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Spinal Decompression

Ramesh Kumar, Frederic W B Deleyiannis, Corbett Wilkinson, Brent R O'Neill
OBJECTIVE The authors' goals in this study were to describe a series of dog attacks on children that required neurosurgical consultation and to better understand the pattern of injuries inflicted, the circumstances that place children at risk for attack, and the dog breeds involved. In addition, the authors review the surgical and medical management of these patients. METHODS The authors performed a retrospective review of all children requiring neurosurgical consultation for dog bite at a regional Level 1 pediatric trauma center over a 15-year period...
October 21, 2016: Journal of Neurosurgery. Pediatrics
Giancarlo D'Andrea, Giovanni Sessa, Veronica Picotti, Antonino Raco
We report the case of a large lumbar schwannoma eroding the vertebra and originating from spinal canal with invasion of the retroperitoneal space. We also review all the cases in literature reporting lumbar schwannomas eroding the vertebral bodies and invading the retroperitoneal space focusing on the surgical strategies to manage them. Spinal CT-scan revealed a 44 mm × 55 mm inhomogeneous soft-tissue mass arising from the right L5-S1 neural foramen and its most anterior portion had a clear colliquative aspect...
2016: Case Reports in Surgery
Mohamad Bydon, Mohamed Macki, Panagiotis Kerezoudis, Daniel M Sciubba, Jean-Paul Wolinsky, Timothy F Witham, Ziya L Gokaslan, Ali Bydon
INTRODUCTION: The objective of this study is to determine the incidence and prognostic factors of adjacent segment disease (ASD) following first-time lumbar discectomy (LD). METHODS: We retrospectively reviewed all neurosurgical patients who underwent first-time LD for degenerative lumbar disease from 1990 to 2012. ASD was defined as a clinical and radiographic progression of degenerative spinal disease that required surgical decompression (with or without fusion) at the level above or below the index discectomy...
October 17, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Tsuyoshi Goto, Toshinori Sakai, Tetsuya Enishi, Nori Sato, Koji Komatsu, Koichi Sairyo, Shinsuke Katoh
Neurogenic intermittent claudication is a main symptom in lumbar spinal stenosis (LSS), and postural change is often observed during walking. This study aimed to identify the changes in posture and muscle activity in the trunk and legs during walking in patients with LSS by examining 6 patients who had undergone decompression surgery. None of them had significant paralysis. Gait analysis using Vicon motion capture system(®) with electromyographic recordings of the paravertebral muscles (PVM) and vastus lateralis muscle (VL) was performed preoperatively and 2 weeks postoperatively...
October 6, 2016: Gait & Posture
Dat T Vo, George F Cravens, Robert E Germann
BACKGROUND: Intramedullary abscess is a rare neurosurgical condition that usually arises in the setting of penetrating trauma to the spinal cord, infected congenital dural sinuses, or tuberculosis. CASE PRESENTATION: We describe a case of a 35-year-old African American male who presented with sepsis and a clinical picture of meningitis. The patient continued to have declining neurological status with decreasing sensation and worsening motor strength in all four extremities...
October 19, 2016: Journal of Medical Case Reports
Shiro Imagama, Noriaki Kawakami, Yuji Matsubara, Taichi Tsuji, Tetsuya Ohara, Yoshito Katayama, Naoki Ishiguro, Tokumi Kanemura
STUDY DESIGN: Retrospective clinical study. OBJECTIVE: To investigate adjacent segment degeneration (ASD) at 5 years after L4/5 posterior lumbar interbody fusion with pedicle screw instrumentation and L4/5 decompression surgery using plain radiographs, computed tomography (CT), and magnetic resonance imaging (MRI), with the evaluation of annual changes on MRI. SUMMARY OF BACKGROUND DATA: Methods of evaluation have been inconsistent among studies of ASD...
November 2016: Clinical Spine Surgery
Maarten van Dijke, Stein J Janssen, Thomas D Cha, Kirkham B Wood, Lawrence F Borges, Mitchel B Harris, Christopher M Bono, Joseph H Schwab
STUDY DESIGN: This is a retrospective study. OBJECTIVE: To compare (1) recurrence of radiculopathy and (2) back pain after decompression with and without fusion for patients with a symptomatic synovial cyst. BACKGROUND: Previous work described favorable outcomes following cyst excision with and without fusion. Because of the association of facet cysts with spinal instability it is hypothesized that a decompression with fusion will lead to better outcomes...
October 6, 2016: Clinical Spine Surgery
M Ohashi, T Hirano, K Watanabe, K Katsumi, H Shoji, A Sano, H Tashi, I Takahashi, M Wakasugi, Y Shibuya, N Endo
STUDY DESIGN: Retrospective multicenter study. OBJECTIVES: To analyze the predictive factors for postoperative ambulatory recovery in paretic non-ambulatory patients with metastatic spinal cord compression (MSCC). SETTING: Japan. METHODS: Eighty-two consecutive patients (74.4% men; mean age, 66.2 years) who could not walk before surgery due to cervical or thoracic MSCC and underwent posterior decompressive surgery between 2003 and 2014 were included...
October 18, 2016: Spinal Cord
Javier Quillo-Olvera, Javier Quillo-Reséndiz, Carlos-Francisco Gutiérrez-Partida, Manuel Rodríguez-García
BACKGROUND: Arachnoid cysts of spine are a very rare occurrence. The aetiology still remains unclear, but the most accepted explanation is the existence of areas of weakness in the spinal dura. Symptoms depend on the location in the spine. Magnetic resonance imaging is used for its diagnosis. Management depends of clinical presentation, and the surgery is reserved for patients with neurological impairment. CLINICAL CASE: A case is described of 67 year-old male with myelopathy and radiculopathy symptoms, both diagnosed simultaneously...
October 14, 2016: Cirugia y Cirujanos
Andreas Kiilerich Andresen, Carsten Ernst, Mikkel Ø Andersen
Lumbar spinal stenosis is the most common reason for spinal surgery in Denmark. Lumbar spinal stenosis is a clinical syndrome of pain in the buttocks or lower extremities, with or without back pain. It is associated with reduced space available for the neural and vascular elements of the lumbar spine. The condition is often exacerbated by standing, walking or lumbar extension and relieved by forward flexion. The options for non-surgical management include drugs and physiotherapy. Treatment outcomes seem to be better for surgical neural decompression than for non-operative treatment...
October 10, 2016: Ugeskrift for Laeger
Abolfazl Rahimizadeh, Housain Soufiani, Valliolah Hassani, Ava Rahimizadeh
In this study the authors report the first example of spinal pseudarthrosis in a patient with ochronosis, and they describe the application of posterior-only 360° surgery as an alternative approach to combined anterior-posterior surgery in the management of pseudarthrosis of an ankylosed spine, regardless of its etiology. Spinal involvement in ochronosis produces loss of flexibility and ankylosis of thoracic and lumbar segments. Pseudarthrosis is a serious complication of the diseases that present with ankylosis of the spine...
October 14, 2016: Journal of Neurosurgery. Spine
Ikemefuna Onyekwelu, Steven D Glassman, Anthony L Asher, Christopher I Shaffrey, Praveen V Mummaneni, Leah Y Carreon
OBJECTIVE Prior studies have shown obesity to be associated with higher complication rates but equivalent clinical outcomes following lumbar spine surgery. These findings have been reproducible across lumbar spine surgery in general and for lumbar fusion specifically. Nevertheless, surgeons seem inclined to limit the extent of surgery, perhaps opting for decompression alone rather than decompression plus fusion, in obese patients. The purpose of this study was to ascertain any difference in clinical improvement or complication rates between obese and nonobese patients following decompression alone compared with decompression plus fusion for lumbar spinal stenosis (LSS)...
October 14, 2016: Journal of Neurosurgery. Spine
Marc Dreimann, Michael Hoffmann, Lennart Viezens, Lukas Weiser, Patrick Czorlich, Sven Oliver Eicker
PURPOSE: Metastatic epidural spinal cord compression (MESCC) often requires anterior-posterior decompression and stabilization. To reduce approach-related complications, single-stage posterolateral vertebrectomy and 360° fusion is often performed. However, a sufficient reduction of kyphotic deformity through this approach has not been reported. The purpose of this study is to investigate the efficacy of kyphotic deformity reduction by this approach in MESCC. METHODS: A retrospective analysis and chart review was performed for 14 consecutive patients who underwent a vertebrectomy and decompression from a posterolateral approach...
October 11, 2016: European Spine Journal
Shota Takenaka, Yukitaka Nagamoto, Hiroyuki Aono, Takashi Kaito, Noboru Hosono
BACKGROUND CONTEXT: The time of onset of postoperative upper limb palsy (ULP), also referred to as C5 palsy, varies among patients. Although some studies addressed the relationship between the time of onset of ULP and potential etiologies, no meta-analysis has been conducted regarding the association between the time of onset of ULP and other factors such as surgical procedure type and treated diseases. PURPOSE: To elucidate differences in the time of onset of ULP among spinal surgical procedures and treated diseases to understand its etiology...
October 7, 2016: Spine Journal: Official Journal of the North American Spine Society
Kae Sian Tay, Anupreet Bassi, William Yeo, Wai Mun Yue
BACKGROUND CONTEXT: There is no current literature comparing outcomes of patients with and without lumbar scoliosis having neurological symptoms undergoing Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS TLIF) technique. PURPOSE: To determine whether associated lumbar scoliosis will result in different clinical, radiological and operative outcomes in patients undergoing focal MISTLIF for neurogenic symptoms, without specific correction of the scoliosis...
October 7, 2016: Spine Journal: Official Journal of the North American Spine Society
Marin Stančić, Ivana Stančić, Petra Barl, Ivan Pašalić
OBJECTIVE: Scarcity of implants during the economic crisis has partially replaced cervical spondylotic myelopathy decompression and instrumented fusion with implant-less expansile cervical laminopalsty. The aim of the study was comparison of the results obtained with instrumented anterior cervical corpectomy and fusion (ACCF) with implant-less expansile cervical laminoplasty (ECL). METHODS: Patients suffering from cervical spondylotic myelopathy (CSM) Nurick 3-5, with preoperative tethering and postoperative untethering were included...
October 7, 2016: World Neurosurgery
Jonathan M Weimer, Martin Marinov, Rafi Avitsian
A 58-year old male with grade II L4-L5 spondylolisthesis and degenerative changes presented for single level transforaminal lumbar interbody fusion. During decompression of the L4 foramina, distraction of the disc space, and placement of the interbody cage and pedicle screws, episodes of extreme bradycardia with up to 5 seconds of asystole were detected on both EKG and invasive hemodynamic monitoring. The events correlated with and could possibly be a result of traction on the dura. Lumbar spinal surgery may be associated with electrophysiological and hemodynamic abnormalities, and anesthesia providers should be aware of such possibilities and the need to respond appropriately with sympathomimetic or vagolytic interventions...
October 7, 2016: World Neurosurgery
Samira Saadoun, Marios C Papadopoulos
This paper challenges the current management of acute traumatic spinal cord injury based on our experience with monitoring from the injury site in the neurointensive care unit. We argue that the concept of bony decompression is inadequate. The concept of optimum spinal cord perfusion pressure, which differs between patients, is introduced. Such variability suggests individualized patient treatment. Failing to optimize spinal cord perfusion limits the entry of systemically administered drugs into the injured cord...
October 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
Hideki Shigematsu, Jason Pui Yin Cheung, Kin-Cheung Mak, Mauro Bruzzone, Keith D K Luk
PURPOSE: Patients with pre-existing cervical spinal canal stenosis (CSCS) may have minimal or no symptoms. However, performing preventive decompression is controversial as the incidence of CSCS leading to severe cord injury is unknown. Hence, this study aims to revisit the threshold for surgery in "silent" CSCS by reviewing the neurologic outcomes of patients with undiagnosed CSCS who sustained a cervical spinal cord injury (CSCI). METHODS: Two groups of subjects were recruited for analysis...
October 3, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Yong-Hyun Hwang, Hee-Chun Lee, Jae-Hoon Lee
OBJECTIVE: To examine the technical feasibility of percutaneous endoscopic pediculectomy using a lateral approach and to evaluate its use for decompression and examination of the thoracic and lumbar spinal canals in small dogs. STUDY DESIGN: Experimental study. ANIMALS: Clinically normal adult dogs (n=10). METHODS: After optimizing the technique in cadavers, percutaneous endoscopic pediculectomy was performed using a lateral approach to the thoracic (T12) or lumbar (L2) vertebrae in 5 dogs each...
October 6, 2016: Veterinary Surgery: VS
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