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https://www.readbyqxmd.com/read/29775161/surgical-treatment-of-middle-cluneal-nerve-entrapment-neuropathy-technical-note
#1
Juntaro Matsumoto, Toyohiko Isu, Kyongsong Kim, Naotaka Iwamoto, Daijiro Morimoto, Masanori Isobe
OBJECTIVE The etiology of low-back pain (LBP) is heterogeneous and is unknown in some patients with chronic pain. Superior cluneal nerve entrapment has been proposed as a causative factor, and some patients suffer severe symptoms. The middle cluneal nerve (MCN) is also implicated in the elicitation of LBP, and its clinical course and etiology remain unclear. The authors report the preliminary outcomes of a less invasive microsurgical release procedure to address MCN entrapment (MCN-E). METHODS The authors enrolled 11 patients (13 sites) with intractable LBP judged to be due to MCN-E...
May 18, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29774198/a-rare-cause-of-thoracic-spinal-cord-compression-by-multiple-large-tarlov-cysts
#2
Ahmed-Salem Kleib, Sidi-Mohamed Salihy, Hussein Hamdi, Romain Carron, Outouma Soumaré
Spinal extradural arachnoid cyst (SEAC) is a rare cause of spinal cord compression. Bifocal location of thoracic and sacral SEACs is rarely reported in the literature. We report a case of thoracic spinal cord compression by SEAC associated with asymptomatic multiple sacral Tarlov cysts (TC). The surgical management and postoperative outcome of the patient are discussed. A 34-year-old woman was referred to the hospital for acute thoracic pain with a history of chronic long-standing back pain. She complained of walking difficulties...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29770178/dynamic-stabilization-for-degenerative-diseases-in-the-lumbar-spine-2-years-results
#3
Ahmed Hosny Khalifa, Timo Stübig, Oliver Meier, Christian Walter Müller
Following lumbar fusion, adjacent segment degeneration has been frequently reported. Dynamic systems are believed to reduce main fusion drawbacks. We conducted a retrospective study on patients with degenerative lumbar disease treated with posterior dynamic stabilization with monoaxial hinged pedicular screws and lumbar decompression. VAS and ODI were used to compare clinical outcomes. As radiological outcomes, LL and SVA were used. 51 patients were included with an average follow-up of 24 months. 13 patients were revised because of postoperative radiculopathy (n=4), subcutaneous hematoma (n=2), L5 screw malposition (n=1) and adjacent segment disease (n=6)...
March 29, 2018: Orthopedic Reviews
https://www.readbyqxmd.com/read/29766939/minimally-invasive-options-for-surgical-management-of-adjacent-segment-disease-of-the-lumbar-spine
#4
Mazda K Turel, Mena G Kerolus, Brian T David, Richard G Fessler
Background: The incidence of adjacent segment disease (ASD) after lumbar spine surgery is a condition that has become increasingly common as the rate of lumbar spine surgery continues to rise. Minimally invasive techniques continue to be refined and offer an opportunity to treat ASD with minimal tissue disruption, lower blood loss, a shorter hospital stay, and decreased morbidity. The aim of this report is to describe the various minimally invasive options for ASD with a comprehensive review of the existing literature...
May 2018: Neurology India
https://www.readbyqxmd.com/read/29758566/long-term-results-for-the-bacjac-interspinous-device-in-lumbar-spine-degenerative-disease
#5
Aldo Spallone, Luigi Lavorato, Daniele Belvisi
OBJECTIVE:  To evaluate the long-term results of using the BacJac interspinous device (Pioneer Surgical Technology Inc.) in a series of patients with degenerative lumbar spine disease. METHODS:  Forty-one patients undergoing lumbar surgery with implantation of a BacJac device from 2009 to 2012 were enrolled in the present study. Patients were evaluated using the Oswestry Disability Scale (ODI). RESULTS:  Although all patients showed a significant improvement of the ODI score immediately after surgery, only 41% of patients showed a satisfactory outcome...
May 14, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/29754188/comparison-of-bilateral-versus-unilateral-decompression-incision-of-minimally-invasive-transforaminal-lumbar-interbody-fusion-in-two-level-degenerative-lumbar-diseases
#6
Yongzhao Zhao, Yanjie Zhu, Hailong Zhang, Chuanfeng Wang, Shisheng He, Guangfei Gu
PURPOSE: To compare the efficacy and safety of two different surgical incisions for minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the management of two-level degenerative lumbar diseases. METHODS: We conducted a retrospective study of 129 patients, who underwent two-level MIS-TLIF for degenerative lumbar diseases from September 2014 to December 2015. Sixty-two patients underwent MIS-TLIF with unilateral long decompression incision (group A) and 67 patients underwent MIS-TLIF with bilateral short decompression incision (group B)...
May 13, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29753081/postoperative-changes-in-moderate-to-severe-nonspecific-low-back-pain-after-cervical-myelopathy-surgery
#7
Chi Heon Kim, Chun Kee Chung, Urim Lee, Yunhee Choi, Sung Bae Park, Jong-Myung Jung, Sung Hwan Hwang, Seung Heon Yang
OBJECTIVE: Cervical myelopathy patients sometimes experience concurrent nonspecific moderate to severe low back pain (msLBP). However, postoperative changes in msLBP after cervical myelopathy surgery have rarely been reported. Awareness of postoperative changes in msLBP may be helpful in consultation. Therefore, the objective of this study was to examine postoperative changes in msLBP. METHODS: Patients with cervical myelopathy and msLBP (a visual analog pain score ≥ 5/10) were prospectively reviewed, and 53 patients (M:F, 28:25; mean age, 63...
May 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29746537/kinetic-and-kinematic-variables-affecting-trunk-flexion-during-level-walking-in-patients-with-lumbar-spinal-stenosis
#8
Tatsuya Igawa, Junji Katsuhira, Akira Hosaka, Kenta Uchikoshi, Shinichi Ishihara, Ko Matsudaira
Lumbar spinal stenosis causes cauda equina and nerve root compression, resulting in neurological symptoms. Although trunk flexion during level walking may alleviate these symptoms by enabling spinal canal decompression, some patients do not use this strategy. We aimed to identify the kinetic and kinematic variables that affect trunk flexion in patients during level walking. Gait was recorded in 111 patients using a three-dimensional motion capture system and six force plates. From the data recorded, walking velocity, bilateral step length, cycle time, maximum trunk flexion angle, forward pelvic tilt angle, pelvic rotation angle, maximum and minimum joint angles, and moment and power of the lower limb were calculated...
2018: PloS One
https://www.readbyqxmd.com/read/29742720/sacral-epiduroscopic-laser-decompression-for-complex-regional-pain-syndrome-after-lumbar-spinal-surgery-a-case-report
#9
Jae-Wook Jung, Yong Han Kim, Hyojoong Kim, Eunsu Kang, Hyunji Jo, Myoung Jin Ko
RATIONALE: CRPS after a lumbar surgery has symptoms that are similar to PSSS. However, standard criteria for distinguishing CRPS from PSSS do not exist. We present a case report of a 31-year-old female with CRPS symptoms after lumbar spinal surgery treated by performing SELD. PATIENT CONCERNS: This patient was referred to our pain clinic for left ankle pain. She received a lumbar discectomy for a herniated lumbar disc (L5/S1) but the pain was aggravated after surgery...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29740508/case-presentation-and-short-perspective-on-management-of-foraminal-far-lateral-discs-and-stenosis
#10
REVIEW
Nancy E Epstein
Background: The management of lumbar foraminal/far lateral discs (FOR/FLD) with stenosis remains controversial. Operative choices should be based on each patient's preoperative dynamic X-ray findings, magnetic resonance (MR), and computed tomography (CT) studies. Here we reviewed several options for decompression alone vs. decompression with fusion. Methods: Safe excision of FOR/FLD with stenosis should begin at the level above the disc herniation, as identification of the superior, foraminally, and far laterally exiting nerve root is critical...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29734574/sensorineural-hearing-loss-after-spine-surgery-treated-with-hyperbaric-oxygen-therapy-two-case-reports
#11
Eric Goodrich, Richard P Goodrich, Charles A Reese
Acute idiopathic sudden sensorineural hearing loss (ISSNHL) following lumbar spinal surgery is an exceedingly rare phenomenon. This paper presents a case of ISSNHL presenting acutely after lumbar spine decompression and fusion treated with transtympanic steroids and hyperbaric oxygen (HBO₂) therapy. It also presents the ironic case of SSNHL secondary to presumed viral pathology sustained by the patient's operative surgeon who was treated with transtympanic steroids and HBO₂ as well. Proposed etiologies of the patient's ISSNHL include: hypotension, prone operative position, malfitted/malpositioned headrest, microemboli from a cell-saver, and nitrous oxide anesthesia...
March 2018: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/29732430/effect-of-interbody-fusion-cage-on-clinical-and-radiological-outcome-of-surgery-in-l4-l5-lumbar-degenerative-spondylolisthesis
#12
Farzad Omidi-Kashani, Reza Jalilian, Farideh Golhasani-Keshtan
Background: Lumbar degenerative spondylolisthesis (LDS) is a degenerative slippage of a lumbar vertebra relative to the adjacent vertebra below that can be clinically symptomatic. We aim to compare radiological and clinical outcome of surgery in L4-L5 LDS with or without applying the interbody fusion cage. Methods: We studied 60 patients (mean age, 51.3±13.2 years; follow-up, 53.3±14.6 months) with L4-L5 LDS who had been treated by decompression, pedicle screw and rod instrumentation associated with posterolateral fusion (PLF) without and with transforaminal lumbar interbody fusion (TLIF) in equally divided groups A and B, respectively...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29732427/do-intra-operative-neurophysiological-changes-predict-functional-outcome-following-decompressive-surgery-for-lumbar-spinal-stenosis-a-prospective-study
#13
Krzysztof Piasecki, Gerit Kulik, Katarzyna Pierzchala, Etienne Pralong, Prashanth J Rao, Constantin Schizas
Background: To analyse the relation between immediate intraoperative neurophysiological changes during decompression and clinical outcome in a series of patients with lumbar spinal stenosis (LSS) undergoing surgery. Methods: Twenty-four patients with neurogenic intermittent claudication (NIC) due to LSS undergoing decompressive surgery were prospectively studied. Intra operative trans-cranial motor evoked potentials (tcMEPs) were recorded before and immediately after surgical decompression...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29730270/management-of-iatrogenic-spinal-cerebrospinal-fluid-leaks-a-cohort-of-124-patients
#14
Royce W Woodroffe, Kirill V Nourski, Logan C Helland, Brian Walsh, Jennifer Noeller, Panagiotis Kerezoudis, Patrick W Hitchon
OBJECTIVES: Cerebrospinal fluid leaks are a frequent complication of spinal surgery, with reported rates between 2 and 20%. Management is highly variable and dependent on comorbidities, complexity of the index procedure, and surgeons' experience. Treatment options include primary or delayed repair, with or without spinal drainage. Using a retrospective cohort, the authors aim to identify the appropriate management of iatrogenic spinal cerebrospinal fluid (CSF) leaks. PATIENTS AND METHODS: We queried our institutional database for postoperative spinal CSF leaks between 1/1/2007 and 3/14/2017 using Current Procedural Terminology (CPT) and International Classification of Disease (ICD) codes...
April 22, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29727270/pedicle-distraction-increases-intervertebral-and-spinal-canal-area-in-a-cadaver-and-bone-model
#15
Matthew Hughes, Nikolaos Papadakos, Tim Bishop, Jason Bernard
INTRODUCTION: Lumbar spinal stenosis is degenerative narrowing of the spinal canal and/or intervertebral foramen causing compression of the spinal cord and nerve roots. Traditional decompression techniques can often cause significant trauma and vertebral instability. This paper evaluates a method of increasing pedicle length to decompress the spinal and intervertebral foramen, which could be done minimally invasive. METHODS: Three Sawbone (Sawbones Europe, Sweden) and 1 cadaveric lumbar spine underwent bilateral pedicle distraction at L4...
2018: SICOT-J
https://www.readbyqxmd.com/read/29726793/sublaminar-fixation-for-traumatic-lumbar-fracture-subluxation-with-lateral-listhesis-in-a-2-year-old-patient
#16
Daniel S Yanni, Aurora S Cruz, Alexander Y Halim, Amandip S Gill, Michael G Muhonen, Robert F Heary, Ira M Goldstein
Pediatric spinal trauma can present a surgeon with difficult management decisions given the rarity of these cases, pediatric anatomy, and a growing spine. The need to stabilize a traumatically unstable pediatric spine can be an operative challenge given the lack of instrumentation available. The authors present a surgical technique and an illustrative case that may offer a novel, less disruptive method of stabilization. A 2-year-old girl presented after an assault with an L1-2 fracture subluxation with lateral listhesis and fractured jumped facets exhibited on CT scans...
May 4, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29721359/acute-cauda-equina-syndrome-following-orthopedic-procedures-as-a-result-of-epidural-anesthesia
#17
Lisa B E Shields, Vasudeva G Iyer, Yi Ping Zhang, Christopher B Shields
Background: Cauda equina syndrome (CES) is a rare complication of spinal or epidural anesthesia. It is attributed to direct mechanical injury to the spinal roots of the cauda equina that may result in saddle anesthesia and paraplegia with bowel and bladder dysfunction. Case Description: The first patient underwent a hip replacement and received 5 mL of 1% lidocaine epidural anesthesia. Postoperatively, when the patient developed an acute CES, the lumbar magnetic resonance imaging (MRI) scan demonstrated clumping/posterior displacement of nerve roots of the cauda equina consistent with adhesive arachnoiditis attributed to the patient's previous L4-L5 lumbar decompression/fusion...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29713419/comparison-of-clinical-and-radiologic-results-of-mini-open-transforaminal-lumbar-interbody-fusion-and-extreme-lateral-interbody-fusion-indirect-decompression-for-degenerative-lumbar-spondylolisthesis
#18
Yutaka Kono, Hogaku Gen, Yoshio Sakuma, Yasuhide Koshika
Study Design: Retrospective study. Purpose: In this study, we compared the postoperative outcomes of extreme lateral interbody fusion (XLIF) indirect decompression with that of mini-open transforaminal lumbar interbody fusion (TLIF) in patients with lumbar degenerative spondylolisthesis. Overview of Literature: There are very few reports examining postoperative results of XLIF and minimally invasive TLIF for degenerative lumbar spondylolisthesis, and no reports comparing XLIF and mini-open TLIF...
April 2018: Asian Spine Journal
https://www.readbyqxmd.com/read/29713410/minimally-invasive-lumbar-spinal-decompression-in-elderly-patients-with-magnetic-resonance-imaging-morphological-analysis
#19
Seungman Ha, Youngho Hong, Seungcheol Lee
Study Design: Case-control study. Purpose: In this study, we aimed to investigate clinical outcomes and morphological features in elderly patients with lumbar spinal stenosis (LSS) who were treated by minimally invasive surgery (MIS) unilateral laminectomy for bilateral decompression (ULBD) using a tubular retractor. Overview of Literature: Numerous methods using imaging have been attempted to describe the severity of spinal stenosis. But the relationship between clinical symptoms and radiological features remains debatable...
April 2018: Asian Spine Journal
https://www.readbyqxmd.com/read/29713407/the-incidence-of-adjacent-segment-degeneration-after-the-use-of-a-versatile-dynamic-hybrid-stabilization-device-in-lumbar-stenosis-results-of-a-5-8-year-follow-up
#20
Mauro Dobran, Davide Nasi, Domenico Paolo Esposito, Maurizio Gladi, Massimo Scerrati, Maurizio Iacoangeli
Study Design: Retrospective study with long-term follow-up. Purpose: To evaluate the long-term incidence of adjacent segment degeneration (ASD) and clinical outcomes in a consecutive series of patients who underwent spinal decompression associated with dynamic or hybrid stabilization with a Flex+TM stabilization system (SpineVision, Antony, France) for lumbar spinal stenosis. Overview of Literature: The incidence of ASD and clinical outcomes following dynamic or hybrid stabilization with the Flex+TM system used for lumbar spinal stenosis have not been well investigated...
April 2018: Asian Spine Journal
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