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https://www.readbyqxmd.com/read/28187803/management-of-acute-traumatic-spinal-cord-injuries
#1
C D Shank, B C Walters, M N Hadley
Acute traumatic spinal cord injury (SCI) is a devastating disease process affecting tens of thousands of people across the USA each year. Despite the increase in primary prevention measures, such as educational programs, motor vehicle speed limits, automobile running lights, and safety technology that includes automobile passive restraint systems and airbags, SCIs continue to carry substantial permanent morbidity and mortality. Medical measures implemented following the initial injury are designed to limit secondary insult to the spinal cord and to stabilize the spinal column in an attempt to decrease devastating sequelae...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28168635/imaging-of-post-surgical-treatment-and-of-related-complications-in-spinal-trauma
#2
REVIEW
F Caranci, G Leone, L Ugga, E Cesarano, R Capasso, S Schipani, A Bianco, P Fonio, F Briganti, L Brunese
Spinal trauma is a devastating event with a high morbidity and mortality. The rationale of imaging is to diagnose the traumatic abnormalities and characterize the type of injury, to estimate the severity of the lesions, to evaluate the potential spinal instability. In case of spinal instability, the goals of operative treatment are decompression of the spinal cord canal and stabilization of the disrupted vertebral column. Particularly, diagnostic imaging, mainly by CT and MR, has a main role in the post-treatment evaluation...
February 6, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28159488/lateral-lumbar-retroperitoneal-transpsoas-approach-in-the-setting-of-spondylodiscitis-a-technical-note
#3
George M Ghobrial, Fadi Al-Saiegh, Daniel Franco, Daniel Benito, Joshua Heller
Thoracolumbar spondylodiscitis is a morbid disease entity, impacting a sick patient population with multiple comorbidities. Wherever possible, surgical measures in this population should limit the extent of soft tissue disruption and overall morbidity that is often associated with anteroposterior thoracolumbar decompression and fusion. The authors describe the rationale, technique, and use of the lateral lumbar transpsoas retroperitoneal approach in tandem with posterior decompression and instrumented fusion in the treatment of circumferential thoracolumbar spondylodiscitis with or without epidural abscesses...
January 31, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28144983/human-olfactory-mesenchymal-stromal-cell-transplants-promote-remyelination-and-earlier-improvement-in-gait-co-ordination-after-spinal-cord-injury
#4
Susan L Lindsay, Andrew Toft, Jacob Griffin, Ahmed M M Emraja, Susan Carol Barnett, John S Riddell
Autologous cell transplantation is a promising strategy for repair of the injured spinal cord. Here we have studied the repair potential of mesenchymal stromal cells isolated from the human olfactory mucosa after transplantation into a rodent model of incomplete spinal cord injury. Investigation of peripheral type remyelination at the injury site using immunocytochemistry for P0, showed a more extensive distribution in transplanted compared with control animals. In addition to the typical distribution in the dorsal columns (common to all animals), in transplanted animals only, P0 immunolabelling was consistently detected in white matter lateral and ventral to the injury site...
February 1, 2017: Glia
https://www.readbyqxmd.com/read/28125047/identifying-the-long-term-role-of-inducible-nitric-oxide-synthase-after-contusive-spinal-cord-injury-using-a-transgenic-mouse-model
#5
Dominic M Maggio, Amanpreet Singh, J Bryan Iorgulescu, Drew H Bleicher, Mousumi Ghosh, Michael M Lopez, Luis M Tuesta, Govinder Flora, W Dalton Dietrich, Damien D Pearse
Inducible nitric oxide synthase (iNOS) is a potent mediator of oxidative stress during neuroinflammation triggered by neurotrauma or neurodegeneration. We previously demonstrated that acute iNOS inhibition attenuated iNOS levels and promoted neuroprotection and functional recovery after spinal cord injury (SCI). The present study investigated the effects of chronic iNOS ablation after SCI using inos-null mice. iNOS(-/-) knockout and wild-type (WT) control mice underwent a moderate thoracic (T8) contusive SCI...
January 25, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28107590/endocannabinoid-activation-of-cb1-receptors-contributes-to-long-lasting-reversal-of-neuropathic-pain-by-repetitive-spinal-cord-stimulation
#6
L Sun, L Tai, Q Qiu, R Mitchell, S Fleetwood-Walker, E A Joosten, C W Cheung
BACKGROUND: Spinal cord stimulation (SCS) has been shown to be effective in the management of certain neuropathic pain conditions, however, the underlying mechanisms are incompletely understood. In this study, we investigated repetitive SCS in a rodent neuropathic pain model, revealing long-lasting and incremental attenuation of hyperalgesia and a mechanism of action involving endocannabinoids. METHOD: Animals were implanted with monopolar electrodes at the time of partial sciatic nerve injury...
January 20, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28103119/iatrogenic-spinal-cord-injury-in-a-trauma-patient-with-ankylosing-spondylitis
#7
Ahmad Maarouf, Colleen M McQuown, Jennifer A Frey, Rami A Ahmed, Lisa Derrick
BACKGROUND: The recommended practice for over 30 years has been to routinely immobilize patients with unstable cervical spinal injuries using cervical spinal collars. It is shown that patients with Ankylosing spondylitis (AS) are four times more likely to suffer a spinal fracture compared to the general population and have an eleven-fold greater risk of spinal cord injury. Current protocols of spinal immobilization were responsible for secondary neurologic deterioration in some of these patients...
January 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28090452/classifying-thoracolumbar-fractures-role-of-quantitative-imaging
#8
REVIEW
Fernando Ruiz Santiago, Pablo Tomás Muñoz, Elena Moya Sánchez, Marta Revelles Paniza, Alberto Martínez Martínez, Antonio Luis Pérez Abela
This article describes different types of vertebral fractures that affect the thoracolumbar spine and the most relevant contributions of the different classification systems to vertebral fracture management. The vertebral fractures types are based on the three columns model of Denis that includes compression, burst, flexion-distraction and fracture-dislocation types. The most recent classifications systems of these types of fractures are reviewed, including the Thoracolumbar Injury Classification and Severity score (TLICS) and the Arbeitsgemeinschaft für Osteosynthesefragen Spine Thoracolumbar Injury Classification and Severity score (AOSpine-TLICS)...
December 2016: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28072502/wallerian-degeneration-beyond-the-corticospinal-tracts-conventional-and-advanced-mri-findings
#9
REVIEW
Yin Jie Chen, Seyed Ali Nabavizadeh, Arastoo Vossough, Sunil Kumar, Laurie A Loevner, Suyash Mohan
Wallerian degeneration (WD) is defined as progressive anterograde disintegration of axons and accompanying demyelination after an injury to the proximal axon or cell body. Since the 1980s and 1990s, conventional magnetic resonance imaging (MRI) sequences have been shown to be sensitive to changes of WD in the subacute to chronic phases. More recently, advanced MRI techniques, such as diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI), have demonstrated some of earliest changes attributed to acute WD, typically on the order of days...
November 7, 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28035466/a-rare-postoperative-complication-of-anterior-lower-thoracic-instrumentation-diaphragmatic-laceration-with-hemothorax
#10
Yat Wa Wong, Jason Pui Yin Cheung, Keith Dip Kei Luk, Kenneth Man Chee Cheung
PURPOSE: To highlight the importance of preventing visceral injury due to prominent anterior implants at the spinal column. METHODS: A 52-year-old man with cord compression was treated with a T9/10 discectomy and instrumented fusion via a right thoracotomy and trans-pleural approach. Postoperatively, he had improved lower limb numbness. However, after a bout of coughing, there was sudden increase in chest drain output, hemodynamic instability and massive fluid collection in the right chest cavity...
December 29, 2016: European Spine Journal
https://www.readbyqxmd.com/read/28028650/occult-subaxial-cervical-disco-ligamentous-injuries-in-computer-tomography-negative-trauma-patients
#11
Jiun-Lih Lin, Sumant Samuel, Randolph Gray, Stephen Ruff, Con Vasili, Andrew Cree, Nathan Hartin
PURPOSE: Due to lack of cervical clearance consensus in literature and the devastating consequences of missed cervical injuries, Magnetic resonance imaging (MRI) of the neurologically intact symptomatic patient with negative CT scan is frequently done to rule out disco-ligamentous injuries. This study retrospectively evaluates occult disco-ligamentous injuries detected by MRI in patients with no abnormalities detected by modern multi-detector CT scanning and postulates a new theory of ligamentous stability of cervical spine...
December 27, 2016: European Spine Journal
https://www.readbyqxmd.com/read/28009224/mesenteric-ischemia-following-the-correction-of-adult-spinal-deformity-case-report
#12
Krishn Khanna, Sigurd H Berven
Vascular complications are an important adverse event that can be associated with spinal reconstructive surgery. Direct injury of vessels, or indirect traction or compression of vessels, can cause both arterial and venous injury. Indirect compression of the mesenteric vessels is a well-recognized complication of bracing and surgical care of children with spinal deformity (superior mesenteric artery syndrome), but the complication is not common or well recognized in the adult population with spinal deformity...
December 23, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28005617/lateral-extracavitary-approach-versus-posterior-extensive-circumferential-decompression-in-the-treatment-of-complicated-thoracic-and-lumbar-tuberculous-spondylitis
#13
Khaled Omran, Ahmed S Abdel-Fattah, Ahmed M A Othman, Ahmed O Youssef, Amr Solimen, Mohamed A ElRefai, Ahmed N Saleh, Mohammed Ali
OBJECTIVES AND STUDY DESIGN: The aim of this study was to retrospectively evaluate 45 patients operated upon either by posterior extensive circumferential decompression (PECD) or by the lateral extracavitary (LEC) technique and compare the clinical, radiologic, laboratory, and functional outcomes. SUMMARY OF BACKGROUND: The debate continues on the best decompression-fusion technique for treating complicated spinal tuberculosis. In recent times, the advantages of combined surgery have been successfully achieved using the 1-stage salvage technique, with enough accessibility to all 3 spinal columns...
December 21, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27988344/combined-chondroitinase-and-klf7-expression-reduce-net-retraction-of-sensory-and-cst-axons-from-sites-of-spinal-injury
#14
Zimei Wang, Kristen Winsor, Christopher Nienhaus, Evan Hess, Murray G Blackmore
Axon regeneration in the central nervous system is limited both by inhibitory extracellular cues and by an intrinsically low capacity for axon growth in some CNS populations. Chondroitin sulfate proteoglycans (CSPGs) are well-studied inhibitors of axon growth in the CNS, and degradation of CSPGs by chondroitinase has been shown to improve the extension of injured axons. Alternatively, axon growth can be improved by targeting the neuron-intrinsic growth capacity through forced expression of regeneration-associated transcription factors...
December 14, 2016: Neurobiology of Disease
https://www.readbyqxmd.com/read/27917533/human-spinal-ejaculation-generator
#15
Clément Chéhensse, Patricia Facchinetti, Stéphane Bahrami, Philippe Andrey, Jean-Marc Soler, Fabrice Chrétien, Jacques Bernabé, Pierre Clément, Pierre Denys, François Giuliano
OBJECTIVE: A spinal ejaculation generator (SEG) has been identified in the rat with lumbar galaninergic interneurons playing a pivotal role (Science 2002;297:1566-1569). The aim was to evidence a SEG in humans. METHODS: Spatial distribution of galaninergic neurons was studied in postmortem spinal cord segments of 6 men and compared with that of 6 women for evidencing sexual dimorphism. Based on the identified segmental distribution of galaninergic neurons, the ability for penile vibratory stimulation (PVS) to elicit ejaculation when the concerned spinal segments were injured was studied in 384 patients with clinically complete spinal cord injury (SCI) and consequent anejaculation...
January 2017: Annals of Neurology
https://www.readbyqxmd.com/read/27915066/the-impact-of-hospital-teaching-status-on-timing-of-intervention-inpatient-morbidity-and-mortality-after-surgery-for-vertebral-column-fractures-with-spinal-cord-injury
#16
Rafael De la Garza Ramos, Jonathan Nakhla, Rani Nasser, Ajit Jada, Daniel M Sciubba, Merritt D Kinon, Reza Yassari
OBJECTIVE: To investigate the impact of hospital teaching status on the timing of intervention and inpatient morbidity and mortality after surgery for acute spinal cord injury (SCI). METHODS: Data from the Nationwide Inpatient Sample (2002 - 2011) were reviewed. Patients were included if they had a diagnosis of closed vertebral column fracture with SCI, underwent spine surgery, and were admitted urgently or emergently. Early intervention (the day of or the day after admission), inpatient morbidity and mortality rates were compared between patients admitted to teaching versus nonteaching hospitals...
November 30, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27913838/isolated-transverse-process-fractures-insignificant-injury-or-marker-of-complex-injury-pattern
#17
G Lombardo, P Petrone, K Prabhakaran, C P Marini
INTRODUCTION: This study investigates the incidence of isolated transverse process fractures (ITPFx) amongst vertebral fractures in trauma patients, and specific-associated injury patterns present in patients with ITPFx. MATERIALS AND METHODS: A retrospective, 4-year review of our Level 1 Trauma Center registry was performed. Patients with blunt spinal column fractures were identified. Data collected included patient demographics, Injury Severity Score (ISS), type of imaging obtained, and concomitant injuries, including rib and pelvic fractures, liver, spleen, and kidney injury (SOI)...
December 2, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27906739/posterior-vertebral-column-resection-with-intraoperative-manual-retraction-for-the-treatment-of-posttubercular-kyphosis-in-upper-thoracic-spine-or-cervicothoracic-junction
#18
Yuqiao Chen, Guohua Lü, Bing Wang, Lei Li, Lei Kuang
STUDY DESIGN: This is a case-series. OBJECTIVE: To evaluate the clinical and radiologic outcomes of posterior vertebral column resection (PVCR) for treatment of posttubercular kyphosis in upper thoracic spine and cervicothoracic junction (CTJ). SUMMARY OF BACKGROUND DATA: Surgical management of severe posttubercular kyphosis in upper thoracic spine or CTJ is challenging. A new technique that combines PVCR and intraoperative manual traction in a single procedure, was developed to maximize the correction rate and minimize the risk of dural buckling and spinal cord injury...
November 30, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27871718/aza%C3%A3-%C3%A3-n-s-disease-a-19th-century-epidemic-of-neurolathyrism-in-spain
#19
REVIEW
S Giménez-Roldán, P S Spencer
The cultivation and consumption of grasspea (Lathyrus sativus) in Spain probably dates back centuries, especially during times of famine when the neurotoxic potential of this legume was expressed in the form of a spastic paraparesis known as neurolathyrism. Little known outside the country, the epidemic of neurolathyrism in the years following the Spanish Civil War (1936-1939) came to affect more than a thousand people. In late 1872, during the Six Years Revolutionary Term, young Alejandro San Martín Satrústegui (1847-1908), then editor of the popular weekly El Siglo Médico, travelled to Azañón, a remote village in the province of Guadalajara, to clarify a so-far unknown disease...
December 2016: Revue Neurologique
https://www.readbyqxmd.com/read/27867025/comparison-of-short-segment-pedicle-fixation-with-versus-without-inclusion-of-the-fracture-level-in-the-treatment-of-mild-thoracolumbar-burst-fractures
#20
COMPARATIVE STUDY
Chao Sun, Guoping Guan, Xinhui Liu, Hailong Zhang, Bin Wang
BACKGROUND: A review of the literature showed that posterior short-segment fixation including the fractured vertebra (PSFFV) has better outcomes in the treatment of thoracolumbar burst fractures(TBFs) than patients with short-segment pedicle screw fixation(SSPF) alone. However, its efficacy in mild TBFs with load-sharing scores of 3 and 4 points has not been specifically analyzed. The aim of this study was to compare the clinical, functional and radiologic results of PSFFV with SSPF for mild TBFs and to determine whether the screws in the fractured vetebra were necessary for these patients...
December 2016: International Journal of Surgery
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