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https://www.readbyqxmd.com/read/29165642/the-corticospinal-reserve-capacity-reorganization-of-motor-area-and-excitability-as-a-novel-pathophysiological-concept-in-cervical-myelopathy
#1
Anna Zdunczyk, Vera Schwarzer, Michael Mikhailov, Brendon Bagley, Tizian Rosenstock, Thomas Picht, Peter Vajkoczy
BACKGROUND: In degenerative cervical myelopathy (DCM), the dynamics of disease progression and the outcome after surgical decompression vary interindividually and do not necessarily correlate with radiological findings. OBJECTIVE: To improve diagnostic power in DCM by better characterization of the underlying pathophysiology using navigated transcranial magnetic stimulation (nTMS). METHODS: Eighteen patients with DCM due to cervical spinal canal stenosis were examined preoperatively with nTMS...
November 18, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29165239/does-smoking-affect-the-outcomes-of-lumbar-decompression-surgery
#2
Radha Mehta, Himanshu Sharma
INTRODUCTION: Lumbar decompressions and micro-discectomies are commonly performed non-complex spinal surgeries that do not involve the insertion of metalwork into the spine and are done for symptomatic disc prolapse and lumbar spinal stenosis, whereas complex-spinal surgery does require metalwork [1]. Studies of complex-spinal surgeries show that smoking has a significant negative impact on the outcome of the surgery [2] therefore, the cessation of smoking is advised prior to surgery [3]...
2017: SICOT-J
https://www.readbyqxmd.com/read/29162138/predictability-of-the-effects-of-facet-joint-infiltration-in-the-degenerate-lumbar-spine-when-assessing-mri-scans
#3
Ulf Krister Hofmann, Ramona Luise Keller, Christian Walter, Falk Mittag
BACKGROUND: Imaging results are frequently considered as hallmarks of disease by spine surgeons to plan their future treatment strategy. Numerous classification systems have been proposed to quantify or grade lumbar magnetic resonance imaging (MRI) scans and thus objectify imaging findings. The clinical impact of the measured parameters remains, however, unclear. To evaluate the pathological significance of imaging findings in patients with multisegmental degenerative findings, clinicians can perform image-guided local infiltrations to target defined areas such as the facet joints...
November 21, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29155001/postoperative-pain-following-posterior-iliac-crest-bone-graft-harvesting-in-spine-surgery-a-prospective-randomized-trial
#4
Evan D Sheha, Dennis S Meredith, Grant D Shifflett, Benjamin T Bjerke, Sravisht Iyer, Jennifer Shue, Joseph Nguyen, Russel C Huang
BACKGROUND CONTEXT: Post-operative pain at the site of bone graft harvest for posterior spine fusion is reported to occur in 6% to 39% of cases. However, the area around the posterior, superior iliac spine is a frequent site of referred pain for many structures. Therefore, many postoperative spine patients may have pain in the vicinity of the posterior iliac crest that may not in fact be caused by bone graft harvesting. The literature may then overestimate the true incidence of postoperative iliac crest pain...
November 14, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29149159/in-errata-cost-utility-analysis-of-lumbar-interlaminar-epidural-injections-in-the-treatment-of-lumbar-disc-herniation-central-spinal-stenosis-and-axial-or-discogenic-low-back-pain
#5
https://www.readbyqxmd.com/read/29149145/endoscopic-epidural-laser-decompression-versus-transforaminal-epiduroscopic-laser-annuloplasty-for-lumbar-disc-herniation-a-prospective-randomized-trial
#6
Chang Hong Park, Sang Ho Lee
BACKGROUND: Lumbar radicular pain often results from lumbar disc herniation, spinal stenosis, or degenerative spondylolisthesis. Minimally invasive disc decompression procedures, such as nucleo-annuloplasty or epiduroscopic neural decompression by laser, have been devised to treat such pain. OBJECTIVE: The short-term outcomes of disc decompression by endoscopic epidural laser decompression (EELD) or transforaminal epiduroscopic laser annuloplasty (TELA) were compared in patients with lumbar radicular pain due to disc herniation...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29145512/impact-of-the-surgical-strategy-on-the-incidence-of-c5-nerve-root-palsy-in-decompressive-cervical-surgery
#7
Theresa Krätzig, Malte Mohme, Klaus C Mende, Sven O Eicker, Frank W Floeth
OBJECTIVE: Our aim was to identify the impact of different surgical strategies on the incidence of C5 palsy. BACKGROUND: Degenerative cervical spinal stenosis is a steadily increasing morbidity in the ageing population. Postoperative C5 nerve root palsy is a common complication with severe impact on the patients´ quality of life. METHODS: We identified 1708 consecutive patients who underwent cervical decompression surgery due to degenerative changes...
2017: PloS One
https://www.readbyqxmd.com/read/29142628/perioperative-results-and-complications-after-posterior-lumbar-interbody-fusion-for-spinal-stenosis-in-geriatric-patients-over-than-70-years-old
#8
Jong Min Choi, Man Kyu Choi, Sung Bum Kim
Objective: As increasing the size of the geriatric population, the number of elderly patients, who need the surgery for painful degenerative spinal stenosis has been increasing. The geriatric population may be relatively high complications, because of age and age-associated medical conditions. However, there is a lack of studies addressing the perioperative complications and outcomes in elderly patients with posterior lumbar inter body fusion with screw augmentation (PLIF). Methods: We retrospectively reviewed the medical records and radiographic studies of geriatric patients who had spine surgery of PLIF due to spinal stenosis for 11 years...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29137932/the-tibial-nerve-compression-test-for-the-diagnosis-of-lumbar-spinal-canal-stenosis-a-simple-and-reliable-physical-examination-for-use-by-primary-care-physicians
#9
Shu Adachi, Atsushi Nakano, Akihiro Kin, Ichiro Baba, Yoshitaka Kurokawa, Masashi Neo
OBJECTIVES: In the present study, we aimed to evaluate the diagnostic accuracy and suitability of the 'Tibial Nerve Compression Test (TNCT)' as a screening tool for lumbar spinal canal stenosis (LSS). METHODS: A total of 108 consecutive patients admitted to our hospital for surgical treatment or diagnosis of LSS were included in this study. Fifty healthy volunteers were examined as a control group. The severity of tenderness was scored (tenderness score) and measured on a visual analogue scale (P-VAS score)...
November 11, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29137917/radiation-exposure-with-hybrid-image-guidance-based-minimally-invasive-transforaminal-lumbar-interbody-fusion
#10
Michael M Safaee, Taemin Oh, Murat Pekmezci, Aaron J Clark
The transforaminal lumbar interbody fusion (TLIF) is used for the treatment of back and leg pain secondary to spinal stenosis, degenerative disc disease, and spondylolisthesis. Minimally invasive surgery (MIS) is associated with less estimated blood loss (EBL), decreased length of stay, lower infection rates, and similar outcomes compared to the traditional TLIF. Fluoroscopy time has been reported with MIS-TLIF, but there are limited data on specific radiation dosages. We performed a retrospective analysis of a prospectively acquired cohort of patients undergoing MIS-TLIF...
November 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29131234/the-role-of-triangular-vertebral-canal-shape-in-surgical-management-of-patients-with-lumbar-spinal-stenosis-a-cross-sectional-study
#11
Huseyin Bozkurt, İsmail Kaya, Bilge Oztoprak
AIM: We assessed the role of triangular vertebral canal shape (VCS) in pain severity, pain-related findings, and postoperative satisfaction in patients with lumbar spinal stenosis (LSS) who had undergone decompressive surgery. MATERIAL AND METHODS: This cross-sectional study conducted at a single center included 61 consecutive patients who had undergone surgical treatment for LSS. By comparing pre- and postoperative data, the role of triangular VCS in pain severity [assessed using a visual analog scale (VAS)], pain-related findings, and postoperative satisfaction of patients was examined...
October 18, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29131102/a-case-of-a-4-year-old-female-with-a-primary-spinal-malignancy-presenting-with-froin-s-syndrome
#12
Andrew T Hale, Gregory P Fricker, Travis W Crook
We report the case of a 4-year-old female with a primary extradural intramedullary atypical teratoid/rhabdoid tumor (AT/RT) leading to a middle cerebral artery (MCA) infarct and Froin's syndrome. She presented with a 6-pound weight loss over the previous week, as well as a decreased urinary output and an altered mental status. She underwent a brain MRI that revealed a left MCA infarct, mild ventriculomegaly, and bilateral internal carotid artery, M1, and A1 stenosis. An external ventricular drain (EVD) was placed due to increased intracranial pressure...
November 2, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29119045/lumbar-stenosis-surgery-spine-surgeons-not-insurance-companies-should-decide-when-enough-is-better-than-too-much
#13
EDITORIAL
Nancy E Epstein
Background: Lumbar surgery for spinal stenosis is the most common spine operation being performed in older patients. Nevertheless, every time we want to schedule surgery, we confront the insurance industry. More often than not they demand patients first undergo epidural steroid injections (ESI); clearly they are not aware of ESI's lack of long-term efficacy. Who put these insurance companies in charge anyway? We did. How? Through performing too many unnecessary or overly extensive spinal operations (e...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29119044/nursing-review-of-diagnosis-and-treatment-of-lumbar-degenerative-spondylolisthesis
#14
Nancy E Epstein, Renee D Hollingsworth
Background: In the lumbar spine, degenerative spondylolisthesis or degenerative (not traumatic) slippage of one vertebral body over another is divided into 4 grades - grade I (25%), grade II (50%), grade III (75%), and grade IV (100%). Dynamic X-rays, magnetic resonance (MR), and computed tomography (CT) scans document the slip secondary to arthritic changes of the facet joint plus stenosis, ossification of the yellow ligament, disc herniations, and synovial cysts. MR best demonstrates soft tissue pathology whereas CT better delineates ossific/calcified disease...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29116395/correlations-between-sedimentation-sign-dural-sac-cross-sectional-area-and-clinical-symptoms-of-degenerative-lumbar-spinal-stenosis
#15
Sangbong Ko
PURPOSE: In this study, we addressed the correlation between the cross-sectional area (CSA) of the dural sac and the nerve root sedimentation sign (SedSign) and the correlation between the distance of claudication and the CSA of the dural sac or SedSign in patients with lumbar spinal stenosis. We also evaluated the reliability of clinical symptom prediction. METHODS: We checked claudication distance using a questionnaire, and we gauged low back pain when standing, referred pain, and radiating pain using visual analog scale scores...
November 7, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29101465/changes-in-cervical-motion-after-cervical-spinal-motion-preservation-surgery
#16
Chi Heon Kim, Tae Hyun Park, Chun Kee Chung, Kyoung-Tae Kim, Yun Hee Choi, Seok-Won Chung
BACKGROUND: For patients with single-level cervical radiculopathy, various types of motion preservation surgeries, such as total disc replacement (TDR), posterior cervical foraminotomy (PCF) and posterior percutaneous endoscopic foraminotomy and discectomy (PECF), are available. In addition to motion preservation, the quality of motion is an important issue. The aim of the present study was to evaluate the influence of these surgeries on cervical motion by comparing the instantaneous axis of rotation (IAR) among PECF, TDR and PCF at the index and superior/inferior adjacent segments...
November 3, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29098915/neuro-urological-sequelae-of-lumbar-spinal-stenosis
#17
Jason Gandhi, Janki Shah, Gargi Joshi, Sohrab Vatsia, Andrew DiMatteo, Gunjan Joshi, Noel L Smith, Sardar Ali Khan
Lumbar spinal stenosis (LSS) is characterized by the narrowing of the spinal canal, which subsequently induces impingement of neural elements in the lumbar spine. Thus, symptoms of LSS are typically associated with damage to those neural elements. Herewith, we target the genitourinary symptoms of LSS and the importance of differentiating these symptoms from other genitourinary pathologies, namely benign prostatic hyperplasia. Specifically, we review bladder dysfunction, lower urinary tract symptoms (e.g., urinary incontinence, detrusor overactivity and under-activity, as well as frequent urinary tract infections), renal osteodystrophy, and sexual dysfunction (e...
November 3, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/29097954/redundant-nerve-root-in-a-patient-with-chronic-lumbar-degenerative-canal-stenosis
#18
Federico E Villafañe, Allison Harvey, Norman Kettner
Objective: The purpose of this case report is to describe the diagnostic imaging features of redundant nerve roots caused by chronic lumbar degenerative canal stenosis (CLDCS). Clinical Features: A 56-year-old male presented with severe low back pain. He experienced pain during minimal active lumbar range of motion. The patient demonstrated weakness of the right iliopsoas and hypoesthesia of the L-2 dermatome. A working diagnosis of CLDCS was established. The patient's worsening severe low back pain warranted magnetic resonance imaging of the lumbar spine, which was performed for further evaluation...
September 2017: Journal of Chiropractic Medicine
https://www.readbyqxmd.com/read/29097044/standard-off-the-shelf-multibranched-thoracoabdominal-endograft-in-urgent-and-elective-patients-with-single-and-staged-procedures-in-a-multicenter-experience
#19
Roberto Silingardi, Stefano Gennai, Nicola Leone, Mauro Gargiulo, Gianluca Faggioli, Piergiorgio Cao, Fabio Verzini, Arnaldo Ippoliti, Nicola Tusini, Carmelo Ricci, Michele Antonello, Roberto Chiesa, Enrico Maria Marone, Nicola Mangialardi, Francesco Speziale, Gian Franco Veraldi, Stefano Bonardelli, Luigi Marcheselli
OBJECTIVE: The objective of this study was to assess immediate and midterm outcomes for urgent/emergent and elective patients with thoracoabdominal aortic aneurysms (TAAAs) treated with the first commercially available "off-the-shelf" multibranched endograft for endovascular aneurysm repair, with a single-step or a staged surgical approach. METHODS: A multicenter, nonrandomized, retrospective study was conducted of TAAA patients grouped by urgent/emergent and elective treatment with multibranched endograft for endovascular aneurysm repair at 13 Italian centers from November 2012 to August 2016...
October 31, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29093781/efficacy-of-the-thoracolumbar-interfascial-plane-block-for-lumbar-laminoplasty-a-retrospective-study
#20
Hironobu Ueshima, Tomoyuki Ozawa, Tomoaki Toyone, Hiroshi Otake
Study Design: This paper was a single center-based retrospective study with prospective data collection. Purpose: Compared with other surgeries, limited options are available for perioperative pain management in spinal surgery. Therefore, we aimed to identify new pain management in this study. Overview of Literature: The thoracolumbar interfascial plane (TLIP) block has been reported to provide effective regional analgesia in the lumbar region...
October 2017: Asian Spine Journal
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