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lumbar spinal new

G C Feigl, C Mattersberger, W Rosmarin, R Likar, C Avila González
BACKGROUND: The success of radiofrequency ablation (RF) of the medial branch of the dorsal ramus in patients with facet joint pain depends on the effective coagulation distance. To date, computed tomography(CT)-guided techniques do not reach the nerve in parallel but rather than punctually. We report a new CT-guided technique to enhance parallelism and proximity of the RF needle to the nerve. MATERIALS AND METHODS: Two examiners with different experience with CT-guided procedures in corpses performed all punctures at the lumbar spine on 10 corpses...
March 21, 2018: Der Schmerz
Huiyi H Chang, Jih-Chao Yeh, Ronaldo M Ichiyama, Larissa V Rodriguez, Leif A Havton
Spinal cord epidural stimulation (SCS) represents a form of neuromodulation for the management of spasticity and pain. This technology has recently emerged as a new approach for potentially augmenting locomotion and voiding function in humans and rodents after spinal cord injury. However, the effect of SCS on micturition has not been studied extensively. Here, SCS was first applied as a direct stimulus onto individual segmental levels of the lumbar spinal cord in rats to map evoked external urethral sphincter (EUS) electromyography activity and SCS-induced voiding contractions...
March 9, 2018: Experimental Neurology
Junji Kamogawa, Osamu Kato, Tatsunori Morizane
PURPOSE: The aim of this study was to introduce a new method of producing three-dimensional (3D) images of vertebral venous plexuses (VVPs) by 3D-MRI with and without contrast media, to identify pathoanatomical features that might accelerate or modify spinal canal stenosis. METHODS: We used a 1.5-T MRI unit with two different 3D sequences with and without contrast media. Multi planar reconstruction (MPR) images of VVPs could be obtained by volume image subtraction methods with a workstation for dural sac from whole 3D volume MPR without contrast media, using images before and after gadoteridol injection...
March 7, 2018: Japanese Journal of Radiology
Shunan Liu, Yuancheng Zhang, Hongda Bao, Peng Yan, Zezhang Zhu, Zhen Liu, Bangping Qian, Yong Qiu
BACKGROUND: A proper restoration of sagittal alignment is essential in AIS patients, but few studies provided a formula to predict an optimal surgical thoracic kyphosis (TK) gain in adolescent idiopathic scoliosis (AIS) patients. A formula was recently proposed (LL = (PI+TK)/2 + 10) to predict the optimal lumbar lordosis (LL) in adult spinal deformity patients, which has not been validated in adolescents. The aim of this study is to establish a formula with TK and pelvic parameters in normal adolescents and predict an optimal TK with this formula pre- and post-operatively in Lenke 1 AIS patients...
March 7, 2018: BMC Musculoskeletal Disorders
G Frigieri, R A P Andrade, C C Wang, D Spavieri, L Lopes, R Brunelli, D A Cardim, R M M Verzola, S Mascarenhas
OBJECTIVE:  We developed a new minimally invasive method for intracranial pressure monitoring (ICPMI). The objective of this project is to verify the similarities between the ICPMI and the invasive method (ICPInv), for different components of the intracranial pressure signal-namely, the mean value (trend) as well as its pulsatile component. MATERIALS AND METHODS:  A 9 kg anesthetized pig was used for simultaneous ICP monitoring with both methods. ICP was increased by performing ten infusions of 6 ml 0...
2018: Acta Neurochirurgica. Supplement
Anshit Goyal, Panagiotis Kerezoudis, Mohammed Ali Alvi, Sandy Goncalves, Mohamad Bydon
A variety of surgical approaches have been described to treat low grade lumbar degenerative spondylolisthesis (DS). Minimally invasive spinal fusion techniques were first introduced to minimize morbidities associated with invasive surgical treatments. Minimally invasive lateral transpsoas interbody fusion, also known as lateral lumbar interbody fusion (LLIF), is a relatively new method of lumbar arthrodesis that avoids various approach related complications compared to its posterior and anterior counterparts...
February 16, 2018: Clinical Neurology and Neurosurgery
Jae-Sung Ahn, Ho-Jin Lee, Dae-Jung Choi, Ki-Young Lee, Sung-Jin Hwang
This study was performed to describe the extraforaminal approach of biportal endoscopic spinal surgery (BESS) as a new endoscopic technique for transforaminal decompression and discectomy and to demonstrate the clinical outcomes of this new procedure for the first time. Twenty-one patients (27 segments) who underwent the extraforaminal approach of BESS between March 2015 and April 2016 were enrolled according to the inclusion and exclusion criteria. The operative time (minutes/level) and complications after the procedure were recorded...
February 23, 2018: Journal of Neurosurgery. Spine
Tangjun Zhou, Lin Du, Chen Chen, Chen Han, Xunlin Li, An Qin, Changqing Zhao, Kai Zhang, Jie Zhao
BACKGROUND/AIMS: Hypertrophic ligamentum flavum (LF) is a major cause of lumbar spinal stenosis. Our previous work showed that high levels of lysophosphatidic acid (LPA) expression are positively correlated with LF hypertrophy. This study aimed to further unveil how LPA regulates LF hypertrophy Methods: We studied LPAR1 expression in human LF cells using PCR and western blotting. Cell viability cell cycle, apoptosis rate and molecular mechanisms were assayed in LPAR1 knockdown or overexpression LF cells...
February 16, 2018: Cellular Physiology and Biochemistry
Michael A Bohl, Randy J Hlubek, U Kumar Kakarla, Steve W Chang
BACKGROUND: A major drawback to the use of cortical bone trajectory pedicle screws (CBTPS) with traditional posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) grafts is that traditional graft insertion trajectories require a wider posterior exposure. This wider exposure, beyond the limits otherwise required for CBTPS placement, negates a primary benefit of CBTPS fixation. OBJECTIVE: To define an alternative surgical technique for interbody graft placement that, when used in conjunction with CBTPS fixation, permits both minimal soft tissue dissection and optimal graft placement...
February 17, 2018: World Neurosurgery
William M Rambo
INTRODUCTION: Septic infection of a lumbar intervertebral disc is a serious disorder which is often difficult to diagnose and appropriately treat because of the rarity of the disease, the varied presentation of symptoms, and the frequency of low-back pain within the overall population. Its etiology can be pyogenic, granulomatous, fungal, or parasitic; its incidence is rising due to increased patient susceptibility and improved diagnostic tools. Conservative treatments involve antibiotics, physical therapy, and/or immobilization...
February 10, 2018: International Journal of Surgery Case Reports
Stanley Sau Ching Wong, Qiu Qiu, Chi Wai Cheung
OBJECTIVE: Lumbar transforaminal epidural steroid injection is commonly used for treating lumbar radicular pain. We report a case of segmental spinal myoclonus that developed during lumbar transforaminal epidural injection with local anesthetic and steroid. CASE REPORT: A 58-year-old woman with failed back surgery syndrome presented with low back and right L3 and L4 radicular pain. As she had responded well previously to diagnostic selective nerve root injection with local anesthetic at the right L3 and L4 levels, lumbar transforaminal epidural steroid injection at the same levels was scheduled...
February 16, 2018: Regional Anesthesia and Pain Medicine
Seba Ramhmdani, Yuanxuan Xia, Risheng Xu, Thomas Kosztowski, Daniel Sciubba, Timothy Witham, Ali Bydon
OBJECTIVE: The diagnosis and surgical management of post-laminectomy spondylolisthesis in patients without pre-operative instability is presented with a review of relevant literature. METHODS: We reviewed the medical records and radiographic studies of 105 patients who underwent first-time bilateral 1-4 level open laminectomies for degenerative lumbar disease at a single academic institution. Patients who initially presented with listhesis and had additional discectomy or fusion procedures were excluded...
February 14, 2018: World Neurosurgery
Joost M Costerus, Matthijs C Brouwer, Diederik van de Beek
Technological advances have changed the indications for and the way in which lumbar puncture is done. Suspected CNS infection remains the most common indication for lumbar puncture, but new molecular techniques have broadened CSF analysis indications, such as the determination of neuronal autoantibodies in autoimmune encephalitis. New screening techniques have increased sensitvity for pathogen detection and can be used to identify pathogens that were previously unknown to cause CNS infections. Evidence suggests that potential treatments for neurodegenerative diseases, such as Alzheimer's disease, will rely on early detection of the disease with the use of CSF biomarkers...
March 2018: Lancet Neurology
Brian M Clemency, Christopher T Tanski, Jennifer Gibson Chambers, Michael O'Brien, Andrew S Knapp, Alexander J Clark, Patrick McGoff, Johanna Innes, Heather A Lindstrom, David Hostler
BACKGROUND: Backboards have been shown to cause pain in uninjured patients. This may alter physical exam findings, leading emergency department (ED) providers to suspect a spinal injury when none exists resulting in additional imaging of the thoracolumbar spine. New York had previously employed a "Spinal Immobilization" protocol that included compulsory backboard application for all patients with suspected spinal injuries. In 2015, New York instituted a new "Spinal Motion Restriction" protocol that made backboard use optional for these patients...
February 15, 2018: Prehospital Emergency Care
Ryutaro Shiboi, Shogo Hayashi, Shinichi Kawata, Zhong-Lian Li, Philipp Pieroh, Hisashi Koga, Yuichi Takano, Hirohiko Inanami, Masahiro Itoh
The pedicle screw is one of the most common medical devices used in spinal surgery. Although there are well-established insertion points based on anatomical landmarks, such as the mammillary process and the transverse process, morphological data on the relationship between the accessory process and the pedicle are still scarce. To clarify this relationship, we recruited 50 cases of hernia of lumbar intervertebral disc, diagnosed using three-dimensional computed tomography of the lumbar vertebrae. We identified the pedicle isthmus in a transverse plane parallel to the upper endplate and measured the angles and distances from the tip of the accessory process to the intersection points at the medial or lateral surface, or at the midpoint between the two intersection points...
February 9, 2018: Anatomical Science International
Andrei F Joaquim, Alpesh A Patel, Gregory D Schroeder, Alexander R Vaccaro
Context Current treatment of TLST should consider injury morphology, neurological status, clinical status (pain and disability) and also multimodal radiological evaluation (MMRE) with CT, MRI and dynamic/ standing plain radiographs. Methods A narrative literature review was performed to propose a treatment algorithm to guide the management of thoracolumbar spinal trauma (TLST). In order to classify injuries and surgical indications, we utilized the two most recent classification systems (TLICS and new AO spine classification) and related recent literature...
February 7, 2018: Journal of Spinal Cord Medicine
Christina Jackson, Brian W Yang, Wenya Linda Bi, E Antonio Chiocca, Michael W Groff
BACKGROUND: Adult tethered cord syndrome is a rare neurological disorder that classically presents with back or leg pain, weakness, and urinary dysfunction. Spinal cord tethering has been associated with acquired Chiari malformations. While the effects of tethered cord release on Chiari malformation symptoms have been previously described, we report an unusual case of acquired tethered cord syndrome following Chiari decompression. CASE DESCRIPTION: We report a 68-year-old man with a history of distant T12-level spinal cord injury who presented with two weeks of progressive bilateral lower extremity weakness...
January 31, 2018: World Neurosurgery
Deeptee Jain, Sigurd Berven, John Carter, Alan L Zhang, Vedat Deviren
BACKGROUND CONTEXT: Severely obese patients with operative spinal pathology present a challenge to the spine surgeon, given the increased complication risk. PURPOSE: Determine the impact of bariatric surgery on perioperative complications of posterior lumbar fusion. STUDY DESIGN: Retrospective cohort study. PATIENT SAMPLE: Patients undergoing posterior lumbar fusion surgery in the State Inpatient Databases (SID) of New York, Florida, North Carolina, Nebraska, Utah, and California...
February 2, 2018: Spine Journal: Official Journal of the North American Spine Society
Kevin M Bell, Adrianna Oh, Harold A Cook, Yiguo Yan, Joon Y Lee
In-vitro biomechanical testing is widely performed for characterizing the load-displacement characteristics of intact, injured, degenerated, and surgically repaired osteoligamentous spine specimens. Traditional specimen fixture devices offer an unspecified rigidity of fixation, while varying in the associated amounts and reversibility of damage to and "coverage" of a specimen - factors that can limit surgical access to structures of interest during testing as well as preclude the possibility of testing certain segments of a specimen...
January 5, 2018: Journal of Biomechanics
Julia Gerhardt, Stefanie Bette, Insa Janssen, Jens Gempt, Bernhard Meyer, Yu-Mi Ryang
OBJECTIVE: An increasing demographic aging of the general population results in a rising incidence of octo- and nonagenarians with spine disease. Patients over 65 years of age represent the majority of patients with degenerative lumbar spine disease in our daily clinical routine. Due to an increased rate of comorbidities indication for surgery is seen very reluctant. We therefore assessed complication rates of lumbar decompression with regard to neurological outcome, medical conditions in patients 80 years or older in a retrospective single center series...
January 29, 2018: World Neurosurgery
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