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https://www.readbyqxmd.com/read/28340495/residents-learning-curve-of-lumbar-transforaminal-epidural-steroid-injections
#1
Holger Joswig, Sarah Roberta Haile, Gerhard Hildebrandt, Martin Nikolaus Stienen
Background and Study Aims There is a paucity of literature on beginners' training and on its connection with patient safety for transforaminal epidural steroid injections (TFESIs). This study retrospectively assessed the learning curves and associated complications of neurosurgery residents never previously exposed to TFESI and compared them with experienced board-certified faculty neurosurgeons (BCFNs). Material and Methods Procedure time in minutes, dose-area product (DAP) in cGy*cm(2), periprocedural observations, and complications in 354 TFESIs for radicular pain secondary to lumbar disk herniation or lumbar spinal stenosis were extracted from operative notes and the electronic infiltration logbook in the per-injection format...
March 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28331980/combined-intra-extradural-approach-for-posterolateral-thoracic-disk-herniations-preliminary-study-and-technical-note
#2
Antonio Bocchetti, Valentina Cioffi, Raffaele de Falco
Purpose Thoracic disk herniation is uncommon. It still represents a challenge for spinal surgeons. Multiple surgical strategies are available and, often, they are matter of debate. We describe a preliminary experience about a combined extra-intra dural approach for posterolateral disk herniation in patients affected by spinal cord compression. METHODS: We performed a combined extra-intra dural approach in two preliminary cases. We performed bilateral laminectomy of adjacent vertebrae and unilateral partial medial arthrectomy of the involved segment...
March 22, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28320028/extent-of-decompression-of-lumbar-spinal-canal-after-endoscopic-surgery
#3
Naresh Kumar Dewanngan, Yad Ram Yadav, Vijay Singh Parihar, Shailendra Ratre, Yatin Kher, Pushpraj Bhatele
Introduction Endoscopic techniques are being used in lumbar disk disease and lumbar canal stenosis to decompress the spinal canal. The present study analyzed pre- and postoperative magnetic resonance imaging (MRI) measurements of the lumbar canal. Material and Methods This was a prospective study of 30 lumbar levels. Patients < 18 years of age with unilateral compression, previous surgery at the same level, and spinal instability were excluded. Endoscopic posterior decompression was used. Pre- and postoperative MRIs of all the patients were performed...
March 20, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28303561/extraforaminal-lumbar-interbody-fusion-at-the-l5-s1-level-technical-considerations-and-feasibility
#4
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/28295616/associations-between-anesthetic-variables-and-functional-outcome-in-dogs-with-thoracolumbar-intervertebral-disk-extrusion-undergoing-decompressive-hemilaminectomy
#5
J Fenn, E Laber, K Williams, C A Rousse, P J Early, C L Mariani, K R Muñana, S De Decker, H A Volk, N J Olby
BACKGROUND: Outcome of acute experimental spinal cord injury is strongly associated with tissue perfusion and oxygenation. Cardiopulmonary depression could affect outcome in dogs undergoing general anesthesia for surgical treatment of thoracolumbar intervertebral disk extrusion (IVDE). HYPOTHESIS/OBJECTIVES: To evaluate the effects of general anesthesia on functional outcome in dogs undergoing surgery to treat thoracolumbar IVDE. ANIMALS: Eighty-four client-owned dogs with acute thoracolumbar IVDE treated by decompressive hemilaminectomy...
March 13, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28266959/morphometric-analysis-of-the-retroperitoneal-vessels-with-respect-to-lateral-access-surgery-in-adult-scoliosis
#6
Heeren S Makanji, Hai Le, Kirkham B Wood, Louis G Jenis, Thomas D Cha
STUDY DESIGN: Cross-sectional study reviewing 62 magnetic resonance imaging or computed tomography scans from consecutive adult patients with scoliotic spinal deformity in the thoracolumbar spine. OBJECTIVE: To investigate the variation in anatomic position of retroperitoneal vessels in relationship to curve direction, location, magnitude, and axial rotation of curves in adult scoliosis. SUMMARY OF BACKGROUND DATA: The minimally invasive lateral approach to the thoracolumbar spine avoids manipulation of abdominal and retroperitoneal structures and decreases risk of injury to paraspinal musculature...
March 6, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28253289/comparison-of-harmonic-blade-versus-traditional-approach-in-canine-patients-undergoing-spinal-decompressive-surgery-for-naturally-occurring-thoracolumbar-disk-extrusion
#7
Bianca F Hettlich, Laurie Cook, Cheryl London, Geoffrey T Fosgate
OBJECTIVES: To assess feasibility of the harmonic Osteovue blade (HOB) for use in the soft tissue approach for dogs undergoing hemilaminectomy and to compare outcomes between dogs undergoing HOB or traditional approach (TRAD). METHODS: A prospective randomized clinical trial was performed using 20 client-owned dogs with thoracolumbar intervertebral disk extrusion requiring hemilaminectomy. Dogs were randomly assigned to HOB or TRAD. Neurologic function and pain scores were assessed pre-operatively...
2017: PloS One
https://www.readbyqxmd.com/read/28207618/magnetic-resonance-imaging-evaluation-of-the-effects-of-surgical-invasiveness-on-paravertebral-muscles-after-muscle-preserving-interlaminar-decompression-mild
#8
Hitoshi Tonomura, Yoichiro Hatta, Yasuo Mikami, Takumi Ikeda, Tomohisa Harada, Masateru Nagae, Hironori Koike, Hitoshi Hase, Toshikazu Kubo
STUDY DESIGN: This is a retrospective study. OBJECTIVES: The aim of this study was to determine the extent of damage to the paravertebral muscles after muscle-preserving interlaminar decompression (MILD) using magnetic resonance imaging to evaluate changes in the multifidus muscle (MF). SUMMARY OF BACKGROUND DATA: Short-term surgical outcomes of MILD for lumbar spinal canal stenosis (LSCS) are satisfactory; however, the extent of damage to the paravertebral muscles after MILD remains unclear...
March 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28202380/impact-of-surgical-site-infection-and-surgical-debridement-on-lumbar-arthrodesis-a-single-institution-analysis-of-incidence-and-risk-factors
#9
Timothy Y Wang, Adam G Back, Eliza Hompe, Kevin Wall, Oren N Gottfried
This study identifies the rate of pseudarthrosis following surgical debridement for deep lumbar spine surgical site infection and identify associated risk factors. Patients who underwent index lumbar fusion surgery from 2013 to 2014 were included if they met the following criteria: 1) age >18years, 2) had debridement of deep lumbar SSI, and had 3) lumbar spine AP, lateral and flexion/extension X-rays and computed tomography (CT) at 12months or greater postoperatively. Criteria for fusion included 1) solid posterolateral, facet, or disk space bridging bone, 2) no translational or angular motion on flexion/extension X-rays, and 3) intact posterior hardware without evidence of screw lucency or breakage...
February 12, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28191383/minimally-invasive-direct-lateral-interbody-fusion-mis-dlif-proof-of-concept-and-perioperative-results
#10
Hamid Abbasi, Ali Abbasi
BACKGROUND: Minimally invasive direct lateral interbody fusion (MIS-DLIF) is a novel approach for fusions of the lumbar spine. In this proof of concept study, we describe the surgical technique and report our experience and the perioperative outcomes of the first nine patients who underwent this procedure. STUDY DESIGN/SETTING: In this study we establish the safety and efficacy of this approach. MIS-DLIF was performed on 15 spinal levels in nine patients who failed to respond to conservative therapy for the treatment of a re-herniated disk, spondylolisthesis, or other severe disk disease of the lumbar spine...
January 14, 2017: Curēus
https://www.readbyqxmd.com/read/28174631/medication-related-osteonecrosis-of-the-jaws-caused-lethal-sepsis-in-an-edentulous-patient-with-multiple-systemic-factors
#11
Keisuke Yamashiro, Aki Sato, Fumihiko Okazaki, Makoto Nakano, Koichi Sawaki, Yasuhisa Hirata, Eiki Yamachika, Seiji Iida, Shogo Takashiba
Medication-related osteonecrosis of the jaw (MRONJ) is developed even in the patients who are edentulous and treated with short-term bisphosphonate therapy and oral administration. It sometimes causes lethal sepsis in patients who have multiple health problems such as diabetes, cirrhosis, steroid use for interstitial pneumonia, sepsis, and spinal disk herniation.
February 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28165305/effect-of-anesthesia-associated-hypotension-on-neurologic-outcome-in-dogs-undergoing-hemilaminectomy-because-of-acute-severe-thoracolumbar-intervertebral-disk-herniation-56-cases-2007-2013
#12
Alexandra Dixon, Amy E Fauber
OBJECTIVE To evaluate the effect of anesthesia-associated hypotension on final motor and urinary function in paraplegic dogs without nociception that underwent hemilaminectomy because of acute, severe thoracolumbar intervertebral disk herniation (IVDH). DESIGN Retrospective case series. ANIMALS 56 paraplegic dogs with acute thoracolumbar IVDH and absent nociception. PROCEDURES Medical records were reviewed, and signalment, history, anesthetic details, and results of serial neurologic assessments performed for at least 4 weeks after surgery were recorded...
February 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28149529/prophylactic-vertebroplasty-procedure-applied-with-a-resorbable-bone-cement-can-decrease-the-fracture-risk-of-sandwich-vertebrae-long-term-evaluation-of-clinical-outcomes
#13
Pu Jia, Hai Tang, Hao Chen, Li Bao, Fei Feng, He Yang, Jinjun Li
A sandwich vertebra is formed after multiple osteoporotic vertebral fractures treated by percutaneous vertebroplasty, which has a risk of developing new fractures. The purpose of our study was to (i) investigate the occurrence of new fractures in sandwich vertebra after cement augmentation procedures and to (ii) evaluate the clinical outcomes after prophylactic vertebral reinforcement applied with resorbable bone cement. From June 2011 to 2014, we analysed 55 patients with at least one sandwich vertebrae and treated with percutaneous vertebroplasty...
February 2017: Regenerative Biomaterials
https://www.readbyqxmd.com/read/28144987/prevalence-and-risk-factors-for-presumptive-ascending-descending-myelomalacia-in-dogs-after-thoracolumbar-intervertebral-disk-herniation
#14
F Balducci, S Canal, B Contiero, M Bernardini
BACKGROUND: Ascending/descending myelomalacia (ADMM) is a severe complication of thoracolumbar intervertebral disk herniation (TL-IVDH) in dogs. HYPOTHESIS/OBJECTIVES: To investigate the prevalence and risk factors for ADMM in nonambulatory dogs with surgically treated TL-IVDH. ANIMALS: Six-hundred and fifty-two client-owned dogs evaluated for TL-IVDH that underwent decompressive spinal surgery. METHODS: Retrospective medical record review from February 2007 through December 2015...
March 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28127375/predictors-of-reoperation-after-microdecompression-in-lumbar-spinal-stenosis
#15
Hee-Jong Hwang, Hyung-Ki Park, Gwang-Soo Lee, June-Young Heo, Jae-Chil Chang
OBJECTIVE: The risk factors of reoperation after microdecompression (MD) for lumbar spinal stenosis (LSS) are unclear. In this study, we presented the outcomes of MD for degenerative LSS and investigated the risk factors associated with reoperation. METHODS: A retrospective review was conducted using the clinical records and radiographs of patients with LSS who underwent MD. For clinical evaluation, we used the Japanese Orthopedic Association (JOA) scoring system for low back pain, body mass index, and Charlson comorbidity index...
December 2016: Korean Journal of Spine
https://www.readbyqxmd.com/read/28125786/ct-abnormalities-in-the-sacroiliac-joints-of-patients-with-diffuse-idiopathic-skeletal-hyperostosis
#16
Naama Leibushor, Einat Slonimsky, Dvora Aharoni, Merav Lidar, Iris Eshed
OBJECTIVE: The purpose of this study is to characterize sacroiliac joints (SIJs) findings at CT of patients with diffuse idiopathic skeletal hyperostosis (DISH), a condition characterized (using the Resnick classification criteria) by ossification of at least four contiguous vertebrae in the thoracic spine and preserved disk space, but without radiographic evidence of intraarticular SIJ abnormalities. MATERIALS AND METHODS: Pelvic CT examinations of 104 patients with DISH (fulfilling the Resnick criteria on spinal CT) and 106 age- and sex-matched control subjects whose entire spine lacked CT evidence of DISH (total, 149 men and 61 women; mean [± SD] age, 72...
April 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28107234/comparison-between-acrylic-cage-and-polyetheretherketone-peek-cage-in-single-level-anterior-cervical-discectomy-and-fusion-a-randomized-clinical-trial
#17
Majid R Farrokhi, Zahra Nikoo, Mehrnaz Gholami, Khadijeh Hosseini
STUDY DESIGN: Prospective, single-blind randomized-controlled clinical study. OBJECTIVE: To compare polyetheretherketone (PEEK) cage with a novel Acrylic cage to find out which fusion cage yielded better clinical outcomes following single-level anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA: ACDF is considered a standard neurosurgical treatment for degenerative diseases of cervical intervertebral disks. There are many options, including bone grafts, bone cement, and spacers made of titanium, carbon fiber, and synthetic materials, used to restore physiological disk height and enhance spinal fusion, but the ideal device, which would provide immediate structural support and subsequent osteointegration and stability, has not been identified yet...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28099187/a-comparative-study-of-anterior-decompression-with-fusion-and-posterior-decompression-with-laminoplasty-for-the-treatment-of-cervical-spondylotic-myelopathy-patients-with-large-anterior-compression-of-the-spinal-cord
#18
Takashi Hirai, Toshitaka Yoshii, Yoshiyasu Arai, Kenichiro Sakai, Ichiro Torigoe, Hidetsugu Maehara, Masaki Tomori, Takashi Taniyama, Hirokazu Sato, Atsushi Okawa
STUDY DESIGN: This is a retrospective observational single-center study. OBJECTIVES: To compare anterior decompression and fusion (ADF) and laminoplasty (LAMP) for the treatment of cervical spondylotic myelopathy (CSM) patients with large anterior compression in terms of clinical and radiologic outcomes. SUMMARY OF BACKGROUND DATA: We have reported that insufficient posterior decompression could be often seen after laminoplasty for CSM patients with preoperative anterior clearance of the spinal cord, defined as an interval <4 mm between the preoperative the modified K-line and anterior structure of the spinal canal at most compressive segment on sagittal T1-weighted magnetic resonance imaging...
January 17, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28091734/level-of-conus-medullaris-termination-in-adult-population-analyzed-by-kinetic-magnetic-resonance-imaging
#19
An Liu, Kaixiang Yang, Daling Wang, Changqing Li, Zhiwei Ren, Shigui Yan, Zorica Buser, Jeffrey C Wang
PURPOSE: To investigate the change of conus medullaris termination (CMT) level in neutral, flexion and extension positions and to analyze the effects of age and gender on the CMT level. METHODS: The midline sagittal T2-weighted kinetic magnetic resonance imaging (kMRI) study of 585 patients was retrospectively reviewed to identify the level of CMT. All patients were in an upright position. A straight line perpendicular to the long axis of the cord was drawn from the tip of the cord and then subtended to the adjacent vertebra or disk space...
January 16, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28061487/thermal-induced-osteonecrosis-of-adjacent-vertebra-after-intradiscal-electrothermal-therapy
#20
Soonjoon Kim, Sun-Ho Lee, Eun-Sang Kim, Whan Eoh
A 42-year-old man was admitted to our hospital with complaints of low back pain and intermittent right thigh pain. Twelve weeks before admission, the patient received intradiscal electrothermal therapy (IDET) at a local hospital. The patient still reported low back pain after the procedure that was managed with narcotic analgesics. Follow-up magnetic resonance imaging (MRI) was performed, and his referring physician thought the likely diagnosis was spondylodiscitis at the L4-5 spinal segment with a small epidural abscess...
January 1, 2017: Journal of Korean Neurosurgical Society
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