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International Journal of Spine Surgery

Pierluigi Vergara, Dominic G O'Donovan
Background: Symptomatic spinal gout is relatively rare. Open laminectomy, with or without fusion, has been so far the standard treatment for symptomatic spinal gout. We describe here the first case of spinal tophaceus gout treated with minimally invasive surgery. Methods: A 60-year-old patient, morbidly obese, with no previous history of gout, presented with neurogenic claudication due to severe lumbar canal stenosis at L3/4. Surgery was performed through a minimally invasive approach, using tubular retractors...
2017: International Journal of Spine Surgery
Catherine W Cahill, Kristen E Radcliffe, Charles Reitman
Background: Very little normative CT scan data exist defining expected relationships of vertebral structures in the intact cervical spine. Better understanding of normal relationships should improve sensitivity of injury detection, particularly for facet subluxation. The purpose of this paper was to describe the normal anatomical relationships and most sensitive measurements to detect abnormal alignment in the subaxial cervical spine. Methods: A group of 30 CT scans with no documented cervical spine injury were utilized from an established data base in a trauma population...
2017: International Journal of Spine Surgery
Joseph A Sclafani, Deborah I Ross, Brian H Weeks, Michelle Yang, Choll W Kim
Background: Existing evaluative instruments for dysphagia, odynophagia, and voice disturbance are cumbersome, focus pre-dominately on dysphagia, and often require administration by a certified Speech Pathologist. This study was conducted to utilize widely accepted instruments such as the American Speech and Hearing Association's National Outcomes Measurement System (NOMS) and VAS pain scales to validate a novel, patient-reported instrument that quantifies the severity of post-operative dysphagia, odynophagia, and voice disabilities (DOV)...
2017: International Journal of Spine Surgery
Satyajit V Marawar, Ian A Madom, Mark Palumbo, Richard A Tallarico, Nathaniel R Ordway, Umesh Metkar, Dongliang Wang, Adam Green, William F Lavelle
Background: Treating surgeon's visual assessment of axial MRI images to ascertain the degree of stenosis has a critical impact on surgical decision-making. The purpose of this study was to prospectively analyze the impact of surgeon experience on inter-observer and intra-observer reliability of assessing severity of spinal stenosis on MRIs by spine surgeons directly involved in surgical decision-making. Methods: Seven fellowship trained spine surgeons reviewed MRI studies of 30 symptomatic patients with lumbar stenosis and graded the stenosis in the central canal, the lateral recess and the foramen at T12-L1 to L5-S1 as none, mild, moderate or severe...
2017: International Journal of Spine Surgery
Remi M Ajiboye, Howard Y Park, Jeremiah R Cohen, Evan E Vellios, Elizabeth L Lord, Adedayo O Ashana, Zorica Buser, Jeffrey C Wang
Background: Intraoperative neuromonitoring (ION) such as motor-evoked potential (MEP), somatosensory evoked potentials (SSEP) and electromyography (EMG) are used to detect impending neurological injuries during spinal surgery. To date, little is known on the trends in the use of ION for scoliosis surgery in the United States. Methods: A retrospective review was performed using the PearlDiver Database to identify patients that had scoliosis surgery with and without ION from years 2005 to 2011...
2017: International Journal of Spine Surgery
Pavlos Panteliadis, Omar Musbahi, Senthil Muthian, Shivam Goyal, Alexander Sheriff Montgomery, Arun Ranganathan
Introduction: Management of thoracolumbar fractures remains controversial in the literature. The primary aims of this study were to assess different levels of fixation with respect to radiological outcomes in terms of fracture reduction and future loss of correction. Methods: This is a single center, retrospective study. Fifty-five patients presenting with thoracolumbar fractures between January 2012 and December 2015 were analyzed in the study. The levels of fixation were divided in 3 groups, 1 vertebra above and 1 below the fracture (1/1), 2 above and 2 below (2/2), and 2 above and 1 below (2/1)...
2017: International Journal of Spine Surgery
Kris Radcliff, Reginald J Davis, Michael S Hisey, Pierce D Nunley, Gregory A Hoffman, Robert J Jackson, Hyun W Bae, Todd Albert, Dom Coric
Background: Cervical total disc replacement (TDR) is an increasingly accepted procedure for the treatment of symptomatic cervical degenerative disc disease. Multiple Level I evidence clinical trials have established cervical TDR to be a safe and effective procedure in the short-term. The objective of this study is to provide a long-term assessment of TDR versus anterior discectomy and fusion for the treatment of one- and two-level disc disease. Methods: This study was a continuation of a prospective, multicenter, randomized, US FDA IDE clinical trial comparing cervical TDR with the Mobi-C© Cervical Disc versus ACDF through 7 years follow-up...
2017: International Journal of Spine Surgery
H Bahadir Gokcen, Sinan Erdogan, Gurkan Gumussuyu, Sidar Ozturk, Cagatay Ozturk
Introduction: Thoracic disc herniation is not as common as other disc herniations seen at other levels of spinal column. Th1-Th2 disc herniation is an extremely rare condition. Physical and cautious radiological examination is significantly important for diagnosis. Case Presentation: We report a 45 years old male case with complaint of neck pain radiating to right upper extremity. The physical examination revealed Th1 radiculopathy symptoms. According to his images degeneration at C6-7 level and right T1 root compression due to Th1-Th2 disc herniation at foraminal region were evaluated...
2017: International Journal of Spine Surgery
Daniel Berman, Jonathan H Oren, John Bendo, Jeffrey Spivak
Background: Spinal fusion surgery is performed about half a million times per year in the United States and millions more worldwide. It is an effective method for reducing pain, increasing stability, and correcting deformity in patients with various spinal conditions. In addition to being a well-established risk factor for a variety of medical conditions, smoking has deleterious effects on the bone healing of spinal fusions. This review aims to specifically analyze the ways in which smoking affects the outcomes of spinal fusion and to explore ways in which these negative consequences can be avoided...
2017: International Journal of Spine Surgery
Stylianos Kapetanakis, Grigorios Gkasdaris, Tryfon Thomaidis, Georgios Charitoudis, Konstantinos Kazakos
Background: Studies describing the efficacy of TPED on shortness of recovery and improvement of postoperative quality of life are limited, especially regarding gender something that has never been reported before in the literature. The purpose of this study is to evaluate possible differences of the health-related quality of life in patients who underwent TPED for LDH in accordance with sex. Methods: Seventy-six patients diagnosed and treated with TPED for LDH with 1 year follow-up were selected and divided into two groups of equal number depending on sex...
2017: International Journal of Spine Surgery
Kristen E Jones, Elissa K Butler, Tara Barrack, Charles T Ledonio, Mary L Forte, Claudia S Cohn, David W Polly
Background: Multilevel posterior spine fusion is associated with significant intraoperative blood loss. Tranexamic acid is an antifibrinolytic agent that reduces intraoperative blood loss. The goal of this study was to compare the percent of total blood volume lost during posterior spinal fusion (PSF) with or without tranexamic acid in patients with adolescent idiopathic scoliosis (AIS). Methods: Thirty-six AIS patients underwent PSF in 2011-2014; the last half (n=18) received intraoperative tranexamic acid...
2017: International Journal of Spine Surgery
Nitin Agarwal, David R Hansberry, Ira M Goldstein
Introduction: The etiology and treatment of tethered cord syndrome remains controversial, especially in adults. We present an unusual case of tethered cord syndrome with an associated epidural lipomatosis likely due to chronic over shunting of cerebrospinal fluid (CSF). Methods: A 25-year-old woman had a history of Chiari malformation, hydrocephalus, and a ventriculoperitoneal shunt. She demonstrated progressively worsening gait, which led to a diagnosis of myelopathy and a posterior cervical decompression and fusion was performed...
2017: International Journal of Spine Surgery
Michael Conti Mica, Leonard I Voronov, Gerard Carandang, Robert M Havey, Bartosz Wojewnik, Avinash G Patwardhan
Introduction: A novel expandable lumbar interbody fusion cage has been developed which allows for a broad endplate footprint similar to an anterior lumbar interbody fusion (ALIF); however, it is deployed from a minimally invasive transforaminal unilateral approach. The perceived benefit is a stable circumferential fusion from a single approach that maintains the anterior tension band of the anterior longitudinal ligament.The purpose of this biomechanics laboratory study was to evaluate the biomechanical stability of an expandable lumbar interbody cage inserted using a transforaminal approach and deployed in situ compared to a traditional lumbar interbody cage inserted using an anterior approach (control device)...
2017: International Journal of Spine Surgery
Neel Anand, Ryan B Cohen, Jason Cohen, Babak Kahndehroo, Sheila Kahwaty, Eli Baron
BACKGROUND: CMIS techniques are heavily dependent on placement of lateral interbody cages. Cages with an increased lordotic angle are being advocated to improve segmental lordosis and SVA. We assessed the segmental lordosis achieved with the individual cages. We further studied three variables and the effect each had on segmental lordosis: the lordosis angle of the cage, the position of the cage in the intervertebral space, and the level that it has been placed. METHODS: This is a retrospective study of 66 consecutive patients who underwent lateral interbody fusion using lordotic cages as part of CMIS correction of scoliosis from June 2012 to January 2016...
2017: International Journal of Spine Surgery
Pierino G Bonanni
PURPOSE: A method for measuring spinal curvature that provides a useful analog to the Cobb angle and is tolerant of degraded image quality is proposed. Conventional methods require a higher standard of discernibility for vertebra features and suffer high variability. METHODS: Assumption is made that the natural representation of the spine for the purpose of scoliosis monitoring is that of a continuous curved contour rather than a series of discrete vertebral bodies with individual orientations...
2017: International Journal of Spine Surgery
Dean N Papaliodis, Pierino G Bonanni, Timothy T Roberts, Khalid Hesham, Nicholas Richardson, Robert A Cheney, James P Lawrence, Allen L Carl, William F Lavelle
BACKGROUND: The standard for evaluating scoliosis is PA radiographs using Cobb angle to measure curve magnitude. Newer PACS systems allow easier Cobb angle calculations, but have not improved inter/intra observer precision of measurement. Cobb angle and its progression are important to determine treatment; therefore, angle variability is not optimal. This study seeks to demonstrate that a performance equivalent to that achieved in the manual method is possible using a novel computer algorithm with limited user input...
2017: International Journal of Spine Surgery
Srinidhi Nagaraja, Vivek Palepu
BACKGROUND: Screw loosening is a well-known adverse event in traditional spinal fusion instrumentation. This phenomenon may hinder segmental stability of the spine leading to bony non-union. In recent years numerous lumbar integrated fixation cages (IFC) have been introduced that offer a low profile alternative to a standard cage with an anterior plate (AP+C). The fixation approach for IFCs is different than a traditional anterior approach; therefore, it is unclear whether IFCs may loosen from the surrounding bone over time...
2017: International Journal of Spine Surgery
Yu Chao Lee, Francis Brooks, Simon Sandler, Yun-Hom Yau, Michael Selby, Brian Freeman
PURPOSE: The purpose of this study is to perform a citation analysis on the most frequently cited articles in the topic of cervical spine surgery and report on the top 100 most cited publication in this topic. METHODS: We used the Thomson Reuters Web of Science to search citations of all articles from 1945 to 2015 relevant to cervical spine surgery and ranked them according to the number of citations. The 100 most cited articles that matched the search criteria were further analyzed by number of citations, first author, journal, year of publication, country and institution of origin...
2017: International Journal of Spine Surgery
Ram Haddas, Theodore Belanger
BACKGROUND: Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the axial skeleton, including the sacroiliac joints, costovertebral joints, and the spine. Patients with AS found to have an alter gait pattern. The purpose of this study was to investigate biomechanical alterations in gait after surgical correction in a patient with severe kyphosis from AS. METHODS: A case report in controlled laboratory study, a pretest-posttest design...
2017: International Journal of Spine Surgery
Remi M Ajiboye, Stephen D Zoller, Adedayo A Ashana, Akshay Sharma, William Sheppard, Langston T Holly
BACKGROUND: Laminectomy with fusion (LF) and laminoplasty are two posterior-based surgical approaches for the surgical treatment of cervical spondylotic myelopathy (CSM). The decompressive effect of these approaches is thought to be primarily related to the dorsal drift of the spinal cord away from ventral compressive structures. A lesser known mechanism of spinal cord decompression following cervical LF is regression of the ventral disc osteophyte complexes which is postulated to result from the alteration of motion across the fused motion segment...
2017: International Journal of Spine Surgery
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