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Kevin Phan, Joshua Xu, Daniel B Scherman, Prashanth J Rao, Ralph J Mobbs
STUDY DESIGN: A systematic review and meta-analysis OBJECTIVE.: To investigate the outcomes of anterior lumber interbody fusion (ALIF) with and without an "access surgeon". SUMMARY OF BACKGROUND DATA: Anterior approaches for spine operations have become increasingly popular but may often involve unfamiliar anatomy and territory for spine surgeons, potentially placing the patient at risk to a greater proportion of approach-related complications. Thus many spine surgeons require or prefer the assistance of an "access surgeon" to perform the exposure...
September 23, 2016: Spine
Anthony J Boniello, Kushagra Verma, Austin Peters, Baron S Lonner, Thomas Errico
BACKGROUND: Pre-donation of autologous blood prior to spine fusion for adolescent idiopathic scoliosis (AIS) has been used in deformity surgery. The effect of pre-donation on pre-operative hematocrit (Hct) remains debated. Multiple factors may influence pre-operative Hct including intravascular volume status, patient factors, and timing of pre-operative blood donation. The purpose of this study was to determine if pre-donation significantly lowers pre-incision Hct in AIS patients. METHODS: A retrospective cohort study of a Level-1 prospective randomized trial was conducted...
2016: International Journal of Spine Surgery
Masatoshi Teraguchi, Dino Samartzis, Hiroshi Hashizume, Hiroshi Yamada, Shigeyuki Muraki, Hiroyuki Oka, Jason Pui Yin Cheung, Ryohei Kagotani, Hiroki Iwahashi, Sakae Tanaka, Hiroshi Kawaguchi, Kozo Nakamura, Toru Akune, Kenneth Man-Chee Cheung, Noriko Yoshimura, Munehito Yoshida
INTRODUCTION: High intensity zones (HIZ) of the lumbar spine are a phenotype of the intervertebral disc noted on MRI whose clinical relevance has been debated. Traditionally, T2-weighted (T2W) magnetic resonance imaging (MRI) has been utilized to identify HIZ of lumbar discs. However, controversy exists with regards to HIZ morphology, topography, and association with other MRI spinal phenotypes. Moreover, classification of HIZ has not been thoroughly defined in the past and the use of additional imaging parameters (e...
2016: PloS One
Varun Puvanesarajah, Rabia Qureshi, Jourdan M Cancienne, Hamid Hassanzadeh
Cervical spine trauma in the athlete is not an insignificant occurrence with possibly catastrophic results. Football remains one of the most common and most well studied sporting activities associated with spine injuries. Transient spinal cord and peripheral nerve injuries may manifest as quadriparesis or burners/stingers with symptoms that resolve completely. More severe spinal cord injuries, typically from axial loading on the cervical spine, will cause bilateral symptoms with residual neurological deficit...
September 16, 2016: Clinical Spine Surgery
Felipe J Bodaleo, Christian Gonzalez-Billault
The capacity of the nervous system to generate neuronal networks relies on the establishment and maintenance of synaptic contacts. Synapses are composed of functionally different presynaptic and postsynaptic compartments. An appropriate synaptic architecture is required to provide the structural basis that supports synaptic transmission, a process involving changes in cytoskeletal dynamics. Actin microfilaments are the main cytoskeletal components present at both presynaptic and postsynaptic terminals in glutamatergic synapses...
2016: Frontiers in Molecular Neuroscience
John Frederick Burke, John K Yue, Laura Benjamin Ngwenya, Ethan A Winkler, Jason Talbott, Jonathan Pan, Adam Ferguson, Michael Beattie, Jacqueline Bresnahan, Jenny Haefeli, William Whetstone, Catherine Suen, Michael C Huang, Geoffrey T Manley, Phiroz E Tarapore, Sanjay S Dhall
INTRODUCTION: Spinal cord injury (SCI) is a devastating condition with very few treatment options. Surgical decompression of the spine after injury has been shown to improve outcomes; however, the optimal timing of surgery is a matter of debate. METHODS: We collected data from 78 patients with SCI. Based on the time to surgical decompression, we grouped patients into an ultra-early group (decompression within 12 hours of presentation), an early group (within 12-24 hours), and a late group (>24 hours)...
August 2016: Neurosurgery
Aymeric Amelot, Joseph Cristini, Céline Salaud, Alexis Moles, Olivier Hamel, Philippe Moreau, Eric Bord, Kevin Buffenoir
STUDY DESIGN: Fifty-one patients with spinal multiple myeloma (MM) metastases were operated and followed between January 2004 and July 2014. OBJECTIVE: To consider the efficiency of surgical prognosis scores in the management of spinal metastases myelomas SUMMARY OF BACKGROUND DATA.: The spine is the most common site of bone metastases in Multiple Myeloma (MM). Surgery in spine metastases MM is a matter of debate and its impact on the increase of a patient's survival time is not clear...
July 7, 2016: Spine
Beth Linker
Just as the prevalence of scoliosis began to decline precipitously after World War II, American orthopedic surgeon Dr. Paul R. Harrington devised a new, invasive surgical system whereby implantable prosthetic metal rods and hooks were used to straighten curved backs. By the 1970s, "Harrington rods" had become the gold standard of surgical scoliosis care in the United States, replacing more conventional methods of exercise, bracing, and casting. This article situates the success of Harrington rods within a much larger and historically longer debate about why, when compared to those in other nations, American surgeons appear to be "more aggressive" and "knife-happy...
2016: Bulletin of the History of Medicine
Wei Tian, Kai Yan, Xiao Han, Jie Yu, Peihao Jin, Xiaoguang Han
STUDY DESIGN: Prospective non-randomized comparative study. OBJECTIVE: To compare the long-term clinical and radiographic results of cervical artificial disc replacement (CADR) and anterior cervical discectomy and fusion (ACDF), and to provide our evidence whether CADR could reduce adjacent segment degeneration (ASD). SUMMARY OF BACKGROUND DATA: CADR is widely used in spine surgery today. In spite of the short-term results of it having been ascertained, the long-term results are still under observation...
June 28, 2016: Clinical Spine Surgery
Symeon Missios, Kimon Bekelis
BACKGROUND CONTEXT: The value of continuity of care in preventing 30-day readmissions after surgical procedures remains an issue of debate. PURPOSE: To investigate the association of being evaluated in the Emergency Room (ER) of the hospital where the original procedure was performed with 30-day readmissions for spine surgery patients. STUDY DESIGN/SETTING: Cohort study PATIENT SAMPLE.: 16,483 spine surgery patients being evaluated in the ED within 30-days postoperatively OUTCOME MEASURES...
June 24, 2016: Spine Journal: Official Journal of the North American Spine Society
Ryan Mattie, Katri Laimi, Sloane Yu, Mikhail Saltychev
BACKGROUND: Vertebral compression fractures are a common complication of osteoporosis and are often treated by percutaneous vertebroplasty (PVP). The ability of this procedure to relieve pain better than conservative treatment is still debated. The purpose of this study was to compare the degree and duration of pain relief following PVP with that following conservative treatment for osteoporotic compression fractures by means of meta-analysis of randomized controlled trials. METHODS: The CENTRAL (Cochrane Central Register of Controlled Trials), MEDLINE, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Web of Science databases were queried for randomized controlled trials comparing PVP with conservative treatment or placebo/sham...
June 15, 2016: Journal of Bone and Joint Surgery. American Volume
Ali Shahrami, Majid Shojaee, Seyed Mohammadreza Tabatabaee, Elaheh Mianehsaz
INTRODUCTION: Necessity of imaging for symptom-free conscious patients presented to emergency department (ED) following traumatic thoracolumbar spine injuries has been a matter of debate. The present study was aimed to evaluate the diagnostic value of clinical findings in prediction of traumatic thoracolumbar injuries compared tocomputed tomography (CT) scan. METHODS: The present diagnostic value study was carried out using non-random convenience sampling during the time between October 2013 and March 2014...
2016: Emergency (Tehran, Iran)
R Kayser, G Harke
The application of various techniques in manual medicine on infants, toddlers and adolescents enjoys widespread acknowledgement not only in the musculoskeletal field but also beyond that. For a long time, the seminars of the DGMM have been trying to structure the advanced training of doctors and the vocational training of physiotherapists and to adjust it according to the latest clinical and scientific findings (in this subject matter). Considering the controversial debates, this seems particularly necessary and meaningful...
June 2016: Der Orthopäde
N V Todd, R A Dickson
What constitutes cauda equina syndrome (CES), how it should be subclassified and how urgently to image and operate on patients with CES are all matters of debate. A structured review of the literature has led us to evaluate the science and to propose evidence-based guidelines for the management of CES. Our conclusions include this guidance: pain only; MRI negative - recommend: analgesia, ensure imaging complete (not just lumbar spine) adequate follow-up. Bilateral radiculopathy (CESS) with a large central disc prolapse - recommend: discuss with the patient and if for surgery, the next day (unless deteriorates to CESI in which case emergency surgery); CESI - recommend: the true emergency for surgery by day or night; a large central PLID with uncertainty as to whether CESI or CESR (e...
October 2016: British Journal of Neurosurgery
Lea-Marie Wieser, Sven Sauermann, Friedrich Weber
Objective The number of cases of spinal DRGs (German Diagnosis-Related Groups) is calculated on the basis of the data released by the German DRG-Institute. The data thus obtained were subsequently compared with the previously publicly debated data of cases, which were based on the counting of OPS (German Procedure Classification) codes. Methods Specific and Nonspecific Spinal DRGs are identified according to the German Coding Guidelines and the OPS catalogs. Those are verified in a multistage process, including the formation of test cases, to ensure that those DRGs consistently contain spinal cases...
September 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
T Graillon, K Farah, P Rakotozanany, B Blondel, T Adetchessi, H Dufour, S Fuentes
INTRODUCTION: Anterior approach indications in unstable thoracolumbar fractures (UTLF) are debated. The aim of this study was to evaluate the results of anterior fixation and expandable prosthetic vertebral body cage (EPVBC) implantation alone or combined with a posterior approach in the management of UTLF. MATERIALS AND METHODS: Ninety-three patients underwent anterior fixation with implantation of an EPVBC for UTLF from T7 to L5. Long-term kyphosis and vertebral height loss reduction, functional outcomes including visual analogical scale and Oswestry disability index were evaluated...
April 2016: Neuro-Chirurgie
C Eller-Vainicher, A Bassotti, A Imeraj, E Cairoli, F M Ulivieri, F Cortini, M Dubini, B Marinelli, A Spada, I Chiodini
UNLABELLED: The Ehlers-Danlos syndrome is characterized by abnormal connective tissue but bone involvement is debated. We found a reduced BMD and bone quality and increased prevalence of asymptomatic vertebral fractures in eugonadal patients with Ehlers-Danlos syndrome. These findings suggest the need of a bone health evaluation in these patients. INTRODUCTION: The Ehlers-Danlos (EDS) syndrome is characterized by abnormalities of the connective tissue leading to ligamentous laxity and skin and tissue fragility...
August 2016: Osteoporosis International
Aaron J Buckland, Joseph F Baker, Ryan P Roach, Jeffrey M Spivak
PURPOSE: Cervical disc replacement has become an acceptable alternative to anterior cervical fusion for the surgical treatment of cervical spine spondylosis resulting in radiculopathy or myelopathy following anterior discectomy and decompression. This concise overview considers the current state of knowledge regarding the continued debate of the role of cervical disc replacement with an update in light of the latest clinical trial results. METHODS: A literature review was performed identifying clinical trials pertaining to the use of cervical disc replacement compared to cervical discectomy and fusion...
June 2016: International Orthopaedics
Benjamin C Mayo, Dustin H Massel, Daniel D Bohl, William W Long, Krishna D Modi, Kern Singh
STUDY DESIGN: Case-series OBJECTIVE.: To investigate changes in intraoperative and postoperative parameters associated with the surgical learning curve for anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA: ACDF is a common surgical spine procedure. The surgical learning curve for this procedure has not been previously characterized. METHODS: A prospectively maintained surgical database of consecutive patients who underwent primary 1-2 level ACDF for degenerative spine disease from 2006-2014 was reviewed...
March 30, 2016: Spine
Rosalia Crupi, Daniela Impellizzeri, Giuseppe Bruschetta, Marika Cordaro, Irene Paterniti, Rosalba Siracusa, Salvatore Cuzzocrea, Emanuela Esposito
Spinal cord injury (SCI) stimulates activation of astrocytes and infiltration of immune cells at the lesion site; however, the mechanism that promotes the birth of new neurons is still under debate. Neuronal regeneration is restricted after spinal cord injury, but can be stimulated by experimental intervention. Previously we demonstrated that treatment co-ultramicronized palmitoylethanolamide and luteolin, namely co-ultraPEALut, reduced inflammation. The present study was designed to explore the neuroregenerative properties of co-ultraPEALut in an estabished murine model of SCI...
2016: Frontiers in Pharmacology
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