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Vivek Palepu, Melvin Helgeson, Michael Molyneaux-Francis, Srinidhi Nagaraja
Several approaches (anterior, posterior, lateral, and transforaminal) are used in lumbar fusion surgery. However, it is unclear whether one of these approaches has the greatest subsidence risk as published clinical rates of cage subsidence vary widely (7-70%). Specifically, there is limited data on how a patient's endplate morphometry and trabecular bone quality influences cage subsidence risk. Therefore, this study compared the subsidence between anterior (ALIF), lateral (LLIF), posterior (PLIF), and transforaminal (TLIF) lumbar interbody fusion cage designs to understand the impact of endplate and trabecular bone quality on subsidence...
December 5, 2018: Journal of Biomechanical Engineering
Uruj Zehra, Jason Pui Yin Cheung, Cora Bow, William Lu, Dino Samartzis
The aim of the current study was to investigate the multi-dimensional characteristics of lumbar endplate defects in humans in relation to disc degeneration and other MRI phenotypes as well as their role with pain and disability. 108 subjects were recruited and underwent 3T MRI of the lumbar spine. Structural endplate defects were identified and their dimensions were measured in terms of maximum width and depth, and were then standardized to the actual width of the endplate and depth of the vertebral body, respectively...
December 4, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Li-Tai Ma, Yi Yang, Hao Liu, Bei-Yu Wang, Yu-Xiao Deng, Chen Ding, Quan Gong, Tao Li
OBJECTIVE: To explore a method of modified incision to prevent the postoperative spinal lateral angulation via anterior approach for lumbar fracture. METHODS: A total 40 patients with lumbar fracture from January 2016 to Jun 2017 were internalized in the study. Including 28 males and 12 females, aged from 27 to 68 years with an average of (39.5±14.9) years. Among them, 28 cases caused by high fall, 9 cases by heavy injury, 3 cases by traffic accidents; and 35 fractures were located at L₁,4 at L₂,1 at L₃...
November 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Nicola Yan Ying Lee, Bak Siew Steven Wong
An 82-year-old woman presented with neck pain and bilateral upper limb paraesthesia after sustaining an unwitnessed fall at home the day before. Physical examination revealed tenderness over the C4-6 region but no evidence of step deformity or neurological deficit. Magnetic resonance imaging of the cervical spine revealed multiple small fractures at the anteroinferior endplate corners of the C3, C5 and C6 vertebrae with focal kyphosis and marrow oedema at these levels, as well as associated disruption of the anterior longitudinal ligament and central spinal canal stenosis...
November 2018: Singapore Medical Journal
Divya Krishnamoorthy, Robert C Hoy, Devorah M Natelson, Olivia M Torre, Damien M Laudier, James C Iatridis, Svenja Illien-Jünger
Back pain is a leading cause of disability strongly associated with intervertebral disc (IVD) degeneration. Reducing structural disruption and catabolism in IVD degeneration remains an important clinical challenge. Pro-oxidant and structure-modifying advanced glycation end-products (AGEs) contribute to obesity and diabetes, which are associated with increased back pain, and accumulate in tissues due to hyperglycemia or ingestion of foods processed at high heat. Collagen-rich IVDs are particularly susceptible to AGE accumulation due to their slow metabolic rates yet it is unclear if dietary AGEs can cross the endplates to accumulate in IVDs...
November 29, 2018: Disease Models & Mechanisms
(no author information available yet)
OBJECTIVEFixed sagittal spinal malalignment is a common problem in adult spinal deformity (ASD). Various three-column osteotomy techniques, including the extended pedicle subtraction osteotomy (ePSO), may correct global and regional malalignment in this patient population. In contrast to the number of reports on traditional PSO (Schwab grade 3 osteotomy), there is limited literature on the outcomes of ePSO (Schwab grade 4 osteotomy) in ASD surgery. The objective of this retrospective study was to provide focused investigation of radiographic outcomes and complications of single-level lumbar ePSO for ASD patients with fixed sagittal malalignment...
November 1, 2018: Journal of Neurosurgery. Spine
(no author information available yet)
OBJECTIVEAtlantoaxial instability is an important cause of pain and neurological dysfunction in patients with Down syndrome (DS), frequently requiring instrumented fusion of the upper cervical spine. This study provides a quantitative analysis of C2 morphology in DS patients compared with their peers without DS to identify differences that must be considered for the safe placement of instrumentation.METHODSA retrospective chart review identified age-matched patients with and without DS with a CT scan of the cervical spine...
November 1, 2018: Journal of Neurosurgery. Spine
Hironobu Sakaura, Atsunori Ohnishi, Akira Yamagishi, Tetsuo Ohwada
Study Design: Retrospective cohort study. Purpose: We recently reported that when compared to posterior lumbar interbody fusion (PLIF) using traditional pedicle screw fixation, PLIF with cortical bone trajectory screw fixation (CBT-PLIF) provided favorable clinical outcomes and reduced the incidence of symptomatic adjacent segment pathology, but resulted in relatively lower fusion rates. Since titanium-coated polyetheretherketone (PEEK) cages (TP) could improve and accelerate fusion status after CBT-PLIF, early fusion status was compared between CBT-PLIF using TP and carbon PEEK cages (CP)...
November 29, 2018: Asian Spine Journal
Dorthe Schoeler Ziegler, Leah Carreon, Mikkel Oesterheden Andersen, Rikke Krüger Jensen
STUDY DESIGN: This cohort study was an analysis of prospectively collected data in the DaneSpine Database. OBJECTIVE: The objective was to determine whether pre-operative magnetic resonance imaging (MRI) findings were associated with the frequency of surgical revision due to recurrent lumbar disc herniation (LDH) within three years after first-time, single-level, simple lumbar discectomy. SUMMARY OF BACKGROUND DATA: Because of a risk of poorer outcome in patients receiving revision surgery compared to first-time discectomy, there is a need to identify patients with LDH in risk of surgical revision prior to the primary discectomy...
November 20, 2018: Spine
Jian-Feng Zhang, Gang-Liang Wang, Zhi-Jie Zhou, Xiang-Qian Fang, Shuai Chen, Shun-Wu Fan
OBJECTIVE: Turnover of cartilage endplate extracellular matrix (ECM) may play an important role in disc degeneration and low back pain (LBP). However, the expression pattern of pro-inflammatory factors, matrix metalloproteinases (MMP), and tissue inhibitors of metalloproteinases (TIMP) in the cartilage endplates (CEP) of intervertebral discs (IVD) is not understood. We aimed to examine the transcriptional levels of MMP, TIMP, and interleukins (IL), and the correlations between them. METHODS: Thirty degenerated cartilage endplate samples from patients with LBP who underwent lumbar fusion surgery were included in the degenerated group...
November 2018: Orthopaedic Surgery
Chester J Donnally, Karthik Madhavan, Alexander J Butler, Jonathan I Sheu, Dustin H Massel, Barth A Green, Joseph P Gjolaj
Surgical treatment of high-grade spondylolisthesis and spondyloptosis is recommended in symptomatic patients, yet there exists much debate regarding the optimal surgical approach and the need for reduction. Similar to the Bohlman technique in that fixation is achieved across two vertebral endplates, we discuss a novel technique with the advantage of using bilateral threaded pedicle screws of large diameter and length instead of a single fibula allograft. Patients underwent posterior instrumented fusion without spondylolisthesis reduction using a novel technique placing pedicle screws with a transvertebral trajectory through the two end plates involved in the spondylolisthesis...
November 20, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Sarah E Gullbrand, Beth G Ashinsky, Edward D Bonnevie, Dong Hwa Kim, Julie B Engiles, Lachlan J Smith, Dawn M Elliott, Thomas P Schaer, Harvey E Smith, Robert L Mauck
Tissue engineering holds great promise for the treatment of advanced intervertebral disc degeneration. However, assessment of in vivo integration and mechanical function of tissue-engineered disc replacements over the long term, in large animal models, will be necessary to advance clinical translation. To that end, we developed tissue-engineered, endplate-modified disc-like angle ply structures (eDAPS) sized for the rat caudal and goat cervical spines that recapitulate the hierarchical structure of the native disc...
November 21, 2018: Science Translational Medicine
Andrea Hanson-Kahn, Bing Li, Daniel H Cohn, Deborah A Nickerson, Michael J Bamshad, Louanne Hudgins
Stickler syndrome is a connective tissue disorder characterized by hearing loss, ocular anomalies, palatal defects, and skeletal abnormalities. The autosomal dominant form is the most common, but autosomal recessive forms have also been described. We report the second case of autosomal recessive Stickler syndrome due to homozygosity for a loss of function mutation in COL9A3, which encodes the α3 chain of type IX procollagen. The clinical features were similar to the previously described COL9A3 Stickler syndrome family, including moderate to severe sensorineural hearing loss, high myopia, and both tibial and femoral bowing at birth...
November 18, 2018: American Journal of Medical Genetics. Part A
K Lagerstrand, H Hebelka, H Brisby
PURPOSE: The aim was to (1) verify our previous finding that endplates (EPs) display load-induced T2-changes, (2) investigate whether vertebrae display load-induced T2-changes and (3) investigate whether EPs and vertebrae in LBP patients and controls display T2-differences during conventional unloaded MRI and axial loaded MRI (alMRI). METHODS: Twenty-seven patients (mean 39 years) and 12 (mean 38 years) controls were examined with T2-mapping on a 1.5 T scanner during conventional unloaded MRI and subsequently during alMRI (Dynawell® loading device), separated by approximately 20 min...
November 17, 2018: European Spine Journal
Yunfei Hang, Jijun Liu, Lei Guo, Yibin Meng, Dingjun Hao, Jinpeng Du
OBJECTIVE: To introduce a new operation for isthmic spondylolysis in teenagers and to evaluate its clinical efficacy. METHODS: Thirty cases of teenage isthmic spondylolysis patients with chronic low back pain underwent "temporary" short-segmental pedicle screw combined with transverse device fixation and isthmic bone graft repair treatment. X-ray and CT images were evaluated during the regular follow-up to confirm successful bone graft fusion, after which the fixation was removed...
November 15, 2018: World Neurosurgery
Miao Yu, Yinze Diao, Yu Sun, Fengshan Zhang, Shengfa Pan, Xin Chen, Feifei Zhou, Yanbin Zhao, Nanfang Xu
BACKGROUND CONTEXT: An anteroposterior combined approach has been used for the treatment of congenital cervical or cervicothoracic scoliosis. However, its outcomes and surgical risks have not been clarified. PURPOSE: We analyzed the characteristics of congenital cervical and cervicothoracic scoliosis and evaluated the outcomes of an anteroposterior combined approach for its treatment. STUDY DESIGN: We carried out a retrospective clinical study of prospectively collected data...
November 14, 2018: Spine Journal: Official Journal of the North American Spine Society
Kousei Miura, Masao Koda, Masaki Tatsumura, Itsuo Shiina, Takeo Mammoto, Atsushi Hirano, Tetsuya Abe, Toru Funayama, Hiroshi Noguchi, Masashi Yamazaki
Charcot spinal arthropathy (CSA) is a rare spinal disorder presenting neuropathic osteoarthropathy of facet joints leading to progressive destruction. After L4-5 PLIF, a 63-year-old woman with Parkinson's disease (PD) underwent L3-4 and L5-S1 PLIF for primary adjacent segment disease caused by degenerative change, which was found as facet joint osteophytes and a vacuum disc phenomenon with endplate sclerosis. However, her postural disorder from PD deteriorated, and strong opioid analgesics were administered for severe recurring low back pain...
November 13, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Masahito Oshina, Yasushi Oshima, Sakae Tanaka, K Daniel Riew
Study Design: Systematic review. Objectives: Diagnosis of pseudarthrosis after anterior cervical fusion is difficult, and often depends on the surgeon's subjective assessment because recommended radiographic criteria are lacking. This review evaluated the available evidence for confirming fusion after anterior cervical surgery. Methods: Articles describing assessment of anterior cervical fusion were retrieved from MEDLINE and SCOPUS. The assessment methods and fusion rates at 1 and 2 years were evaluated to identify reliable radiographical criteria...
October 2018: Global Spine Journal
Stephen J Lewis, Sam G Keshen, So Kato, Taylor E Dear, Aaron M Gazendam
Study Design: A retrospective case-control study. Objectives: To determine factors influencing the ability to achieve coronal balance following spinal deformity surgery. Methods: Following institutional ethics approval, the radiographs of 47 patients treated for spinal deformity surgery with long fusions to the pelvis, were retrospectively reviewed. The postoperative measurements included coronal balance, L4 tilt, and L5 tilt, levels fused, apical vertebral translation and maximum Cobb angle...
October 2018: Global Spine Journal
Constanze Kiese, Hans-Peter Landgraf, Anna-Lena Danzer, Benedikt Schickling, Anna Nicolau-Torra, Torsten Reitmeier, Wilhelm Schulter-Mattler, Dietrich von Schweinitz, Herrmann Ketterl
The purpose of this study was to develop a user-friendly presentation of surface-EMG data in near-time for intraoperative nerve-monitoring. We have built a novel surface-EMG probe as a diagnostic device to investigate innervation patterns of sphincter muscles in further clinical diagnostic studies. S-EMG data were recorded from 20 healthy volunteers from the orbicularis oris muscles. We developed an automated analysis based on correlation in order to find phase inversions and thus innervation zones automatically...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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