Purpose: Patients with soft tissue sarcomas (STS) of the extremity require ongoing follow-up to detect treatment failures. There is a significant variation in follow-up schemes among sarcoma specialists due to a lack of evidence. Methods: A retrospective single-center review was performed on all patients with a minimum 1-year follow-up after resection of a localized STS, utilizing a prospectively collected database. Kaplan-Meier curves were used to calculate the incidence of local recurrence and metastases on an annual basis over 10 years. Results: There were 407 patients who met the inclusion criteria. Considering the annual incidence of local recurrence and distant metastasis per STS size and grade, patients with small, low-grade STS should be followed yearly for 10 years. Patients with small, intermediate/high-grade STS and those with large, low-grade STS should be followed every 6 months for the first 2 years and then yearly until 10 years postoperatively. Patients with large, intermediate/high-grade STS should be followed every 3 months for the first 2 years and then every 6 months thereafter until 10 years postoperatively. Conclusion Compared to National Comprehensive Cancer Network (NCCN) and European Society for Medical Oncology (ESMO) guidelines, our proposed scheme has the potential to reduce hospital visits, mainly for patients with small intermediate and high-grade tumors. This protocol validates the previously published scheme, despite being relatively more conservative.

Objectives: Hip fragility fractures were regarded as one of the most severe, but recent papers report on the underestimated burden of vertebral compression fractures. This study aims to compare morbidity and mortality of hip and vertebral fragility fractures in patients treated in the same setting. Methods: Patients aged 50 years with hip fracture, and those with vertebral fracture presenting to our hospital between January 2014 and January 2017 were included. Patients were evaluated 1 year after their index fracture. SF-36 scores, mortality, and institutionalization are then recorded. Patients were divided into 2 groups: hip fractures and vertebral fractures. Results: There were 106 and 90 patients respectively evaluated in hip and vertebral fracture groups at 1 year. Patients in both groups were comparable for age, sex, comorbidities and neuropsychiatric condition (P > 0.05). At 1 year follow-up, SF-36 showed better averages in all 8 scales in hip fracture group compared to vertebral fracture group. Mortality in the hip fracture group reached 32.1% compared to 10% for the vertebral fracture group (P < 0.01). Fifteen patients were institutionalized in the hip fracture group compared to 18 patients in the vertebral fracture group (P > 0.05). Conclusions When comparing patients treated in the same setting, hip fracture is associated with significantly increased mortality than vertebral fracture; however, the latter is associated with more morbidity.

The study aimed to review the etiology of failed back surgery syndrome (FBSS) and to propose a treatment algorithm based on a systematic review of the current literature and individual experience. FBSS is a term that groups the conditions with recurring low back pain after spine surgery with or without a radicular component. Since the information on FBSS incidence is limited, data needs to be retrieved from old studies. It is generally accepted that its incidence ranges between 10% and 40% after lumbar laminectomy with or without fusion. Although the etiology of FBSS is not completely understood, it is possibly multifactorial, and the causative factors may be categorized into preoperative, operative, and postoperative factors. The evaluation of patients with FBSS symptoms should ideally initiate with reviewing the patients' clinical history (observing “red flags”), followed by a detailed clinical examination and imaging (whole-body X-ray, magnetic resonance imaging, and computed tomography). FBSS is a complex and difficult pathology, and its accurate diagnosis is of utmost importance. Its management should be multidisciplinary, and special attention should be provided to cases of recurrent disc herniation and postoperative spinal imbalance.
Diagnosis ; Failed Back Surgery Syndrome ; Humans ; Incidence ; Laminectomy ; Low Back Pain ; Magnetic Resonance Imaging ; Pathology ; Postural Balance ; Spine