Methods: This study enrolled 308 patients diagnosed with LDH and concurrent LSTV. All patients underwent microdiscectomy. Clinical evaluation was performed preoperatively and at distinct follow-up intervals of 1, 3, 6, and 12 months, and 2 and 5 years postoperatively. Assessment included clinical examination and implementation of the well-established, patient-reported outcome measures Visual Analog Scale (VAS) and Short-Form 36 (SF-36) Medical Health Survey Questionnaire for Health-Related Quality of Life (HRQoL) analysis. Furthermore, the anatomical relationship between LSTV and LDH was also studied. Results: The SF-36 indices and VAS score were statistically significantly ameliorated within the follow-up period. Maximum improvement was noted at 3 months, with further minimal improvement after 6 months, and stabilization of indices until the end of followup. Castellvi type IB was the most frequent LSTV type. The adjacent level (L4–L5) just above the LSTV was the most affected with an incidence of 72.1%. In the subgroups of Castellvi type IA, IIA, and IIIA, the LDH side was ipsilateral with the LSTV in 38.3% of patients. In this study, all patients underwent microdiscectomy and demonstrated favorable clinical outcomes (functional recovery and pain relief) and notable amelioration of HRQoL. Conclusions To the best of our knowledge, this is the first study to conduct a holistic assessment in an attempt to delineate the impact of LSTV presence on the postoperative HRQoL of these individuals.

Methods: This study enrolled 308 patients diagnosed with LDH and concurrent LSTV. All patients underwent microdiscectomy. Clinical evaluation was performed preoperatively and at distinct follow-up intervals of 1, 3, 6, and 12 months, and 2 and 5 years postoperatively. Assessment included clinical examination and implementation of the well-established, patient-reported outcome measures Visual Analog Scale (VAS) and Short-Form 36 (SF-36) Medical Health Survey Questionnaire for Health-Related Quality of Life (HRQoL) analysis. Furthermore, the anatomical relationship between LSTV and LDH was also studied. Results: The SF-36 indices and VAS score were statistically significantly ameliorated within the follow-up period. Maximum improvement was noted at 3 months, with further minimal improvement after 6 months, and stabilization of indices until the end of followup. Castellvi type IB was the most frequent LSTV type. The adjacent level (L4–L5) just above the LSTV was the most affected with an incidence of 72.1%. In the subgroups of Castellvi type IA, IIA, and IIIA, the LDH side was ipsilateral with the LSTV in 38.3% of patients. In this study, all patients underwent microdiscectomy and demonstrated favorable clinical outcomes (functional recovery and pain relief) and notable amelioration of HRQoL. Conclusions To the best of our knowledge, this is the first study to conduct a holistic assessment in an attempt to delineate the impact of LSTV presence on the postoperative HRQoL of these individuals.

Methods: This study enrolled 308 patients diagnosed with LDH and concurrent LSTV. All patients underwent microdiscectomy. Clinical evaluation was performed preoperatively and at distinct follow-up intervals of 1, 3, 6, and 12 months, and 2 and 5 years postoperatively. Assessment included clinical examination and implementation of the well-established, patient-reported outcome measures Visual Analog Scale (VAS) and Short-Form 36 (SF-36) Medical Health Survey Questionnaire for Health-Related Quality of Life (HRQoL) analysis. Furthermore, the anatomical relationship between LSTV and LDH was also studied. Results: The SF-36 indices and VAS score were statistically significantly ameliorated within the follow-up period. Maximum improvement was noted at 3 months, with further minimal improvement after 6 months, and stabilization of indices until the end of followup. Castellvi type IB was the most frequent LSTV type. The adjacent level (L4–L5) just above the LSTV was the most affected with an incidence of 72.1%. In the subgroups of Castellvi type IA, IIA, and IIIA, the LDH side was ipsilateral with the LSTV in 38.3% of patients. In this study, all patients underwent microdiscectomy and demonstrated favorable clinical outcomes (functional recovery and pain relief) and notable amelioration of HRQoL. Conclusions To the best of our knowledge, this is the first study to conduct a holistic assessment in an attempt to delineate the impact of LSTV presence on the postoperative HRQoL of these individuals.

Objective: Lumbar disc herniation (LDH) represents an increasingly encountered condition in patients with rheumatoid arthritis (RA). The aim of the present study is to assess the progress of health-related quality of life following transforaminal endoscopic lumbar discectomy (TELD) for LDH in patients suffering from RA. Methods: Seventy-four patients, scheduled to undergo elective TELD for LDH, were prospectively enrolled in the study. Group A included 36 otherwise healthy individuals and group B 38 patients complementarily diagnosed with RA according to the 2010 ACR/EULAR (American College of Rheumatology/European League Against Rheumatism) criteria. The Medical Outcomes Study 36-item Short Form health survey (SF-36) was selected for the outcome assessment at baseline and postoperatively, at selected intervals at 6 weeks, 3, 6, and 12 months postoperatively. Results: Group A presented statistically significantly higher scores in all SF-36 domains and all selected intervals (p<0.001), except for mental health parameter. All aspects of SF-36 questionnaire significantly improved postoperatively (p<0.001) and in each group independently. Nevertheless, the absolute improvement between consecutive time intervals did not differ significantly between the 2 groups. Conclusion Patients diagnosed with RA who undergo TELD for LDH demonstrate statistically significant improvement in their health status, as measured by SF-36 questionnaire, one year after the procedure. This improvement is comparable with normal individuals.

Objective: Lumbar disc herniation (LDH) represents an increasingly encountered condition in patients with rheumatoid arthritis (RA). The aim of the present study is to assess the progress of health-related quality of life following transforaminal endoscopic lumbar discectomy (TELD) for LDH in patients suffering from RA. Methods: Seventy-four patients, scheduled to undergo elective TELD for LDH, were prospectively enrolled in the study. Group A included 36 otherwise healthy individuals and group B 38 patients complementarily diagnosed with RA according to the 2010 ACR/EULAR (American College of Rheumatology/European League Against Rheumatism) criteria. The Medical Outcomes Study 36-item Short Form health survey (SF-36) was selected for the outcome assessment at baseline and postoperatively, at selected intervals at 6 weeks, 3, 6, and 12 months postoperatively. Results: Group A presented statistically significantly higher scores in all SF-36 domains and all selected intervals (p<0.001), except for mental health parameter. All aspects of SF-36 questionnaire significantly improved postoperatively (p<0.001) and in each group independently. Nevertheless, the absolute improvement between consecutive time intervals did not differ significantly between the 2 groups. Conclusion Patients diagnosed with RA who undergo TELD for LDH demonstrate statistically significant improvement in their health status, as measured by SF-36 questionnaire, one year after the procedure. This improvement is comparable with normal individuals.

Objective: Lumbar disc herniation (LDH) represents an increasingly encountered condition in patients with rheumatoid arthritis (RA). The aim of the present study is to assess the progress of health-related quality of life following transforaminal endoscopic lumbar discectomy (TELD) for LDH in patients suffering from RA. Methods: Seventy-four patients, scheduled to undergo elective TELD for LDH, were prospectively enrolled in the study. Group A included 36 otherwise healthy individuals and group B 38 patients complementarily diagnosed with RA according to the 2010 ACR/EULAR (American College of Rheumatology/European League Against Rheumatism) criteria. The Medical Outcomes Study 36-item Short Form health survey (SF-36) was selected for the outcome assessment at baseline and postoperatively, at selected intervals at 6 weeks, 3, 6, and 12 months postoperatively. Results: Group A presented statistically significantly higher scores in all SF-36 domains and all selected intervals (p<0.001), except for mental health parameter. All aspects of SF-36 questionnaire significantly improved postoperatively (p<0.001) and in each group independently. Nevertheless, the absolute improvement between consecutive time intervals did not differ significantly between the 2 groups. Conclusion Patients diagnosed with RA who undergo TELD for LDH demonstrate statistically significant improvement in their health status, as measured by SF-36 questionnaire, one year after the procedure. This improvement is comparable with normal individuals.

Objective: Lumbar disc herniation (LDH) represents an increasingly encountered condition in patients with rheumatoid arthritis (RA). The aim of the present study is to assess the progress of health-related quality of life following transforaminal endoscopic lumbar discectomy (TELD) for LDH in patients suffering from RA. Methods: Seventy-four patients, scheduled to undergo elective TELD for LDH, were prospectively enrolled in the study. Group A included 36 otherwise healthy individuals and group B 38 patients complementarily diagnosed with RA according to the 2010 ACR/EULAR (American College of Rheumatology/European League Against Rheumatism) criteria. The Medical Outcomes Study 36-item Short Form health survey (SF-36) was selected for the outcome assessment at baseline and postoperatively, at selected intervals at 6 weeks, 3, 6, and 12 months postoperatively. Results: Group A presented statistically significantly higher scores in all SF-36 domains and all selected intervals (p<0.001), except for mental health parameter. All aspects of SF-36 questionnaire significantly improved postoperatively (p<0.001) and in each group independently. Nevertheless, the absolute improvement between consecutive time intervals did not differ significantly between the 2 groups. Conclusion Patients diagnosed with RA who undergo TELD for LDH demonstrate statistically significant improvement in their health status, as measured by SF-36 questionnaire, one year after the procedure. This improvement is comparable with normal individuals.

Objective: Lumbar disc herniation (LDH) represents an increasingly encountered condition in patients with rheumatoid arthritis (RA). The aim of the present study is to assess the progress of health-related quality of life following transforaminal endoscopic lumbar discectomy (TELD) for LDH in patients suffering from RA. Methods: Seventy-four patients, scheduled to undergo elective TELD for LDH, were prospectively enrolled in the study. Group A included 36 otherwise healthy individuals and group B 38 patients complementarily diagnosed with RA according to the 2010 ACR/EULAR (American College of Rheumatology/European League Against Rheumatism) criteria. The Medical Outcomes Study 36-item Short Form health survey (SF-36) was selected for the outcome assessment at baseline and postoperatively, at selected intervals at 6 weeks, 3, 6, and 12 months postoperatively. Results: Group A presented statistically significantly higher scores in all SF-36 domains and all selected intervals (p<0.001), except for mental health parameter. All aspects of SF-36 questionnaire significantly improved postoperatively (p<0.001) and in each group independently. Nevertheless, the absolute improvement between consecutive time intervals did not differ significantly between the 2 groups. Conclusion Patients diagnosed with RA who undergo TELD for LDH demonstrate statistically significant improvement in their health status, as measured by SF-36 questionnaire, one year after the procedure. This improvement is comparable with normal individuals.

STUDY DESIGN: Prospective clinical study. PURPOSE: To investigate the effect of percutaneous transforaminal endoscopic surgery (PTES) for lateral recess stenosis (LRS)(LRS) in elderly patients and to assess patients’ health-related quality of life (HRQoL). OVERVIEW OF LITERATURE: PTES is an increasingly used surgical approach, primarily employed for lumbar disc herniation treatment. However, indications for PTES have been increasing in recent years. PTES has been recommended as a beneficial alternative to open decompression surgery in specific LRS cases; PTES is termed as percutaneous endoscopic ventral facetectomy (PEVF) in such cases. METHODS: In total, 65 elderly patients with LRS were prospectively studied. Patients presented severe comorbidities (coronary insufficiency, heart failure, diabetes mellitus, and respiratory failure); thus, general anesthesia administration would potentially cause considerable hazards. All the patients underwent successful PEVF in 2015–2016. The patients were assessed preoperatively and at 6 weeks; 3, 6, and 12 months; and 2 years postoperatively. Patients’ objective assessment was conducted according to specific clinical scales; the Visual Analog Scale (VAS) was separately used for leg and low-back pain (VAS-LP and VAS-BP, respectively), whereas the Short Form 36 Health Survey Questionnaire was used for the HRQoL evaluation. RESULTS: All studied parameters presented maximal improvement at 6 weeks postoperatively, with less enhancement at 3 and 6 months with subsequent stabilization. Statistical significance was found in all follow-up intervals for all parameters (p<0.05). Parameters with maximal absolute amelioration were VAS-LP, bodily pain, and role limitations due to physical health problems. In contrast, VAS-BP, general health, and mental health were comparatively less enhanced. CONCLUSIONS: PEVF was associated with remarkably enhanced HRQoL 2 years postoperatively. PEVF is thus a safe and effective alternative for LRS surgical management in elderly patients with severe comorbidities.
Aged ; Anesthesia, General ; Clinical Study ; Comorbidity ; Constriction, Pathologic ; Decompression ; Diabetes Mellitus ; Follow-Up Studies ; Health Surveys ; Heart Failure ; Humans ; Leg ; Mental Health ; Prospective Studies ; Quality of Life ; Visual Analog Scale ; Weights and Measures

A 45-year-old male was autopsied. He had fallen backwards from a two-stairs height to the ground and passed away. A skull fracture was detected in the left occipital area, extending up to the left side of the skull base. The patient's death occurred due to the very low thickness of the calvarial bones, which led to the aforementioned fracture, and in turn resulted in subarachnoid hemorrhage and death. The cortical thickness was measured and compared with average values at standardized points. Uniform bone thinning was confirmed rather than localized. Calvarial thinning may result from various conditions. In the present case study, however, the exact mechanism which led to the low thickness of the calvarial bones of the patient is undetermined. Death due to the susceptible structure and fracture of calvarial bones has rarely been reported throughout relevant literature.