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https://www.readbyqxmd.com/read/29447489/compulsory-use-of-the-backboard-is-associated-with-increased-frequency-of-thoracolumbar-imaging
#1
Brian M Clemency, Christopher T Tanski, Jennifer Gibson Chambers, Michael O'Brien, Andrew S Knapp, Alexander J Clark, Patrick McGoff, Johanna Innes, Heather A Lindstrom, David Hostler
BACKGROUND: Backboards have been shown to cause pain in uninjured patients. This may alter physical exam findings, leading emergency department (ED) providers to suspect a spinal injury when none exists resulting in additional imaging of the thoracolumbar spine. New York had previously employed a "Spinal Immobilization" protocol that included compulsory backboard application for all patients with suspected spinal injuries. In 2015, New York instituted a new "Spinal Motion Restriction" protocol that made backboard use optional for these patients...
February 15, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29445966/thoracic-ossification-of-ligamentum-flavum-manifesting-holocord-syringomyelia-case-report
#2
Yoshiaki Takamura, Yasuhiro Takeshima, Ryuta Matsuoka, Young Soo Park, Hiroyuki Nakase
It has been reported that syringomyelia is rarely associated with degenerative spinal disorders, but the case of holocord syringomyelia is never reported. We here present a case of a 59-year-old woman with right shoulder pain, dysesthesia of the right hand, and gait disturbance. Radiographically, examinations of the spine demonstrated holocord syringomyelia with ossification of ligamentum flavum at T2/3 level. Holocord syringomyelia was reduced remarkably after posterior decompression at the T2/3 level, and her symptoms also improved...
February 14, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29445602/uniportal-video-assisted-thoracoscopic-surgery-vats-sleeve-resections-for-non-small-cell-lung-cancer-patients-an-observational-prospective-study-and-technique-analysis
#3
Aris Koryllos, Erich Stoelben
Bronchus sleeve resection for operative treatment of non-small cell lung cancer (NSCLC) is a gold standard in modern thoracic surgery in cases of centrally located tumors or hilär lymph node metastases. Advanced instruments and growing surgical experience allowed surgeons to reduce the required incisions (from 3-port to uniportal) and to resect larger and more centrally located malignancies minimal invasively. It is a logical and expected advance in thoracic surgery that video-assisted thoracoscopic surgery (VATS) would be ultimately used also for complex bronchial resections...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29445595/anesthesia-and-analgesia-how-does-the-role-of-anesthetists-changes-in-the-eras-program-for-vats-lobectomy
#4
Federico Piccioni, Riccardo Ragazzi
Enhanced recovery after surgery (ERAS) programs are developed to prevent factors that delay postoperative recovery as well as issues that cause complications. The development of video-assist thoracoscopic surgery (VATS) techniques favors the fast recovery after thoracic procedures. ERAS strategies are based on multidisciplinary approach in which the anesthetist plays an important role from the preoperative to the postoperative phase with several goals. After preoperative evaluation and medical optimization, the anesthetist must ensure a tailored anesthetic plan aiming to a fast recovery and adequate pain relief to reduce the response to the surgical stress...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29440051/cold-forced-open-water-swimming-a-natural-intervention-to-improve-postoperative-pain-and-mobilisation-outcomes
#5
Tom B Mole, Pieter Mackeith
Postoperative neuropathic pain exacerbated by movement is poorly understood and difficult to treat but a relatively common complication of surgical procedures such as endoscopic thoracic sympathectomy. Here, we describe a case of unexpected, immediate, complete and sustained remission of postoperative intercostal neuralgia after the patient engaged in an open-water swim in markedly cold conditions. Though an incidental chance association is possible, the clear temporal proximity linking the swim with pain remission makes a causal relationship possible...
February 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29437731/massive-thoracic-ganglioneuroma-with-significant-mass-effect-on-left-hemithorax
#6
Jacob T Lambdin, Kyongjune B Lee, Gregory Trachiotis, Carlose Picone
A 42-year-old, otherwise healthy, woman presented with persistent left-sided chest pain. A chest X-ray revealed a large opacity in the left hemithorax which prompted further investigation with an MRI. MRI revealed a large left apical mass occupying approximately two-thirds of the left hemithorax. The mass was investigated further with a CT with contrast which did not reveal any vascular involvement or invasion into adjacent structures. The patient successfully underwent tumour resection via left thoracotomy...
February 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29434866/logistic-regression-analysis-of-risk-factors-for-postoperative-recurrence-of-spinal-tumors-and-analysis-of-prognostic-factors
#7
Shanyong Zhang, Lili Yang, Chuangang Peng, Minfei Wu
The aim of the present study was to investigate the risk factors for postoperative recurrence of spinal tumors by logistic regression analysis and analysis of prognostic factors. In total, 77 male and 48 female patients with spinal tumor were selected in our hospital from January, 2010 to December, 2015 and divided into the benign (n=76) and malignant groups (n=49). All the patients underwent microsurgical resection of spinal tumors and were reviewed regularly 3 months after operation. The McCormick grading system was used to evaluate the postoperative spinal cord function...
February 2018: Oncology Letters
https://www.readbyqxmd.com/read/29430564/sensory-symptom-profiles-differ-between-trigeminal-and-thoracolumbar-postherpetic-neuralgia
#8
Stefanie Rehm, Moritz Groβkopf, Maria Kabelitz, Thomas Keller, Rainer Freynhagen, Thomas R Tölle, Ralf Baron
Introduction: Animal experimental evidence suggests that mechanisms of pain generation and response to treatment differ between neuropathic pain in the cephalic and the extracephalic innervation territories. Objectives: The objective of the study was to examine whether in humans an identical peripheral painful neuropathy is associated with different pain qualities and sensory abnormalities in the face as compared with the thoracic region. Methods: We retrospectively analysed epidemiological and clinical data of 639 patients with postherpetic neuralgia (PHN) in the face and at the trunk who were collected within a cross-sectional cohort survey and compared the respective sensory symptom profiles captured with the painDETECT questionnaire...
January 2018: Pain Reports (Baltimore, Md.)
https://www.readbyqxmd.com/read/29430434/spontaneous-disappearance-of-a-pericardial-cyst-case-report-and-literature-review
#9
Angelo Pio Moffa, Luca Pio Stoppino, Domenico Loizzi, Paola Milillo
Pericardial cysts are rare benign anomalies generally discovered as incidental findings on radiographic images. Rarely, pericardial cysts cause symptoms and may lead to complications. A 56-year-old woman presented to the emergency department for mild chest pain. A cardiovascular and respiratory examination revealed no abnormalities, while a chest X-ray and subsequent thoracic computed tomography (CT) showed a pericardial cyst. The patient refused both percutaneous treatment and thoracic surgery. Three years later, a thoracic CT scan showed that the pericardial cyst had disappeared...
February 2018: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29429578/thoracic-duct-cyst-presenting-as-abdominal-pain
#10
Ahmed Abu-Zaid, Ali Mohammed Alakhtar, Faisal Dkhalallah Alshamdin, Waleed Saleh
No abstract text is available yet for this article.
February 8, 2018: Surgery
https://www.readbyqxmd.com/read/29428926/immediate-changes-after-manual-therapy-in-patients-with-persistent-nonspecific-back-pain-a-randomized-controlled-trial
#11
Gemma Victoria Espí-López, Maria-Arantzazu Ruescas-Nicolau, M Luz Sanchez-Sanchez, Anna Arnal-Gómez, Mercè Balasch-Bernat, Elena Marques-Sule
Context • Thoracic manipulation decreases pain and disability. However, when such manipulation is contraindicated, the use of other manual techniques based on the regional interdependence of the thoracic spine, upper ribs, and shoulders is an alternative approach. Objective • The study intended to investigate the immediate changes resulting from 3 manual therapy treatments on spinal mobility, flexibility, comfort, and pain perception in patients with persistent, nonspecific back pain as well as changes in their sense of physical well-being and their perception of change after treatment...
February 10, 2018: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/29428372/comparative-study-on-the-analgesic-effect-of-acute-ipsilateral-shoulder-pain-after-open-thoracotomy-between-preoperative-ultrasound-guided-suprascapular-nerve-block-snb-and-intraoperative-phrenic-nerve-infiltration-pni-in-cancer-lung-patients
#12
Bassel M Elfokery, Sahar A Tawfic, Abdelrahman M Abdelrahman, Dina N Abbas, Ikramy M Abdelghaffar
INTRODUCTION: Acute ipsilateral shoulder pain (ISP) is a common complaint in patients after thoracotomy. The incidence ranges from 21% to 97%. Unfortunately, clinical studies did not put enough focus on ISP post thoracic surgery. AIM OF THE WORK: This study was designed to compare the effectiveness of suprascapular nerve block (SNB) and phrenic nerve infiltration (PNI) for controlling ISP. PATIENTS AND METHODS: One hundred and thirty-five lung cancer patients (135) scheduled for open-lung surgery were randomly allocated into three equal groups; control group: received thoracic epidural with general anesthesia, suprascapular group: (SNB) one hour before the operation with 10 ml bupivacaine plus thoracic epidural with general anesthesia and phrenic nerve group: (PNI) was performed by the operating surgeon with 10 ml bupivacaine plus thoracic epidural with general anesthesia...
February 7, 2018: Journal of the Egyptian National Cancer Institute
https://www.readbyqxmd.com/read/29428017/long-term-functional-outcomes-after-traumatic-thoracic-and-lumbar-spine-fractures
#13
Ashley P Marek, Jean Dominique Morancy, Jeffrey G Chipman, Rachel M Nygaard, Robert M Roach, Michele M Loor
The incidence of thoracolumbar spine fractures in blunt trauma is 4 to 5 per cent. These fractures may lead to neurologic injury, chronic back pain, and disability. Most studies from United States trauma centers focus on neurologic sequelae and/or compare treatment modalities. However, most patients with spine fractures do not have a neurologic deficit. Our primary objective was to determine the long-term outcome of traumatic thoracolumbar spine fractures, specifically addressing quality of life, chronic pain, and employment using a validated patient outcome survey...
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29425323/long-term-effectiveness-of-gross-total-resection-for-symptomatic-spinal-cord-cavernous-malformations
#14
Tej D Azad, Anand Veeravagu, Amy Li, Michael Zhang, Venkatesh Madhugiri, Gary K Steinberg
BACKGROUND: Intramedullary spinal cord cavernous malformations (CMs) account for 5% of all CMs in the central nervous system and 5% to 12% of all spinal cord vascular lesions, yet their optimal management is controversial. OBJECTIVE: To identify factors associated with the clinical progression of spinal cord CMs and quantify the range of surgical outcomes. METHODS: Retrospective observational cohort study of 32 patients who underwent open surgical resection for spinal CMs, the majority of which presented to a dorsal or lateral pial surface, from 1996 to 2017 at a single institution...
February 6, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29424677/prospective-assessment-of-the-safety-and-early-outcomes-of-sublaminar-band-placement-for-the-prevention-of-proximal-junctional-kyphosis
#15
Vibhu K Viswanathan, Sunil Kukreja, Amy J Minnema, H Francis Farhadi
OBJECTIVE Proximal junctional kyphosis (PJK) can progress to proximal junctional failure (PJF), a widely recognized early and serious complication of multisegment spinal instrumentation for the treatment of adult spinal deformity (ASD). Sublaminar band placement has been suggested as a possible technique to prevent PJK and PJF but carries the theoretical possibility of a paradoxical increase in these complications as a result of the required muscle dissection and posterior ligamentous disruption. In this study, the authors prospectively assess the safety as well as the early clinical and radiological outcomes of sublaminar band insertion at the upper instrumented vertebra (UIV) plus 1 level (UIV+1)...
February 9, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29424675/intradural-spinal-arachnoid-cyst-resection-implications-of-duraplasty-in-a-large-case-series
#16
Ziev B Moses, Gabriel N Friedman, David L Penn, Isaac H Solomon, John H Chi
OBJECTIVE Optimal diagnosis and management strategies for intradural spinal arachnoid cysts (SACs) are still unresolved given the rare nature of this entity, with few large case series and virtually no statistical analyses of patient characteristics in the literature. Here, the authors studied a large patient cohort with these lesions to determine whether pre- or postoperative attributes could be used to aid in either diagnosis or prognosis. METHODS A chart review was completed at a single institution for the period from 2002 to 2016 to determine the preoperative characteristics and postoperative outcomes of 21 patients with exclusively intradural SACs...
February 9, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29424157/-clinical-observation-of-5-cases-of-diabetes-insipidus-complicated-with-skeletal-fluorosis
#17
Shuan-Chi Wang, Xiao-Bing Tao, Fang-Fang Wang, Nan Zhang
OBJECTIVE: To investigate the mechanism of diabetes insipidus complicated with skeletal fluorosis and the surgical treatment of spinal canal stenosis caused by skeletal fluorosis. METHODS: From January 2000 to November 2011, 5 patients with diabetes insipidus complicated with skeletal fluorosis were treated with drug and cervical or thoracic posterior decompression including 2 males and 3 females with age of 35, 45, 47, 49, 55 years old respectively. The symptoms was mainly limb motor sensory disturbance accompanied by polyuria and polyuria...
July 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29423163/metastatic-epicardial-leiomyoma-with-uncertain-malignant-potential
#18
Miroslav P Peev, Anne Therese C Lim, Tianle Zou, Laurence H Brinckerhoff
A 49-year-old female with history of uterine leiomyoma and intermittent shortness of breath presented to the emergency department with new onset of tachycardia and chest pain. Subsequent cardiac work up revealed hypoechoic mass compressing the right ventricle. Computer tomography guided biopsy for tissue characterization revealed a benign spindle cell tumor. Surgical resection of a large epicardial tumor was undertaken. The histologic examination of the tumor was consistent with Estrogen and Progesterone positive leiomyoma of uncertain malignant potential...
September 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29416908/acute-tetraplegia-following-laryngotracheal-reconstruction-surgery
#19
Belgin Erhan, Rahsan Kemerdere, Osman Kizilkilic, Berrin Gunduz, Murat Hanci
Background: Paraplegia following thoracic spinal surgery or abdominal operations is usually attributed to spinal cord ischemia due to interruption of the segmental spinal vascular supply. Alternatively, the etiology of spinal cord ischemia following cervical surgery is less clear. Case Description: A 14-year-old male became acutely tetraplegic with a C4 sensory level and sphincteric dysfunction 12 h following surgery for tracheal stenosis due to prior intubation...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29416472/anesthetic-considerations-for-video-assisted-thoracoscopic-surgery-in-a-child-with-glenn-shunt-for-thoracic-duct-ligation-and-pleurodesis
#20
Bhavna Kakkar, Munisha Agarwal, Aakanksha Sehgal, Neelam Prasad Govil
Glenn shunt is an anastomosis between superior vena cava and right pulmonary artery to palliate patients with single ventricle physiology of the heart. Chylothorax is a frequent and troublesome complication after the creation of this shunt, which if not controlled with medical management, might require pleurodesis, and thoracic duct ligation. Video-assisted thoracoscopic surgery (VATS) causes less postoperative pain, earlier mobilization, lower overall morbidity, a shortened hospital stay with reduced cost, and a cosmetic incision...
January 2018: Saudi Journal of Anaesthesia
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