenchymal* ; Humans ; Laminectomy ; Lumbosacral Region ; Male

PURPOSE: To evaluate the reliance of standard AP radiograph and Ferguson radiograph in assessment of instrumented lumbosacral fusion mass with interobserver and intraobserver reproducibilities. MATERIALS AND METHODS: Postoperative standard AP radiograph and Ferguson radiograph were used to evaluate the fusion mass at the lumbosacral region of 44 consecutive patients who underwent posterolateral L4-S1 or L5-S1 instrumented fusion with pedicle screws & autogenous iliac bone graft. Ferguson radiograph was performed with the x-ray beam oriented toward the cranial portion at 40degree relative to the x-ray table. All observations were performed independently by three observers, blinded to the history, diagnosis, and patient identity. The fusion mass was graded as solid, pseudarthrosis or questionable. A second review was repeated at 2 weeks after index review. Interobserver and intraobserver reproducibilities were analyzed with Fleiss'method. RESULTS: Ferguson radiographs were more reliable than standard AP radiographs in detecting the fusion mass. Kappa values with the interobserver reproducibility were higher in Ferguson radiographs than in the standard AP radiographs. Kappa values with the intraobserver reproducibility of all three observers were higher in Ferguson radiographs than in the standard AP radiographs. The questionable fusion masses in the standard AP radiographs were revealed solid or pseudarthrosis in Ferguson radiographs in 67%. CONCLUSIONS: Ferguson radiograph is a more reliable method than standard AP radiograph in evaluating instrumented posterolateral fusion mass in lumbosacral region.
Diagnosis ; Humans ; Lumbosacral Region ; Pseudarthrosis ; Transplants

Compared to the lumbar region, it is very rare to encounter far lateral disc herniation in the cervical spine, and because of this, correct diagnosis before surgery is difficult: the condition can, however, be identified through the use of advanced MRI imaging techniques. In this case, far lateral disc herniation at C7-T1 was effectivery removed through posterior laminoforaminotomy, and soon after surgery, the patient's symptoms showed complete remission.
Diagnosis ; Lumbosacral Region ; Magnetic Resonance Imaging ; Spine

Lumbar spondylolysis and spondylolisthesis are common spinal disorders that most of the times are incidental findings or respond favorably to conservative treatment. In a small percentage of the patients, surgical intervention becomes necessary. Because too much attention has been paid to novel surgical techniques and new modern spinal implants, some of fundamental concepts have been forgotten. Identifying that small but important number of patients with lumbar spondylolysis or spondylolisthesis who would really benefit from lumbar surgery is one of those forgotten concepts. In this paper, we have developed an algorithmic approach to determine who is a good candidate for surgery due to lumbar spondylolysis or spondylolisthesis.
Humans ; Incidental Findings ; Lumbosacral Region ; Spondylolisthesis* ; Spondylolysis*

There are reports showing considerable morphological abnormalities in the lumbosacral region, which are usually caused by certain diseases or simply by anatomical variations. It is possible that if a caudal block is performed in patients with these anatomical abnormalities it will either fail or another unexpected difficult situation will result. However, there is no case report regarding such issues. We experienced two cases of an unexpected dural puncture during a trial of caudal block, and one case in whom the dural puncture would most likely have been caused by a trial of caudal block. The dural punture was caused by morphological abnormalities in the lumbosacral region i.e., diffuse ectasia of the lumbosacral dura and a posterior sacral meningocele with an enlargement of the lumbosacral canal. The dural termination was located more distally in the potential dural puncture case than in the normal cases.
Dilatation, Pathologic ; Humans ; Lumbosacral Region ; Meningocele ; Punctures*

OBJECTIVETo show the space structures of Mingmen (GV 4) area and its adjacent tissues.

METHODSA frozen female corpse was cut into about 0.5 mm thick sections with a high-speed steel plane machine and photographed with digital and optical camera. Two 2-D transverse phase picture data sets were obtained and then were sequenced, matched, modified and divided. The 3-D reconstruction software was used to reconstruct the outline form of the lumbar part containing Mingmen (GV 4) to attain transverse phase picture data sets (3 022 sheets, 0.57 mm in thickness). The sagittal, coronal and different oblique plane were cut and the tissue structures in these pictures were analyzed. Thus, the reconstruction data sets were obtained.

CONCLUSIONAfter the structures of Mingmen (GV 4) were reconstructed with computer, the form of Mingmen (GV 4) can be dynamically observed from any angle and the space construction law of gross form of Mingmen (GV 4) can be proved.