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Thoracic Manipulation

Eric Z Herring, John H Shin, Sean J Nagel, Ajit A Krishnaney
BACKGROUND: Idiopathic ventral thoracic spinal cord herniation is a rare condition that usually presents with progressive myelopathy or Brown-Séquard syndrome. More than 100 cases have been reported with significant variance in surgical treatment strategies and likewise, significant variance in patient outcomes. Although laminectomy has often been used, to date, there is no consensus regarding the optimal surgical approach or strategy for ventral dural repair. OBJECTIVE: To report and illustrate a novel approach to repair the ventral dural defect with more than 2 yr of clinical follow-up...
December 4, 2018: Operative Neurosurgery (Hagerstown, Md.)
Nicola R Heneghan, S Gormley, C Hallam, Alison Rushton
BACKGROUND: The thoracic spine (TS) is relatively under-researched compared to the neck and low back. As the challenge of managing spinal pain persists, understanding current physiotherapy clinical practice for TS pain and dysfunction is necessary to inform future research in this area. OBJECTIVE: To investigate physiotherapy practice for managing thoracic spine pain and dysfunction (TSPD) in the UK, with a secondary focus on examining differences across settings and expertise...
November 22, 2018: Musculoskeletal Science & Practice
Teresa Kilgore, Marilyn Malia, Brian Di Giacinto, Stephanie Minter, John Samies
Context: In 2012, the US wound registry estimated that the cost of managing chronic wounds in the United States exceeded $50 billion. A large percentage of these wounds are venous stasis ulcers of the lower extremity. Evidence suggests that adjuvant osteopathic manipulative treatment (OMT) may provide a benefit by reducing edema and subsequent healing times in venous stasis ulcers of the lower extremity. Objective: To determine whether a lymphatic OMT protocol improves wound healing rates among patients with lower-extremity edema...
December 1, 2018: Journal of the American Osteopathic Association
Elena Bignami, Francesco Saglietti, Antonio Di Lullo
Mechanical ventilation during surgery is a highly complex procedure, particularly in cardiothoracic surgery, where patients need to undergo substantial hemodynamic management, involving large fluid exchanges and pharmacological manipulation of vascular resistance, as well as direct manipulation of the lungs themselves. Cardiothoracic surgery is burdened by a high rate of postoperative pulmonary complication (PPC), comorbidity, and mortality. Recent trials have examined various techniques to preserve lung function, although consensus on best practice has yet to be reached...
October 2018: Annals of Translational Medicine
Nicola R Heneghan, Sally E Davies, Emilio J Puentedura, Alison Rushton
OBJECTIVES: The perceived relative safety of thoracic thrust joint manipulation (TTJM) has contributed to evidence supporting its use. Yet, TTJM is not without risk, where transient side effects (SE) and severe adverse events (AE) have been documented. With evidence supporting the importance of prethrust examination in reducing AE in other spinal regions this study investigated TTJM knowledge and pre-TTJM examination. Method : An e-survey, informed by existing evidence and expertise was designed and piloted...
December 2018: Journal of Manual & Manipulative Therapy
Bernardo Benussi, Giuseppe Gatti, Florida Gripshi, Federico Biondi, Aldostefano Porcari, Danilo Ruggiero, Manuel Belgrano, Elisabetta Rauber, Gianfranco Sinagra, Aniello Pappalardo
BACKGROUND: To minimize aortic manipulation and maximize use of arterial conduits are aims of modern coronary surgery. METHODS: From March 2012 to October 2016, 890 consecutive patients with multivessel coronary disease underwent isolated coronary surgery using both internal thoracic arteries (ITAs). In 205 (23%; mean age, 67.6±9.2 years), the right ITA was proximally transected and used as free graft, while its in situ stump was elongated with a saphenous vein graft...
November 13, 2018: Annals of Thoracic Surgery
Pedro Belón-Perez, Antonio Ignacio Cuesta-Vargas
OBJECTIVES: The purpose of this study was to evaluate the immediate effect of thoracic spine manipulation upon active flexion and abduction mobility of the shoulder, spine temperature, and the size of the subacromial space as measured by ultrasound in 3 positions (internal, neutral, and external rotation) of the glenohumeral joint in patients who have undergone surgery because of subacromial impingement. METHODS: Quasi-experimental, prospective, short-term effect study with consecutively sampled participants...
September 2018: Journal of Manipulative and Physiological Therapeutics
Takatsugu Fujii, Shusuke Haruta, Yu Ohkura, Aya Honda, Nao Kobayashi, Tsuyoshi Tanaka, Masaki Ueno, Harushi Udagawa
Diaphragmatic eventration refers to an abnormal elevation of the diaphragm. Here, we report the case of a patient with gastric cancer who underwent successful laparoscopic distal gastrectomy despite the presence of diaphragmatic eventration. The patient was a 72-year-old man diagnosed with early gastric cancer in the antrum, as detected by upper gastrointestinal endoscopy. Preoperative imaging revealed an elevation of the left side of the diaphragm, which was diagnosed as diaphragmatic eventration. Laparoscopic surgery is beneficial for obtaining an optimal field of view...
November 8, 2018: Asian Journal of Endoscopic Surgery
Mégane Pasquier, Florian Barbier-Cazorla, Yannick Audo, Martin Descarreaux, Arnaud Lardon
OBJECTIVE: The purpose of this study was to investigate gender differences and expertise effects on biomechanical parameters as well as force accuracy and variability for students learning spinal manipulation. METHODS: A total of 137 fourth- and fifth-year students were recruited for the study. Biomechanical parameters (preload, time to peak force, peak force, rate of force), as well as accuracy and variability of thoracic spine manipulation performance, were evaluated during 5 consecutive trials using a force-sensing table and a target force of 450 N...
November 8, 2018: Journal of Chiropractic Education
Charlie Bouthors, Ahmed Benzakour, Charles Court
BACKGROUND: Surgical treatment of thoracic disc herniation (TDH) is technically demanding due to its proximity to the spinal cord. METHODS: Literature review. RESULTS: Symptomatic TDH is a rare condition predominantly localized between T8 and L1. Surgical indications include intractable back or radicular pain, neurological deficits, and myelopathy signs. Giant calcified TDH (> 40% spinal canal occupation) are frequently associated with myelopathy, intradural extension, and post-operative complications...
November 8, 2018: International Orthopaedics
Kazumasa Orihashi
Transesophageal echocardiography (TEE) provides real-time information on both morphology and hemodynamics without radiation exposure or contrast media, interruption of surgical procedures, or need for transferring the patient to other division, and thus can be used as intraoperative monitoring as well as diagnostic imaging. TEE is helpful for confirming the adequacy of routine surgical procedures, ruling out an occurrence of unexpected adverse events, or even navigating the manipulations of cannulae and catheters...
September 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Rodney Laing, Ivan Timofeev, Roberto Colasanti, Andrew Dean, Alessandro Di Rienzo
OBJECTIVE: Surgical treatment of ventrally located intradural cysts is difficult and controversial. Laminectomy with division of the denticulate ligaments and gentle cord mobilization remains the standard approach but risks further neurologic deterioration secondary to cord manipulation. Our purpose is to evaluate the safety and effectiveness of a midline cord-splitting approach as an alternative for treating ventral thoracic intradural cysts. METHODS: We describe 2 patients who were treated for ventral intradural cysts causing progressive and severe myelopathy...
October 5, 2018: World Neurosurgery
Yoshihiro Uchikado, Satoshi Yoshino, Kenta Ohmure, Hiroyuki Tabata, Shigeki Tateishi, Mitsuru Ohishi
An 84-year-old woman was admitted to our hospital because of congestive heart failure, rapid atrial fibrillation, and ischemic heart disease. Percutaneous coronary intervention (PCI) via the left radial artery was performed, and a stent was deployed successfully into left anterior descending coronary artery (LAD). She got into shock state one hour after PCI. Chest X-ray and computed tomography scan revealed increase of soft tissue around the left axilla and implied the existence of hematoma. Hemoglobin level decreased from 13...
November 2017: Journal of Cardiology Cases
Nishanth Lakshman, Wenjun Xu, Cindi M Morshead
Neural stem cells (NSCs) in the adult mammalian spinal cord are a relatively mitotically quiescent population of periventricular cells that can be studied in vitro using the neurosphere assay. This colony-forming assay is a powerful tool to study the response of NSCs to exogenous factors in a dish; however, this can also be used to study the effect of in vivo manipulations with the proper understanding of the strengths and limitations of the assay. One manipulation of the clinical interest is the effect of injury on endogenous NSC activation...
September 13, 2018: Journal of Visualized Experiments: JoVE
Yichao Han, Yajie Zhang, Hecheng Li
Intrathoracic esophagogastric anastomosis is the mainstay of esophageal reconstruction after esophagectomy for the middle and lower esophageal cancer, which is the majority of esophageal cancer. In spite of the constant development of techniques and instruments for esophageal reconstruction, incidence of anastomotic complications stays high, including anastomotic leak and stricture. The current common esophagogastric anastomosis primarily consists of hand-sewn anastomosis and stapled anastomosis. This review presented different ways of intrathoracic esophagogastric anastomosis in reference to the literatures in China and abroad, and comparisons and analyses were made according to operative techniques, anastomotic complication rates, postoperative mortality rates, etc...
September 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Stefanie S Portelli, Elizabeth N Robertson, Cassandra Malecki, Kiersten A Liddy, Brett D Hambly, Richmond W Jeremy
Genetically triggered thoracic aortic aneurysms (TAAs) account for 30% of all TAAs and can result in early morbidity and mortality in affected individuals. Epigenetic factors are now recognised to influence the phenotype of many genetically triggered conditions and have become an area of interest because of the potential for therapeutic manipulation. Major epigenetic modulators include DNA methylation, histone modification and non-coding RNA. This review examines epigenetic modulators that have been significantly associated with genetically triggered TAAs and their potential utility for translation to clinical practice...
October 2018: Biophysical Reviews
Abigail J Rao, Zoe Teton, Victor Rodriguez, Brandon H Tieu, Ahmed M Raslan
BACKGROUND: Myelomeningocele patients with shunt-dependent hydrocephalus often require multiple shunt revisions, eventually exhausting first-line distal diversion sites. Ventriculoatrial (VA) shunts are used less commonly than ventriculoperitoneal (VP) shunts, but knowledge of their use and complications is important to the neurosurgeon's armamentarium. VA shunts differ from VP and ventriculopleural shunts in that the ideal distal catheter target is an anatomically small area in comparison to the peritoneal and pleural cavities...
September 25, 2018: World Neurosurgery
Oleh Kachmar, Anna Kushnir, Oles Matiushenko, Marko Hasiuk
Objectives: The aim of this study was to investigate the short-term effects of spinal manipulation (SM) on wrist muscle spasticity and manual dexterity in participants with cerebral palsy (CP). Methods: After baseline examination, 78 participants with spastic CP (7-18 years) without contractures or hyperkinetic syndrome were randomly allocated into 2 groups. The experimental group underwent SM to the cervical, thoracic, and lumbar spine, and the control group received sham SM...
September 2018: Journal of Chiropractic Medicine
Monica Henshaw, Paul A Oakley, Deed E Harrison
[Purpose] To present the case of a total reduction of pseudoscoliosis spinal deformity in an adult female suffering from recurrent back pains. [Participant and Methods] A 29 year old female suffering from recurrent back pains was diagnosed with lateral thoracic translation posture; aka pseudoscoliosis. The patient was initially given 12 treatments of relief care including spinal manipulative therapy, then another 24 treatments receiving the same plus mirror image® translation traction and exercises. [Results] The patient achieved a complete reduction of the lateral thoracic translation posture (pseudoscoliosis) as indicated on a post-treatment radiograph after 36 total treatments...
September 2018: Journal of Physical Therapy Science
Göktuğ Akyoldaş, Salim Şentürk, Onur Yaman, Nail Özdemir, Emre Acaroğlu
OBJECTIVE: Thoracic pedicles have special and specific properties. In particular, upper thoracic pedicles are positioned in craniocaudal plane. Therefore, manipulation of thoracic pedicle screws on the left side is difficult for right-handed surgeons. We recommend a new position to insert thoracic pedicle screw that will be much comfortable for spine surgeons. METHODS: We retrospectively reviewed 33 patients who underwent upper thoracic pedicle screw instrumentation...
September 2018: Journal of Korean Neurosurgical Society
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