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Spinal Decompression

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https://www.readbyqxmd.com/read/28643037/pediatric-spondylolysis-spinal-stenosis-and-disc-herniation-national-trends-in-decompression-and-discectomy-surgery-evaluated-through-the-kids-inpatient-database
#1
Tridu R Huynh, Carlito Lagman, Fadi Sweiss, Faris Shweikeh, Miriam Nuño, Doniel Drazin
PURPOSE: The purpose of this study is to describe national trends in spinal decompression without fusion and discectomy procedures in the US pediatric inpatient population. METHODS: The Kids' Inpatient Database (KID) was queried for pediatric patients with primary diagnoses of spinal spondylolysis/stenosis or disc herniation and having undergone spinal decompression without fusion or discectomy over more than a decade (2000 to 2012). The primary (indirect) outcomes of interest were in-hospital complication rates, length of stay (LOS), total costs, and discharge dispositions...
June 22, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28642180/obese-bmi-30-patients-have-greater-functional-improvement-and-reach-equivalent-outcomes-at-12-months-following-decompression-surgery-for-symptomatic-lumbar-stenosis
#2
Galal Elsayed, Matthew C Davis, Esther C Dupépé, Samuel G McCluggage, Paul Szerlip, Beverly C Walters, Mark N Hadley
OBJECTIVE: Here we evaluate the effect of obesity on 12-month functional outcomes following surgery for lumbar stenosis in an adult population. METHODS: Data were collected prospectively on patients treated with lumbar laminectomy for symptomatic lumbar spinal stenosis as part of an observational registry at a single institution from 2012 through 2014, and analyzed using a retrospective cohort study design. Patients with BMI>30 were compared to patients with BMI <30 with respect to baseline, 3-month, and 12-month functional status, adjusted for potential confounders...
June 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28638492/importance-of-radiological-evaluation-of-global-spinal-balance-together-with-lower-limb-alignment-in-planning-lumbar-spine-deformity-surgery-illustrative-case-presentation
#3
Mariusz Głowacki, Jerzy Walecki, Przemysław Kołakowski, Danuta Kolońska
BACKGROUND: The presented case illustrates the critical role of a detailed preoperative radiological evaluation in complex spine surgery. CASE REPORT: A 49-year-old patient was admitted for a revision surgery after L3-L5 fusion. Preoperative assessment showed preserved sagittal balance, coronal imbalance and valgus knee deformity. The patient reported pain of 8-10 in VAS (Visual Analogue Scale) and had an ODI (Oswestry Disability Index) of 60%. The first step of the surgery was L2-S1 fusion with decompression and spine deformity correction...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28637119/disco-vertebral-osteomyelitis-causing-intradural-spinal-abscess-with-cauda-equina-compression
#4
Anan Shtaya, Samantha Hettige
Intradural extramedullary spinal infections causing cauda equina compression are uncommon. We report an Escherichia coli bacteraemia causing lumbar discitis and an intracanalicular collection compressing the cauda equina: initially thought to be an epidural empyema, however microsurgery revealed an intradural location. Decompression, drainage, antibiotics, and neuropathy treatment are essential management.
March 3, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28637118/asymptomatic-chiari-type-i-malformation-should-patients-be-advised-against-participation-in-contact-sports
#5
Robert Spencer, Paul Leach
BACKGROUND: Chiari type I malformation (CM-I) is characterised by caudal displacement of the cerebellar tonsils through the foramen magnum, crowding the craniocervical junction. It is being increasingly diagnosed in asymptomatic patients due to the widespread availability of MRI, and there are case reports of these patients suffering sudden death or neurological injury following head or neck trauma, raising the issue of whether they should be prohibited from contact sport participation, given the likelihood of frequent trauma...
March 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28637116/neurosurgeon-or-spinal-surgeon-who-should-treat-cauda-equina-syndrome
#6
Christopher James Andrew Cowie, Jonathan Richard Ellenbogen
Suspected cauda equina syndrome (CES) requires urgent evaluation, investigation and treatment. Timing of cauda equina decompression is crucial, and delays in its management, leading to significant irreversible disability can be devastating for patient and surgeon alike. The standard of care in CES therefore needs to be clear and unambiguous. Todd and Dickson have written an excellent paper summarising the condition, and have outlined what they feel is the standard of care. We would ask the authors to clarify an important point...
March 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28634709/incidental-durotomy-in-decompression-for-lumbar-spinal-stenosis-incidence-risk-factors-and-effect-on-outcomes-in-the-spine-tango-registry
#7
Christian Herren, Rolf Sobottke, Anne F Mannion, Thomas Zweig, Everard Munting, Philippe Otten, Tim Pigott, Jan Siewe, Emin Aghayev
PURPOSE: The three aims of this Spine Tango registry study of patients undergoing decompression for spinal stenosis were to: report the rate of dural tear (DT) stratified by treatment centre; find factors associated with an increased likelihood of incurring a DT; and compare treatment outcomes in relation to DT (none vs. repaired vs. unrepaired DT). METHODS: Multivariate logistic regression was used to assess the association between DT and patient and treatment characteristics...
June 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28632590/comparison-of-anterior-and-posterior-surgery-for-degenerative-cervical-myelopathy-an-mri-based-propensity-score-matched-analysis-using-data-from-the-prospective-multicenter-aospine-csm-north-america-and-international-studies
#8
So Kato, Aria Nouri, Dongjin Wu, Satoshi Nori, Lindsay Tetreault, Michael G Fehlings
BACKGROUND: Surgeons often choose between 2 different approaches (anterior and posterior) for surgical treatment of degenerative cervical myelopathy on the basis of imaging features of spinal cord compression, the number of levels affected, and the spinal alignment. However, there is a lack of consensus on which approach is preferable. The objective of the present study was to use magnetic resonance imaging (MRI)-based propensity-score-matched analysis to compare postoperative outcomes between the anterior and posterior surgical approaches for degenerative cervical myelopathy...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28632556/watertight-sealing-without-lumbar-drainage-for-incidental-ventral-dural-defect-in-transthoracic-spine-surgery-a-retrospective-review-of-53-cases
#9
Sang-Hyeop Jeon, Sang-Ho Lee, Yi Sheng Tsang, Tag-Geun Jung, Ki-Hyoung Moon, Gun Choi, Ketan D Dilip
STUDY DESIGN: A retrospective review. OBJECTIVES: To evaluate the therapeutic efficacy of the triple layer closure technique to establish watertight sealing without diversion of lumbar drainage, in preventing persistent incidental subarachnoid-pleural fistula and other neurological complications related to excessive drainage of cerebrospinal fluid (CSF) after dural defect in transthoracic ossified posterior longitudinal ligament (OPLL) surgery. SUMMARY OF BACKGROUND DATA: CSF leakage into the pleural cavity leads to unfavorable conditions for natural healing of incidental durotomy due to the negative pressure environment of the pleural space and lack of wound healing around the bony cavity near the decompressed spinal cord...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28632546/clinical-outcome-and-postoperative-ct-measurements-of-microendoscopic-decompression-for-lumbar-spinal-stenosis
#10
Xu Zhou, Lei Zhang, Hai-Long Zhang, Shi-Sheng He, Xin Gu, Guang-Fei Gu, Qing-Song Fu
STUDY DESIGN: This was a retrospective case series. OBJECTIVE: To retrospectively evaluate the clinical outcome of microendoscopic decompression for lumbar spinal stenosis (LSS) including an evaluation of the extent of decompression using computed tomography. SUMMARY OF BACKGROUND DATA: Microendoscopic decompression has been a widely applied procedure to treat LSS with satisfactory outcomes and comparatively fewer complications and revision...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28631747/optimization-of-the-mean-arterial-pressure-and-timing-of-surgical-decompression-in-traumatic-spinal-cord-injury-a-retrospective-study
#11
A Dakson, D Brandman, G Thibault-Halman, S D Christie
STUDY DESIGN: A retrospective comparative study. OBJECTIVES: This study aims to investigate the extent to which early surgical decompression and maintenance of MAP ⩾85 mm Hg for 5 days postinjury affected neurological recovery utilizing internal controls for comparison of outcomes in patients with traumatic spinal cord injury. SETTING: Acute trauma center, Halifax, Nova Scotia, Canada. METHODS: We identified 94 cases of traumatic SCI...
June 20, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28625903/the-need-for-clinical-practice-guidelines-in-assessing-and-managing-perioperative-neurologic-deficit-results-from-a-survey-of-the-aospine-international-community
#12
A Nater, J C Murray, A R Martin, A Nouri, L Tetreault, M G Fehlings
OBJECTIVES: There is no standardized approach to assess and manage perioperative neurologic deficit (PND) in patients undergoing spinal surgery. This survey aimed to evaluate the awareness and usage of clinical practice guidelines (CPGs) as well as investigate how surgeons performing spine surgeries feel about and manage PND, and how they perceive the value of developing CPGs for the management of PND. METHODS: An invitation to participate was sent to the AOSpine International community...
June 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28624565/a-case-of-laterally-extended-high-positioned-chordoma-treated-using-the-high-cervical-retropharyngeal-approach
#13
Kiyoshi Ito, Takuya Nakamura, Tatsuro Aoyama, Tetsuyoshi Horiuchi, Kazuhiro Hongo
BACKGROUND: Several surgical approaches for the treatment of pathologies of the craniovertebral junction (CVJ) and high cervical regions have been reported. For the best postoperative results, selection of a surgical route to treat such pathologies should be based on a complete understanding of the approach. CASE DESCRIPTION: Here, we describe the case of a 64-year-old woman who presented with a 5-year history of motor and sensory disturbances in her right upper extremity...
June 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28623403/diffusion-tensor-imaging-can-predict-surgical-outcomes-of-patients-with-cervical-compression-myelopathy
#14
Satoshi Maki, Masao Koda, Mitsuhiro Kitamura, Taigo Inada, Koshiro Kamiya, Mitsutoshi Ota, Yasushi Iijima, Junya Saito, Yoshitada Masuda, Koji Matsumoto, Masatoshi Kojima, Takayuki Obata, Kazuhisa Takahashi, Masashi Yamazaki, Takeo Furuya
PURPOSE: The aim of this study was to assess the potential role of diffusion tensor imaging (DTI) as a predictor of surgical outcomes in patients with cervical compressive myelopathy (CCM). Surgical decompression is often recommended for symptomatic CCM. It is important to know the prognosis of surgical outcomes and to recommend appropriate timing for surgery. METHODS: We enrolled 26 patients with CCM who underwent surgery. The Japanese Orthopaedic Association (JOA) score for cervical myelopathy was evaluated before and 6 months after surgery...
June 16, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28620788/comparison-of-intraoperative-neurophysiologic-monitoring-outcomes-between-cervical-and-thoracic-spine-surgery
#15
Shujie Wang, Yuan Tian, Xiangquan Lin, Zhifu Ren, Yu Zhao, Jiliang Zhai, Xiaojuan Zhang, Yanwei Zhao, Yingyue Dong, Congran Zhao, Ye Tian
PURPOSE: The objective is to compare the intraoperative monitoring (IOM) outcomes between degenerative cervical and thoracic spine decompression surgery. METHOD: A total of 97 patients with cervical compression myelopathy (CCM) and 75 patients with thoracic compression myelopathy (TCM) were prospectively collected between December 2012 and June 2015 in our spine center. Somatosensory-evoked potentials (SSEP) and motor-evoked potentials (MEP) were used for IOM. The postoperative neurologic status of each patient was assessed immediately after surgery...
June 15, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28616883/treatment-for-thoracic-ossification-of-posterior-longitudinal-ligament-with-posterior-circumferential-decompression
#16
Zhao-Wan Xu, Yong-Cheng Hu, Chui-Guo Sun, Xiao-Peng Shang, Deng-Xing Lun, Feng Li, Xu-Bin Ji, Da-Yong Liu, Nai-Wang Chen, Qing-Shan Zhuang
OBJECTIVE: To report the results of the posterior approach for thoracic ossification of posterior longitudinal ligament (TOPLL) by using a special "L" osteotome. METHODS: The present study enrolled 16 consecutive patients (9 men and 7 women) between May 2009 and September 2013. All patients underwent a posterior circumferential decompression osteotomy and segmental instrumentation with interbody fusion. The mean age at surgery was 57.3 years (range, 37-68 years)...
June 14, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28616261/nerve-entrapment-as-a-cause-of-shoulder-pain-in-the-spinal-cord-injured-patient
#17
Catherine M Curtin, Carl-Goran Hagert, Claes Hultling, Elisabet Hagert
INTRODUCTION: Many people with chronic spinal cord injury (SCI) develop shoulder pain, which can adversely impact transfers and independence. Yet effective treatments remain elusive. CASE PRESENTATION: This report presents two patients with tetraplegia who had long-standing shoulder pain. Our exam showed muscle weakness and point tenderness, suggestive of nerve entrapments of the radial and axillary nerves in the posterior shoulder. These nerves were surgically decompressed and post-operatively the patients' pain resolved...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28616222/a-case-report-of-an-unusual-cause-of-postoperative-leg-pain-after-posterior-lumbar-fusion
#18
R Daureeawoo, S Baliga, W Mohahmed, E B Ahmed
We report the case of a 36-year old man who underwent elective posterior lumbar spinal fusion after presenting with bilateral leg pain with associated back pain. He had undergone a L5/S1 discectomy in 2001, which provided good symptomatic relief. On this admission, he underwent elective L4-S1 posterolateral fusion and bilateral L4/5 and L5/S1 decompression. Intra-operatively a pedicle screw had to be re-inserted after fluoroscopy confirmed a lateral breech. The patient had no major postoperative complications until the sixth day when the patient re-presented with acute leg pain and weakness...
July 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28614233/discordant-lumbar-epidural-hematoma-after-caudal-steroid-injection-a-case-report-care-compliant
#19
Jung Ju Choi, Young Jin Chang, Wol Seon Jung, Kyung Cheon Lee, Ju Ho Kim, Youn Yi Jo
RATIONALE: Caudal epidural injection is one of the conventional treatments of chronic back pain. Even though spinal epidural hematoma after caudal epidural injection is rare but it can cause serious neurologic complication. PATIENT CONCERNS: An 83-year-old woman taking cilostazol received caudal epidural steroid injection because of her chronic back pain. Six hours later, she experienced an acute hip pain which worsened with time. DIAGNOSIS: Magnetic resonance image showed acute cord compression due to a spinal epidural hematoma at L2-S1 level with concomitant central canal compromise at L2/3, L3/4 level...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28607814/chiari-i-malformation-and-syringomyelia-in-mucopolysaccharidosis-type-i-hurler-syndrome-treated-with-posterior-fossa-decompression-case-report-and-review-of-the-literature
#20
Vyacheslav Makler, Christina L Goldstein, Daniel Hoernschemeyer, Tomoko Tanaka
BACKGROUND: Hurler Syndrome is the most severe phenotype of mucopolysaccharidosis type I. With bone marrow transplant and enzyme replacement therapy, the life expectancy of a child with Hurler syndrome has been extended, predisposing them to multiple musculoskeletal issues most commonly involving the spine. CASE DESCRIPTION: This is the case report of a 6-year-old male with Hurler syndrome who was diagnosed with Chiari I malformation and cervicothoracic syringomyelia on a preoperative magnetic resonance imaging (MRI) for his thoracolumbar kyphosis...
2017: Surgical Neurology International
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