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Lumbar instrumentation

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https://www.readbyqxmd.com/read/28330963/decrease-in-a%C3%AE-42-predicts-dopa-resistant-gait-progression-in-early-parkinson-disease
#1
Lynn Rochester, Brook Galna, Sue Lord, Alison J Yarnall, Rosie Morris, Gordon Duncan, Tien K Khoo, Brit Mollenhauer, David J Burn
OBJECTIVE: This prospective observational study investigates the role of CSF biomarkers in predicting progression of dopa-resistant gait impairments in Parkinson disease (PD) in the first 36 months from diagnosis. METHODS: Quantitative gait analysis was carried out longitudinally using an instrumented walkway (GAITRite) in 108 people with PD and 130 age-matched controls. A subgroup of 44 people with PD underwent lumbar puncture from which a battery of CSF biomarkers was measured: β-amyloid 1-42 and 1-40 (Aβ42 and Aβ40), total and phosphorylated tau protein (t-tau/p-tau181), and α-synuclein (αSyn)...
March 22, 2017: Neurology
https://www.readbyqxmd.com/read/28328849/protrusion-of-a-rod-into-the-spinal-canal-10-years-after-segmental-lumbar-spine-surgery
#2
Siyi Cai, Xiangyi Kong, Chengrui Yan, Yipeng Wang, Xueshuai Wan, Jialu Zhang, Guixing Qiu, Keyi Yu
The objective of this article is to report an unusual case of a spinal rod that protruded into the spinal canal after lumbar spine surgery.Only 4 cases of spinal rod migration with protrusion into the spinal canal have been reported. This is the first report of a case involving the use of posterior low lumbar segmental instrumentation with a screw-rod system. The left side of the rod gradually migrated and finally protruded into the canal and compressed the cord.A 60-year-old woman presented with pain and numbness of the posterior aspect of the left leg after a long-distance walk...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328741/sagittal-plane-parameters-in-growing-rod-patients-following-final-fusion
#3
Robert F Murphy, John B Emans, Michael Troy, Patricia E Miller, Michael T Hresko, Lawrence I Karlin, Daniel J Hedequist, Michael P Glotzbecker
Almost half of growing rod (GR) patients that undergo final fusion (FF) have an extension of instrumented levels. The purpose of this study was to review sagittal plane radiographic parameters of patients with distal extension of instrumented levels at FF to those whose levels remained the same. Radiographs were assessed preoperatively, after GR insertion/first lengthening, following GR treatment before FFs, and after FF. Measurements included sagittal balance, lumbar lordosis, thoracic kyphosis, and distal junction angle (DJA)...
March 21, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28324328/interspinous-implants-to-treat-spinal-stenosis
#4
REVIEW
Raj J Gala, Glenn S Russo, Peter G Whang
PURPOSE OF REVIEW: Lumbar spinal stenosis has historically been treated with open decompressive surgery which is associated with significant morbidity and may give rise to various complications. Interspinous spacers (ISS) have been developed as a less invasive strategy which may serve to avoid many of these risks. The two current spacers that are FDA approved and commercially available are the Coflex and Superion devices. The goal is to review these two implants, their indications, and patient selection...
March 21, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28324213/-split-and-splayed-c3-traumatic-lateral-c2-3-dislocation-without-neurological-deficits-unique-case-and-its-management
#5
Apinderpreeet Singh, Pravin Salunke, Rajeev P Kamble
BACKGROUND: Traumatic C2-3 dislocation has been often described in the antero-posterior plane but is extremely rare in the lateral plane. Such dislocations have been described in thoraco-lumbar and C1-2. The need to study the imaging in multiple planes has been highlighted to plan proper realignment. METHODS: A young male presented with neck pain alone following a train accident. The imaging showed a fracture of C3 splaying it. The C2-3 showed lateral dislocation in the lateral plane with locked C2-3 facets on one side and C3-4 facets on the other...
March 21, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28323717/treatment-of-lumbar-split-fracture-dislocation-with-short-segment-or-long-segment-posterior-fixation-and-anterior-fusion
#6
Fei Chen, Yijun Kang, Haisheng Li, Guohua Lv, Chang Lu, Jing Li, Bing Wang, Weihua Chen, Zhehao Dai
STUDY DESIGN: Retrospective analysis of 16 patients. SUMMARY OF BACKGROUND DATA: The lumbar split fracture-dislocation is a rare but severe injury, which is type C1.2.1 fracture in the Association for the Study of Internal Fixation spine fracture classification. The axial compressive and torsional force shattered the vertebral body into 2 halves and displaced them rotationally. This kind of fracture is so highly unstable that the treatment is very challenging. PURPOSE: The purpose of this study was to report and compare on clinical outcome and complications of patients with lumbar split fracture-dislocation which had been treated either short-segment or long-segment posterior fixation and anterior fusion...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323700/electrophysiological-study-for-nerve-root-entrapment-in-patients-with-isthmic-spondylolisthesis
#7
Masahiro Morita, Akira Miyauchi, Shinya Okuda, Takenori Oda, Motoki Iwasaki
STUDY DESIGN: A case series study. OBJECTIVE: To investigate the electrophysiological location of nerve root entrapment in patients with isthmic spondylolisthesis. SUMMARY OF BACKGROUND DATA: Although the lesion of the nerve root in patients with isthmic spondylolisthesis has been thought to be located at the pars interarticularis due to proliferation of fibrous cartilage, there is no electrophysiological study in relation to this accomplished fact...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323699/use-of-nanocrystalline-hydroxyapatite-with-autologous-bma-and-local-bone-in-the-lumbar-spine-a-retrospective-ct-analysis-of-posterolateral-fusion-results
#8
Stephen Robbins, Carl Lauryssen, Matthew N Songer
STUDY DESIGN: A retrospective, multicenter, medical record review and independent analysis of computed tomographic scans was performed in 46 patients to determine radiographic arthrodesis rates after 1-segment, 2-segment, or 3-segment instrumented posterolateral fusions (PLF) using autograft, bone marrow aspirate (BMA), and a nanocrystalline hydroxyapatite bone void filler (nHA). OBJECTIVE: To determine the radiographic arthrodesis rates after instrumented lumbar PLF using local autograft, BMA, and nHA...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323239/biomechanical-analysis-of-lateral-interbody-fusion-strategies-for-adjacent-segment-degeneration-in-the-lumbar-spine
#9
Melodie F Metzger, Samuel T Robinson, Ruben C Maldonado, Jeremy Rawlinson, John Liu, Frank L Acosta
BACKGROUND CONTEXT: Surgical treatment of symptomatic adjacent segment disease (ASD) typically involves extension of previous instrumentation to include the newly-affected level(s). Disruption of the incision-site can present challenges and increases the risk of complication. Lateral-based interbody fusion techniques may provide a viable surgical alternative that avoids these risks. This study is the first to analyze the biomechanical effect of adding a lateral-based construct to an existing fusion...
March 17, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28303382/a-rare-case-of-non-traumatic-multi-level-bilateral-pedicle-fractures-of-the-lumbar-spine-in-a-60-year-old-patient
#10
Timo Schmid, Paul Heini, Lorin Benneker
INTRODUCTION: We report a 60-year-old patient who sustained non-traumatic, multi-level, bilateral lumbar pedicle fractures in the setting of unilateral lumbar spondylolysis. A possible fracture mechanism is evaluated and a review of the literature is presented. Whereas contralateral pedicle fractures of lumbar vertebrae with unilateral spondylosis are well described in young athletes, there is only one case report of multi-level, bilateral pedicle fractures of the lumbar spine in a young patient who sustained a high-impact motorcycle accident...
March 16, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28291409/association-between-bicortical-screw-fixation-at-upper-instrumented-vertebra-and-risk-for-upper-instrumented-vertebra-fracture
#11
Young-Seop Park, Seung-Jae Hyun, Ho Yong Choi, Ki-Jeong Kim, Tae-Ahn Jahng
OBJECTIVE The aim of this study was to investigate the risk of upper instrumented vertebra (UIV) fractures associated with UIV screw fixation (unicortical vs bicortical) and polymethylmethacrylate (PMMA) augmentation after adult spinal deformity surgery. METHODS A single-center, single-surgeon consecutive series of adult patients who underwent lumbar fusion for ≥ 4 levels (that is, the lower instrumented vertebra at the sacrum or pelvis and the UIV of the thoracolumbar spine [T9-L2]) were retrospectively reviewed...
March 3, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28288396/adjacent-segment-disease-after-instrumented-fusion-for-adult-lumbar-spondylolisthesis-incidence-and-risk-factors
#12
Zhao-Ming Zhong, Vedat Deviren, Bobby Tay, Shane Burch, Sigurd H Berven
OBJECTIVE: A potential long-term complication of lumbar fusion is the development of adjacent segment disease (ASD), which may necessitate second surgery and adversely affect outcomes. The objective of this is to determine the incidence of ASD following instrumented fusion in adult patients with lumbar spondylolisthesis and to identify the risk factors for this complication. PATIENTS AND METHODS: We retrospectively assessed adult patients who had undergone decompression and instrumented fusion for lumbar spondylolisthesis between January 2006 and December 2012...
February 27, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28282990/validation-and-accuracy-of-intraoperative-ct-scan-using-the-philips-alluraxper-fd20-angiography-suite-for-assessment-of-spinal-instrumentation
#13
Edin Nevzati, Javier Fandino, Bawarjan Schatlo, Michel Heimberg, Serge Marbacher, Luca Remonda, Ali-Reza Fathi
BACKGROUND: With the concept of the hybrid operating room gaining popularity, the authors adapted a hybrid angiographic suite with intraoperative computed tomography (iCT) to evaluate accuracy of pedicle screw placement in spinal fusion. This retrospective review examines how well iCT detected extrapedicular screw violation, to then allow repositioning and potentially avoid revision surgery. METHODS: A total of 36 consecutive patients underwent pedicle screw placement in posterior cervical, thoracic, and lumbosacral spinal fusions...
March 10, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28279660/validity-of-the-instrumented-push-and-release-test-to-quantify-postural-responses-in-persons-with-multiple-sclerosis
#14
Mahmoud El-Gohary, Daniel Peterson, Geetanjali Gera, Fay B Horak, Jessie M Huisinga
OBJECTIVE: To test the validity of wearable inertial sensors to provide objective measures of postural stepping responses to the Push and Release clinical test in people with multiple sclerosis DESIGN: Cross-sectional SETTING: University medical center balance disorders laboratory PARTICIPANTS: 52 PwMS and 21 age-matched healthy controls MAIN OUTCOME MEASURES: stepping latency, time and number of steps required to reach stability, and initial step length were calculated from three inertial measurement units placed on participants' lumbar spine and feet...
March 6, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28267911/-360-degrees-instrumentation-for-cervical-instability-due-to-metastatic-bone-disease-case-report
#15
J E Vargas-Jasso, M A Clara-Altamirano, G Reyes-Soto, M Cuéllar-Hubbe, J A Mejía-Pérez
INTRODUCTION: The spine is the most common site for bone metastases; being the breast, prostate and lung cancer which have most affected. The thoracic spine is involved in 70% of cases, followed by the lumbar and cervical region. MATERIAL AND METHODS: This is a 59 years old female diagnosed with breast adenocarcinoma and metastatic bone disease in cervical spine C2, C3 level and instability of that segment because of a compression fracture of C3 greater than 80% without invasion of the spinal canal, she begins with paresthesias of upper limbs...
July 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28266956/iatrogenic-flatback-and-flatback-syndrome-evaluation-management-and-prevention
#16
Barrett S Boody, Brett D Rosenthal, Tyler J Jenkins, Alpesh A Patel, Jason W Savage, Wellington K Hsu
Flatback syndrome can be a significant source of disability, affecting stance and gait, and resulting in significant pain. Although the historical instrumentation options for thoracolumbar fusion procedures have been commonly regarded as the etiology of iatrogenic flatback, inappropriate selection, or application of modern instrumentation can similarly produce flatback deformities. Patients initially compensate with increased lordosis at adjacent lumbar segments and reduction of thoracic kyphosis. As paraspinal musculature fatigues and discs degenerate, maintaining sagittal balance requires increasing pelvic retroversion and hip extension...
March 6, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28263001/assessment-of-bone-health-in-patients-with-type-1-gaucher-disease-using-impact-microindentation
#17
Sabina Herrera, Jordi Pérez-López, Marc Moltó-Abad, Roberto Güerri-Fernández, Elena Cabezudo, Silvana Novelli, Jordi Esteve, Albert Hernández, Inmaculada Roig, Xavier Solanich, Daniel Prieto-Alhambra, Xavier Nogués, Adolfo Díez-Pérez
BACKGROUND: Gaucher disease (GD), one of the commonest lysosomal disorders (a global population incidence of 1:50,000), is characterized by beta-glucocerebrosidase deficiency. Some studies have demonstrated bone infiltration in up to 80% of patients, even if asymptomatic. Bone disorder remains the main cause of morbidity in these patients, along with osteoporosis, avascular necrosis, and bone infarcts. Enzyme replacement therapy (ERT) has been shown to improve these symptoms. METHODS: This cross-sectional study included patients with type 1 Gaucher disease (GD1) selected from the Catalan Study Group on GD...
March 6, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28259005/removal-of-fixation-construct-could-mitigate-adjacent-segment-stress-after-lumbosacral-fusion-a-finite-element-analysis
#18
Yueh-Ying Hsieh, Chia-Hsien Chen, Fon-Yih Tsuang, Lien-Chen Wu, Shang-Chih Lin, Chang-Jung Chiang
BACKGROUND DATA: Combined usage of posterior lumbar interbody fusion and transpedicular fixation has been extensively used to treat the various lumbar degenerative disc diseases. The transpedicular fixator aims to increase stability and enhance the fusion rate. However, how the fused disc and bridged vertebrae respectively affect adjacent-segment diseases progression is not yet clear. METHODS: Using a validated lumbosacral finite-element model, three variations at the L4-L5 segment were analyzed: 1) moderate disc degeneration, 2) instrumented with a stand-alone cage and pedicle screw fixators, and 3) with the cage only after fusion...
February 23, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28258287/-trisegmental-fusion-by-vertebral-body-replacement-outcome-following-traumatic-multisegmental-fractures-of-the-thoracic-and-lumbar-spine
#19
Michael Kreinest, Dorothee Schmahl, Paul A Grützner, Stefan Matschke
BACKGROUND: Around 5% of all trauma patients suffer from spinal trauma. Spinal fractures are mainly located in the thoracic and lumbar spine. For multisegmental vertebral fractures categorized as instable, combined dorsal instrumentation and ventral stabilization is recommended. Numerous vertebral body replacement systems are available for ventral stabilization. OBJECTIVES: The aim of the current study was to analyze radiological results following the implantation of a hydraulic expandable vertebral body replacement and the evaluation of patients' outcome three years after implantation...
March 3, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28254672/is-the-use-of-minimally-invasive-fusion-technologies-associated-with-improved-outcomes-after-elective-interbody-lumbar-fusion-analysis-of-a-nationwide-prospective-patient-reported-outcomes-registry
#20
Matthew J McGirt, Scott L Parker, Praveen Mummaneni, John Knightly, Deborah Pfortmiller, Kevin Foley, Anthony L Asher
BACKGROUND CONTEXT: Over the last decade, clinical investigators and biomedical industry groups have used significant resources to develop advanced technologies that enable less invasive spine fusions. These minimally invasive surgery (MIS) technologies often require increased expenditures by hospitals and payers. While several small single center studies have suggested MIS technologies decrease surgical morbidity and reduce hospital stay, evidence documenting benefit from a patient perspective remains limited...
February 27, 2017: Spine Journal: Official Journal of the North American Spine Society
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