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Spinal Decompression

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https://www.readbyqxmd.com/read/28731393/the-impact-of-decompression-with-instrumentation-on-local-failure-following-spine-stereotactic-radiosurgery
#1
Jacob A Miller, Ehsan H Balagamwala, Camille A Berriochoa, Lilyana Angelov, John H Suh, Edward C Benzel, Alireza M Mohammadi, Todd Emch, Anthony Magnelli, Andrew Godley, Peng Qi, Samuel T Chao
OBJECTIVE Spine stereotactic radiosurgery (SRS) is a safe and effective treatment for spinal metastases. However, it is unknown whether this highly conformal radiation technique is suitable at instrumented sites given the potential for microscopic disease seeding. The authors hypothesized that spinal decompression with instrumentation is not associated with increased local failure (LF) following SRS. METHODS A 2:1 propensity-matched retrospective cohort study of patients undergoing SRS for spinal metastasis was conducted...
July 21, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28727709/transforaminal-percutaneous-endoscopic-discectomy-and-foraminoplasty-after-lumbar-spinal-fusion-surgery
#2
Jian-Jun Wu, Hui-Zhen Chen, Changkun Zheng
BACKGROUND: The most common causes of pain following lumbar spinal fusions are residual herniation, or foraminal fibrosis and foraminal stenosis that is ignored, untreated, or undertreated. The original surgeon may advise his patient that nothing more can be done in his opinion that the nerve was visually decompressed by the original surgery. Post-operative imaging or electrophysiological assessment may be inadequate to explain all the reasons for residual or recurrent symptoms. Treatment of failed lumbar spinal fusions by repeat traditional open revision surgery usually incorporates more extensive decompression causing increased instability and back pain...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28723776/a-case-of-idiopathic-hypertrophic-pachymeningitis-presenting-with-chronic-headache-and-multiple-cranial-nerve-palsies-a-case-report
#3
Yuanyuan Huang, Jun Chen, Li Gui
RATIONALE: Idiopathic hypertrophic pachymeningitis (IHP) is a rare condition, characterized by a chronic fibrosing inflammatory process usually involving either the intracranial or spinal dura mater, but rarely both. Here, we report a rare case of IHP affecting both the intracranial and spinal dura mater. We also discussed the diagnosis, management, and outcome of IHP. PATIENT CONCERNS: We reviewed the case of a 60-year-old woman presenting with chronic headache, multiple cranial nerve palsies and gait disturbance...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28720998/spontaneous-spinal-epidural-abscess-in-a-normoglycemic-diabetic-patient-keep-it-as-a-differential
#4
Avinash Kumar, Vishal Kumar, Sarvdeep S Dhatt, Hitesh Lal, Raj Bahadur
Spinal epidural abscess (SEA) is a rare and serious condition which can lead to permanent neurological deficit. Spontaneous SEA is even rarer condition with an incidence of less than 1 per 10,000 person-year. Being spontaneous, it has high chances of being misdiagnosed, more so when the risk factors are not clearly explainable for the condition. This is a case report of such a case in a middle aged normoglycemic recently diagnosed diabetic man with atypical presentation. The diagnosis was made after magnetic resonance imaging and confirmed after surgical intervention in form of spinal decompression and patient recovered after appropriate antibiotics...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28720997/ossified-ligamentum-flavum-causing-neurological-deficit-above-the-level-of-post-tuberculous-kyphotic-deformity
#5
Suresh Subramani, Ajoy Prasad Shetty, Rishi Mugesh Kanna, Rajasekaran Shanmuganathan
Late onset paraplegia is a rare complication of spinal tuberculosis. Disease reactivation and cord compression by internal gibbus are the common causes for neurological deficit. We report a patient with post-tubercular kyphotic deformity in whom the late onset paraplegia is caused by ossified ligamentum flavum above the level of kyphotic deformity. The deficit was attributable to the ossified ligamentum flavum and she recovered completely following posterior decompression and instrumented posterolateral fusion...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28720994/early-migration-of-bone-graft-causing-sigmoid-colon-perforation-after-trans-foraminal-lumbar-interbody-fusion
#6
Bhavuk Garg, Amit Singla, Sahil Batra, Senthil Kumar
BACKGROUND: Tran foraminal lumbar interbody fusion (TLIF) is a well accepted and standard technique of achieving spinal fusion using pedicle screws, cage and bone graft. We are presenting here a case of L4-L5 lumbar canal stenosis managed with TLIF that presented with sigmoid colon perforation due to bone graft migration 4 days after surgery. CASE REPORT: A 35 years old female underwent open TLIF (from right side) with decompression for L4-L5 lumbar canal stenosis...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28720987/management-of-post-traumatic-neglected-cervical-facet-dislocation
#7
Vinay Prabhat, Tankeshwar Boruah, Hitesh Lal, Ramesh Kumar, Ashish Dagar, Harekrushna Sahu
BACKGROUND: Post-traumatic unilateral or bilateral sub-axial cervical spine dislocations with locked facets are quite common. In developing countries like India, many patients with cervical injuries report late due to many reasons like rural backgrounds, lack of infrastructures and skilled surgeons, unawareness, poor socioeconomic status, lack of transportation to the specialized center with proper facility, etc. Early management is essential to maximize better neurological outcome. Delayed or neglected presentation makes treatment more challenging...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28720984/spinal-cord-injury-the-role-of-surgical-treatment-for-neurological-improvement
#8
REVIEW
N Rath, B Balain
Acute spinal cord injury (ASCI) is common and no consensuses have been reached regarding timing of surgical decompression. This article highlights the main issues regarding surgical management of ASCI patients. The importance of timing of surgery along with physiological stability of the cord, and indications for surgery has been discussed to facilitate better understanding of the condition. The importance of the type of injury to the spinal column, besides the cord injury, is also discussed. A brief review of relevant literature has been done to try and answer the question whether early or late surgical treatment for ASCI is better than conservative management, reflecting the ethos of treatment for these problems in Robert Jones And Agnes Hunt Orthopaedic Hospital in Oswestry...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28720144/identifying-predictors-for-postoperative-clinical-outcome-in-lumbar-spinal-stenosis-patients-using-smart-shoe-technology
#9
Sunghoon I Lee, Andrew Campion, Alex Huang, Eunjeong Park, Jordan H Garst, Nima Jahanforouz, Marie Espinal, Tiffany Siero, Sophie Pollack, Marwa Afridi, Meelod Daneshvar, Saif Ghias, Majid Sarrafzadeh, Daniel C Lu
BACKGROUND: Approximately 33% of the patients with lumbar spinal stenosis (LSS) who undergo surgery are not satisfied with their postoperative clinical outcomes. Therefore, identifying predictors for postoperative outcome and groups of patients who will benefit from the surgical intervention is of significant clinical benefit. However, many of the studied predictors to date suffer from subjective recall bias, lack fine digital measures, and yield poor correlation to outcomes. METHODS: This study utilized smart-shoes to capture gait parameters extracted preoperatively during a 10 m self-paced walking test, which was hypothesized to provide objective, digital measurements regarding the level of gait impairment caused by LSS symptoms, with the goal of predicting postoperative outcomes in a cohort of LSS patients who received lumbar decompression and/or fusion surgery...
July 18, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/28712735/spontaneous-regression-of-post-traumatic-syringomyelia-a-case-report-and-literature-review
#10
Monish M Maharaj, Kevin Phan, Ralph Mobbs
Syringomyelia defines a condition in which myelopathy develops secondary to the formation of a cyst or cavity within the spinal cord parenchyma known as a syrinx. Although there is a significant volume of studies analysing the underlying mechanisms behind their formation, the management of such cavities remains an ongoing topic of debate. Aside from conservative approach, a range of surgical options exist, however long term outcomes are poor and a literature search reveals that the overall benefits are questionable...
July 13, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28711540/in-hospital-complications-following-lumbar-spine-surgery-in-patients-with-parkinson-s-disease-evaluation-of-the-national-inpatient-sample-database
#11
Joseph F Baker, Shearwood McClelland, Breton G Line, Justin S Smith, Robert A Hart, Christopher P Ames, Chris Shaffrey, Shay Bess
BACKGROUND: Previous reports suggest that patients with Parkinson's disease (PD) have increased complication rates following spine surgery however data from these reports are limited by small patient size. The aim of this study was to utilize the National Inpatient Sample (NIS) database to compare in-hospital complications for PD compared to patients without following elective lumbar spine surgery. METHODS: The NIS database was accessed to find patients who underwent lumbar spine surgery with and without a diagnosis of PD...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28711534/primary-intradural-extramedullary-cervical-spinal-cysticercosis
#12
Vetrivel Muralidharan, Bijesh Ravindran Nair, Bimal Patel, Vedantam Rajshekhar
BACKGROUND: Spinal cysticercosis has been reported only in 0.7 to 3.0% of patients with neurocysticercosis. Most of the patients with spinal cysticercosis have a coexisting intracranial disease. Most often these present as intradural extramedullary lesions, involving thoracic and lumbar regions or intramedullary lesions. Intradural extramedullary primary spinal cysticercosis presenting as cervical myelopathy is extremely rare and not reported till date. CASE DESCRIPTION: The authors describe a 56 year old man from the northeastern part of India with progressive spastic quadriparesis...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28710985/spinal-cord-compression-secondary-to-idiopathic-thoracic-epidural-lipomatosis-in-an-adolescent-a-case-report-and-review-of-literature
#13
Rumaiza Al-Yafeai, Yazid Maghrabi, Hussein Malibary, Saleh Baeesa
INTRODUCTION: Spinal epidural lipomatosis (SEL) is a rare condition that presents with progressive spinal cord or nerve root compression. It is commonly reported in patients receiving long-term exogenous steroid therapy or in patients with endogenous steroid overproduction. The occurrence of this condition as an idiopathic entity is rarely reported. CASE PRESENTATION: The authors present the clinical course and outcome of a 16-year-old male student, who presented with progressive spastic paraparesis of a one-year duration caused by idiopathic spinal epidural lipomatosis...
July 6, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28710043/minimally-invasive-computer-navigation-assisted-endoscopic-transforaminal-interbody-fusion-with-bilateral-decompression-via-a-unilateral-approach-initial-clinical-experience-at-one-year-follow-up
#14
Yaqing Zhang, Chuang Xu, Yue Zhou, Bo Huang
OBJECTIVE: The purpose of this study was to assess the feasibility of minimally invasive transforaminal lumbar interbody fusion (TLIF) and bilateral decompression via a unilateral approach that was performed with a novel working retractor with an endoscopic system for degenerative lumbar spondylolisthesis associated with spinal stenosis, to minimize surgical trauma without compromising the quality of the treatment outcome. METHODS: In this case series, the procedure was performed in 17 patients...
July 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28708647/pneumocephalus-induced-oculomotor-nerve-palsy-after-atlanto-occipital-decompression-with-dural-plasty
#15
Yunfeng Han, Jianjun Sun, Zhenyu Wang
BACKGROUND: Pneumocephalus after posterior fossa craniotomy is very common. However, cranial nerve dysfunction secondary to pneumocephalus is a very rare phenomenon. PATIENT PRESENTATION: This case reports a patient who suffers from Chiari I malformation with syringomyelia in cervical spinal cord and develops unilateral oculomotor nerve palsy after atlanto-occipital decompression with dural plasty. CONCLUSIONS: Cranial nerve dysfunction caused by pneumocephalus after craniotomy is rare and easily misdiagnosed...
July 13, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28705257/single-stage-transforaminal-decompression-debridement-interbody-fusion-and-posterior-instrumentation-for-lumbosacral-brucellosis
#16
Yakefu Abulizi, Wei-Dong Liang, Aikeremujiang Muheremu, Maierdan Maimaiti, Wei-Bin Sheng
BACKGROUND: Spinal brucellosis is a less commonly reported infectious spinal pathology. There are few reports regarding the surgical treatment of spinal brucellosis in existing literature. This retrospective study was conducted to determine the effectiveness of single-stage transforaminal decompression, debridement, interbody fusion, and posterior instrumentation for lumbosacral spinal brucellosis. METHODS: From February 2012 to April 2015, 32 consecutive patients (19 males and 13 females, mean age 53...
July 14, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28703331/high-resolution-diffusion-tensor-imaging-in-cervical-spondylotic-myelopathy-a-preliminary-follow-up-study
#17
Li Guan, Xiaolong Chen, Yong Hai, Xiaodong Ma, Le He, Guangzhi Wang, Chun Yuan, Hua Guo
Diffusion imaging is a promising technique as it can provide microstructural tissue information and thus potentially show viable changes in spinal cord. However, the traditional single-shot imaging method is limited as a result of various image artifacts. In order to improve measurement accuracy, we used a newly developed, multi-shot, high-resolution, diffusion tensor imaging (DTI) method to investigate diffusion metric changes and compare them with T2 -weighted (T2W) images before and after decompressive surgery for cervical spondylotic myelopathy (CSM)...
July 13, 2017: NMR in Biomedicine
https://www.readbyqxmd.com/read/28703022/lumbar-idiopathic-intervertebral-disc-calcification-associated-with-ossification-of-the-ligamentum-flavum-in-adult-a-case-report
#18
Danjie Zhu, Yu Chen
A 23 year-old female was diagnosed with lumbar idiopathic intervertebral disc calcification associated with ossification of OLF. The patient underwent posterior decompression and posterolateral fusion with pedicle screw fixation, which achieved excellent clinical improvement. Surgical intervention of a posterior approach for decompression and instrumented fusion is indicated in cases that the spinal cord compression with neurologic deficits was involved.
July 13, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28699426/management-of-hemothorax-after-thoracic-endovascular-aortic-repair-for-ruptured-aneurysms
#19
Mila H Ju, Michael J Nooromid, Heron E Rodriguez, Mark K Eskandari
Background Thoracic aortic aneurysm rupture is often a fatal condition. Emergent thoracic endovascular aortic repair (TEVAR) has emerged as a suitable treatment option. Unfortunately, respiratory complications from hemothorax continue to be an important cause of morbidity and mortality even after successful management of the aortic rupture. We hypothesize that early hemothorax decompression after TEVAR for ruptured aneurysms decreases the rate of postoperative respiratory complications. Methods Single-center, retrospective eight-year review of ruptured thoracic aneurysms treated with TEVAR...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28696946/optimal-treatment-for-lumbar-spinal-stenosis-an-update
#20
Janus Patel, Ian Osburn, Anne Wanaselja, Ryan Nobles
PURPOSE OF REVIEW: Our review of current literature within the past 12-24 months for the treatment of lumbar spinals stenosis (LSS) serves to update providers on recent advances and comparisons regarding therapy spanning lifestyle modification, pharmacologic therapy, minimally invasive interventions, and surgical interventions. RECENT FINDINGS: Current literature supporting the inclusion of physical therapy and gabapentin/pregabalin within an initial treatment regimen have been positive...
July 10, 2017: Current Opinion in Anaesthesiology
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