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https://www.readbyqxmd.com/read/28162204/-evidence-based-clinical-practice-guidelines-for-the-treatment-of-dural-tears-and-the-consequent-cerebrospinal-fluid-leak-during-spine-surgery
#1
(no author information available yet)
Dural tears (DT) and the consequent cerebral spinal fluid (CSF) leak are not rare in spine surgeries. CSF leak can be troublesome, leading to pseudomeningocele, cutaneous CSF fistula, and meningitis. Revision surgery is unavoidable in some cases. The reported incidences of DT and CSF leak are different according to the various pathologies. Ossification of the posterior longitudinal ligament, revision spine surgery and multi-segment laminectomy have higher risks for DT. Various techniques have been described to manage this complication, such as bed rest, repair with dural substitutes, fibrin glue, gelatin sponge, lumbar drain, muscle flap, etc...
February 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28160246/hypogonadotropic-hypogonadism-in-males-with-glycogen-storage-disease-type-1
#2
Evelyn M Wong, Anna Lehman, Philip Acott, Jane Gillis, Daniel L Metzger, Sandra Sirrs
BACKGROUND: Glycogen storage disease type 1 is an autosomal recessive disorder with an incidence of 1 in 100,000. Long-term complications include chronic blood glucose lability, lactic academia, short stature, osteoporosis, delayed puberty, gout, progressive renal insufficiency, systemic or pulmonary hypertension, hepatic adenomas at risk for malignant transformation, anemia, vitamin D deficiency, hyperuricemic nephrocalcinosis, inflammatory bowel syndrome (type 1b), hypertriglyceridemia, and irregular menstrual cycles...
February 4, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28158163/prevalence-of-specific-types-of-pain-diagnoses-in-a-sample-of-united-states-adults
#3
Kelly Ryan Murphy, Jing L Han, Siyun Yang, Syed Mohammed Qasim Hussaini, Aladine A Elsamadicy, Beth Parente, Jichun Xie, Promila Pagadala, Shivanand P Lad
BACKGROUND: Patients with pain conditions place significant demands on health care services globally. Health economists have reported the annual economic cost of pain in the United States as high as $635 billion. A common challenge in treating patients suffering from chronic pain conditions is accurate diagnosis and treatment. OBJECTIVE: The aim of this study was to determine the modern-day prevalence of individual types of pain diagnoses in adults. STUDY DESIGN: Retrospective analysis of Truven MarketScan® Commercial and Medicare Supplemental database...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28158159/full-endoscopic-assisted-lumbar-decompressive-surgery-performed-in-an-outpatient-ambulatory-facility-report-of-5-years-of-complications-and-risk-factors
#4
Solomon Kamson, Andrea M Trescot, Paul D Sampson, Yiyi Zhang
BACKGROUND: Minimally invasive surgery (MIS) technique is becoming the standard tissue sparing approach for decompression of lumbar central and lateral recess stenosis, intervertebral disc herniation, or any situation that would have required extensive open decompression laminectomy. Full-endoscopic or arthroscopic assisted surgery is arguably the "ultra-MIS" approach to lumbar spinal pathology. Age and body mass index (BMI) are significant risk factors to be considered in full-endoscopic assisted ultra-MIS...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28114923/intervertebral-disc-and-vertebral-endplate-subchondral-changes-associated-with-modic-1-changes-of-the-lumbar-spine-a-cross-sectional-study
#5
Christelle Nguyen, Marylène Jousse, Serge Poiraudeau, Antoine Feydy, François Rannou
BACKGROUND: Modic 1 changes are usually associated with degenerative disc disease (DDD). We aimed to compare Modic 1 changes with advanced degenerative disc disease (>50%-intervertebral space narrowing [IVSN]) to Modic 1 changes with less advanced lumbar degenerative disc disease (≤50%-IVSN). METHODS: We conducted a cross-sectional study. The computerized MRI database from a French tertiary care hospital was searched. Patients were included if they were ≥ 18 years old and had a lumbar MRI between January 1, 2006 and January 31, 2008, that showed a Modic 1 signal at a single level...
January 23, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28072809/optimal-angle-of-contralateral-oblique-view-in-cervical-interlaminar-epidural-injection-depending-on-the-needle-tip-position
#6
Jun Young Park, Myung-Hwan Karm, Doo Hwan Kim, Jae-Young Lee, Hye-Joo Yun, Jeong Hun Suh
BACKGROUND: Chronic neck and upper extremity pain associated with cervical origin is common, and cervical interlaminar epidural steroid injections (CILESIs) are frequently used to manage the symptoms of cervical spinal disorders. However, CILESIs are associated with risks such as dural puncture and cord injury. OBJECTIVES: We aimed to determine the optimal needle tip visualization, in order to minimize CILESIs-induced complications. STUDY DESIGN: Retrospective observational study...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28068232/analysis-of-the-factors-contributing-to-vertebral-compression-fractures-after-spine-stereotactic-radiosurgery
#7
David Boyce-Fappiano, Erinma Elibe, Lonni Schultz, Samuel Ryu, M Salim Siddiqui, Indrin Chetty, Ian Lee, Jack Rock, Benjamin Movsas, Farzan Siddiqui
PURPOSE: To determine our institutional vertebral compression fracture (VCF) rate after spine stereotactic radiosurgery (SRS) and determine contributory factors. METHODS AND MATERIALS: Retrospective analysis from 2001 to 2013 at a single institution was performed. With institutional review board approval, electronic medical records of 1905 vertebral bodies from 791 patients who were treated with SRS for the management of primary or metastatic spinal lesions were reviewed...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28063601/bone-marrow-fat-content-is-correlated-with-hepatic-fat-content-in-paediatric-non-alcoholic-fatty-liver-disease
#8
N Y Yu, T Wolfson, M S Middleton, G Hamilton, A Gamst, J E Angeles, J B Schwimmer, C B Sirlin
AIM: To investigate the relationship between bone marrow fat content and hepatic fat content in children with known or suspected non-alcoholic fatty liver disease (NAFLD). MATERIALS AND METHODS: This was an institutional review board-approved, Health Insurance Portability and Accountability Act (HIPAA)-compliant, cross-sectional, prospective analysis of data collected between October 2010 to March 2013 in 125 children with known or suspected NAFLD. Written informed consent was obtained for same-day research magnetic resonance imaging (MRI) of the lumbar spine, liver, and abdominal adiposity...
January 4, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28046784/mo-fg-campus-jep3-03-detection-of-unpredictable-patient-movement-during-sbrt-using-a-single-kv-projection-of-an-on-board-cbct-system-simulation-study
#9
Y Park, G Sharp, B Winey
PURPOSE: An unpredictable movement of a patient can occur during SBRT even when immobilization devices are applied. In the SBRT treatments using a conventional linear accelerator detection of such movements relies heavily on human interaction and monitoring. This study aims to detect such positional abnormalities in real-time by assessing intra-fractional gantry mounted kV projection images of a patient's spine. METHODS: We propose a self-CBCT image based spine tracking method consisting of the following steps: (1)Acquire a pre-treatment CBCT image; (2)Transform the CBCT volume according to the couch correction; (3)Acquire kV projections during treatment beam delivery; (4)Simultaneously with each acquisition generate a DRR from the CBCT volume based-on the current projection geometry; (5)Perform an intensity gradient-based 2D registration between spine ROI images of the projection and the DRR images; (6)Report an alarm if the detected 2D displacement is beyond a threshold value...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045758/a-virtual-reality-simulation-model-of-spinal-ultrasound-role-in-teaching-spinal-sonoanatomy
#10
Reva Ramlogan, Ahtsham U Niazi, Rongyu Jin, James Johnson, Vincent W Chan, Anahi Perlas
BACKGROUND AND OBJECTIVES: Ultrasound assessment of the lumbar spine improves the success of spinal and epidural anesthesia, especially for patients with underlying difficult anatomy. To assist with the teaching and learning of ultrasound-guided neuraxial anesthesia, we have created an online interactive educational model (http://www.usra.ca/vspine.php and http://pie.med.utoronto.ca/vspine). The aim of the current study was to determine whether the virtual spine model improved the knowledge of neuraxial anatomy and sonoanatomy...
March 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27913262/neurosurgeons-in-japan-are-exclusively-brain-surgeons
#11
REVIEW
Shunji Asamoto
In Japan, neurosurgeons have mainly treated brain diseases, with most cases involving the spine and spinal diseases historically being treated by orthopedists. Nowadays, spinal surgery is just one of the many subspecialties in the neurosurgical field in Japan. Most patients with neurological deficits or suspected neurological diseases are taken to board-certified neurosurgeons or go to them directly in Japan, not through referrals from family doctors or specialists in other fields. Problems originating in the spine and spinal cord have been overlooked or misdiagnosed in these situations...
November 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27909653/magnetic-resonance-imaging-of-the-cervical-spine-under-represents-sagittal-plane-deformity-in-degenerative-myelopathy-patients
#12
Douglas S Weinberg, Arunit J Chugh, Jeremy J Gebhart, Jason D Eubanks
BACKGROUND: In treating patients with cervical myelopathy, surgical approach may be dictated by sagittal balance, highlighting the need for accurate pre-operative assessment. Magnetic Resonance Imaging (MRI) is widely-recognized for its utility in the diagnosis and surgical planning of cervical myelopathy. Plain radiographs (X-rays) are a reliable tool to assess bony alignment. However, they may not always be included in standard pre-operative evaluation, especially in an era of restricted payer-environments...
2016: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/27909651/hybrid-decompression-and-fixation-technique-for-the-treatment-of-multisegmental-cervical-spondylotic-myelopathy
#13
Barón Zárate-Kalfopulos, Walter Araos-Silva, Alejandro Reyes-Sánchez, Luis Miguel Rosales-Olivarez, Armando Alpizar-Aguirre, Francisco Lopez Melendez
BACKGROUND: Cervical spondilotic myelopathy (CSM) is defined as the compromise of the spinal cord due to degenerative changes of the cervical spine. It is the most common cause of spinal cord dysfunction in patients over 55 years. An early surgical management it is paramount to achieve better neurological outcome. There is still controversy regarding the appropriate surgical treatment for multisegmental CSM involving three or more levels. The hybrid decompression and fixation technique combines one or two level corpectomy and a single level discectomy in order to obtain optimum decompression and fixation in patients with multilevel cervical myelopathy...
2016: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/27906944/the-safety-of-ct-guided-epidural-steroid-injections-in-an-older-patient-cohort
#14
Andrew J Fenster, Kevin Fernandes, Alan L Brook, Todd Miller
BACKGROUND: Epidural steroid injections (ESIs) are a common method for treating lower back pain, which is one of the most prevalent health-related complaints in the adult US population. Although the safety of CT-guided ESIs has been extensively studied in adults, there is limited data concerning the procedure's safety profile in an older patient population. OBJECTIVE: This retrospective study analyzed safety data among a single-center cohort of patients > 65 years-old who received one or more CT-guided interlaminar ESIs from 2012 to 2015...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27856389/mini-laparoscopy-of-removal-partial-adnexae-at-the-time-of-hysterectomy
#15
António Gutierrez Setúbal, João Sequeira Alves, Olga Lavado, Joana Faria
STUDY OBJECTIVE: To describe our technique of mini laparoscopic adnexectomy or salpingectomy at the time of total laparoscopic hysterectomy DESIGN: Step-by-step video explanation of our technique SETTING: The advantages of laparoscopic surgery have been widely recognised in the past two decades: improved vision, exposure, reduction in operative trauma because of smaller incisions and more gentle tissue´s handling, that result in a faster postoperative recovery. The technology development has allowed the use of smaller caliber instruments while maintaining the high standard surgical performance...
November 14, 2016: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27830448/estimating-the-effect-of-intravenous-acetaminophen-for-postoperative-pain-management-on-length-of-stay-and-inpatient-hospital-costs
#16
E Eve Shaffer, An Pham, Robert L Woldman, Andrew Spiegelman, Scott A Strassels, George J Wan, Thomas Zimmerman
INTRODUCTION: The provision of safe, effective, cost-efficient perioperative inpatient acute pain management is an important concern among clinicians and administrators within healthcare institutions. Overreliance on opioid monotherapy in this setting continues to present health risks for patients and increase healthcare costs resulting from preventable adverse events. The goal of this study was to model length of stay (LOS), potential opioid-related complications, and costs for patients reducing opioid use and adding intravenous acetaminophen (IV APAP) for management of postoperative pain...
January 2017: Advances in Therapy
https://www.readbyqxmd.com/read/27797678/anorexia-nervosa-analysis-of-trabecular-texture-with-ct
#17
Azadeh Tabari, Martin Torriani, Karen K Miller, Anne Klibanski, Mannudeep K Kalra, Miriam A Bredella
Purpose To determine indexes of skeletal integrity by using computed tomographic (CT) trabecular texture analysis of the lumbar spine in patients with anorexia nervosa and normal-weight control subjects and to determine body composition predictors of trabecular texture. Materials and Methods This cross-sectional study was approved by the institutional review board and compliant with HIPAA. Written informed consent was obtained. The study included 30 women with anorexia nervosa (mean age ± standard deviation, 26 years ± 6) and 30 normal-weight age-matched women (control group)...
October 31, 2016: Radiology
https://www.readbyqxmd.com/read/27779601/a-normative-baseline-for-the-srs-22-from-over-1000-healthy-adolescents-in-india-which-demographic-factors-affect-outcome
#18
Kushagra Verma, Senthil T Nathan, Carly D Comer, Baron Lonner, Suken A Shah
STUDY DESIGN: Prospective Analysis OBJECTIVE.: This study aims to: 1) establish a baseline for the SRS-22 in South East Asia and 2) evaluate the influence of patient demographics on the SRS-22. SUMMARY OF BACKGROUND DATA: Previous studies have established a baseline for the SRS-22 in the US and described the impact of patient demographics. While the SRS-22 is used internationally, limited normative data is available. METHODS: After approval from the local hospital and school board, 1200 adolescents (age 10-18) were asked to anonymously complete the SRS-22 in English...
October 24, 2016: Spine
https://www.readbyqxmd.com/read/27764719/leptomeningeal-metastasis-from-gynecologic-cancers-diagnosed-by-brain-mri
#19
Masafumi Toyoshima, Keita Tsuji, Shogo Shigeta, Hideki Tokunaga, Kiyoshi Ito, Yoh Watanabe, Kosuke Yoshinaga, Takeo Otsuki, Hitoshi Niikura, Nobuo Yaegashi
Leptomeningeal metastasis (LM) is rarely observed in gynecologic cancers. As gadolinium-enhanced magnetic resonance imaging (Gd-MRI) is highly effective for diagnosing LM, the aim of this study is to describe the clinical behaviors and outcomes of LM patients who were diagnosed by Gd-MRI. After securing institutional review board approvals, we retrospectively reviewed patient records. Eight patients were found to have LM from gynecological malignancies. Primary tumors included three ovarian cancers, one tubal cancer, one peritoneal cancer, two endometrial cancers, and one cervical cancer...
January 2017: Clinical Imaging
https://www.readbyqxmd.com/read/27748690/cervical-spine-immobilization-during-extrication-of-the-awake-patient-a-narrative-review
#20
Alan Cowley, Ashley Hague, Neal Durge
Techniques for extricating vehicle occupants after road-traffic collisions have evolved largely through fear of worsening a cervical spine injury, rather than being evidence-based. Recent research has looked at the safety of allowing the alert patient to self-extricate, rather than being assisted with equipment such as long spinal boards and semirigid cervical collars. This review aims to elucidate whether it is safe to allow an alert, ambulant patient to self-extricate from a vehicle with minimal or no cervical spine immobilization...
September 29, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
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