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https://www.readbyqxmd.com/read/28524751/pseudogout-of-the-cervical-and-thoracic-spine-mimicking-infection-after-lumbar-fusion-case-report
#1
Kelly J Bridges, Carli L Bullis, Ajay Wanchu, Khoi D Than
Pseudogout is a form of acute calcium pyrophosphate deposition (CPPD) disease that typically afflicts the elderly. CPPD commonly involves larger joints, such as the knees, wrists, shoulders, and hips, and has been known to involve the spine. The authors report the case of a 66-year-old woman with a recent history of lumbar laminectomy and fusion who presented 5 weeks postprocedure with a clinical and radiographic picture consistent with multilevel skip lesions involving the cervical and thoracic spine, thoracic discitis, and epidural abscess...
May 19, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28498074/an-analysis-from-the-quality-outcomes-database-part-1-disability-quality-of-life-and-pain-outcomes-following-lumbar-spine-surgery-predicting-likely-individual-patient-outcomes-for-shared-decision-making
#2
Matthew J McGirt, Mohamad Bydon, Kristin R Archer, Clinton J Devin, Silky Chotai, Scott L Parker, Hui Nian, Frank E Harrell, Theodore Speroff, Robert S Dittus, Sharon E Philips, Christopher I Shaffrey, Kevin T Foley, Anthony L Asher
OBJECTIVE Quality and outcomes registry platforms lie at the center of many emerging evidence-driven reform models. Specifically, clinical registry data are progressively informing health care decision-making. In this analysis, the authors used data from a national prospective outcomes registry (the Quality Outcomes Database) to develop a predictive model for 12-month postoperative pain, disability, and quality of life (QOL) in patients undergoing elective lumbar spine surgery. METHODS Included in this analysis were 7618 patients who had completed 12 months of follow-up...
May 12, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28498068/predictors-of-extended-length-of-stay-discharge-to-inpatient-rehab-and-hospital-readmission-following-elective-lumbar-spine-surgery-introduction-of-the-carolina-semmes-grading-scale
#3
Matthew J McGirt, Scott L Parker, Silky Chotai, Deborah Pfortmiller, Jeffrey M Sorenson, Kevin Foley, Anthony L Asher
OBJECTIVE Extended hospital length of stay (LOS), unplanned hospital readmission, and need for inpatient rehabilitation after elective spine surgery contribute significantly to the variation in surgical health care costs. As novel payment models shift the risk of cost overruns from payers to providers, understanding patient-level risk of LOS, readmission, and inpatient rehabilitation is critical. The authors set out to develop a grading scale that effectively stratifies risk of these costly events after elective surgery for degenerative lumbar pathologies...
May 12, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28478791/oblique-intrathecal-injection-in-lumbar-spine-surgery-a-technical-note
#4
Gordon A E Jewett, Daniel Yavin, Perry Dhaliwal, Tara Whittaker, JoyAnne Krupa, Stephan Du Plessis
OBJECTIVES: Intrathecal morphine (ITM) is an efficacious method of providing postoperative analgesia and reducing pain associated complications. Despite adoption in many surgical fields, ITM has yet to become a standard of care in lumbar spine surgery. Spine surgeons' reticence to make use of the technique may in part be attributed to concerns of precipitating a cerebrospinal fluid (CSF) leak. METHODS: Herein we describe a method for oblique intrathecal injection during lumbar spine surgery to minimize risk of CSF leak...
May 8, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28456353/a-prospective-study-of-recovery-from-leg-numbness-following-decompression-surgery-for-lumbar-spinal-stenosis
#5
Hiroki Oba, Takahiro Tsutsumimoto, Mutsuki Yui, Takayuki Kamanaka, Hiroshi Ohta, Hidemi Kosaku, Hiromichi Misawa
BACKGROUND: Residual leg numbness (LN) following lumbar surgery can lower patient satisfaction; however, prospective studies are sparse. The purpose of this study was to evaluate recovery from LN following decompression surgery for lumbar spinal stenosis (LSS). METHODS: A total of 145 patients with LSS were enrolled. All patients underwent decompressive surgery, with or without spinal fusion, followed by a 12 month prospective follow-up. The degree of LN and leg pain (LP) was assessed using the visual analog scale (VAS), a patient-reported outcome measure...
April 26, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28435318/prevalence-characteristics-and-burden-of-failed-back-surgery-syndrome-the-influence-of-various-residual-symptoms-on-patient-satisfaction-and-quality-of-life-as-assessed-by-a-nationwide-internet-survey-in-japan
#6
Shinsuke Inoue, Mitsuhiro Kamiya, Makoto Nishihara, Young-Chang P Arai, Tatsunori Ikemoto, Takahiro Ushida
We conducted a cross-sectional, Internet-based survey with a nationally representative sample of Japanese adults to assess the prevalence and characteristics of failed back surgery syndrome (FBSS). Data regarding the residual symptoms and patient satisfaction from an online survey of 1842 lumbar surgery patients revealed the prevalence of FBSS to be 20.6% (95% confidence interval [CI], 18.8-22.6). The prevalence of low back pain, dull ache, numbness, cold sensations, and paresthesia after surgery was 94.0%, 71...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28385519/complications-and-readmission-after-lumbar-spine-surgery-in-elderly-patients-an-analysis-of-2-320-patients
#7
Ahmed Saleh, Caroline Thirukumaran, Addisu Mesfin, Robert W Molinari
BACKGROUND CONTEXT: There is a paucity of literature describing risk factors for adverse outcomes after geriatric lumbar spinal surgery. As the geriatric population increases, so does the number of lumbar spinal surgeries in this cohort. PURPOSE: The purpose of the study was to determine how safe lumbar surgery is in elderly patients. Does patient selection, type of surgery, length of surgery, and other comorbidities in the elderly patient affect complication and readmission rates after surgery? STUDY DESIGN/SETTING: This is a retrospective cohort study...
April 3, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28379575/no-transfer-of-pressure-to-adjacent-discs-during-human-low-pressure-controlled-discography-a-prospective-clinical-study
#8
Jan Willem Kallewaard, José W Geurts, Michel Terheggen, Chris Terwiel, Alfons Kessels, Maarten van Kleef, Paul C Willems
Background. : A substantial part of low back pain (LBP) originates from degeneration of the intervertebral disc. To confirm the diagnosis of discogenic pain, provocation discography seems the best available tool. However, provocation discography is also considered to be a controversial and subjective test because the patient's personal pain response is the most crucial for the result of the test. Recently, an in vivo porcine study and a study in nine human subjects showed passing of pressure to the adjacent discs during discography...
April 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28374329/the-prevalence-of-tandem-spinal-stenosis-and-its-characteristics-in-a-population-based-mri-study-the-wakayama-spine-study
#9
Keiji Nagata, Noriko Yoshimura, Hiroshi Hashizume, Yuyu Ishimoto, Shigeyuki Muraki, Hiroshi Yamada, Hiroyuki Oka, Hiroshi Kawaguchi, Toru Akune, Sakae Tanaka, Kozo Nakamura, Munehito Yoshida
PURPOSE: Tandem spinal stenosis (TSS) is a condition of combined spinal stenosis in the cervical and lumbar regions. The purpose of this study was to determine the prevalence of radiographic TSS and its association with developmental canal stenosis (DCS). The second purpose was to investigate the extent to which radiographic TSS is associated with cervical myelopathy and symptomatic LSS. METHODS: We recruited 1011 (336 men and 675 women) participants in this population-based study...
April 3, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28372312/the-recovery-of-damaged-paraspinal-muscles-by-posterior-surgical-treatment-for-patients-with-lumbar-degenerative-diseases-and-its-clinical-consequence
#10
Jae-Ryong Cha, Yong-Chan Kim, Wan-Keun Yoon, Won-Gyu Lee, Tae-Hwan Kim, Jae-Keun Oh, Seok-Woo Kim, Suk Hoon Ohn, Ji Hao Cui
BACKGROUND: Posterior lumbar surgery can lead to damage on paraspinal muscles. OBJECTIVE: Our study aimed to examine the recovery in the denervated paraspinal muscles by posterior lumbar surgery and to determine that of improvement in the lower back pain (LBP). METHODS: Depending on surgical treatments, the patients were divided into two groups: The group I (interspinous implantation with decompression) and II (posterior lumbar interbody fusion with decompression)...
March 24, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/28339445/transforaminal-endoscopic-decompression-for-a-giant-epidural-gas-containing-pseudocyst-a-case-report-and-literature-review
#11
Bin Zhu, Liang Jiang, Xiao Guang Liu
The isolated epidural gas-containing pseudocyst is an uncommon pathogenic factor for severe pain of the lower limb as a result of nerve root compression. After reviewing these rare cases reported in the literature, we found that the name, pathogenesis, and treatment strategy of this pathology remained controversial. The most common treatment is conservative treatment or percutaneous aspiration which might result inpoor pain relief and high recurrence rates. Moreover, the patient who received open surgery had good clinical outcome; however, he or she might experience a significant soft tissue injury...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28263225/predictors-of-long-term-opioid-use-following-lumbar-fusion-surgery
#12
Joseph Connolly, Zulqarnain Javed, Mukaila A Raji, Winston Chan, Yong-Fang Kuo, Jacques Baillargeon
STUDY DESIGN: A population-based retrospective cohort study. OBJECTIVE: The aim of this study was to examine risk factors for long-term opioid use following lumbar spinal fusion surgery in a nationally representative cohort of commercially insured adults. SUMMARY OF BACKGROUND DATA: Opioid prescription rates for the management of low back pain have more than doubled in the US over the past decade. Although opioids are commonly used for the management of pain following lumbar spinal fusion surgery, to date, no large-scale nationally representative studies have examined the risk factors for long-term opioid use following such surgical intervention...
March 3, 2017: Spine
https://www.readbyqxmd.com/read/28254514/the-prognostic-value-of-preoperative-participation-in-activities-of-daily-living-on-postoperative-outcomes-following-lumbar-discectomy
#13
Dana A Leonard, Andrew J Schoenfeld, Mitchel B Harris, Christopher M Bono
OBJECTIVES: In other surgical fields, preoperative level of participation in activities of daily living (ADLs) has been found to be important in predicting outcomes. To date, postoperative ADL measurements have only been used to characterize outcomes following lumbar discectomy. The present study's goal was to determine if patients' preoperative ability to perform ADLs correlates with their postoperative outcomes after lumbar discectomy at 3 months and 1 year. PATIENTS AND METHODS: This retrospective study was performed using prospectively collected data from patients prospectively enrolled in a randomized clinical trial...
April 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28248893/risk-factors-for-poor-patient-reported-quality-of-life-outcomes-after-posterior-lumbar-interbody-fusion-an-analysis-of-two-year-follow-up
#14
Takahiro Makino, Takashi Kaito, Hiroyasu Fujiwara, Hirotsugu Honda, Yusuke Sakai, Shota Takenaka, Hideki Yoshikawa, Kazuo Yonenobu
STUDY DESIGN: A retrospective review of prospectively collected data. OBJECTIVE: This study aimed to identify risk factors for poor patient-reported quality of life (QOL) outcomes, based on five categories (pain-related disorders, lumbar spine dysfunction, gait disturbance, social life dysfunction, and psychological disorders) of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), after posterior lumbar interbody fusion (PLIF) at the two-year follow-up...
February 28, 2017: Spine
https://www.readbyqxmd.com/read/28207665/healthy-physical-activity-levels-below-recommended-thresholds-two-years-after-lumbar-spine-surgery
#15
Carol A Mancuso, Roland Duculan, Federico P Girardi
STUDY DESIGN: Prospective analysis. OBJECTIVE: To quantify physical activity after lumbar surgery and identify spine-related variables associated with not meeting recommended activity thresholds. SUMMARY OF BACKGROUND DATA: National guidelines recommend ≥150 minutes/week of moderate-intensity activity; however, only 52% of the general population meets this threshold. For patients not participating in exercise/sports, ≥1400 kcal/week of energy expenditure, including from walking, is another threshold...
February 15, 2017: Spine
https://www.readbyqxmd.com/read/28198782/inpatient-outcomes-in-dialysis-dependent-patients-undergoing-elective-lumbar-surgery-for-degenerative-lumbar-disease
#16
Andrew S Chung, David H Campbell, Joshua W Hustedt, Neil Olmscheid, Norman Chutkan
STUDY DESIGN: . Retrospective cohort study OBJECTIVE.: To evaluate hospital outcomes in dialysis dependent patients undergoing elective lumbar surgeries. SUMMARY OF BACKGROUND DATA: Due to their overall poor health status and concomitant comorbidity burden, spinal surgery in dialysis dependent patients represents a significant challenge to spine surgeons. Large studies evaluating their immediate post-operative outcomes in elective lumbar surgery are lacking. METHODS: Utilizing the National Inpatient Sample (NIS), an estimated 1,834 dialysis-dependent patients undergoing elective lumbar spine surgery for degenerative lumbar conditions were compared to an estimated 2,522,594 non-dialysis dependent patients undergoing the same procedures between 2002 and 2012...
February 14, 2017: Spine
https://www.readbyqxmd.com/read/28181949/lumbar-epidural-blood-patch-via-a-caudal-catheter-after-surgical-dural-tear-and-failed-repair-a-case-report
#17
Michael Dorbad, John Han, Shaik Ahmed, Brian Monroe, Michael Entrup
We report a patient who developed a positional headache and pseudomeningocele after multiple lumbar surgeries for low back and radicular pain. An epidural blood patch via a lumbar approach was not feasible as a result of distorted lumbar anatomy after multiple back surgeries. An epidural blood patch was performed via catheter-threaded cephalad from a caudal approach. The patient had immediate relief after the procedure and at 1 year was still symptom-free. This combination technique may be considered as an alternative approach when a percutaneous lumbar epidural blood patch is disadvantageous...
February 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28164163/change-of-sagittal-spinal-alignment-and-its-association-with-pain-and-function-after-lumbar-surgery-augmented-with-an-interspinous-implant
#18
Rebecca J Crawford, Quentin J Malone, Roger I Price
BACKGROUND: Interspinous spacer/implants like the Device for Intervertebral Assisted Motion (DIAM™) are controversially yet commonly used in the surgical treatment of lumbar degenerative pathologies. Criticism is based on ill-defined indications, lack of superiority over decompression, and a poorly understood mechanical effect. Yet, continued use by surgeons implies their perceived clinical merit. We examined radiographic spinal alignment for 12 months, and pain and function for 24 months, after DIAM-augmented surgery to improve the understanding of the mechanical effect relating to clinical outcomes in patients...
2017: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/28156206/heparin-induced-thrombocytopenia-presenting-as-unilateral-lower-limb-paralysis-following-lumbar-spine-surgery-case-report
#19
Brandon W Smith, Jacob R Joseph, Paul Park
Heparin-induced thrombocytopenia (HIT) is a state of thrombocytopenia with a paradoxically elevated thrombotic potential after exposure to heparin. Severe cases can present with multiorgan involvement with direct and secondary effects. Although HIT has been reported following other surgeries, to the authors' knowledge there has not been a report of HIT after spinal surgery. The present case details the course of a patient who underwent elective lumbar surgery followed by delayed presentation of shortness of breath due to multiple pulmonary embolisms and right lower-extremity paralysis due to extensive iliofemoral clot burden with acute compartment syndrome...
May 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28151913/factors-predicting-surgical-site-infection-after-posterior-lumbar-surgery-a-multicenter-retrospective-study
#20
MULTICENTER STUDY
Tao Wang, Hui Wang, Da-Long Yang, Li-Qiang Jiang, Li-Jun Zhang, Wen-Yuan Ding
This is a retrospective study.The purpose of this study is to explore incidence and risk factors for surgical site infection (SSI) after posterior lumbar surgery.SSI is a common complication after posterior lumbar surgery, bringing mental and physical pain and prolonging hospital stay. However, predisposing factors, as reported less, remain controversial.Patients who underwent posterior lumbar surgery at 3 centers between 2006 and 2016 were included. The possible factors include 3 aspects: demographic variables-age, sex, body mass index (BMI), waist-to-hip radio (WHR), hypertension, diabetes, heart disease, smoking, drinking, steroidal injection, surgical time between June and September, preoperative shower; blood test variables-white blood cell (WBC), neutrophil, red blood cell (RBC), hemoglobin (Hb), total protein (TP), albumin, albumin/globulin (A/G), C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR) and surgical related variables-operation time, blood loss, operative level, instrumentation, incision length...
February 2017: Medicine (Baltimore)
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