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Spinal column injury

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https://www.readbyqxmd.com/read/29456917/neuromonitoring-in-spinal-deformity-surgery-a-multimodality-approach
#1
REVIEW
Joseph L Laratta, Alex Ha, Jamal N Shillingford, Melvin C Makhni, Joseph M Lombardi, Earl Thuet, Ronald A Lehman, Lawrence G Lenke
Study Design: Literature review. Objective: The aim of this study was to provide an overview of the available intraoperative monitoring techniques and the evidence around their efficacy in vertebral column resection. Methods: The history of neuromonitoring and evolution of the modalities are reviewed and discussed. The authors' specific surgical techniques and preferred methods are outlined in detail. In addition, the authors' experience and the literature regarding vertebral column resection and surgical mitigation of neurologic alarms are discussed at length...
February 2018: Global Spine Journal
https://www.readbyqxmd.com/read/29454115/traumatic-spinal-injury-global-epidemiology-and-worldwide-volume
#2
Ramesh Kumar, Jaims Lim, Rania A Mekary, Abbas Rattani, Michael C Dewan, Salman Y Sharif, Enrique Osorio-Fonseca, Kee B Park
BACKGROUND: Traumatic spinal injury (TSI) results from injury to bony, ligamentous and/or neurological structures of the spinal column and can cause significant morbidity and mortality. The global burden of TSI is poorly understood, so we performed a systematic review and meta-analysis to estimate the global volume of TSI. METHODS: We performed a systematic review through PubMed, Embase and Cochrane Databases on TSI studies published from 2000 to 2016. Collected data were used to perform a meta-analysis to estimate the annual incidence of TSI across World Health Organization (WHO) regions and World Bank income groups using random effect models...
February 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29452281/incidence-and-risk-factors-of-post-operative-neurological-decline-after-complex-adult-spinal-deformity-surgery-results-of-the-scoli-risk-1-study
#3
Michael G Fehlings, So Kato, Lawrence G Lenke, Hiroaki Nakashima, Narihito Nagoshi, Christopher I Shaffrey, Kenneth M C Cheung, Leah Carreon, Mark B Dekutoski, Frank J Schwab, Oheneba Boachie-Adjei, Khaled M Kebaish, Christopher P Ames, Yong Qiu, Yukihiro Matsuyama, Benny T Dahl, Hossein Mehdian, Ferran Pellisé-Urquiza, Stephen J Lewis, Sigurd H Berven
BACKGROUND CONTEXT: Significant variability in neurologic outcomes following surgical correction for adult spinal deformity (ASD) has been reported. Risk factors for decline in neurologic motor outcomes are poorly understood. PURPOSE: The objective of the present investigation was to identify the risk factors for post-operative neurological motor decline in patients undergoing complex ASD surgery. STUDY DESIGN/SETTING: A prospective international multicenter cohort study...
February 13, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29434794/biomechanical-analysis-of-brachial-plexus-injury-availability-of-three-dimensional-finite-element-model-of-the-brachial-plexus
#4
Atsushi Mihara, Tsukasa Kanchiku, Norihiro Nishida, Haruki Tagawa, Junji Ohgi, Hidenori Suzuki, Yasuaki Imajo, Masahiro Funaba, Daisuke Nakashima, Xian Chen, Toshihiko Taguchi
Adult brachial plexus injuries frequently lead to significant and permanent physical disabilities. Investigating the mechanism of the injury using biomechanical approaches may lead to further knowledge with regard to preventing brachial plexus injuries. However, there are no reports of biomechanical studies of brachial plexus injuries till date. Therefore, the present study used a complex three-dimensional finite element model (3D-FEM) of the brachial plexus to analyze the mechanism of brachial plexus injury and to assess the validity of the model...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29416908/acute-tetraplegia-following-laryngotracheal-reconstruction-surgery
#5
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/29408659/axonal-regeneration-of-different-tracts-following-transplants-of-human-glial-restricted-progenitors-into-the-injured-spinal-cord-in-rats
#6
Ying Jin, Jed S Shumsky, Itzhak Fischer
The goal of this study was to compare the efficacy of human glial restricted progenitors (hGRPs) in promoting axonal growth of different tracts. We examined the potential of hGRPs grafted into a cervical (C4) dorsal column lesion to test sensory axons, and into a C4 hemisection to test motor tracts. The hGRPs, thawed from frozen stocks, were suspended in a PureCol matrix and grafted acutely into a C4 dorsal column or hemisection lesion. Control rats received PureCol only. Five weeks after transplantation, all transplanted cells survived in rats with the dorsal column lesion but only about half of the grafts in the hemisection...
January 31, 2018: Brain Research
https://www.readbyqxmd.com/read/29405182/-the-characteristic-features-of-vertebral-lesions-in-the-victims-of-a-road-traffic-accident-with-intrusion-into-the-passenger-car-compartment
#7
I A Dubrovin, E P Sedykh, A S Mosoyan, A A Bychkov, D N Akhmetova
The objective of the present study was to develop the diagnostic criteria for determining the positions of the participants of a road traffic accident inside the passenger car compartment based on the analysis of the characteristic features of vertebral lesions in the victims. The archival documents of forensic medical expertises were used to analyze the specific characteristics of fractured cervical vertebra in the victims of the accident inside the passenger car compartments including the drivers (n=92), the occupants of the forward (n=43) and rear (n=37) seats of the car...
2018: Sudebno-meditsinskaia Ekspertiza
https://www.readbyqxmd.com/read/29404636/-frequency-and-age-distribution-of-combined-sternovertebral-injuries-analysis-of-routine-data-from-german-hospitals-2005-2012
#8
S Krinner, S Schmitt, S Grupp, F F Hennig, A Langenbach, S Schulz-Drost
BACKGROUND: Combinations of sternal and spinal fractures often occur due to high velocity accidents and are associated with a high incidence of concomitant injuries. The anterior thoracic wall is described as the fourth column of torso stability, which is why sternovertebral injuries (SVI) present a high risk of sagittal deformation of the trunk, in particular injuries of the thoracic spine. To date, no studies have been published on the frequency distribution of the involved vertebral bodies in large patient groups...
February 5, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29399061/neuroprotective-effect-of-local-hypothermia-in-a-computer-controlled-compression-model-in-minipig-correlation-of-tissue-sparing-along-the-rostro-caudal-axis-with-neurological-outcome
#9
Stefania Gedrova, Jan Galik, Martin Marsala, Monika Zavodska, Jaroslav Pavel, Igor Sulla, Miroslav Gajdos, Imrich Lukac, Jozef Kafka, Valent Ledecky, Igor Sulla, Martina Karasova, Peter Reichel, Alexandra Trbolova, Igor Capik, Viktoria Lukacova, Katarina Bimbova, Maria Bacova, Andrea Stropkovska, Nadezda Lukacova
This study investigated the neuroprotective efficacy of local hypothermia in a minipig model of spinal cord injury (SCI) induced by a computer-controlled impactor device. The tissue integrity observed at the injury epicenter, and up to 3 cm cranially and caudally from the lesion site correlated with motor function. A computer-controlled device produced contusion lesions at L3 level with two different degrees of tissue sparing, depending upon pre-set impact parameters (8N- and 15N-force impact). Hypothermia with cold (4°C) saline or Dulbecco's modified Eagle's medium (DMEM)/F12 culture medium was applied 30 min after SCI (for 5 h) via a perfusion chamber (flow 2 ml/min)...
January 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29370354/systematic-evaluation-of-collateral-pathways-to-the-artery-of-adamkiewicz-using-computed-tomography
#10
Kunihiro Yoshioka, Ryoichi Tanaka, Hidenobu Takagi, Yuta Ueyama, Tsuyoshi Sugawara, Takuya Chiba, Kazumasa Arakita, Joanne D Schuijf
OBJECTIVES: Preoperative identification of the artery of Adamkiewicz can help prevent postoperative spinal cord injury in patients undergoing thoracic and thoraco-abdominal aortic aneurysm repair. Although several studies have shown the feasibility of evaluating the artery of Adamkiewicz using multidetector row computed tomography (MDCT), no detailed investigations regarding the collateral circulation to the artery of Adamkiewicz have been performed. The purpose of this study was to investigate the collateral circulation to the artery of Adamkiewicz using MDCT in patients with thoracic and thoraco-abdominal aortic aneurysms...
January 22, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29354739/posterolateral-thoracic-decompression-with-anterior-column-cage-reconstruction-versus-decompression-alone-for-spinal-metastases-with-cord-compression-analysis-of-perioperative-complications-and-outcomes
#11
Aladine A Elsamadicy, Owoicho Adogwa, Amanda Sergesketter, Emily Lydon, Carlos A Bagley, Isaac O Karikari
Background: The optimal surgical strategy for patients with spinal metastases remains unknown. The aim of this study was to determine if performing an anterior column reconstruction to a posterolateral approach adds to perioperative complications. Methods: A retrospective review of all adult patients with spinal metastases who had a posterolateral approach for resection between January 2000 and December 2008. Perioperative complications and functional outcomes were determined...
December 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29351637/prospective-multicenter-assessment-of-all-cause-mortality-following-surgery-for-adult-cervical-deformity
#12
Justin S Smith, Christopher I Shaffrey, Han Jo Kim, Peter Passias, Themistocles Protopsaltis, Renaud Lafage, Gregory M Mundis, Eric Klineberg, Virginie Lafage, Frank J Schwab, Justin K Scheer, Emily Miller, Michael Kelly, D Kojo Hamilton, Munish Gupta, Vedat Deviren, Richard Hostin, Todd Albert, K Daniel Riew, Robert Hart, Doug Burton, Shay Bess, Christopher P Ames
BACKGROUND: Surgical treatments for adult cervical spinal deformity (ACSD) are often complex and have high complication rates. OBJECTIVE: To assess all-cause mortality following ACSD surgery. METHODS: ACSD patients presenting for surgical treatment were identified from a prospectively collected multicenter database. Clinical and surgical parameters and all-cause mortality were assessed. RESULTS: Of 123 ACSD patients, 120 (98%) had complete baseline data (mean age, 60...
January 17, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29334957/vertebral-column-decancellation-in-pott-s-deformity-use-of-surgimap-spine-for-preoperative-surgical-planning-retrospective-review-of-18-patients
#13
Wenhao Hu, Xuesong Zhang, Jiayi Yu, Fanqi Hu, Hao Zhang, Yan Wang
BACKGROUND: In the late stage of Spinal tuberculosis, the bony destruction and vertebral collapse often leads to significant kyphosis, presenting clinically as a painful gibbus deformity, with increased instability, vertebral body translations and increased risk of neurologic involvement. Vertebral column decancellation is thought to be suitable for most patients with severe rigid kyphosis. Surgimap Spine, could offer a pragmatic graphical method for the surgical planning of osteotomies...
January 15, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29323044/magnetic-resonance-imaging-guided-focused-ultrasound-to-increase-localized-blood-spinal-cord-barrier-permeability
#14
Allison H Payne, Gregory W Hawryluk, Yoshimi Anzai, Henrik Odéen, Megan A Ostlie, Ethan C Reichert, Amanda J Stump, Satoshi Minoshima, Donna J Cross
Spinal cord injury (SCI) affects thousands of people every year in the USA, and most patients are left with some permanent paralysis. Therapeutic options are limited and only modestly affect outcome. To address this issue, we used magnetic resonance imaging-guided focused ultrasound (MRgFUS) as a non-invasive approach to increase permeability in the blood-spinal cord barrier (BSCB). We hypothesize that localized, controlled sonoporation of the BSCB by MRgFUS will aid delivery of therapeutics to the injury. Here, we report our preliminary findings for the ability of MRgFUS to increase BSCB permeability in the thoracic spinal cord of a normal rat model...
December 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/29280931/pre-injury-patient-characteristics-and-post-injury-neurological-status-are-associated-with-mortality-following-spinal-cord-injury
#15
David S Casper, Benjamin Zmistowski, Gregory D Schroeder, James C McKenzie, John Mangan, Jayanth Vatson, Alan S Hilibrand, Alexander R Vaccaro, Christopher K Kepler
STUDY DESIGN: Retrospective cohort study OBJECTIVES.: This study investigates the association between SCI and post-injury mortality. SUMMARY OF BACKGROUND DATA: Spinal Cord Injuries (SCI) are severe conditions treated in the acute trauma setting. Due to neurological deficits, unstable spinal columns, and associated injuries, these patients often have complex inpatient hospitalizations with significant morbidity and mortality. It is assumed that a high rate of post-injury mortality would follow such severe injuries; however, the effect of SCI, and its treatment on predictors of longevity remain largely unknown...
December 26, 2017: Spine
https://www.readbyqxmd.com/read/29279307/intraneural-injection-of-atp-stimulates-regeneration-of-primary-sensory-axons-in-the-spinal-cord
#16
Dongsheng Wu, Sena Lee, Juan Luo, Haijian Xia, Svetlana Gushchina, Peter M Richardson, John Yeh, Ute Krügel, Heike Franke, Yi Zhang, Xuenong Bo
Injury to the peripheral axons of sensory neurons strongly enhances the regeneration of their central axons in the spinal cord. It remains unclear on what molecules that initiate such conditioning effect. Since ATP is released extracellularly by nerve and other tissue injury, we hypothesize that injection of ATP into a peripheral nerve might mimic the stimulatory effect of nerve injury on the regenerative state of the primary sensory neurons. We found that a single injection of 6 μl of 150 μM ATP into female rat sciatic nerve quadrupled the number of axons growing into a lesion epicenter in spinal cord after a concomitant dorsal column transection...
December 26, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29277840/investigating-comparability-of-quantitative-computed-tomography-with-dual-energy-x-ray-absorptiometry-in-assessing-bone-mineral-density-of-patients-with-chronic-spinal-cord-injury
#17
Hamid Reza Haghighat Khah, Nahid Moradi, Taher Taheri, Morteza Sanei Taheri, Seyed Mansoor Rayegani
STUDY DESIGN: Psychometric study using retrospectively collected data. OBJECTIVES: We investigated the comparability of quantitative computed tomography (qCT) in assessing bone mineral density (BMD) with dual energy X-ray absorptiometry (DXA). We evaluated how well previously suggested normal values for spinal Hounsfield units (HU) correlated with routine DXA results in patients with chronic spinal cord injury (SCI). Furthermore, we investigated inter/intra-observer reliability of measuring HU in the spine...
December 26, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29245216/magnetic-resonance-imaging-of-the-spinal-cord-in-the-evaluation-of-3-patients-with-sensory-neuronopathies-diagnostic-assessment-indications-of-treatment-response-and-impact-of-autoimmunity-a-case-report
#18
Julius Birnbaum, Aliya Lalji, Ezequiel A Piccione, Izlem Izbudak
RATIONALE: Sensory neuronopathy can be a devastating peripheral nervous system disorder. Profound loss in joint position is associated with sensory ataxia, and reflects degeneration of large-sized dorsal root ganglia. Prompt recognition of sensory neuronopathies may constitute a therapeutic window to intervene before there are irreversible deficits. However, nerve-conduction studies may be unrevealing early in the disease course. In such cases, the appearance of dorsal column lesions on spinal-cord MRI can help in the diagnosis...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29227787/major-destructive-asymptomatic-lumbar-charcot-lesion-treated-with-three-column-resection-and-short-segment-reconstruction-case-report-treatment-strategy-and-review-of-literature
#19
Kestutis Valancius, Gaurav Garg, Madalina Duicu, Ebbe Stender Hansen, Cody Bunger
Charcot's spine is a long-term complication of spinal cord injury. The lesion is often localized at the caudal end of long fusion constructs and distal to the level of paraplegia. However, cases are rare and the literature relevant to the management of Charcot's arthropathy is limited. This paper reviews the clinical features, diagnosis, and surgical management of post-traumatic spinal neuroarthropathy in the current literature. We present a rare case of adjacent level Charcot's lesion of the lumbar spine in a paraplegic patient, primarily treated for traumatic spinal cord lesion 39 years before current surgery...
2017: SICOT-J
https://www.readbyqxmd.com/read/29200479/management-of-sub-axial-cervical-spine-injuries
#20
Gautam Zaveri, Gurdip Das
Sub-axial cervical spine injuries are commonly seen in patients with blunt trauma. They may be associated with spinal cord injury resulting in tetraplegia and severe permanent disability. Immobilization of the neck, maintenance of blood pressure and oxygenation, rapid clinical and radiological assessment of all injuries, and realignment of the spinal column are the key steps in the emergency management of these injuries. The role of intravenous methylprednisolone administration in acute spinal cord injuries remains controversial...
November 2017: Indian Journal of Orthopaedics
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