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https://www.readbyqxmd.com/read/29684923/percutaneous-endoscopic-interlaminar-unilateral-ventral-dural-approach-for-symptomatic-bilateral-l5-s1-herniated-nucleus-pulposus-technical-note
#1
Sung Ho Choi, Nitin Maruti Adsul, Hyeun Sung Kim, Ki Joon Kim, Jeong Hoon Kim, Sung Kyun Chung, Jeong Hoon Choi, Jee Soo Jang, Il Tae Jang, Seong Hoon Oh
BACKGROUND:  Percutaneous endoscopic lumbar diskectomy is a good treatment modality for lumbar disk herniation. However, when a patient complains of bilateral lower limb radicular pain with severe disk protrusion at the L5-S1 level, the transforaminal approach is often unable to resolve both lesions owing to anatomical limitations. It is also very difficult to resolve both lesions in an ipsilateral direction using the percutaneous interlaminar approach. We report our surgical technique and clinical results using a ventral dural approach of percutaneous endoscopic interlaminar lumbar diskectomy for L5-S1 herniated nucleus pulposus (HNP) in patients with bilateral radiculopathy due to a severe disk protrusion...
April 23, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/29671108/comparison-of-pure-lateral-and-oblique-lateral-inter-body-fusion-for-treatment-of-lumbar-degenerative-disk-disease-a-multicentric-cohort-study
#2
Massimo Miscusi, Alessandro Ramieri, Stefano Forcato, Mary Giuffrè, Sokol Trungu, Marco Cimatti, Alessandro Pesce, Pietro Familiari, Amedeo Piazza, Cristina Carnevali, Giuseppe Costanzo, Antonino Raco
PURPOSE: The most effective interbody fusion technique for degenerative disk disease (DDD) is still controversial. The purpose of our study is to compare pure lateral (LLIF) and oblique lateral (OLIF) approaches for the treatment of lumbar DDD from L1-L2 to L4-L5, in terms of clinical and radiological outcomes. MATERIALS AND METHODS: 45 patients underwent lumbar interbody fusion for pure lumbar DDD from  L1-L2 to L4-L5 through LLIF (n = 31, mean age 62.1 years, range 45-78 years) or OLIF (n = 14, mean age 57...
April 18, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29652238/challenge-of-handling-a-charcot-spinal-arthropathy-with-a-novel-hybrid-fibular-autograft-and-expandable-cage
#3
Nissim Ohana, Daniel Benharroch, Dimitri Sheinis
A 26-year-old man, who was paraplegic for 6 years due to a motor vehicle accident, presented to the authors' clinic following his incapacity to withstand a sitting posture, the frequent sensation of "clicks" in his back, and a complaint of back pain while in his wheelchair. On imaging, his dorsal spine showed a complete arthrodesis of the primarily fused vertebrae. However, distal to this segment, a Charcot spinal arthropathy with subluxation of T12-L1 was evident. Repair of this complex, uncommon, late complication of his paraplegia by the frequently used fusion techniques was shown to be inappropriate...
April 13, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29643712/surgical-results-of-a-one-stage-combined-anterior-lumbosacral-fusion-and-posterior-percutaneous-pedicle-screw-fixation
#4
Chien-Yuan Huang, Kuang-Ting Yeh, Tzai-Chiu Yu, Ru-Ping Lee, Ing-Ho Chen, Cheng-Huan Peng, Kuan-Lin Liu, Jen-Hung Wang, Wen-Tien Wu
Objectives: Lumbosacral fusion through either an anterior or a posterior approach to achieve good lordosis and stability is always a challenging surgical operation and is often accompanied by a higher rate of pseudarthrosis than when other lumbar segments are involved. This study evaluated the clinical and radiological results of lumbosacral fusions achieved through a combined anterior and posterior approach. Materials and Methods: From June 2008 to 2012, 20 patients who had L5-S1 instability and stenosis were consecutively treated, first by anterior interbody fusion using an allogenous strut bone graft through the pararectus approach and then by posterior pedicle screw fixation...
January 2018: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29628807/sensitivity-and-specificity-of-modified-bragard-test-in-patients-with-lumbosacral-radiculopathy-using-electrodiagnosis-as-a-reference-standard
#5
Kaynoosh Homayouni, Seyedeh Halimeh Jafari, Hossein Yari
Objective: The purpose of this study was to assess the diagnostic accuracy of a modified Bragard test compared with the straight leg raise (SLR) test in patients presenting with electrodiagnostic evidence of L5 and S1 nerve root compression. Methods: This was a cross-sectional study conducted on 506 consecutive patients with signs and symptoms consistent with lumbosacral radiculopathy confirmed by electrodiagnostic study. Patients were evaluated from September 2013 to September 2015 in the physical medicine and rehabilitation outpatient clinic of Shahid Faghihi Teaching Hospital, Shiraz, Iran...
March 2018: Journal of Chiropractic Medicine
https://www.readbyqxmd.com/read/29622665/shock-attenuation-in-the-human-lumbar-spine-during-walking-and-running
#6
Eric R Castillo, Daniel E Lieberman
During locomotion, each step generates a shock wave that travels through the body toward the head. Without mechanisms for attenuation, repeated shocks can lead to pathology. Shock attenuation (SA) in the lower limb has been well studied, but little is known about how posture affects SA in the spine. To test the hypothesis that lumbar lordosis (LL) contributes to SA, 27 adults (14 male, 13 female) walked and ran on a treadmill. Two lightweight, tri-axial accelerometers were affixed to the skin overlying T12/L1 and L5/S1...
April 5, 2018: Journal of Experimental Biology
https://www.readbyqxmd.com/read/29611881/asymmetry-between-the-superior-and-inferior-endplates-is-a-risk-factor-for-lumbar-disc-degeneration
#7
Yitao Wang, Hongli Wang, Feizhou Lv, Xiaosheng Ma, Xinlei Xia, Jianyuan Jiang
Endplate pathology plays an important role in the development of lumbar disc degeneration. Previous research paid little attention to differences between the superior and inferior endplates as a possible risk factor for disc degeneration. The purpose of this study was to test the hypothesis that asymmetry between the superior and inferior endplates is a risk factor for the development of lumbar disc degeneration. A total of 134 patients with lumbar disc herniation(LDH) and100 healthy adults('Controls') underwent magnetic resonance imaging scans...
April 3, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29609581/mild-not-severe-disc-degeneration-is-implicated-in-the-progression-of-bilateral-l5-spondylolysis-to-spondylolisthesis
#8
Vivek A S Ramakrishna, Uphar Chamoli, Luke L Viglione, Naomi Tsafnat, Ashish D Diwan
BACKGROUND: Spondylolytic (or lytic) spondylolisthesis is often associated with disc degeneration at the index-level; however, it is not clear if disc degeneration is the cause or the consequence of lytic spondylolisthesis. The main objective of this computed tomography based finite element modelling study was to examine the role of different grades of disc degeneration in the progression of a bilateral L5-lytic defect to spondylolisthesis. METHODS: High-resolution computed tomography data of the lumbosacral spine from an anonymised healthy male subject (26 years old) were segmented to build a 3D-computational model of an INTACT L1-S1 spine...
April 2, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29605701/the-role-of-posterior-screw-fixation-in-single-level-transforaminal-lumbar-interbody-fusion-during-whole-body-vibration-a-finite-element-study
#9
Wei Fan, Li-Xin Guo
OBJECTIVE: Very few studies have evaluated the need for supplementary instrumentation after lumbar interbody fusion under the condition of whole body vibration (WBV) that is typically present in vehicles. This study aimed to determine the effect of posterior pedicle screw fixation on dynamic response of the whole lumbar spine to vertical WBV after transforaminal lumbar interbody fusion (TLIF). METHODS: A previously validated non-linear, osteoligamentous finite element (FE) model of the intact L1-sacrum human lumbar spine was modified to simulate single-level (L4-L5) TLIF without and with bilateral pedicle screw fixation (BPSF)...
March 29, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29602004/shape-of-the-spinal-canal-is-not-associated-with-success-rates-of-microsurgical-unilateral-laminotomy-and-bilateral-decompression-for-lumbar-spinal-canal-stenosis
#10
Bawarjan Schatlo, Monika Horanin, Silvia Hernandez-Durán, Volodymyr Solomiichuk, Veit Rohde
INTRODUCTION: Lumbar spinal stenosis (LSS) is one of the most frequent neurosurgical affections. It has been reported that the anatomical shape of the spinal canal (oval, round, trefoil) predicts outcome of bilateral decompression performed in an undercutting technique via a unilateral laminotomy in monosegmental LSS. The poorest results were observed in a trefoild spinal canal, leading to the proposal of using a bilateral instead of a unilateral laminotomy. We have been routinely performing a unilateral microsurgical approach with undercutting to decompress both sides of the spinal canal for more than a decade...
March 27, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29600904/a-case-of-junctional-neural-tube-defect-associated-with-a-lipoma-of-the-filum-terminale-a-new-subtype-of-junctional-neural-tube-defect
#11
Simona Mihaela Florea, Alice Faure, Hervé Brunel, Nadine Girard, Didier Scavarda
The embryological development of the central nervous system takes place during the neurulation process, which includes primary and secondary neurulation. A new form of dysraphism, named junctional neural tube defect (JNTD), was recently reported, with only 4 cases described in the literature. The authors report a fifth case of JNTD. This 5-year-old boy, who had been operated on during his 1st month of life for a uretero-rectal fistula, was referred for evaluation of possible spinal dysraphism. He had urinary incontinence, clubfeet, and a history of delayed walking ability...
March 30, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29575220/lumbosacral-plexus-root-thickening-establishing-normal-root-dimensions-using-magnetic-resonance-neurography
#12
Hernán Chaves, Mariana Bendersky, Romina Goñi, César Gómez, Martín Carnevale, Claudia Cejas
INTRODUCTION: Disorders affecting the lumbosacral plexus (LSP) can alter root diameter. Our aim was to determine normal LSP nerve root dimensions using magnetic resonance neurography (MRN). MATERIALS AND METHODS: Eleven asymptomatic patients (ages: 18-53, mean: 34 years) underwent MRN of the LSP on a 3T scanner with an 8-channel torso-PA coil. IDEAL T2-weighted images were acquired and nerve root dimensions were measured from the second lumbar (L2) to the first sacral (S1) vertebrae on the coronal plane, 5 mm from the dorsal root ganglion (DRG)...
March 25, 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29568364/efficacy-of-different-spinal-nerve-roots-for-neuromodulation-of-micturition-reflex-in-rats
#13
Jianshu Ni, Xiaohu Wang, Nailong Cao, Jiemin Si, Baojun Gu
Electrical stimulation of peripheral nerves controlling the bladder is an alternative, nondestructive medical treatment for urinary incontinence and retention. In this study, we aimed to identify the most efficient sensory and motor spinal nerve roots involved in the micturition reflex. Unilateral L5-S2 dorsal and ventral roots were electrically stimulated, and bladder reflex contractions were recorded under isovolumetric conditions. Repeated stimulation of the L6 and S1 dorsal roots not only abolished bladder reflex contractions but also induced a poststimulation inhibitory effect, whereas repeated stimulation of the L5 and S2 dorsal roots had no effect...
March 2, 2018: Oncotarget
https://www.readbyqxmd.com/read/29564921/hollow-modular-anchorage-hma-screws-for-anterior-transvertebral-fixation-in-high-grade-spondylolisthesis-cases-requiring-360-degrees-in-situ-fusion
#14
Matthias A König, Bronek M Boszczyk
OBJECTIVE: 360 degrees in-situ fusion for high-grade spondylolisthesis showed satisfying clinical long-term results. Combining anterior with posterior surgery increases fusion rates. Anteriorly inserted transvertebral HMA screws could be an alternative to strut graft constructs or cages, avoiding donor site complications. In addition, complete posterior muscle detachment is avoided and the injury risk of neural structures is minimized. This study investigates the use of HMA screws in this context...
March 22, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29564634/-lumbar-ct-guided-radiofrequency-ablation-of-the-medial-branch-of-the-dorsal-ramus-of-the-spinal-nerve-anatomic-study-and-description-of-a-new-technique
#15
G C Feigl, C Mattersberger, W Rosmarin, R Likar, C Avila González
BACKGROUND: The success of radiofrequency ablation (RF) of the medial branch of the dorsal ramus in patients with facet joint pain depends on the effective coagulation distance. To date, computed tomography(CT)-guided techniques do not reach the nerve in parallel but rather than punctually. We report a new CT-guided technique to enhance parallelism and proximity of the RF needle to the nerve. MATERIALS AND METHODS: Two examiners with different experience with CT-guided procedures in corpses performed all punctures at the lumbar spine on 10 corpses...
March 21, 2018: Der Schmerz
https://www.readbyqxmd.com/read/29564611/a-review-of-lumbosacral-transitional-vertebrae-and-associated-vertebral-numeration
#16
REVIEW
Jayson Lian, Nicole Levine, Woojin Cho
PURPOSE: To review the current literature on methods of accurate numeration of vertebral segments in patients with Lumbosacral transitional vertebrae (LSTVs). LSTVs are a common congenital anomaly of the L5-S1 junction. While their clinical significance has been debated, unquestionable is the need for their identification prior to spinal surgery. We hypothesize that there are no reliable landmarks by which we can accurately number transitional vertebrae, and thus a full spinal radiograph is required...
March 21, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29559725/the-optimal-anatomic-site-for-a-single-slice-to-estimate-the-total-volume-of-visceral-adipose-tissue-by-using-the-quantitative-computed-tomography-qct-in-chinese-population
#17
X Cheng, Y Zhang, C Wang, W Deng, L Wang, Y Duanmu, K Li, D Yan, L Xu, C Wu, W Shen, W Tian
BACKGROUND/OBJECTIVES: To investigate the relationship between the cross-sectional visceral adipose tissue (VAT) areas at different anatomic sites and the total VAT volume in a healthy Chinese population using quantitative computed tomography (QCT), and to identify the optimal anatomic site for a single slice to estimate the total VAT volume. SUBJECTS/METHODS: A total of 389 healthy Chinese subjects aged 19-63 years underwent lumbar spine QCT scans. The cross-sectional area of total adipose tissue and VAT were measured using the tissue composition module of the software (QCT Pro, Mindways) at each intervertebral disc level from T12 /L1 to L5 /S1 , as well as at the umbilical level...
March 20, 2018: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29552093/high-resolution-nerve-ultrasound-and-magnetic-resonance-neurography-as-complementary-neuroimaging-tools-for-chronic-inflammatory-demyelinating-polyneuropathy
#18
Kalliopi Pitarokoili, Moritz Kronlage, Philip Bäumer, Daniel Schwarz, Ralf Gold, Martin Bendszus, Min-Suk Yoon
Background: We present a clinical, electrophysiological, sonographical and magnetic resonance neurography (MRN) study examining the complementary role of two neuroimaging methods of the peripheral nervous system for patients with chronic inflammatory demyelinating polyneuropathy (CIDP). Furthermore, we explore the significance of cross-sectional area (CSA) increase through correlations with MRN markers of nerve integrity. Methods: A total of 108 nerve segments on the median, ulnar, radial, tibial and fibular nerve, as well as the lumbar and cervical plexus of 18 CIDP patients were examined with high-resonance nerve ultrasound (HRUS) and MRN additionally to the nerve conduction studies...
2018: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/29548343/double-level-lumbar-spondylolysis-and-spondylolisthesis-a-retrospective-study
#19
Shengtao Zhang, Conglin Ye, Qi Lai, Xiaolong Yu, Xuqiang Liu, Tao Nie, Haibo Zhan, Min Dai, Bin Zhang
BACKGROUND: Lumbar spondylolysis and isthmic spondylolisthesis are common conditions. However, double-level lumbar spondylolysis and spondylolisthesis are rare. We report 24 cases of it along with a review of literature and a briefly description of the clinical and radiological features and integrated management of patients with this condition. METHODS: Of 1700 inpatients diagnosed with lumbar spondylolisthesis at our hospital between January 2008 and September 2015, we selected those with a diagnosis of double-level spondylolisthesis who underwent surgery...
March 16, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29540205/the-potential-effect-of-type-2-diabetes-mellitus-on-lumbar-disc-degeneration-a-retrospective-single-center-study
#20
Xiaoming Liu, Fumin Pan, Zhaoyu Ba, Shanjin Wang, Desheng Wu
BACKGROUND: Diabetes mellitus (DM) and low back pain which is mainly caused by degeneration of the intervertebral discs (IVDs) both are major public health problem worldwide. The present study was designed to investigate the association between type 2 diabetes mellitus (T2D) and severity of lumbar disc degeneration (LDD). METHODS: We retrospectively reviewed patients with low back pain visiting our spine clinic in 2014. Low back pain patients all have the lumbar MRI imaging and no previous treatment...
March 14, 2018: Journal of Orthopaedic Surgery and Research
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