Diagnosis and Management of Invalidating Degenerative Spinal Disorders

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 31 October 2024 | Viewed by 892

Special Issue Editor


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Guest Editor
IRCCS Galeazzi-Sant’Ambrogio, Milan, Italy
Interests: cervical spondylotic myelopathy; spinal disorders

Special Issue Information

Dear Colleagues,

We invite you to contribute to this Special Issue focusing on the “Diagnosis and Management of Invalidating Degenerative Spinal Disorders”. The aim of this Special Issue is to update information with regard to the clinical presentation, radiological diagnosis, neurophysiological setting, conservative treatment, surgical treatment, physiotherapeutic management and long term follow up of the most invalidating degenerative spinal disorders (DSDs).

Cervical Myelopathy is a major cause of invalidity in developed countries. CSM is the most frequent cause of spinal cord injury in adults. Delayed diagnosis and management lead to permanent invalidity. The clinical picture includes an alteration of hand dexterity, gait instability, paraparesis/tetraparesis and sphincterial impairments.

The most invalidating degenerative spinal disorders of the dorsal spine are giant dorsal disc herniations and ligamentum flavum calcifications determining spinal cord injury. The clinical picture varies from radicular pain, with heaviness in the lower limbs, to more severe situations of paraparesis or paraplegias with sphincterial impairments.

The most invalidating clinical pictures at the lumbar spine are as follows; a. cauda equina syndrome secondary to disc herniation. b. nerve root damage secondary to disc herniation or severe untreated lumbar stenosis with and without spondylolisthesis.

Radiological evaluation modalities include X-rays, CT, and MRI, with the latter being the most sensitive one.

Neurophysiological settings like somatosensory-evoked potentials (SEPs) and motor-evoked potentials (MEPs) evaluation are required in the assessment of patients with CSM.

Once the diagnosis is determined a therapeutical decision must be made.

Surgery is mandatory and has to be performed as soon as possible in acute events such as acute myelopathy or cauda equina syndrome. A programmed surgery in reasonable time is reserved for progressive myelopathy and disc herniation with strength impairment. Meanwhile, a conservative treatment with clinical and radiological follow up might be considered in patients with stable mild conditions.

This Special Issue is dedicated to the diagnosis (clinical, radiological, neurophysiological) and management (surgical, conservative) of invalidating DSDs.

We encourage the submission of papers that address a wide range of topics, including clinical evaluation, radiological evaluation, neurophysiological evaluation, medical and surgical treatment and long-term follow up.

Join us in this Special Issue in order to advance our knowledge and contribute to the development of improved diagnostic and treatment approaches to DSDs. Submissions should adhere to the journal's guidelines and will undergo a rigorous peer-review process. Together, let us enhance patient care and outcomes by motivating advancements in the management of invalidating DSDs.

Dr. Edvin Zekaj
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • myelopathy
  • cauda equina syndrome
  • degenerative spinal disorders
  • outcomes

Published Papers (1 paper)

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Research

12 pages, 11620 KiB  
Article
Use of Dynamic Spinal Instruments (Dynesys) in Adult Spinal Deformities According to Silva–Lenke and Berjano–Lamartina Classifications
by Mehmet Yigit Akgun, Ege Anil Ucar, Cemil Cihad Gedik, Caner Gunerbuyuk, Mehdi Hekimoglu, Onder Cerezci, Tunc Oktenoglu, Mehdi Sasani, Ozkan Ates and Ali Fahir Ozer
Diagnostics 2024, 14(5), 549; https://doi.org/10.3390/diagnostics14050549 - 05 Mar 2024
Viewed by 643
Abstract
Background: Adult spinal deformities (ASD) present complex challenges in spine surgery. The diverse nature of these deformities requires a comprehensive understanding of their classification and treatment options. Traditional approaches, such as fusion and rigid stabilization are associated with complications, including screw loosening, breakage, [...] Read more.
Background: Adult spinal deformities (ASD) present complex challenges in spine surgery. The diverse nature of these deformities requires a comprehensive understanding of their classification and treatment options. Traditional approaches, such as fusion and rigid stabilization are associated with complications, including screw loosening, breakage, proximal junctional kyphosis (PJK), and pseudoarthrosis. Dynamic stabilization techniques have emerged as promising alternatives, to reduce these complications and preserve spinal motion. Objective: This study investigated the effectiveness of dynamic stabilization using the Dynesys system in the surgical treatment of adult degenerative spinal deformities, with a particular emphasis on their classification. Methods: ASDs were classified according to the Berjano–Lamartina (BL) and Silva–Lenke (SL) classifications. We analyzed the efficacy of the Dynesys system in enhancing sagittal balance, radiological parameters, and clinical outcomes in this context. Results: Dynamic stabilization of patients with ASDs using the Dynesys system significantly improved the visual analog scale and Oswestry Disability Index scores and decreased the complication rates. Patients with BL types 2, 3, and 4 experienced a significant improvement in sagittal balance followed by sagittal vertical axis measurements (p = 0.045, p = 0.015, and p < 0.0001, respectively). Conclusion: The SL and BL classifications, which were originally developed for rigid spinal stabilization, can be applied in dynamic stabilization. Furthermore, dynamic stabilization using the Dynesys system can be used as an alternative to rigid stabilization in SL levels 2 and 3, and BL types 1, 2, and 3, and in some patients with type 4 ASDs. Full article
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