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https://www.readbyqxmd.com/read/28820759/thromboprophylaxis-in-spinal-surgery
#1
William P Mosenthal, David C Landy, Haroutioun H Boyajian, Olumuyiwa A Idowu, Lewis L Shi, Edwin Ramos, Michael J Lee
STUDY DESIGN: Systematic review and meta-analysis OBJECTIVE.: Determine the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) in spinal surgery patients receiving no thromboprophylaxis, mechanoprophylaxis, and chemoprophylaxis. SUMMARY OF BACKGROUND DATA: The incidence of thromboembolic complications after spinal surgery is not well established. While a variety of effective mechanical and chemical thromboprophylaxis interventions exist, their role in spinal surgery remains unclear...
August 17, 2017: Spine
https://www.readbyqxmd.com/read/28818179/multiple-trauma-and-emergency-room-management
#2
Michael Frink, Philipp Lechler, Florian Debus, Steffen Ruchholtz
BACKGROUND: The care of severely injured patients remains a challenge. Their initial treatment in the emergency room is the essential link between first aid in the field and definitive in-hospital treatment. METHODS: We present important elements of the initial in-hospital care of severely injured patients on the basis of pertinent publications retrieved by a selective search in PubMed and the current German S3 guideline on the care of severely and multiply traumatized patients, which was last updated in 2016...
July 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28817819/progressive-kyphosis-associated-with-tethered-cord-syndrome-treated-by-posterior-vertebral-column-resection-in-a-pediatric-patient
#3
Kadir Oktay, Kerem Mazhar Ozsoy, Yurdal Gezercan, Nuri Eralp Cetinalp, Tahsin Erman
Posterior vertebral column resection is a novel surgical approach for the treatment of progressive kyphosis associated with tethered cord syndrome that was first treated with untethering surgery. A patient with tethered cord syndrome associated with kyphosis first underwent untethering surgery, resulting in progressive kyphosis. Posterior vertebral column resection was performed to correct the kyphosis while shortening the spinal column to prevent the spinal cord from stretch injury. Good correction of kyphosis and reduction of tension on the neural elements were achieved without any neurological deficits...
August 18, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28817495/nursing-management-of-the-patient-undergoing-focused-ultrasound-a-new-treatment-option-for-essential-tremor
#4
Katherine Dale Shaw, Amy Sue Johnston, Shelly Rush-Evans, Susan Prather, Kathy Maynard
Essential tremor (ET) is among the most common neurological movement disorders that causes postural or action tremors, with an estimated prevalence nationwide of less than 3% of the population. The incidence of ET increases with age but often affects younger adults and has a familial trait association. Depending on disease progression, ET can cause significant limitations for individuals, in many cases, significantly limiting their ability to perform activities of daily living and occupational responsibilities...
August 16, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28816881/the-shikani-optical-stylet-as-an-alternative-to-awake-fiberoptic-intubation-in-patients-at-risk-of-secondary-cervical-spine-injury-a-randomized-controlled-trial
#5
Rabab S S Mahrous, Aly M M Ahmed
BACKGROUND: Conventional intubation of the trachea and consequent prone positioning of anesthetized patients with cervical spine instability may result in secondary neurological injury. Historically, flexible fiberoptics used to be the chief choice for patients presenting with cervical spine instability surgery with difficult airway. Recently, the rigid optical stylets have shown promise in assisting difficult intubations. PURPOSE: The aim of the present study was to compare the efficacy of Shikani optical stylet (SOS) with the flexible fiberscope for awake intubation in patients with cervical spine instability...
August 14, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28816878/do-formal-laminectomy-and-timing-of-decompression-for-patients-with-sacral-fracture-and-neurologic-deficit-affect-outcome
#6
Christopher K Kepler, Gregory D Schroeder, Douglas A Hollern, Jens R Chapman, Michael G Fehlings, Marcel Dvorak, Carlo Bellabarba, Alexander R Vaccaro
OBJECTIVES: To identify whether formal sacral decompression provides improvement in outcome for patients with neurologic deficit after sacral fracture compared with patients treated with indirect decompression and whether the timing of surgical decompression influences neurologic outcome? DATA SOURCES: MEDLINE was searched via PubMed using combinations of the following search terms: "Sacral fracture," "Traumatic Sacral fracture," "Sacral fracture decompression," "Sacral fracture time to decompression," "Sacral Decompression...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28816874/does-surgical-intervention-or-timing-of-surgery-have-an-effect-on-neurological-recovery-in-the-setting-of-a-thoracolumbar-burst-fracture
#7
So Kato, Jean-Christophe Murray, Brian K Kwon, Gregory D Schroeder, Alexander R Vaccaro, Michael G Fehlings
Traumatic thoracolumbar burst fractures are one of the most common forms of spinal trauma with the majority occurring at the junctional area where mechanical load is maximal (AOSpine Thoracolumbar Spine Injury Classification System Subtype A3 or A4). Burst fractures entail the involvement of the middle column, and therefore, they are typically associated with bone fragment in the spinal canal, which may cause compression of the spinal cord, conus medullaris, cauda equina, or a combination of these. Fortunately, approximately half of the patients with thoracolumbar burst fractures are neurologically intact due to the wide canal diameter...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28816870/spinal-cord-injury-what-are-the-controversies
#8
Christopher S Ahuja, Gregory D Schroeder, Alexander R Vaccaro, Michael G Fehlings
Traumatic spinal cord injuries have a tremendous impact on individuals, families, and society as a whole. Substantial heterogeneity in the patient population, their presentation and underlying pathophysiology has sparked debates along the care spectrum from initial assessment to definitive treatment. This article reviews spinal cord injury (SCI) management followed by a discussion of the salient controversies in the field. Current care practices modeled on the American Association of Neurological Surgeons/Congress of Neurological Surgeons joint section guidelines are highlighted including key recommendations regarding immobilization, avoidance of hypotension, early International Standards for Neurological Classification of SCI examination and intensive care unit treatment...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28816833/perioperative-use-of-erythromycin-reduces-cognitive-decline-after-coronary-artery-bypass-grafting-surgery-a-pilot-study
#9
Evanthia Thomaidou, Helena Argiriadou, Georgios Vretzakis, Kalliopi Megari, Nikolaos Taskos, Georgios Chatzigeorgiou, Kyriakos Anastasiadis
OBJECTIVES: Adverse neurologic outcome can be a debilitating complication after cardiac surgery. The aim of this study was to investigate the potential neuroprotective action of erythromycin, a well known antibiotic agent, regarding postoperative cognitive decline in patients undergoing cardiac surgery. METHODS: Forty patients scheduled for elective coronary artery bypass grafting surgery were prospectively randomly assigned in 2 groups: the erythromycin group (n = 19) who received erythromycin at a dose of 25 mg/kg before and after surgery and the control group (n = 21) who did not receive it...
August 14, 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28815357/carbon-fiber-reinforced-peek-fixation-system-in-the-treatment-of-spine-tumors-a-preliminary-report
#10
Stefano Boriani, Giuseppe Tedesco, Lu Ming, Riccardo Ghermandi, Maurizio Amichetti, Piero Fossati, Marco Krengli, Loredana Mavilla, Alessandro Gasbarrini
BACKGROUND: Protocols including combination of surgery and radiotherapy are more and more frequent in the treatment of bone tumors of the spine. In metastatic disease, combination of surgery and radiotherapy is since long time accepted, as based on clinical evidence. In primary tumors, combination of surgery and radiotherapy can be considered in all the cases in which a satisfactory oncological margin cannot be achieved: high-grade malignancies, recurrent tumors, huge tumors expanding in an extracompartimental area, and when tumor-free margin requires unacceptable functional sacrifices...
August 16, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28812201/effectiveness-of-navigation-guided-cyst-aspiration-before-resection-of-large-cystic-brain-tumors-a-proof-of-concept-for-more-radical-surgery
#11
Tae Hoon Roh, Kyoung Su Sung, Seok-Gu Kang, Ju Hyung Moon, Eui Hyun Kim, Sun Ho Kim, Jong Hee Chang
BACKGROUND: Resection of tumors close to the corticospinal tract (CST) carries a high risk of damage to the CST. For cystic tumors, aspirating the cyst before resection may reduce the risk of damage to vital structures. This study evaluated the effectiveness of cyst aspiration, by comparing the results before and after aspiration of diffusion tensor image (DTI) tractography. METHODS: This study enrolled 23 patients with large cystic brain tumors (>20 cm(3)) between 2012 and 2016...
August 16, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28811142/anatomical-analysis-of-human-ligamentum-flavum-in-the-cervical-spine-special-consideration-to-the-attachments-coverage-and-lateral-extent
#12
Mohammad Suhrab Rahmani, Hidetomi Terai, Javid Akhgar, Akinobu Suzuki, Hiromitsu Toyoda, Masatoshi Hoshino, Koji Tamai, Sayed Abdullah Ahmadi, Kazunori Hayashi, Shinji Takahashi, Hiroaki Nakamura
BACKGROUND: Posterior decompression surgeries of cervical spine such as laminoplasty and laminoforaminotomy are well established and increasing in aging population. The anatomical knowledge of cervical ligamentum flavum (LF) is critical to perform posterior spinal surgeries, however, few studies have evaluated it, especially the relation of LF and neural foramen. METHODS: The whole spine was removed en bloc from 15 formalin-embalmed human cadavers and then divided into two segments along the pedicle bases...
August 12, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28811042/understanding-readmissions-in-children-undergoing-surgery-a-pediatric-nsqip-analysis
#13
Afif N Kulaylat, Dorothy V Rocourt, Anthony Y Tsai, Kathryn L Martin, Brett W Engbrecht, Mary C Santos, Robert E Cilley, Christopher S Hollenbeak, Peter W Dillon
BACKGROUND: Readmission is increasingly being utilized as an important clinical outcome and measure of hospital quality. Our aim was to delineate rates, risk factors, and reasons for unplanned readmission in pediatric surgery. MATERIALS AND METHODS: Retrospective review of pediatric patients (n=130,274) undergoing surgery (2013-2014) at hospitals enrolled in the Pediatric National Surgical Quality Improvement Program (NSQIP-P) was performed. Logistic regression was used to model factors associated with unplanned 30-day readmission...
July 31, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28808901/the-utility-of-routine-intensive-care-admission-for-patients-undergoing-intracranial-neurosurgical-procedures-a-systematic-review
#14
Cesar Cimonari de Almeida, M Dustin Boone, Yosef Laviv, Burkhard S Kasper, Clark C Chen, Ekkehard M Kasper
BACKGROUND: Patients who have undergone intracranial neurosurgical procedures have traditionally been admitted to an intensive care unit (ICU) for close postoperative neurological observation. The purpose of this study was to systematically review the evidence for routine ICU admission in patients undergoing intracranial neurosurgical procedures and to evaluate the safety of alternative postoperative pathways. METHODS: We were interested in identifying studies that examined selected patients who presented for elective, non-emergent intracranial surgery whose postoperative outcomes were compared as a function of ICU versus non-ICU admission...
August 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28808751/new-reduction-technique-for-the-treatment-of-unilateral-locked-facet-joints-of-the-lower-cervical-spine-a%C3%A2-retrospective-analysis-of-12%C3%A2-cases
#15
Xinjia Wang, Guanfeng Yao, Yuchun Chen, Weidong Wang, Jican Zeng
BACKGROUND: Closed reduction of bilateral locked facet joints of the lower cervical spine is possible, but reduction of unilateral locked facet joints of the lower cervical spine (ULFJLCS) is challenging. We explored a new, simple, safe, and effective closed reduction method for the treatment of ULFJLCS. METHODS: A retrospective analysis was done on 12 consecutive cases with traumatic ULFJLCS that underwent closed reduction by Z‑shape elevating-pulling reduction through a halo-vest...
August 14, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28808605/fatal-cerebral-swelling-immediately-after-cranioplasty-a-case-report
#16
Yuta Kaneshiro, Keiji Murata, Shigeru Yamauchi, Yumiko Urano
BACKGROUND: Cranioplasty is a standard neurosurgical procedure which is performed after decompressive craniotomy. Fatal complications associated with this procedure are not well documented. Here, we report a case of fatal cerebral swelling after cranioplasty and discuss the possible mechanism of this complication. CASE DESCRIPTION: A 64-year-old man was admitted with the diagnosis of cerebral hemorrhage, and emergency surgery for hemorrhage removal and decompressive craniotomy were performed...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28807779/syringo-subarachnoid-shunt-for-the-treatment-of-persistent-syringomyelia-following-decompression-for-chiari-type-i-malformation-surgical-results
#17
Jehuda Soleman, Jonathan Roth, Andrea Bartoli, Daniel Rosenthal, Akiva Korn, Shlomi Constantini
BACKGROUND: Approximately 30% of patients treated by foramen magnum decompression (FMD) for Chiari I-associated-syringomyelia will show persistence, recurrence, or progression of the syrinx. OBJECTIVE: This study evaluates the clinical and radiological outcome of syringo-subarachnoid shunt (SSS) as the treatment for persistent syringomyelia after FMD. METHODS: Data was collected retrospectively. The primary outcome measurement was neurological function (assessed with the Modified Japanese Orthopedic Association (mJOA) scale)...
August 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28805756/-an-experience-of-neurophysiological-monitoring-in-neurosurgery
#18
A G Vasyatkina, E A Levin, K Yu Orlov, V V Kobozev
AIM: To evaluate the efficacy of neuromonitoring methods in prevention of postoperative neurological complications and estimation of predictive power of intraoperative changes in monitored characteristics. MATERIAL AND METHODS: Retrospective study examined 240 patients, operated in the years 2014-2015 using intraoperative neurophysiological monitoring. One hundred and seventy-three patients suffered from hemispheric lesions and 67 had lesions located in or near the brainstem...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28805755/-an-analysis-of-postoperative-cognitive-dysfunction-in-different-methods-of-coronary-artery-bypass
#19
G Yu Alekseevich, M V Rodikov, A V Marchenko, P A Myalyuk, G V Alekseevich
AIM: To evaluate changes in cognitive functions in patients with coronary heart disease before and after coronary artery bypass grafting (CABG) in a planned manner. MATERIAL AND METHODS: The study included 192 patients divided into 3 groups: in group 1 patients (n=88) underwent standard CABG; in group 2 (n=61) different methods of CABG were used; a control group consisted of 43 people. MMSE, FAB, Clock drawing test, Shultz tables, semantic verbal fluency, Wechsler adult intelligence scale were used for neurological testing...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28805753/-prognostic-significance-of-leukocyte-count-in-the-venous-blood-in-the-acute-stage-of-cerebral-aneurism-rupture
#20
A A Kalinkin, S S Petrikov, L T Khamidova, V V Krylov
AIM: To determine a prognostic role of leukocyte count in the venous blood in the acute stage of cerebral aneurysm (CA) rupture. MATERIAL AND METHODS: Fifty-one patients with CA rupture, aged from 20 to 65 years, hospitalized in the first 72 h over the period from 01.10.12 to 01.02.16 were examined. The severity of disease and anatomical form of hemorrhage was corresponded to III-IV degree on the W. Hunt - R. Hess scale and Fisher scale. All patients underwent surgery...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
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