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https://www.readbyqxmd.com/read/28332251/measuring-the-depth-of-the-caudal-epidural-space-to-prevent-dural-sac-puncture-during-caudal-block-in-children
#1
Hyun Jeong Lee, Ji Young Min, Hyun Il Kim, Hyo-Jin Byon
BACKGROUND: Caudal blocks are performed through the sacral hiatus in order to provide pain control in children undergoing lower abdominal surgery. During the block, it is important to avoid advancing the needle beyond the sacrococcygeal ligament too much to prevent unintended dural puncture. This study used demographic data to establish simple guidelines for predicting a safe needle depth in the caudal epidural space in children. METHODS: A total of 141 children under 12 years old who had undergone lumbar-sacral magnetic resonance imaging were included...
March 23, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28331906/associations-between-sarcopenia-and-degenerative-lumbar-scoliosis-in-older-women
#2
Yawara Eguchi, Munetaka Suzuki, Hajime Yamanaka, Hiroshi Tamai, Tatsuya Kobayashi, Sumihisa Orita, Kazuyo Yamauchi, Miyako Suzuki, Kazuhide Inage, Kazuki Fujimoto, Hirohito Kanamoto, Koki Abe, Yasuchika Aoki, Tomoaki Toyone, Tomoyuki Ozawa, Kazuhisa Takahashi, Seiji Ohtori
BACKGROUND: Age-related sarcopenia can cause various forms of physical disabilities. We investigated how sarcopenia affects degenerative lumbar scoliosis (DLS) and lumbar spinal canal stenosis (LSCS). METHODS: Subjects comprised 40 elderly women (mean age 74 years) with spinal disease whose chief complaints were low back pain and lower limb pain. They included 15 cases of DLS (mean 74.8 years) and 25 cases of LSCS (mean age 72.9 years). We performed whole-body dual-energy X-ray absorptiometry (DXA) to analyze body composition, including appendicular and trunk skeletal muscle mass index (SMI; lean mass (kg)/height (m)(2)) and bone mineral density (BMD)...
2017: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/28330796/chronic-low-back-pain-after-lumbosacral-fracture-due-to-sagittal-and-frontal-vertebral-imbalance
#3
L Boyoud-Garnier, M Boudissa, S Ruatti, G Kerschbaumer, P Grobost, J Tonetti
PROBLEM AND HYPOTHESIS: Over time, some patients with unilateral or bilateral lumbosacral injuries experience chronic low back pain. We studied the sagittal and frontal balance in a population with these injuries to determine whether mismatch in the pelvic and lumbar angles are associated with chronic low back pain. PATIENTS AND METHODS: Patients with posterior pelvic ring fractures (Tile C1, C2, C3 and A3.3) that had healed were included. Foreign patients and those with an associated spinal or acetabular fracture or nonunion were excluded...
March 19, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28329489/acquired-blue-nevus-of-the-nail-bed
#4
Daniel M Klufas, Syril Keena T Que, Adrienne Berke, Brett Sloan Maryland
Blue nevi are benign proliferations of melaninproducingdendritic melanocytes located in thedermis. These nevi tend to occur mostly on the skin,predominantly on the head and neck, dorsal aspectsof the distal extremities, and the sacral area, butcan also occasionally appear on mucosal surfaces.Blue nevi of the nail apparatus are uncommon. Themajority originate in the nail matrix where there is ahigher density of melanocytes. Herein we report ona 47-year-old man with a rare common blue nevus ofthe nail bed, an area with low melanocyte density...
February 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/28328326/interleukin-12-and-interleukin-23-blockade-in-leukocyte-adhesion-deficiency-type-1
#5
Niki M Moutsopoulos, Christa S Zerbe, Teresa Wild, Nicolas Dutzan, Laurie Brenchley, Giovanni DiPasquale, Gulbu Uzel, Karen C Axelrod, Andrea Lisco, Lucia D Notarangelo, George Hajishengallis, Luigi D Notarangelo, Steven M Holland
A patient with leukocyte adhesion deficiency type 1 (LAD1) had severe periodontitis and an intractable, deep, nonhealing sacral wound. We had previously found a dominant interleukin-23-interleukin-17 signature at inflamed sites in humans with LAD1 and in mouse models of the disorder. Blockade of this pathway in mouse models has resulted in resolution of the immunopathologic condition. We treated our patient with ustekinumab, an antibody that binds the p40 subunit of interleukin-23 and interleukin-12 and thereby blocks the activity of these cytokines, inhibiting interleukin-23-dependent production of interleukin-17...
March 23, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28327453/combining-transcutaneous-electrical-nerve-stimulation-tens-with-oxybutynin-is-superior-to-monotherapy-in-children-with-urge-incontinence-a-randomized-placebo-controlled-study
#6
L Borch, S Hagstroem, K Kamperis, C V Siggaard, S Rittig
PURPOSE: To evaluate if combination therapy with TENS and oxybutynin results in a superior treatment response than monotherapy with the two modalities in childhood urge incontinence. MATERIALS AND METHODS: In this placebo-controlled study 66 urge incontinent children (mean age 7.3 ± 1.6 years) were randomized into three treatment groups. Group 1: active TENS + active oxybutynin (n = 22). Group 2: active TENS + placebo oxybutynin (n = 21). Group 3: active oxybutynin + placebo TENS (n = 23)...
March 18, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28323708/fenestrated-screws-augmented-with-pmma-increase-the-pullout-strength-of-sacral-pedicle-screws
#7
Matthew Colman, Jonathan Pond, Kent Bachus, Brandon D Lawrence, William R Spiker, Darrel S Brodke
STUDY DESIGN: Biomechanics. OBJECTIVE: The objective of this study was to compare the fixation in osteoporotic specimens of a bicortical sacral pedicle screw to the following constructs: a unicortical solid screw augmented with polymethylmethacrylate (PMMA) (TRACT), a unicortical fenestrated screw augmented with PMMA (FEN), and a bicortical screw/sacral alar screw combination (PED/ALA). SUMMARY OF BACKGROUND DATA: Rigid posterior sacral fixation of osteoporotic spines is problematic due to poor bone quality...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323222/laparoscopic-nerve-preserving-sacropexy
#8
Alfredo Ercoli, Stefano Cosma, Francesca Riboni, Giuseppe Campagna, Paolo Petruzzelli, Daniela Surico, Saverio Danese, Giovanni Scambia, Chiara Benedetto
STUDY OBJECTIVE: to demonstrate our developed nerve preserving technique during laparoscopic sacropexy (LSP) for multicompartment pelvic organ prolapse. DESIGN: exemplificative case of our surgical procedure based on a multicentric experience consisting of more than 800 cases in 10 years without major intraoperative complications. Informed consent was taken from the subject, and the institutional review board approved this research. SETTING: public practice at Maggiore della Carità University Hospital, Novara; at Sant'Anna Hospital, City of Health and Science, University of Torino; at A...
March 17, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28322213/chronic-monitoring-of-lower-urinary-tract-activity-via-a-sacral-dorsal-root-ganglia-interface
#9
Abeer Khurram, Shani Ross, Zachariah Sperry, Aileen Ouyang, Christopher Stephan, Ahmad Jiman, Tim M Bruns
OBJECTIVE: Our goal is to develop an interface that integrates chronic monitoring of lower urinary tract (LUT) activity with stimulation of peripheral pathways. APPROACH: Penetrating microelectrodes were implanted in sacral dorsal root ganglia (DRG) of adult male felines. Peripheral electrodes were placed on or in the pudendal nerve, bladder neck and near the external urethral sphincter. Supra-pubic bladder catheters were implanted for saline infusion and pressure monitoring...
March 21, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/28321356/island-posterior-thigh-flap-revisited-in-covering-extensive-sacral-wounds-our-experience-with-two-patients
#10
F Nangole Wanjala, Ajujo Martin
Deep sacral wounds are best covered by flaps. Posterior thigh flaps have routinely been used to cover such wounds. The flap can however be modified as an island flap. Two patients with extensive sacral wounds were managed with island posterior thigh flaps. Both patients were admitted secondary to road traffic accident with subsequent soft tissue loss of the sacral area. The sacral defects in both patients were approximately 17 cm by 23 cm in dimensions. Unilateral island posterior thigh flap was raised and used to cover the wounds...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28321171/presacral-venous-bleeding-during-mobilization-in-rectal-cancer
#11
Jose Enrique Casal Núñez, Vincenzo Vigorita, Alejandro Ruano Poblador, Ana María Gay Fernández, Maria Ángeles Toscano Novella, Nieves Cáceres Alvarado, Lucinda Pérez Dominguez
AIM: To analyze the anatomy of sacral venous plexus flow, the causes of injuries and the methods for controlling presacral hemorrhage during surgery for rectal cancer. METHODS: A review of the databases MEDLINE(®) and Embase™ was conducted, and relevant scientific articles published between January 1960 and June 2016 were examined. The anatomy of the sacrum and its venous plexus, as well as the factors that influence bleeding, the causes of this complication, and its surgical management were defined...
March 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28306640/cervical-alignment-variations-in-different-postures-and-predictors-of-normal-cervical-kyphosis-a-new-understanding
#12
Hwee Weng Dennis Hey, Eugene Tze-Chun Lau, Chengyuan Gordon Wong, Kimberly-Anne Tan, Gabriel Ka-Po Liu, Hee-Kit Wong
STUDY DESIGN: Prospective comparative study OBJECTIVE.: To predict physiological alignment of the cervical spine and study its morphology in different postures. SUMMARY OF BACKGROUND DATA: There is increasing evidence that normal cervical spinal alignment may vary from lordosis to neutral to kyphosis, or form S-shaped or reverse S-shaped curves. METHODS: Standing, erect sitting and natural sitting whole spine radiographs were obtained from 26 consecutive patients without cervical spine pathology...
March 16, 2017: Spine
https://www.readbyqxmd.com/read/28303561/extraforaminal-lumbar-interbody-fusion-at-the-l5-s1-level-technical-considerations-and-feasibility
#13
Arthur Robert Kurzbuch, Denis Kaech, Pawel Baranowski, Alicja Baranowska, Didier Recoules-Arche
Background Extraforaminal lumbar interbody fusion (ELIF) surgery is a muscle-sparing approach that allows the treatment of various degenerative spinal diseases. It is technical challenging to perform the ELIF approach at the L5-S1 level because the sacral ala obstructs the view of the intervertebral disk space. Methods We reported earlier on the ELIF technique in which the intervertebral disk is targeted at an angle of 45 degrees relative to the midline. In this article we describe the technical process we developed to overcome the anatomic relation between the sacral ala and the intervertebral disk space L5-S1 that hinders the ELIF approach at this level...
March 16, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28302363/new-surgical-technique-for-creation-of-a-continent-appendicostomy-invaginated-appendicostomy
#14
Maria Zornoza, Alejandro Ruiz-Montañez, Guillermo Victoria-Morales, Luis De la Torre-Mondragón
INTRODUCTION: The main complications of appendicostomy are stenosis and stomal fecal leakage. Although many authors report that the appendix is naturally continent, it is recommended to perform a plication of the cecum with the appendix to prevent stomal fecal leakage. We present here the creation of a different continent mechanism. Our technique is advantageous when the anatomy, vascularity, or the length of the appendix does not allow for a standard plication procedure. DESCRIPTION OF OPERATIVE TECHNIQUE: During 2014-2016 we performed four appendicostomies in patients with anorectal malformations with fecal incontinence that requested an "Antegrade Continent Enema" procedure after a successful bowel management program in the Colorectal Center for Children of Mexico...
March 7, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28298708/outcomes-of-sacral-nerve-stimulation-for-faecal-incontinence-in-northern-ireland
#15
G W Irwin, B V Dasari, R Irwin, D Johnston, K Khosraviani
BACKGROUND: Sacral nerve root stimulation (SNS) is an effective and developing therapy for faecal incontinence, a debilitating condition that can result in social and personal incapacitation. OBJECTIVES: The objectives of this study are to assess the morbidity of the procedure, improvement in the incontinence scores and Quality of Life (QoL) following SNS. MATERIALS AND METHODS: Patients were identified from the Northern Ireland regional SNS service from 2006 to 2012...
January 2017: Ulster Medical Journal
https://www.readbyqxmd.com/read/28293486/sacral-insufficiency-fractures-recognition-and-treatment-in-patients-with-concurrent-lumbar-vertebral-compression-fractures
#16
Jesse Hatgis, Michelle Granville, Robert E Jacobson, Aldo Berti
INTRODUCTION: In reviewing a larger group of osteoporotic vertebral compression fractures (VCFs), we found that the overall incidence of sacral insufficiency fractures (SIFs) is higher than commonly reported values. This is especially seen in patients with previous or concurrent lumbar VCFs and also in a subgroup that had lumbar stenosis or hip arthroplasty. The altered biomechanics due to associated lumbar stenosis or hip arthroplasty lead to increased mechanical stress on already weakened and deficient sacral alae, which are more vulnerable to osteoporotic weakening than other parts of the sacrum...
February 2, 2017: Curēus
https://www.readbyqxmd.com/read/28292518/the-management-of-penetrating-rectal-and-anal-trauma-a-systematic-review
#17
Daniel P Ahern, Michael E Kelly, Danielle Courtney, Emanuele Rausa, Des C Winter
INTRODUCTION: Traumatic injuries to the lower gastrointestinal tract (rectum and anus) have been largely reported in the military setting with sparse publications from the civilian setting. Additionally, there remains a lack of international consensus regarding definitive treatment pathways. This systematic review aimed to assess the current literature and propose a standardised treatment algorithm to aid management in the civilian setting. METHODS: A systematic review of available literature from 1999 to 2016 that was performed...
March 7, 2017: Injury
https://www.readbyqxmd.com/read/28291560/-sacral-erythemato-violaceous-lobulated-tumor-case-for-diagnosis
#18
Mariem Mohamed, Ines Lahouel, Faten Hammedi, Yosra Soua, Faouzi Noomen, Jameleddine Zili
No abstract text is available yet for this article.
March 10, 2017: Annales de Pathologie
https://www.readbyqxmd.com/read/28291010/ectopic-pelvic-kidney-mimicking-sacral-metastasis-on-post-therapy-iodine-131-scan-of-a-thyroid-cancer-patient
#19
Selin Soyluoğlu Demir, Gül Ege Aktaş, Ahmet Polat, Ali Sarıkaya
A 25-year-old woman had total thyroidectomy and iodine-131 ablation therapy for papillary thyroid carcinoma. Whole body imaging on the 7(th) day of therapeutic activity demonstrated radioiodine uptake in the remnant tissue and intense heterogeneous uptake at the sacral region prominently in the posterior image. Initial interpretation was suspicious for sacral metastasis. Technetium-99m-methylene diphosphonate bone scan demonstrated normal bone uptake and the absence of left kidney. On blood-pool phase of bone scan, the absence of left renal activity and an extra area of uptake in the sacral region suggestive of pelvic kidney were noticed...
February 5, 2017: Molecular Imaging and Radionuclide Therapy
https://www.readbyqxmd.com/read/28288047/bertolotti-syndrome-demonstrated-on-18f-naf-pet-ct
#20
Sharjeel Usmani, Najeeb Ahmed, Fahad Marafi, Fareeda Al Kandari
Bertolotti syndrome is a form of low-back pain associated with lumbosacral transitional vertebrae. We report a case of a 34-year-old woman with breast cancer presented with severe low-back pain. F-NaF PET/CT demonstrates increased radiotracer uptake at the transverse-sacral articulation corresponding to hemisacralized left transverse process of L5 vertebra. Increased tracer uptake in patients with lumbosacral transitional vertebrae seems to correlate with lower-back pain symptoms. F-NaF PET/CT can be useful in evaluation of some uncommon causes of low-back pain...
March 10, 2017: Clinical Nuclear Medicine
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