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Spinal Decompression

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https://www.readbyqxmd.com/read/28338449/development-of-a-preoperative-predictive-model-for-major-complications-following-adult-spinal-deformity-surgery
#1
Justin K Scheer, Justin S Smith, Frank Schwab, Virginie Lafage, Christopher I Shaffrey, Shay Bess, Alan H Daniels, Robert A Hart, Themistocles S Protopsaltis, Gregory M Mundis, Daniel M Sciubba, Tamir Ailon, Douglas C Burton, Eric Klineberg, Christopher P Ames
OBJECTIVE The operative management of patients with adult spinal deformity (ASD) has a high complication rate and it remains unknown whether baseline patient characteristics and surgical variables can predict early complications (intraoperative and perioperative [within 6 weeks]). The development of an accurate preoperative predictive model can aid in patient counseling, shared decision making, and improved surgical planning. The purpose of this study was to develop a model based on baseline demographic, radiographic, and surgical factors that can predict if patients will sustain an intraoperative or perioperative major complication...
March 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28331017/primary-vertebral-leiomyosarcoma-masquerading-as-a-nerve-sheath-tumour
#2
Irfan Ahmad, Nidhi Goyal, Chandi Prasad Bhatt, Kundan Singh Chufal
A 47-year-old woman presented with symptoms of low back pain and weakness in bilateral lower limbs. MRI of the spine revealed a mass arising from T11 vertebra involving neural foramina at bilateral T11-12 and right T10-11 levels with extension to the right paravertebral region. Suspecting a nerve sheath tumour, she underwent posterior spinal decompression, stabilisation and debulking, following which her neurological symptoms resolved. Histopathological and immunohistochemical evaluation revealed a leiomyosarcoma...
March 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28329748/extensive-multilevel-split-laminotomy-for-debulking-a-cervicothoracolumbar-nondysraphic-intramedullary-spinal-cord-lipoma-in-a-2-month-old-infant
#3
Ha Son Nguyen, Sean Lew
INTRODUCTION: Laminectomy is the traditional approach for posterior exposure of the spinal canal for tumor resection. Another technique is split laminotomy, which entails the division and retraction of the spinous processes and laminae to access the thecal sac. This technique has been employed for small-segment exposures, but not extensively explored for long-segment exposures. CASE: A 2-month-old male presented with progressive right-leg plegia. MRI of the spine revealed a large, intramedullary spinal-cord lipoma extending from C6 to L5...
March 23, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28328849/protrusion-of-a-rod-into-the-spinal-canal-10-years-after-segmental-lumbar-spine-surgery
#4
Siyi Cai, Xiangyi Kong, Chengrui Yan, Yipeng Wang, Xueshuai Wan, Jialu Zhang, Guixing Qiu, Keyi Yu
The objective of this article is to report an unusual case of a spinal rod that protruded into the spinal canal after lumbar spine surgery.Only 4 cases of spinal rod migration with protrusion into the spinal canal have been reported. This is the first report of a case involving the use of posterior low lumbar segmental instrumentation with a screw-rod system. The left side of the rod gradually migrated and finally protruded into the canal and compressed the cord.A 60-year-old woman presented with pain and numbness of the posterior aspect of the left leg after a long-distance walk...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28327997/lumbar-fusion-for-degenerative-disease-a-systematic-review-and-meta-analysis
#5
Daniel Yavin, Steven Casha, Samuel Wiebe, Thomas E Feasby, Callie Clark, Albert Isaacs, Jayna Holroyd-Leduc, R John Hurlbert, Hude Quan, Andrew Nataraj, Garnette R Sutherland, Nathalie Jette
BACKGROUND: Due to uncertain evidence, lumbar fusion for degenerative indications is associated with the greatest measured practice variation of any surgical procedure. OBJECTIVE: To summarize the current evidence on the comparative safety and efficacy of lumbar fusion, decompression-alone, or nonoperative care for degenerative indications. METHODS: A systematic review was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (up to June 30, 2016)...
March 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327114/study-protocol-for-a-randomized-controlled-trial-comparing-clinical-and-radiological-results-after-three-different-posterior-decompression-techniques-for-lumbar-spinal-stenosis-the-spinal-stenosis-trial-sst-part-of-the-nordsten-study
#6
Erland Hermansen, Ivar Magne Austevoll, Ulla Kristina Romild, Frode Rekeland, Tore Solberg, Kjersti Storheim, Oliver Grundnes, Jørn Aaen, Jens Ivar Brox, Christian Hellum, Kari Indrekvam
BACKGROUND: There are several posterior decompression techniques for lumbar spinal stenosis (LSS). There is a trend towards performing less invasive surgical procedures, but no multicentre randomized controlled trials have evaluated the relative efficacy of these techniques at short and long-term. METHOD/DESIGN: A multicentre randomized controlled trial [the Spinal Stenosis Trial (SST) (part of the NORDSTEN study)] including 465 patients aged 18-80 years with neurogenic claudication or radiating pain and MRI findings indicating lumbar spinal stenosis without spondylolisthesis is performed to compare three posterior decompression techniques: unilateral laminotomy with crossover, bilateral laminotomy and spinous process osteotomy...
March 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28324328/interspinous-implants-to-treat-spinal-stenosis
#7
REVIEW
Raj J Gala, Glenn S Russo, Peter G Whang
PURPOSE OF REVIEW: Lumbar spinal stenosis has historically been treated with open decompressive surgery which is associated with significant morbidity and may give rise to various complications. Interspinous spacers (ISS) have been developed as a less invasive strategy which may serve to avoid many of these risks. The two current spacers that are FDA approved and commercially available are the Coflex and Superion devices. The goal is to review these two implants, their indications, and patient selection...
March 21, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28323696/a-new-angled-chisel-for-microendoscopic-decompressive-laminotomy
#8
Shu Nakamura, Motohide Shibayama, Fujio Ito, Yasushi Miura
STUDY DESIGN: A retrospective comparative series study. OBJECTIVE: The aim of the study was to describe a new angled chisel (NAC) that facilitates the osteotomy in microendoscopic decompressive laminotomy (MEDL), and to analyze the clinical and radiologic outcomes using the tool. SUMMARY OF BACKGROUND DATA: MEDL for lumbar spinal stenosis is a minimally invasive surgery. The paraspinous unilateral approach for bilateral decompression can preserve the posterior structure better than other methods...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323238/preoperative-retrolisthesis-as-a-predictive-risk-factor-of-reoperation-due-to-delayed-onset-symptomatic-foraminal-stenosis-after-central-decompression-for-lumbar-canal-stenosis-without-fusion
#9
Daisuke Ikegami, Noboru Hosono, Yoshihiro Mukai, Kosuke Tateishi, Takeshi Fuji
BACKGROUND CONTEXT: For patients diagnosed with lumbar central canal stenosis with asymptomatic foraminal stenosis (FS), surgeons occasionally only decompress central stenosis and preserve asymptomatic FS. These surgeries have the potential risk of converting preoperative asymptomatic FS into symptomatic FS postoperatively by accelerating spinal degeneration, which requires reoperation. However, little is known about delayed onset symptomatic FS postoperatively. PURPOSE: This study aimed to evaluate the rate of reoperation for delayed onset symptomatic FS after lumbar central canal decompression in patients with preoperative asymptomatic FS, and determine the predictive risk factors of those reoperations...
March 17, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28321306/alveolar-soft-part-sarcoma-of-the-mediastinum-a-case-report
#10
Yohei Kameda, Teppei Nishii, Masahiro Tsuboi, Hiromasa Arai, Kenji Inui, Takeshi Kaneko, Noriko Kimura, Mitsuhide Naruse, Munetaka Masuda
We report a 53-year-old man with metastases of alveolar soft-part sarcoma originated from the mediastinum. He was hospitalized due to lower extremities' paralysis. Computed tomography scan findings revealed multiple nodules of bilateral lungs, swollen mediastinal lymph nodes, and osteolysis of thoracic vertebrae. We performed spinal decompression and biopsy from vertebra. And, we finally diagnosed this case as metastases of mediastinal alveolar soft-part sarcoma which was removed 10 years ago. Alveolar soft-part sarcoma is rare tumor accounted for 0...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28320890/a-biophysical-vascular-bubble-model-for-devising-decompression-procedures
#11
Ran Arieli, Abraham Marmur
Vascular bubble models, which present a realistic biophysical approach, hold great promise for devising suitable diver decompression procedures. Nanobubbles were found to nucleate on a flat hydrophobic surface, expanding to form bubbles after decompression. Such active hydrophobic spots (AHS) were formed from lung surfactants on the luminal aspect of ovine blood vessels. Many of the phenomena observed in these bubbling vessels correlated with those known to occur in diving. On the basis of our previous studies, which proposed a new model for the formation of arterial bubbles, we now suggest the biophysical model presented herein...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28320256/internal-decompression-for-spinal-stenosis-idss-for-decompression-and-use-of-interlaminar-dynamic-device-coflextm-for-stabilization-in-the-surgical-management-of-degenerative-lumbar-canal-stenosis-with-or-without-mild-segmental-instability-our-initial-results
#12
Sumeet G Pawar, Arjun Dhar, Apurva Prasad, Satyashiva Munjal, P S Ramani
INTRODUCTION: Internal decompression of spinal stenosis (IDSS) and Posterior dynamic stabilization (PDS) form a bridge between decompression laminectomy alone and rigid fusion, by attempting to sustain beneficial effects of decompression and stabilization in an attempt to prevent bad effects of relentless degeneration. OBJECTIVE: To evaluate the clinical outcome in operated patient of posterior dynamic stabilization. DESIGN: Data were collected over 1 year in prospective, nonrandomized follow-up study using outcome scales...
March 21, 2017: Neurological Research
https://www.readbyqxmd.com/read/28320028/extent-of-decompression-of-lumbar-spinal-canal-after-endoscopic-surgery
#13
Naresh Kumar Dewanngan, Yad Ram Yadav, Vijay Singh Parihar, Shailendra Ratre, Yatin Kher, Pushpraj Bhatele
Introduction Endoscopic techniques are being used in lumbar disk disease and lumbar canal stenosis to decompress the spinal canal. The present study analyzed pre- and postoperative magnetic resonance imaging (MRI) measurements of the lumbar canal. Material and Methods This was a prospective study of 30 lumbar levels. Patients < 18 years of age with unilateral compression, previous surgery at the same level, and spinal instability were excluded. Endoscopic posterior decompression was used. Pre- and postoperative MRIs of all the patients were performed...
March 20, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28319468/the-impact-of-cage-dimensions-positioning-and-side-of-approach-in-extreme-lateral-interbody-fusion
#14
Marjan Alimi, Gernot Lang, Rodrigo Navarro-Ramirez, Moritz Perrech, Connor Berlin, Christoph P Hofstetter, Yu Moriguchi, Eric Elowitz, Roger Härtl
STUDY DESIGN: This is a retrospective single-center study. OBJECTIVE: The aim of the study was to evaluate the impact of cage characteristics and position toward clinical and radiographic outcome measures in patients undergoing extreme lateral interbody fusion (ELIF). SUMMARY OF BACKGROUND DATA: ELIF is utilized for indirect decompression and minimally invasive surgical treatment for various degenerative spinal disorders. However, evidence regarding the influence of cage characteristics in patient outcome is minimal...
March 17, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28306488/spinal-neurenteric-cyst-in-a-dog
#15
Daniela S Alder, Anna Oevermann, Stephan A Pfister, Frank Steffen
CASE DESCRIPTION An 11-year-old English Cocker Spaniel was evaluated because of chronic progressive ataxia of the hind limbs. CLINICAL FINDINGS The dog had no history of previous illness, and findings of physical examination and laboratory tests were unremarkable. Neurologic examination revealed that the dog was ambulatory with severe ataxia of the hind limbs. Proprioception was decreased in the right and left hind limbs (right affected more than left), and spinal reflexes were bilaterally unremarkable. Moderate signs of pain were detected during palpation of the lumbar portion of the vertebral column...
April 1, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28304239/immunoglobulin-g4-related-epidural-inflammatory-pseudotumor-presenting-with-pulmonary-complications-and-spinal-cord-compression-case-report
#16
Kavelin Rumalla, Kyle A Smith, Paul M Arnold
Immunoglobulin G4-related disease (IgG4-RD) is a recently defined condition characterized by inflammatory tumefactive lesions in various organ systems. IgG4-RD is a clinical and radiological diagnosis of exclusion and requires the presence of specific histopathological criteria for diagnosis. A 50-year-old man presented to an outside hospital with a 3-month history of progressively worsening back pain and symptoms of pleurisy, nasal crusting, and hematochezia. Radiological workup revealed an epidural-paraspinal mass with displacement of the spinal cord, destruction of the T5-6 vertebrae, and extension into the right lung...
March 17, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28304238/remote-motor-system-metabolic-profile-and-surgery-outcome-in-cervical-spondylotic-myelopathy
#17
Sorin C Craciunas, Mircea R Gorgan, Bogdan Ianosi, Phil Lee, Joseph Burris, Carmen M Cirstea
OBJECTIVE In patients with cervical spondylotic myelopathy (CSM), the motor system may undergo progressive functional/structural changes rostral to the lesion, and these changes may be associated with clinical disability. The extent to which these changes have a prognostic value in the clinical recovery after surgical treatment is not yet known. In this study, magnetic resonance spectroscopy (MRS) was used to test 2 primary hypotheses. 1) Based on evidence of corticospinal and spinocerebellar, rubro-, or reticulospinal tract degeneration/dysfunction during chronic spinal cord compression, the authors hypothesized that the metabolic profile of the primary motor cortices (M1s) and cerebellum, respectively, would be altered in patients with CSM, and these alterations would be associated with the extent of the neurological disabilities...
March 17, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28303070/discrimination-between-spinal-extradural-meningioma-and-both-intra-and-extradural-meningioma-case-report
#18
Kenyu Ito, Shiro Imagama, Kei Ando, Kazuyoshi Kobayashi, Tetsuro Hida, Mikito Tsushima, Akiyuki Matsumoto, Masayoshi Morozumi, Satoshi Tanaka, Yoshihiro Nishida, Naoki Ishiguro
Meningiomas are common spinal tumor and mostly located at intradura. Recurrence rate after surgery for extradural meningioma was higher than intradural meningioma. A patient with intra and extradural spinal meningioma was treated and discussed its features and clinical management. A 41-year-old woman noted numbness of bilateral legs, gait disturbance, and mild bladder disturbance for over the two-month period. Magnetic resonance imaging revealed an epidural mass at T8-9 involving the dura mater from the left side...
February 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/28297693/-a-case-of-central-type-disc-herniation-at-the-c7-t1-level-presenting-with-myelopathy
#19
Masatoshi Yunoki, Takahiro Kanda, Kenta Suzuki, Atsuhito Uneda, Koji Hirashita, Kimihiro Yoshino
In contrast to other levels of upper disc spaces, the Luschka joints are usually absent at the C7/T1 disc space. Therefore, it has been reported that the C7/T1 disc herniation is prone to herniate laterally rather than centrally. In this manuscript, we describe an extremely rare central-type disc herniation at the C7/T1 level presented with myelopathy. A 76-year-old man presented with a 20-day history of progressive gait disturbance. Physical examination revealed bilateral lower extremity hyperreflexia and mild foot numbness with no upper extremity motor weakness or sensory disturbance...
March 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28296378/-type-i-chiari-malformation-associated-with-cerebellar-atrophy-case-report
#20
Luis Rafael Moscote-Salazar, Willem Guillermo Calderón-Miranda, Hernando Raphael Alvis-Miranda, Ángel Lee-Aguirre, Gabriel Alcalá-Cerra
Chiari malformation is characterized by caudal displacement of the cerebellar tonsils that penetrate into the spinal canal through the foramen magnum, achieving reach the atlas or axis. trunk and any drop of the fourth ventricle is observed. Typically is seen in young adults. In some cases scoliosis and Syringomyelic cavities may occur. The authors present (as far as they know) the first case in the literature with long term follow-up, of a caucasian woman with an unusual form of cerebellar atrophy and Chiari Type I malformation, suffering from weakness in his upper and lower extremities with rapidly progression...
March 2017: Revista Médica del Instituto Mexicano del Seguro Social
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