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Fernando Ruiz Santiago, Pablo Tomás Muñoz, Elena Moya Sánchez, Marta Revelles Paniza, Alberto Martínez Martínez, Antonio Luis Pérez Abela
This article describes different types of vertebral fractures that affect the thoracolumbar spine and the most relevant contributions of the different classification systems to vertebral fracture management. The vertebral fractures types are based on the three columns model of Denis that includes compression, burst, flexion-distraction and fracture-dislocation types. The most recent classifications systems of these types of fractures are reviewed, including the Thoracolumbar Injury Classification and Severity score (TLICS) and the Arbeitsgemeinschaft für Osteosynthesefragen Spine Thoracolumbar Injury Classification and Severity score (AOSpine-TLICS)...
December 2016: Quantitative Imaging in Medicine and Surgery
Taemin Oh, Renaud Lafage, Virginie Lafage, Themistocles Protopsaltis, Vincent Challier, Christopher Shaffrey, Han Jo Kim, Paul Arnold, Jens Chapman, Frank Schwab, Eric Massicotte, Tim Yoon, Shay Bess, Michael Fehlings, Justin Smith, Christopher Ames
BACKGROUND: Although cervical spondylotic myelopathy (CSM) can be devastating, its relative impact on general health remains unclear. Patient responses to the SF-36 PCS/MCS were compared between CSM and other diseases to evaluate their respective impacts on quality of life. OBJECTIVE: Compare SF-36 PCS/MCS scores in CSM to population and disease-specific norms. METHODS: Retrospective analysis of a prospective, multi-center AOSpine North American CSM Study database...
January 5, 2017: World Neurosurgery
Philippe Gillet
No abstract text is available yet for this article.
October 2016: Acta Chirurgica Belgica
Mehmet Onur Yüksel, Mehmet Sabri Gürbüz, Merih Iş, Hakan Somay
AIM: The aim of this study was to determine whether Thoracolumbar Injury Classification and Severity Score (TLICS) and AOSpine Thoracolumbar Injury Classification System have any superiority to each other regarding the reliability of their recommendations in the surgical management of unstable thoracolumbar burst fractures. MATERIAL AND METHODS: Fifty-five consecutive patients with thoracolumbar burst fractures undergoing instrumentation between 2010 and 2015 were analyzed retrospectively...
November 18, 2016: Turkish Neurosurgery
Gregory D Schroeder, James S Harrop, Alexander R Vaccaro
Useful thoracolumbar injury classifications allow for meaningful and concise communication between surgeons, trainees, and researchers. Although many have been proposed, none have been able to obtain universal acceptance. Historically, classifications focused only on the osseous injuries; more recent classifications focused on the injury morphology and other critical determinants of treatment, including the posterior ligamentous complex integrity and the patient's neurologic status. This review details the important historic classifications and reviews more contemporary thoracolumbar injury classifications, such as the Thoracolumbar Injury Classification System and the AOSpine Thoracolumbar Injury Classification System...
January 2017: Neurosurgery Clinics of North America
Aria Nouri, Allan Martin, Lindsay Tetreault, Anick Nater, So Kato, Hiroaki Nakashima, Narihito Nagoshi, Hamed Reihani-Kermani, Michael G Fehlings
STUDY DESIGN: Ambispective Analysis OBJECTIVE.: To report the global prevalence of specific degenerative cervical pathologies in patients with DCM through detailed review of MRIs SUMMARY OF BACKGROUND DATA.: Degenerative Cervical Myelopathy (DCM) encompasses a spectrum of age-related conditions that result in progressive spinal cord injury. METHODS: MRIs of 458 patients (age 56.4 +/-11.8, 285 Male, 173 Female) patients were reviewed for specific degenerative features, directionality of cord compression, levels of spinal cord compression, and signal changes on T2WI and T1WI...
November 16, 2016: Spine
Dean Chou, Mark H Bilsky, Alessandro Luzzati, Charles G Fisher, Ziya L Gokaslan, Laurence D Rhines, Mark B Dekutoski, Michael G Fehlings, Ravi Ghag, Peter Varga, Stefano Boriani, Niccole M Germscheid, Jeremy J Reynolds
OBJECTIVE Malignant peripheral nerve sheath tumors (MPNSTs) are rare soft-tissue sarcomas. Resection is the mainstay of treatment and the most important prognostic factor. However, complete resection of spinal MPNSTs with tumor-free margins is challenging due to the likelihood of residual tumor cells. The objective of this study was to describe whether the type of Enneking resection in the management of spinal MPNSTs had an effect on local recurrence and survival. METHODS The AOSpine Knowledge Forum Tumor developed a multicenter database that includes demographic, diagnostic, therapeutic, local recurrence, and survival data on patients with primary spinal column tumors...
November 11, 2016: Journal of Neurosurgery. Spine
Jie Cheng, Peng Liu, Dong Sun, Tingzheng Qin, Zikun Ma, Jingpei Liu
PURPOSE: The objective of this study was to analyze the interobserver reliability and intraobserver reproducibility of the new AOSpine thoracolumbar spine injury classification system in young Chinese orthopedic surgeons with different levels of experience in spinal trauma. Previous reports suggest that the new AOSpine thoracolumbar spine injury classification system demonstrates acceptable interobserver reliability and intraobserver reproducibility. However, there are few studies in Asia, especially in China...
November 2, 2016: European Spine Journal
Jeffrey C Wang, Jens R Chapman, Karsten Wiechert
No abstract text is available yet for this article.
November 2016: Global Spine Journal
Christopher D Witiw, Lindsay A Tetreault, Fabrice Smieliauskas, Branko Kopjar, Eric M Massicotte, Michael G Fehlings
BACKGROUND CONTEXT: Degenerative cervical myelopathy (DCM) represents the most common cause of non-traumatic spinal cord impairment in adults. Surgery has been shown to improve neurologic symptoms and functional status, but it is costly. As sustainability concerns in the field of health care rise, the value of care has come to the forefront of policy decision-making. Evidence for both health-related quality of life outcomes and financial expenditures is needed to inform resource allocation decisions...
January 2017: Spine Journal: Official Journal of the North American Spine Society
Gregory D Schroeder, Mark F Kurd, Christopher K Kepler, James C Krieg, Jefferson R Wilson, Conor P Kleweno, Reza Firoozabadi, Carlo Bellabarba, Frank Kandizoria, Klause J Schnake, S Rajesekaran, Marcel F Dvorak, Jens R Chapman, Luiz R Vialle, F C Oner, Alexander R Vaccaro
Study Design Survey study. Objective To determine the global perspective on controversial aspects of sacral fracture classifications. Methods While developing the AOSpine Sacral Injury Classification System, a survey was sent to all members of AOSpine and AOTrauma. The survey asked four yes-or-no questions to help determine the best way to handle controversial aspects of sacral fractures in future classifications. Chi-square tests were initially used to compare surgeons' answers to the four key questions of the survey, and then the data was modeled through multivariable logistic regression analysis...
November 2016: Global Spine Journal
Nasir A Quraishi, Stefano Boriani, Silviu Sabou, Peter P Varga, Alessandro Luzzati, Ziya L Gokaslan, Michael G Fehlings, Charles G Fisher, Mark B Dekutoski, Laurence D Rhines, Jeremy J Reynolds, Niccole M Germscheid, Chetan Bettegowda, Richard P Williams
BACKGROUND CONTEXT: Spinal osteoid osteomas are benign primary tumours arising predominantly from the posterior column of the spine. These 'osteoblastic' lesions have traditionally been treated with intralesional excision. PURPOSE: The purpose of this study was to review the treatment and local recurrence rates for symptomatic spinal osteoid osteomas. STUDY DESIGN/SETTING: Multicentre ambispective cross-sectional observational cohort study...
October 17, 2016: Spine Journal: Official Journal of the North American Spine Society
Chetan Bettegowda, Stephen Yip, Sheng-Fu Larry Lo, Charles G Fisher, Stefano Boriani, Laurence D Rhines, Joanna Y Wang, Aron Lazary, Marco Gambarotti, Wei-Lien Wang, Alessandro Luzzati, Mark B Dekutoski, Mark H Bilsky, Dean Chou, Michael G Fehlings, Edward F McCarthy, Nasir A Quraishi, Jeremy J Reynolds, Daniel M Sciubba, Richard P Williams, Jean-Paul Wolinsky, Patricia L Zadnik, Ming Zhang, Niccole M Germscheid, Vasiliki Kalampoki, Peter Pal Varga, Ziya L Gokaslan
BACKGROUND: Chordomas are rare, locally aggressive bony tumors associated with poor outcomes. Recently, the single nucleotide polymorphism (SNP) rs2305089 in the T (brachyury) gene was strongly associated with sporadic chordoma development, but its clinical utility is undetermined. METHODS: In 333 patients with spinal chordomas, we identified prognostic factors for local recurrence-free survival (LRFS) and overall survival and assessed the prognostic significance of the rs2305089 SNP...
September 23, 2016: Neuro-oncology
Michael G Fehlings, Carlo Santaguida, Lindsay Tetreault, Paul Arnold, Giuseppe Barbagallo, Helton Defino, Shashank Kale, Qiang Zhou, Tim S Yoon, Branko Kopjar
BACKGROUND CONTEXT: It remains unclear whether cervical laminoplasty (LP) offers advantages over cervical laminectomy and fusion (LF) in patients undergoing posterior decompression for degenerative cervical myelopathy (DCM). PURPOSE: The objective of this study is to compare outcomes of LP and LF. STUDY DESIGN/SETTING: This is a multicenter international prospective cohort study. PATIENT SAMPLE: A total of 266 surgically treated symptomatic DCM patients undergoing cervical decompression using LP (N=100) or LF (N=166) were included...
January 2017: Spine Journal: Official Journal of the North American Spine Society
Parker E Bohm, Michael G Fehlings, Branko Kopjar, Lindsay A Tetreault, Alexander R Vaccaro, Karen K Anderson, Paul M Arnold
BACKGROUND CONTEXT: The timed 30-m walking test (30MWT) is used in clinical practice and in research to objectively quantify gait impairment. The psychometric properties of 30MWT have not yet been rigorously evaluated. PURPOSE: This study aimed to determine test-retest reliability, divergent and convergent validity, and responsiveness to change of the 30MWT in patients with degenerative cervical myelopathy (DCM). STUDY DESIGN/SETTING: A retrospective observational study was carried out...
August 31, 2016: Spine Journal: Official Journal of the North American Spine Society
Dino Samartzis, Jason Pui Yin Cheung, Shanmuganathan Rajasekaran, Yoshiharu Kawaguchi, Shankar Acharya, Mamoru Kawakami, Shigenobu Satoh, Wen-Jer Chen, Chun-Kun Park, Chong-Suh Lee, Thanit Foocharoen, Hideki Nagashima, Sunguk Kuh, Zhaomin Zheng, Richard Condor, Manabu Ito, Motoki Iwasaki, Je Hoon Jeong, Keith D K Luk, Bambang Prijambodo, Amol Rege, Tae-Ahn Jahng, Zhuojing Luo, Warat Tassanawipas, Narayana Acharya, Rohit Pokharel, Yong Shen, Takui Ito, Zhihai Zhang, Janardhana Aithala P, Gomatam Vijay Kumar, Rahyussalim Ahmad Jabir, Saumyajit Basu, Baojun Li, Vishal Moudgil, Ben Goss, Phoebe Sham, Richard Williams
STUDY DESIGN: An international, multicenter cross-sectional image-based study performed in 33 institutions in the Asia Pacific region. OBJECTIVE: The study addressed the role of facet joint angulation and tropism in relation to L4-L5 degenerative spondylolisthesis (DS). METHODS: The study included 349 patients (63% females; mean age: 61.8 years) with single-level DS; 82 had no L4-L5 DS (group A) and 267 had L4-L5 DS (group B). Axial computed tomography and magnetic resonance imaging were utilized to assess facet joint angulations and tropism (i...
August 2016: Global Spine Journal
Anick Nater, Lindsay L Tetreault, Aileen M Davis, Arjun A Sahgal, Abhaya V Kulkarni, Michael G Fehlings
OBJECTIVE: Accurate prediction of surgical outcomes in patients suffering from metastatic epidural spinal cord compression (MESCC) is challenging. This survey aims to obtain expert opinion on which preoperative clinical factors are the most relevant predictors of survival, neurologic, functional, and health-related quality of life (HRQoL). METHODS: Members of AOSpine International were invited to participate in a 15-question electronic survey. Results from the entire sample and differences across geographic regions and between neurosurgeons and orthopedic surgeons were analyzed...
September 2016: World Neurosurgery
Michael G Fehlings, Branko Kopjar, Robert G Grossman
INTRODUCTION: There is convincing evidence from the preclinical realm that the pharmacologic agent riluzole attenuates certain aspects of the secondary injury cascade leading to diminished neurological tissue destruction in animal spinal cord injury (SCI) models. The safety and pharmacokinetic profile of riluzole have been studied in a multicenter pilot study in 36 patients. Efficacy of riluzole in acute human SCI has not been established. METHODS: This ongoing multi-center, international double-blinded phase III randomized controlled trial will enroll 351 patients with acute C4 C8 SCI and ASIA Impairment Grade A, B, or C randomly assigned 1:1 to riluzole and placebo...
August 2016: Neurosurgery
Aria Nouri, Allan R Martin, Lindsay Tetreault, Anick Nater, So Kato, Hiroaki Nakashima, Narihito Nagoshi, Hamed Reihani-Kermani, Michael G Fehlings
INTRODUCTION: Degenerative cervical myelopathy (DCM) encompasses a spectrum of age-related conditions that result in progressive spinal cord injury through static and dynamic injury mechanisms. Through detailed review of MRIs from prospective AOSpine multicenter studies, the global prevalence of degenerative cervical pathologies of surgically treated DCM patients is reported. METHODS: MRIs of 458 patients were obtained from North America (n = 197), Europe (n = 92), Latin America (n = 57), and Asia-Pacific (n = 112) and assessed for the type of pathology, source of stenosis, level of maximum cord compression, levels of spinal cord compression (SCC), presence of signal changes on T2-weighted images (T2WI) and T1-weighted images, and the levels of T2WI signal change...
August 2016: Neurosurgery
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