Youn-Kwan Park

Facet fusion in the lumbosacral spine: a 2-year follow-up study.

OBJECTIVE A clinical and radiological follow-up study was undertaken to assess the safety, efficacy, and complication rate associated with instrumented facet fusion of the lumbar and lumbosacral spine. METHODS This study involved 99 patients with degenerative lumbar disorders who were treated surgically at the authors’ neurosurgical department and followed for more than 2 years. Eighty-two patients underwent one-level fusion for the treatment of Grade I or II degenerative spondylolisthesis and accompanying spinal canal stenosis (44 patients) or recurrent disc herniation (38 patients). Seventeen patients underwent two-level fusion for the treatment of either double instances of the above indications (seven patients) or concurrent stenosis at the adjacent level (10 patients). RESULTS There were no technique-related complications. The overall 2-year success rate of fusion was 96%; the success rates by fusion type were 99% in one-level fusions and 88% in two-level fusions. Degenerative spondylolisthesis had the highest success rate at 100%, whereas the success rate in patients who had not responded to previous discectomy was 93%. Patients with concurrent stenosis experienced the lowest success rate: 80%. Excellent or good clinical results were obtained for 85% of patients with one-level fusions and for 65% of patients with two-level fusions. CONCLUSION Instrumented facet fusion alone is a simple, safe, and effective surgical option for the treatment of patients with single-level disorders, especially patients with degenerative spondylolisthesis.

Unusual fatal infections after anterior cervical spine surgeries.

We report two cases of cervical spinal epidural abscess (SEA), which are related to anterior cervical surgeries. The first case reveals a late postoperative infection without any predisposing factor. The second case reveals combined complication of infection and instrument failure (artificial disc). Both two cases manifested ascending infections that are unusual courses of anterior cervical infections. The abscess extended upwards and, finally, caused life threatening bacterial meningitis. We suggest aggressive surgical interventions with anti-bacterial therapies in such cases.