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Spinal anatomy

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https://www.readbyqxmd.com/read/29223522/custom-made-titanium-3d-printed-interbody-cages-for-treatment-of-osteoporotic-fracture-related-spinal-deformity
#1
Timothy Siu, Jeffrey M Rogers, Kainu Lin, Robert Thompson, Mark Owbridge
BACKGROUND: Advances in minimally invasive interbody fusion have greatly enhanced surgeons' capability to correct adult spinal deformity with reduced morbidity. However, the feasibility of such approaches is limited in patients with previous osteoporotic fractures as the resultant vertebral deformity renders the endplate geometry incongruous with conventional interbody implants. Current 3D printing technology offers a novel solution by fabricating custom-made implants tailored to individual anatomy...
December 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29223517/combined-spinal-arteriovenous-malformation-and-spinal-dysraphism
#2
Civan Islak, Sedat Giray Kandemirli, Osman Kizilkilic, Naci Kocer, Saffet Tuzgen, Mehmet Murat Hanci
BACKGROUND: Spinal vascular malformations as a group are rare entities and coexistence of spinal arteriovenous malformation in or around the spinal dysraphism is extremely rare. CASE DESCRIPTION: Herein, we report two cases of combined spinal dysraphism and vascular malformations of the spinal cord. The first case is an arteriovenous malformation located in a filum terminale lipoma fed by the artery of filum terminale. This case was managed by multiple endovascular embolizations followed by surgery...
December 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29222266/impact-of-bone-disease-and-pain-in-thalassemia
#3
REVIEW
Antonio Piga
Conventional treatment of thalassemia, namely regular blood transfusion and iron chelation, improves perspectives and quality of life; however, successful treatment leads to more time in which long-term complications such as bone disease can develop. Thalassemia bone disease (TBD) is unique: all aspects, from bone anatomy and bone quality to mineral density, may be affected, with important morbidity including osteoporosis, fractures, spinal deformities, nerve compression, and pain. Clinical presentations include growth impairment, rickets-like features, back pain, spinal deformities, any sign of nerve compression, severe osteoporosis, and fragility fractures...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29202743/posterior-intervertebral-space-debridement-annular-bone-grafting-and-instrumentation-for-treatment-of-lumbosacral-tuberculosis
#4
Weiwei Li, Jun Liu, Liqun Gong, Yongchun Zhou, Dapeng Duan
BACKGROUND: The choice of surgical methods for lumbosacral tuberculosis is controversial due to the complex anterior anatomy and peculiar biomechanics of the lumbosacral junction. The objective of this study was to explore the clinical effect of posterior intervertebral space debridement with annular bone graft fusion and fixation for the treatment of lumbosacral tuberculosis. METHODS: We retrospectively analysed data from 23 patients with lumbosacral tuberculosis who had undergone posterior intervertebral space debridement with annular bone fusion and fixation between January 2008 and September 2014...
December 4, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29189495/lumbar-spine-anatomy-in-women-sustaining-unintentional-dural-puncture-during-labor-epidural-placement-a-descriptive-study-using-magnetic-resonance-imaging-and-ultrasound
#5
Nicholas M Barrett, Cristian Arzola, Timo Krings, Kristi Downey, Jose C A Carvalho
BACKGROUND AND OBJECTIVES: Unintentional dural puncture is one of the most frequent complications of the epidural technique. One previous study suggested that atypical sonoanatomy of the ligamentum flavum/dura mater unit may be a risk factor for this complication. In this study, we describe the anatomy of the lumbar spine, assessed by magnetic resonance imaging (MRI) and ultrasound, in women sustaining unintentional dural puncture during epidural catheter placement for labor analgesia...
November 15, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29173662/image-and-contrast-flow-pattern-interpretation-for-attempted-epidural-steroid-injections
#6
REVIEW
Michael B Furman, Anthony A Cuneo
Fluoroscopically guided, contrast-enhanced epidural steroid injections (ESIs) are frequently performed for radicular symptoms. Interventionalists performing these procedures should have a thorough and detailed understanding of spinal anatomy to safely and effectively deliver the desired injectate to the targeted site. Being able to differentiate epidural from nonepidural contrast flow is vital as is recognizing flow to undesired locations. This article summarizes the characteristics that distinguish between ideal epidural flow patterns and nonideal subarachnoid, intradural, and other suboptimal contrast flow patterns...
February 2018: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/29150315/surgical-options-for-osteoporotic-vertebral-compression-fractures-complicated-with-spinal-deformity-and-neurologic-deficit
#7
Kalliopi Alpantaki, Michael Dohm, Panagiotis Korovessis, Alexander G Hadjipavlou
INTRODUCTION: This paper describes surgical options for Osteoporotic vertebral compression fracture (OVCF) with acute flexible or chronic rigid kyphosis, and pseudarthrosis complicated with pain and neurologic deficit. METHODS: This study has two components. a) A prospective clinical study of surgical treatment of 31 patients (age: 69±11 years) with either acute flexible or progressive pseudarthrotic kyphosis manifested with severe pain or neurological deficit between 2010 and 2014...
November 12, 2017: Injury
https://www.readbyqxmd.com/read/29135880/histological-osteoarthritic-changes-in-the-human-cervical-spine-facet-joints-related-to-age-and-gender
#8
Lars Uhrenholt, Annie Vesterby Charles, Markil Gregersen, Jan Hartvigsen, Ellen-Margrethe Hauge
STUDY DESIGN: Cross-sectional autopsy study. OBJECTIVE: Quantify histological changes in the lower cervical spine facet joints with regard to age and gender using systematic random sampling of entire joints. SUMMARY OF BACKGROUND DATA: Neck pain is a common debilitating musculoskeletal condition and one of the highest ranked causes of years lived with disability. The cause of neck pain is multifactorial and osteoarthritis is one potential cause...
November 10, 2017: Spine
https://www.readbyqxmd.com/read/29100806/comparison-of-sacrificed-healthy-aorta-during-thoracoabdominal-aortic-aneurysm-repair-using-off-the-shelf-endovascular-branched-devices-and-open-surgery
#9
Luca Bertoglio, Tommaso Cambiaghi, Ciro Ferrer, Domenico Baccellieri, Fabio Verzini, Germano Melissano, Roberto Chiesa, Yamume Tshomba
BACKGROUND: Off-the-shelf devices for branched endovascular aortic repair of thoracoabdominal aortic aneurysm (TAAA) have been developed to overcome the manufacturing- and logistics-related delays characteristic of device customization. Nonetheless, the structural requirements of branched endovascular aortic repair, together with the need for additional thoracic components to suit different anatomies, might lead to a large sacrifice of healthy aorta. METHODS: We enrolled 18 consecutive TAAA patients treated between 2010 and 2016 in two centers employing the off-the-shelf t-Branch (Cook Medical, Bloomington, Ind) device (TB group)...
October 31, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29098965/orthopedic-injuries-in-pediatric-trauma
#10
Eman Loubani, Rodrick Lim, Debra Bartley
Trauma remains the leading cause of death in children, of which the majority of patients have orthopedic injuries. The range of injured bones is various, each requiring knowledge and expertise to appropriately manage in a timely fashion. The importance of a systematic approach to the pediatric polytrauma patient is paramount. This chapter will highlight orthopedic issues important to the pediatric polytrauma patient including the unique anatomy and properties of pediatric bone. A systematic approach to the pediatric polytrauma patient will also be discussed...
September 11, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29082563/magnetic-resonance-imaging-of-the-upper-airway-in-patients-with-quadriplegia-and-obstructive-sleep-apnea
#11
Fergal J O'donoghue, Hailey Meaklim, Lynne Bilston, Alice Hatt, Alan Connelly, Graeme Jackson, Shawna Farquharson, Kate Sutherland, Peter A Cistulli, Douglas J Brown, David J Berlowitz
The aim of this study was to investigate upper airway anatomy in quadriplegics with obstructive sleep apnea. Fifty subjects were recruited from three hospitals in Australia: people with quadriplegia due to spinal cord injury and obstructive sleep apnea (n = 11), able-bodied people with obstructive sleep apnea (n = 18), and healthy, able-bodied controls (n = 19). All underwent 3-Tesla magnetic resonance imaging of their upper airway. A subgroup (n = 34) received a topical vasoconstrictor, phenylephrine and post-phenylephrine magnetic resonance imaging...
October 30, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/29079071/occult-spinal-cord-injury-after-blunt-force-trauma-in-a-patient-with-achondroplasia-a-case-report-and-review-of-trauma-management-strategy
#12
Martin Huecker, Zach Harris, Eric Yazel
BACKGROUND: Achondroplastic dwarfism is associated with anatomic abnormalities that can predispose to occult injury and challenges in trauma management. Airway anatomy is problematic due to macrocephaly, midface hypoplasia, and a narrow nasopharynx. Manipulation of the neck is very dangerous due to the high likelihood of preexisting cervicomedullary stenosis. Restrictive lung disease and obstructive sleep apnea may complicate respiratory status. Peripheral and central venous access can be difficult to obtain...
October 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29075183/the-role-of-functional-neuroanatomy-of-the-lumbar-spinal-cord-in-effect-of-epidural-stimulation
#13
Carlos A Cuellar, Aldo A Mendez, Riazul Islam, Jonathan S Calvert, Peter J Grahn, Bruce Knudsen, Tuan Pham, Kendall H Lee, Igor A Lavrov
In this study, the neuroanatomy of the swine lumbar spinal cord, particularly the spatial orientation of dorsal roots was correlated to the anatomical landmarks of the lumbar spine and to the magnitude of motor evoked potentials during epidural electrical stimulation (EES). We found that the proximity of the stimulating electrode to the dorsal roots entry zone across spinal segments was a critical factor to evoke higher peak-to-peak motor responses. Positioning the electrode close to the dorsal roots produced a significantly higher impact on motor evoked responses than rostro-caudal shift of electrode from segment to segment...
2017: Frontiers in Neuroanatomy
https://www.readbyqxmd.com/read/29073499/management-of-major-vascular-injury-during-pedicle-screw-instrumentation-of-thoracolumbar-spine
#14
Aleem K Mirza, Mohammed Ali Alvi, Ryan M Naylor, Panagiotis Kerezoudis, William E Krauss, Michelle J Clarke, Daniel L Shepherd, Ahmad Nassr, Randall R DeMartino, Mohamad Bydon
OBJECTIVES: Vascular injury is a rare complication of spinal instrumentation. Presentation can vary from immediate hemorrhage to pseudoaneurysm formation. In the literature, surgical approach to repair has varied based on anatomy, acuity of diagnosis, infection, and available technology. In this manuscript, we aim to describe our institutional experience with vascular injuries in thoraco-lumbar spine surgery. PATIENTS AND METHODS: We report our institutional experience of three cases of vascular injury secondary to pedicle screw misplacement and their management, as well as a review of the literature...
October 16, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29057355/systematic-review-of-3d-printing-in-spinal-surgery-the-current-state-of-play
#15
REVIEW
Ben Wilcox, Ralph J Mobbs, Ai-Min Wu, Kevin Phan
Three-dimensional printing (3DP), also known as "Additive Manufacturing", is a rapidly growing industry, particularly in the area of spinal surgery. Given the complex anatomy of the spine and delicate nature of surrounding structures, 3DP has the potential to aid surgical planning and procedural accuracy. We perform a systematic review of current literature on the applications of 3DP in spinal surgery. Six electronic databases were searched for original published studies reporting cases or outcomes for 3DP surgical models, guides or implants for spinal surgery...
September 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29054315/cord-topographical-anatomy-and-its-role-in-evaluating-intramedullary-lesions
#16
REVIEW
James Andrew Spain, Scott Cressman, Horia Marin, Suresh C Patel, John J Corrigan, Brent Griffith
Intramedullary spinal lesions present a wide differential diagnosis including infectious, inflammatory, traumatic, ischemic, benign, or malignant neoplastic etiologies. Using knowledge of anatomy and physiology within the spinal cord, many similar appearing entities can be parsed into a prioritized differential. The purpose of this article is to review anatomy and pathophysiology of the spinal cord, with subsequent discussion of how this knowledge can be used to differentiate several similar appearing intramedullary pathologic processes...
September 18, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/29053676/laminotomy-for-lumbar-dorsal-root-ganglion-access-and-injection-in-swine
#17
Mark D Unger, Timothy P Maus, Ross C Puffer, Laura K Newman, Bradford L Currier, Andreas S Beutler
Dorsal root ganglia (DRG) are anatomically well defined structures that contain all primary sensory neurons below the head. This fact makes DRG attractive targets for injection of novel therapeutics aimed at treating chronic pain. In small animal models, laminectomy has been used to facilitate DRG injection because it involves surgical removal of the vertebral bone surrounding each DRG. We demonstrate a technique for intraganglionic injection of lumbar DRG in a large animal species, namely, swine. Laminotomy is performed to allow direct access to DRG using standard neurosurgical techniques, instruments, and materials...
October 10, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29033731/ultrasound-guided-continuous-spinal-anesthesia-for-cesarean-section-in-a-parturient-with-scoliosis-corrected-with-harrington-s-rod-surgery
#18
Amer Majeed, Iftikhar Ahmed, Ghadah Jamaan Alkahtani, Nasser Abdullah Altahtam
With rapid improvement in healthcare in Saudi Arabia, increasing number of women with surgically corrected kyphoscoliosis are likely to present for cesarean section (CS) or vaginal delivery requiring anesthesia or analgesia. Despite the surgical correction, these patients have poor cardiopulmonary reserves which increase the risks associated with general anesthesia. Whereas altered vertebral anatomy from previous surgery and the presence of metal work in spine make performing of regional anesthesia (RA) difficult and unpredictable, we report anesthetic management of such a patient who underwent CS using continuous spinal anesthesia technique...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29032887/virtual-simulation-in-enhancing-procedural-training-for-fluoroscopy-guided-lumbar-puncture-a-pilot-study
#19
Saad Ali, Monther Qandeel, Rishi Ramakrishna, Carina W Yang
RATIONALE AND OBJECTIVES: Fluoroscopy-guided lumbar puncture (FGLP) is a basic procedural component of radiology residency and neuroradiology fellowship training. Performance of the procedure with limited experience is associated with increased patient discomfort as well as increased radiation dose, puncture attempts, and complication rate. Simulation in health care is a developing field that has potential for enhancing procedural training. We demonstrate the design and utility of a virtual reality simulator for performing FGLP...
October 9, 2017: Academic Radiology
https://www.readbyqxmd.com/read/29024413/deep-tissue-loads-in-the-seated-buttocks-on-an-off-loading-wheelchair-cushion-versus-air-cell-based-and-foam-cushions-finite-element-studies
#20
Lea Peko Cohen, Amit Gefen
For wheelchair users, a common injury is a sitting-acquired pressure ulcer (PU) which typically onsets near the interface between the ischial tuberosity (IT) and the overlying soft tissues. The risk of developing PUs can be reduced considerably if an adequate cushion is placed on the wheelchair in order to protect tissues from PUs by minimising interface mechanical loads between the body and cushion and also, exposure to internal soft tissue loads. In this work, we studied the biomechanical performances of an off-loading (OL) cushion with limited adjustability, in comparison to a standard foam cushion and a fully adjustable air-cell-based (ACB) cushion...
September 6, 2017: International Wound Journal
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