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https://www.readbyqxmd.com/read/28640129/vacter-syndrome-with-situs-inversus-totalis-case-report-and-a-new-syndrome
#1
Wei Wu, Zhibao Lv, Weijue Xu, Jiangbing Liu, Wei Jia
INTRODUCTION: The association of situs inversus totalis (SIT) and VACTERL syndrome an extremely rare coincidence. PATIENTS: The patient was first diagnosed as simple SIT with lumbosacral neoplasms according to the prenatal magnetic resonance imaging (MRI) examination; however, the local hospital ignored the important to physical examination so that missed anal atresia with fistula. The patient was presented to our hospital owing to constipation for 1 week. And then, she was diagnosed as VACTER syndrome with situs inversus totalis...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28640096/effect-of-transforaminal-epidural-polydeoxyribonucleotide-injections-on-lumbosacral-radiculopathy-a-case-report
#2
Keum Nae Kang, Tae Woong Kim, Jin Woo Koh, Han Byeol Oh, Jong-Uk Mun, Mi Sook Seo, Young Uk Kim
RATIONALE: Transforaminal epidural glucocorticoids administration is widely performed for the management of lumbosacral radiculopathy. However, it may worsen the condition of patients with type 2 diabetes mellitus (DM). Polydeoxyribonucleotide (PDRN) was recently noted as a substitute for glucocorticoids. PATIENT CONCERNS: A 44-year-old male patient was admitted to our pain clinic with symptoms of low back pain with severe pain and tingling sensation of left posterolateral leg...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28631069/-s2-ala-iliac-screws-for-extended-pelvic-fixation-in-longer-lumbar-instrumentations-description-of-a-freehand-technique
#3
REVIEW
F Lattig, S Weckbach
OBJECTIVE: To reduce the rate of implant failures at the lumbosacral junction in polysegmental lumbar fusions. INDICATIONS: Spinal fusion with deformity correction including L5/S1, revision surgery for pseudoarthrosis L5/S1, screw pull-out and pedicle fractures in S1, and S1/S2 fractures after polysegmental fusions. CONTRAINDICATIONS: Osteosynthesis of complex pelvic ring fractures, tumors of the ilium. Relative contraindication: infection, to avoid contamination of the iliosacral joint...
June 19, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28627954/reliability-analysis-of-cobb-measurement-in-degenerative-lumbar-scoliosis-using-endplate-versus-pedicle-as-bony-landmarks
#4
Jing Guo, Xian-Chao Deng, Qin-Jie Ling, Zhi-Xun Yin, Er-Xing He
OBJECTIVES: Degenerative changes of endplates in older patients and tilting of vertebral body in lumbosacral lordosis could make an accurate identification of endplates for the Cobb measurement difficult. Pedicles have been proposed as alternative landmarks because they are usually better visualized, and offer similar clinical validity to the endplates. The objective of this study was to investigate the reliability of the pedicle method of Cobb measurement in degenerative lumbar scoliosis and compare it with the traditional endplate method...
June 21, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28622188/differences-in-fundamental-sagittal-pelvic-parameters-based-on-age-sex-and-race
#5
Robert K Merrill, Jun S Kim, Dante M Leven, Joung Heon Kim, Joshua J Meaike, Rachel S Bronheim, Kelly I Suchman, Doug Nowacki, Sunder S Gidumal, Samuel K Cho
STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: To determine whether age, sex, and race have independent effects on sagittal pelvic parameters. SUMMARY OF BACKGROUND DATA: Pelvic parameters and sagittal balance correlate with health-related quality of life and are important for patient assessment and surgical planning. Age, sex, and race are 3 unalterable patient factors that may influence pelvic morphology. METHODS: We conducted a retrospective review of consecutive adult patients who presented to our radiology practice between 2010 and 2015 and had a standing, lateral lumbosacral radiograph...
June 15, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28620719/large-coverage-mr-neurography-in-cidp-diagnostic-accuracy-and-electrophysiological-correlation
#6
Moritz Kronlage, Philipp Bäumer, Kalliopi Pitarokoili, Daniel Schwarz, Véronique Schwehr, Tim Godel, Sabine Heiland, Ralf Gold, Martin Bendszus, Min-Suk Yoon
The objective of this study was to evaluate large coverage magnetic resonance neurography (MRN) in chronic inflammatory demyelinating polyneuropathy (CIDP). In this prospective study, 18 patients with CIDP and 18 healthy controls were examined by a standardized MRN protocol at 3 T. Lumbosacral plexus was imaged by a T2-weighted 3D sequence and peripheral nerves of the upper and lower extremity by axial T2-weighted turbo spin-echo sequences. Lesions were characterized by nerve cross-sectional area (CSA) and T2-weighted signal (nT2)...
June 15, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28617741/soft-tissue-reconstruction-of-large-spinal-defects-a-12-year-institutional-experience
#7
Chris Devulapalli, Justin Broyles, Ricardo Bello, Tarek Elgendy, Georgia Yalanis, Richard Redett, Gedge D Rosson, Justin Sacks
BACKGROUND: Radical spinal resections can lead to considerable defects requiring soft tissue reconstruction. The purpose of this study was to review our institutional experience of over a decade with reconstruction of spinal defects and identify risk factors predictive of wound complications, particularly focusing on timing of reconstruction with ablative surgery. METHODS: We retrospectively reviewed patients who underwent spinal resection and required soft tissue reconstruction from 2002-2014...
June 14, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28614281/transcranial-motor-evoked-potential-alarm-criteria-to-predict-foot-drop-injury-during-lumbosacral-surgery
#8
Arvydas Tamkus, Kent S Rice, Gregory Hoffman
STUDY DESIGN: Retrospective cohort analysis. OBJECTIVE: This study aims to investigate whether waveform alterations in transcranial motor evoked potentials (TCMEP) can reliably predict postoperative foot drop. SUMMARY OF BACKGROUND DATA: Nerve injury leading to foot drop is a potential complication of lumbosacral surgery. Very limited data exist on the use of intraoperative TcMEPs to identify iatrogenic foot drop. METHODS: We retrospectively reviewed neuromonitoring data from 130 consecutive spine surgeries with instrumentation involving L4-S1...
June 13, 2017: Spine
https://www.readbyqxmd.com/read/28605134/impact-of-direct-epispinal-stimulation-on-bladder-and-bowel-functions-in-pigs-a-feasibility-study
#9
Thomas Guiho, Claire Delleci, Christine Azevedo-Coste, Charles Fattal, David Guiraud, Jean-Rodolphe Vignes, Luc Bauchet
AIMS: This study assesses the potential of epispinal (subdural) stimulation application in the treatment of urinary and bowel neurological disorders. Acute experiments were performed on a large animal model - the domestic pig - to develop a new methodology facilitating future results and technology transfers to human. METHODS: After rectal and bladder catheterization, four Landrace pigs (45-50 kg) underwent spinal cord surgery - that is, lumbosacral incision, laminectomy [L4-S4], dural opening and microsurgical arachnoid dissection...
June 12, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28600004/the-sacroiliac-joint
#10
REVIEW
David W Polly
The sacroiliac joint moves 2.5°. It is innervated with nociceptive fibers. It is a common cause of low back pain (15%-30%). Degenerative changes occur, especially after lumbosacral fusion. When performed in series, physical examination maneuvers are diagnostic. Confirmatory image-guided injections can aid the diagnosis. In randomized clinical trials, surgical treatment in appropriately selected patients has been demonstrated to be statistically and clinically superior to nonsurgical management.
July 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28599647/association-of-lumbar-spine-stiffness-and-flexion-relaxation-phenomenon-with-patient-reported-outcomes-in-adults-with-chronic-low-back-pain-a-single-arm-clinical-trial-investigating-the-effects-of-thrust-spinal-manipulation
#11
Ting Xia, Cynthia R Long, Robert D Vining, Maruti R Gudavalli, James W DeVocht, Gregory N Kawchuk, David G Wilder, Christine M Goertz
BACKGROUND: Spinal manipulation (SM) is used commonly for treating low back pain (LBP). Spinal stiffness is routinely assessed by clinicians performing SM. Flexion-relaxation ratio (FRR) was shown to distinguish between LBP and healthy populations. The primary objective of this study was to examine the association of these two physiological variables with patient-reported pain intensity and disability in adults with chronic LBP (>12 weeks) receiving SM. METHODS: A single-arm trial provided 12 sessions of side-lying thrust SM in the lumbosacral region over 6 weeks...
June 9, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28594516/lumbar-spine-injuries-in-the-athlete
#12
Dustin H Massel, Kern Singh
Low back pain is the most common complaint expressed by adult patients in the primary care setting, and the incidence of low back pain in adolescents is rising. Adolescents who are involved in athletics most commonly suffer from spondylolysis, spondylolisthesis, mechanical low back pain, and herniated disks, whereas adult athletes most commonly suffer from lumbosacral strain and herniated or degenerative disks. Initial nonsurgical management aims to reduce inflammation and noninvasively strengthen damaged tissues...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28593199/analysis-of-instrumentation-failures-after-three-column-osteotomies-of-the-spine
#13
Niranjan Kavadi, Richard A Tallarico, William F Lavelle
BACKGROUND: Correction of fixed spinal imbalance in a sagittal and/or coronal plane frequently needs a tricolumnar wedge resection when the deformity is rigid. Complications associated with deformity correction surgery are pseudoarthrosis and implant failure located along the construct. The purposes of this study were to assess comparative rates of pseudoarthrosis (implant failure) at weaker points along lumbosacral junction and level of osteotomy, estimate overall incidence of implant failure, and comparatively analyze failures at different points along the construct...
2017: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/28587051/evaluating-intensity-modulated-proton-therapy-relative-to-passive-scattering-proton-therapy-for-increased-vertebral-column-sparing-in-craniospinal-irradiation-in-growing-pediatric-patients
#14
Drosoula Giantsoudi, Joao Seco, Bree R Eaton, F Joseph Simeone, Hanne Kooy, Torunn I Yock, Nancy J Tarbell, Thomas F DeLaney, Judith Adams, Harald Paganetti, Shannon M MacDonald
PURPOSE: At present, proton craniospinal irradiation (CSI) for growing children is delivered to the whole vertebral body (WVB) to avoid asymmetric growth. We aimed to demonstrate the feasibility and potential clinical benefit of delivering vertebral body sparing (VBS) versus WVB CSI with passively scattered (PS) and intensity modulated proton therapy (IMPT) in growing children treated for medulloblastoma. METHODS AND MATERIALS: Five plans were generated for medulloblastoma patients, who had been previously treated with CSI PS proton radiation therapy: (1) single posteroanterior (PA) PS field covering the WVB (PS-PA-WVB); (2) single PA PS field that included only the thecal sac in the target volume (PS-PA-VBS); (3) single PA IMPT field covering the WVB (IMPT-PA-WVB); (4) single PA IMPT field, target volume including thecal sac only (IMPT-PA-VBS); and (5) 2 posterior-oblique (-35°, +35°) IMPT fields, with the target volume including the thecal sac only (IMPT2F-VBS)...
May 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28580360/complete-cranial-iliac-osteotomy-to-approach-the-lumbosacral-foramen
#15
Barbara Dyall, Hugo Schmökel
An approach using a complete cranial iliac osteotomy (CCIO) to access the lumbosacral (LS) foramen in dogs from lateral was developed using cadavers and applied in a clinical patient with degenerative lumbosacral stenosis (DLSS). The foraminal enlargement in the cadavers and the patient was documented on postoperative CT scans. The preoperative CT scan of the patient showed moderate cranial telescoping of the sacral roof and a moderate central disk protrusion, leading to moderate to severe compression of the cauda equina...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28579881/impacts-of-triamcinolone-acetonide-on-femoral-head-chondrocytic-structures-in-lumbosacral-plexus-block
#16
Dashou Wang, Qian Chen, Fengjun Cai, Qi Pan, Xuesong Li, Qianming Wu, Yong Gan, Fei Meng, Ping Luo
Objective: To investigate impacts of triamcinolone acetonide (TRI) on femoral head chondrocytic (FHC) structures when used for lumbosacral plexus block (LPB). Methods: A total of 32 6-month-old New Zealand white rabbits were selected (averagely weighing 2.75-3.25 kg) and added TRI into nerve block solution for LPB. The rabbit were randomly divided into four groups: group A1: 2.5 ml × 2 times, group A2 2.5 ml × 4 times, group B1 5 ml × 2 times, and group B2 5 ml × 4 times; the time interval among the injection was 5 days, and the structural changes of FHC were the observed using 50/100/200 light microscope; the modified Mankin pathological scoring was also performed for the evaluation...
May 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28579621/fetal-pathology-of-neural-tube-defects-an-overview-of-68-cases
#17
Katharina Schoner, Roland Axt-Fliedner, Rainer Bald, Barbara Fritz, Juergen Kohlhase, Thomas Kohl, Helga Rehder
INTRODUCTION: The prevalence of neural tube defects worldwide is 1 - 2 per 1000 neonates. Neural tube defects result from a disturbance of neurulation in the 3rd or 4th week of development and thus represent the earliest manifestation of organ malformation. Neural tube defects (NTD) are classified into cranial dysraphism leading to anencephaly or meningoencephalocele and spinal dysraphism with or without meningomyelocele. In isolated form they have multifactorial causes, and the empirical risk of recurrence in Central Europe is 2%...
May 2017: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/28578842/what-is-the-impact-of-a-spinal-fusion-on-acetabular-implant-orientation-in-functional-standing-and-sitting-positions
#18
Jean Y Lazennec, Ian C Clark, Dominique Folinais, Imen N Tahar, Aidin E Pour
BACKGROUND: This study used EOS imaging of primary total hip arthroplasty (THA) patients, with and without predating spinal fusion, to investigate (1) the impact of spinal fusion on acetabular implant anteversion and inclination, and (2) whether more extensive spinal fusion (fusion starting above the thoracolumbar junction or extension of fusion to the sacrum) affects acetabular implant orientation differently than lumbar only spinal fusion. METHODS: Ninety-three patients had spinal fusion (case group), and 150 patients were without spinal fusion (controls)...
May 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28575334/characterization-of-peripheral-and-central-sensitization-after-dorsal-root-ganglion-intervention-in-patients-with-unilateral-lumbosacral-radicular-pain-a-prospective-pilot-study
#19
V Mehta, S Snidvongs, B Ghai, R Langford, T Wodehouse
Background.: Quantitative sensory testing (QST) has been used to predict the outcome of epidural steroid injections in lumbosacral radicular pain and has the potential to be an important tool in the selection of appropriate treatment (such as epidural steroid injections vs surgery) for patients with chronic radicular pain. In addition, QST assists in identification of the pain pathways of peripheral and central sensitization in selected groups of patients. Methods.: Twenty-three patients were given dorsal root ganglion (DRG) infiltration with local anaesthesia and steroid ('DRG block'), and those who demonstrated at least 50% pain relief were offered pulsed radiofrequency (PRF) to the DRG...
June 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28566158/diagnostic-challenges-in-poems-syndrome-presenting-with-polyneuropathy-a-case-series
#20
Yuebing Li, Jason Valent, Payam Soltanzadeh, Nimish Thakore, Bashar Katirji
OBJECTIVE: To analyze the clinical characteristics of patients with POEMS presenting with polyneuropathy and discuss associated diagnostic challenges. METHOD: Retrospective analysis of 6 patients from 2 tertiary-care institutions. RESULTS: Six patients presented with progressive sensorimotor deficits predominantly or exclusively in the lower extremities and were diagnosed with POEMS syndrome. In 4 patients, a diagnosis of chronic inflammatory demyelinating polyradiculopathy (CIDP) was mistakenly made...
July 15, 2017: Journal of the Neurological Sciences
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