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https://www.readbyqxmd.com/read/29443765/clinical-significance-of-superior-articular-process-as-a-reference-point-for-free-hand-pedicle-screw-insertion-in-thoracic-spine
#1
Tae Hoon Kim, Suk Ha Lee, Jae Hyuk Yang, Jae Young Hong, Seung Woo Suh
The trajectory of the pedicle screw perpendicular to the SAP (superior articular process) is consistent with the universal trajectory presented in the previous study of the entry point using computed tomography. The ideal entry point and trajectory of pedicle screw insertion have been a matter of considerable debate. We attempted to find the relationship between SAP and entry point and trajectory of the pedicle screw.Thoracic spine CT (computed tomography) scans of 9 volunteers were studied. A safe zone for the trajectory of the screw in the axial (MarginAx) and sagittal (MarginSag) was defined as the zone between lines perpendicular to the SAP along the medial and lateral cortex of the pedicle in the axial section, and the superior and inferior cortex in the sagittal section without violation of the pedicle walls...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29438136/risk-factors-for-low-bone-mineral-density-in-pediatric-inflammatory-bowel-disease-the-positive-role-of-physical-activity
#2
Stefano Nobile, Richard J Grand, Helen M Pappa
OBJECTIVE: In pediatric inflammatory bowel disease (IBD), the prevalence of low bone mineral density (BMD) and bone fractures and the relationship between these are still debated. Our aim was to report data from a cohort of pediatric patients with IBD. PATIENTS AND METHODS: Cross-sectional assessment of growth and BMD [(dual-energy x-ray absorptiometry (DXA)] and retrospective chart review were performed to report the lifetime prevalence of bone fractures and clinical associations with patients' data...
February 12, 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29433181/craniovertebral-junction-transoral-approach-predictive-factors-of-complications
#3
Aymeric Amelot, Louis-Marie Terrier, Guillaume Lot
BACKGROUND: The transoral approach provides the most direct exposure to extradural lesions of the ventral craniovertebral junction. The morbidity and mortality from this approach greatly limits its use because they are still feared and debated. Using univariable and multivariable logistic regression analyses, this study aims to identify the factors associated with short-term complications in patients undergoing the transoral approach. METHODS: A consecutive cohort analysis of prospectively collected data in several neurosurgery spine departments evaluated 143 consecutive patients who had undergone craniovertebral junction transoral approach surgery...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29372862/damage-capitation-in-the-modern-liability-climate-a-primer-for-neurosurgeons-and-systematic-review-of-the-literature
#4
Jacob R Lepard, Beverly C Walters, Curtis J Rozzelle
OBJECTIVE Neurosurgery, and particularly spine surgery, is among the most highly litigated medical specialties in the US, rendering the current malpractice climate of primary importance to spine surgeons nationwide. One of the primary methods of tort reform in the civil justice system is malpractice damage capitation (or "caps"); however, its efficacy is widely debated. The purpose of this article is to serve as a review for the practicing neurosurgeon, with particular emphasis on short- and long-term effects of damage caps and on the current debate regarding their utility, based on a systematic review of the literature...
January 26, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29352353/regarding-loads-after-spinal-fusion-every-level-should-be-seen-separately-a-musculoskeletal-analysis
#5
A Benditz, S Auer, J F Spörrer, S Wolkerstorfer, J Grifka, F Suess, S Dendorfer
INTRODUCTION: The number of spinal fusion surgeries is steadily increasing and biomechanical consequences are still in debate. The aim of this study is to provide biomechanical insights into the sagittal balance of the spine and to compare spinal load before and after spinal fusion. METHOD: The joint reaction forces of 52 patients were analyzed in proximo-distal and antero-posterior direction from the levels T12-L1 to L5-S1 using musculoskeletal simulations. RESULTS: In 104 simulations, pre-surgical forces were equal to post-surgical...
January 19, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29201564/an-exceptionally-preserved-armored-dinosaur-reveals-the-morphology-and-allometry-of-osteoderms-and-their-horny-epidermal-coverings
#6
Caleb M Brown
Although the evolution and function of "exaggerated" bony projections in ornithischian dinosaurs has been subject to significant debate recently, our understanding of the structure and morphology of their epidermal keratinized coverings is greatly limited. The holotype of Borealopelta, a new nodosaurid ankylosaur, preserves osteoderms and extensive epidermal structures (dark organic residues), in anatomic position across the entire precaudal length. Contrasting previous specimens, organic epiosteodermal scales, often in the form of horn-like (keratinous) sheaths, cap and exaggerate nearly all osteoderms, allowing for morphometric and allometric analyses of both the bony osteoderms and their horny sheaths...
2017: PeerJ
https://www.readbyqxmd.com/read/29200483/biomechanical-analysis-of-range-of-motion-and-failure-characteristics-of-osteoporotic-spinal-compression-fractures-in-human-cadaver
#7
Robert F Heary, Naresh K Parvathreddy, Nitin Agarwal
Background: Vertebroplasty is a treatment for osteoporotic vertebral compression fractures. The optimal location of needle placement for cement injection remains a topic of debate. As such, the authors assessed the effects of location of two types of cement instillations. In addition, the motion and failure modes at the index and adjacent segments were measured. Materials and Methods: Seven human osteoporotic cadaver spines (T1-L4), cut into four consecutive vertebral segments, were utilized...
November 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29186747/-volume-growth-of-inpatient-treatments-for-spinal-disease-analysis-of-german-nationwide-hospital-discharge-data-from-2005-to-2014
#8
Ulrike Nimptsch, Claire Bolczek, Melissa Spoden, Ekkehard Schuler, Josef Zacher, Thomas Mansky
Background Marked volume growth of inpatient treatments for spinal disease has been observed since diagnosis related groups (DRG) were introduced as payment for inpatient services in Germany. This study aims to analyse this increase by population and stratified by types of treatment. Material and Methods Using German nationwide hospital discharge data (DRG statistics), inpatient treatments for spinal disease with or without surgery were identified. Trends in case numbers were analysed from 2005 to 2014 with consideration of demographic changes, in order to explore which age groups and which types of treatment are affected by volume growth...
November 29, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29090349/bone-disease-in-axial-spondyloarthritis
#9
REVIEW
Margot Van Mechelen, Giulia Rossana Gulino, Kurt de Vlam, Rik Lories
Axial spondyloarthritis is a chronic inflammatory skeletal disorder with an important burden of disease, affecting the spine and sacroiliac joints and typically presenting in young adults. Ankylosing spondylitis, diagnosed by the presence of structural changes to the skeleton, is the prototype of this disease group. Bone disease in axial spondyloarthritis is a complex phenomenon with the coexistence of bone loss and new bone formation, both contributing to the morbidity of the disease, in addition to pain caused by inflammation...
October 31, 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/29050896/intraoperative-pedicle-screw-navigation-does-not-significantly-affect-complication-rates-after-spine-surgery
#10
Scott C Wagner, Patrick B Morrissey, Ian D Kaye, Arjun Sebastian, Joseph S Butler, Christopher K Kepler
Various forms of intraoperative computer-assisted navigation technologies exist, and have consistently been shown to improve pedicle screw accuracy. However, the overall clinical effects of inaccurate pedicle screw placement have been debated. We examined the clinical effects of improved pedicle screw accuracy with computer navigation technology in reducing complication rates in patients undergoing multi-level spinal fusion. We retrospectively reviewed the ACS-NSQIP registry utilizing Current Procedural Terminology (CPT) codes 22843 + 22844 to identify patients undergoing spinal instrumentation of greater than 7 levels, as well as the CPT code 61783 to denote the use of intraoperative computer-assisted navigation...
October 16, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29027857/is-there-added-value-in-obtaining-cervical-spine-mri-in-the-assessment-of-nontraumatic-angiographically-negative-subarachnoid-hemorrhage-a-retrospective-study-and-meta-analysis-of-the-literature
#11
Gelareh Sadigh, Chad A Holder, Jeffrey M Switchenko, Seena Dehkharghani, Jason W Allen
OBJECTIVE Diagnostic algorithms for nontraumatic angiographically negative subarachnoid hemorrhage (AN-SAH) vary, and the optimal method remains subject to debate. This study assessed the added value of cervical spine MRI in identifying a cause for nontraumatic AN-SAH. METHODS Consecutive patients 18 years of age or older who presented with nontraumatic SAH between February 1, 2009, and October 31, 2014, with negative cerebrovascular catheter angiography and subsequent cervical MRI were studied. Patients with intraparenchymal, subdural, or epidural hemorrhage; recent trauma; or known vascular malformations were excluded...
October 13, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28980809/elucidating-the-behavior-of-cyclic-volatile-methylsiloxanes-in-a-subarctic-freshwater-food-web-a-modeled-and-measured-approach
#12
Ingjerd S Krogseth, Emma Undeman, Anita Evenset, Guttorm N Christensen, Mick J Whelan, Knut Breivik, Nicholas A Warner
Cyclic volatile methylsiloxanes (cVMS) are used in personal care products and emitted to aquatic environments through wastewater effluents, and their bioaccumulation potential is debated. Here, a new bentho-pelagic version of the ACC-HUMAN model was evaluated for polychlorinated biphenyls (PCBs) and applied to cVMS in combination with measurements to explore their bioaccumulation behavior in a subarctic lake. Predictions agreed better with measured PCB concentrations in Arctic char (Salvelinus alpinus) and brown trout (Salmo trutta) when the benthic link was included than in the pelagic-only model...
November 7, 2017: Environmental Science & Technology
https://www.readbyqxmd.com/read/28962950/transoral-decompression-and-stabilization-of-the-upper-cervical-segments-of-the-spine-using-custom-made-implants-in-various-pathologic-conditions-of-the-craniovertebral-junction
#13
Alexey N Shkarubo, Alexander A Kuleshov, Ilia V Chernov, Marchel S Vetrile, Igor N Lisyansky, Sergey N Makarov, George P Ponomarenko, Michael Spyrou
BACKGROUND: Surgical treatment of patients with atlantoaxial instability caused by pathologic changes of the skull base and craniovertebral junction combined with anterior compression of the brain stem is still associated with substantial technical difficulties and remains a matter of debate. Currently, anterior stabilization of the atlantoaxial junction is a promising approach that allows for the resection of the pathologic lesion of the skull base and craniovertebral junction with subsequent stabilization of C1-C2 or C1-C3 in 1 stage...
September 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28962908/should-long-segment-cervical-fusions-be-routinely-carried-into-the-thoracic-spine-a-multicenter-analysis
#14
Eeric Truumees, Devender Singh, Matthew J Geck, John K Stokes
BACKGROUND CONTEXT: Although recommendations for caudal "end level" in posterior cervical reconstruction remain highly variable, the benefits of routine extension of posterior cervical fusions into the thoracic spine remain unclear. PURPOSE: We compared clinical and radiographic outcomes in patients in whom posterior fusions ended in the cervical spine versus those in whom the fusion was extended into the thoracic spine. STUDY DESIGN/SETTING: A multicenter retrospective analysis of prospectively followed patients was carried out...
September 28, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28915316/plate%C3%A2-pattern-clarification-of-the-marine-dinophyte-heterocapsa-triquetra-sensu-stein-dinophyceae-collected-at-the-kiel-fjord-germany
#15
Urban Tillmann, Mona Hoppenrath, Marc Gottschling, Wolf-Henning Kusber, Malte Elbrächter
One of the most common marine dinophytes is a species known as Heterocapsa triquetra. When Stein introduced the taxon Heterocapsa, he formally based the type species H. triquetra on the basionym Glenodinium triquetrum. The latter was described by Ehrenberg and is most likely a species of Kryptoperidinium. In addition to that currently unresolved nomenclatural situation, the thecal plate composition of H. triquetra sensu Stein (1883) was controversial in the past. To clarify the debate, we collected material and established the strain UTKG7 from the Baltic Sea off Kiel (Germany, the same locality as Stein had studied), which was investigated using light and electron microscopy, and whose systematic position was inferred using molecular phylogenetics...
September 15, 2017: Journal of Phycology
https://www.readbyqxmd.com/read/28904564/the-role-of-pre-reduction-mri-in-the-management-of-complex-cervical-spine-fracture-dislocations-an-ongoing-controversy
#16
Sergiu Botolin, Todd F VanderHeiden, Ernest E Moore, Herbert Fried, Philip F Stahel
BACKGROUND: Cervical spine fracture-dislocations in neurologically intact patients represent a surgical challenge due to the risk of inflicting iatrogenic spinal cord compression by closed reduction maneuvers. The use of MRI for early advanced imaging in these injuries remains controversially debated. CASE PRESENTATION: A 54-year old man sustained a fall over the handlebars of his racing bicycle. The helmeted patient sustained a fall on his head which resulted in a hyperflexion injury of the neck...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28890222/identifying-subsets-of-patients-with-single-level-degenerative-disc-disease-for-lumbar-fusion-the-value-of-prognostic-tests-in-surgical-decision-making
#17
Victor E Staartjes, Pieter-Paul A Vergroesen, Dick J Zeilstra, Marc L Schröder
BACKGROUND CONTEXT: Fusion surgery for degenerative disc disease (DDD) has become a standard of care, albeit not without controversy. Outcomes are inconsistent and a superiority over conservative treatment is debatable. Proper patient selection is key to clinical success, and a comprehensive understanding of prognostic tests does not currently exist. PURPOSE: To investigate the value of prognostic tests and sociodemographic factors in predicting outcomes following lumbar fusion surgery for DDD...
September 7, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28838807/skeletal-health-in-breast-cancer-survivors
#18
REVIEW
Olivier Bruyère, Pierre Bergmann, Etienne Cavalier, Evelien Gielen, Stefan Goemaere, Jean-Marc Kaufman, Serge Rozenberg, Jean-Jacques Body
Although some risk factors for breast cancer might be protective for osteoporosis, several cross-sectional studies have reported, nevertheless, that patients with breast cancer have a lower bone mass and potentially a higher incidence of fractures than expected. In any case, it appears that patients with breast cancer are not protected from osteoporosis, which provides further support for the recommendation that bone health is assessed after a diagnosis of breast cancer. Most adjuvant therapies will lead to increased bone loss and a higher fracture rate...
November 2017: Maturitas
https://www.readbyqxmd.com/read/28755918/indeterminate-dendritic-cell-tumor-in-thoracic-spine-a-case-report-and-review-of-literature
#19
Sze Kiat Tan, Lee Onn Chieng, Karthik Madhavan, Andrew Rosenberg, Ian Cote
Indeterminate dendritic cell tumor (IDCT) is an extremely rare hematological disorder with poorly understood pathogenesis. Occasionally encountered by hematologists, unusual presentations of IDCT have never been reported in the spine literature. The authors report a case of a 51-year-old man who presented with progressively worsening axial thoracic back pain radiating to his sides for three months. MRI revealed a large 3-cm enhancing mass at the T9 vertebral body with an exophytic component causing significant canal stenosis...
July 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28690777/hemangiopericytoma-of-the-thoracic-spine-a-case-report
#20
Luen Shaun Chew, Xinguang Julian Han, Kheng Kooi Tan, Manish Mahadeorao Bundele
Hemangiopericytoma (HPC) has been described to be aggressive and potentially a malignant tumour. We report a rare case of a 63-year-old Chinese male who presented with primary intradural extramedullary HPC of the thoracic spine. The main presenting complaint was gradual progression of back pain, associated with paraparesis and sensory deficit of lower limbs. He had MRI thoracolumbar with contrast which showed T9 lesion compressing on spinal cord and oedema, he was then operated upon and histopathology report confirmed a thoracic spine HPC...
July 2017: Journal of Surgical Case Reports
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