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https://www.readbyqxmd.com/read/28437349/a-new-navigational-tool-for-pedicle-screw-placement-in-patients-with-severe-scoliosis-a-pilot-study-to-prove-feasibility-accuracy-and-identify-operative-challenges
#1
Michael Putzier, Patrick Strube, Riccardo Cecchinato, Claudio Lamartina, Eike K Hoff
STUDY DESIGN: Pilot study. OBJECTIVE: To develop and validate the feasibility and accuracy of a newly designed navigational spinal instrument guiding tool for patient-matched thoracic and lumbar pedicle screw placement in patients with severe scoliosis, and to identify intraoperative challenges that may be relevant. SUMMARY OF BACKGROUND DATA: Pedicle screw placement is challenging in severely rotated scoliotic spine with small diameters and asymmetrical shape of the pedicles and vertebrae...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28435914/factors-predictive-of-topographical-accuracy-in-spine-level-localization
#2
Jin W Tee, Joost Rutges, Travis Marion, John Street, Scott Paquette, Tamir Ailon, Brian K Kwon, Marcel Dvorak, Michael Boyd
BACKGROUND: Pre-operative spine level localization by palpation of anatomical landmarks (ribs, spinous processes) in posterior approaches for surgeries from T4 to L2 is often inaccurate. This can lead to ineffective utilization of procedural time, increased radiation dose, potentially longer skin incision and wrong level surgery. Factors affecting topographical accuracy includes body mass index (BMI) of the patient, congenital or acquired deformity and knowledge of topographical anatomy...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28431799/an-mri-investigation-of-the-effects-of-user-anatomy-and-wheelchair-cushion-type-on-tissue-deformation
#3
David Brienza, Jaxon Vallely, Patricia Karg, Jonathan Akins, Amit Gefen
AIM OF THE STUDY: Tissue deformation is recognized as an important risk factor for pressure injuries. This study investigated the effects of anatomy and wheelchair cushion type on tissue deformation. MATERIALS AND METHODS: Direct 3-dimensional tissue deformation response was measured for six participants sitting on six different wheelchair cushions using MR imaging. Two participants had a traumatic spinal cord injury (SCI) within one year of the assessment, two sustained traumatic SCI at least 13 years prior, and two were without SCI...
April 11, 2017: Journal of Tissue Viability
https://www.readbyqxmd.com/read/28431428/computational-and-in-vitro-experimental-investigation-of-intrathecal-drug-distribution-parametric-study-of-the-effect-of-injection-volume-cerebrospinal-fluid-pulsatility-and-drug-uptake
#4
Kevin M Tangen, Roxanne Leval, Ankit I Mehta, Andreas A Linninger
BACKGROUND: Intrathecal drug delivery is an attractive option to circumvent the blood-brain barrier for pain management through its increased efficacy of pain relief, reduction in adverse side effects, and cost-effectiveness. Unfortunately, there are limited guidelines for physicians to choose infusion or drug pump settings to administer therapeutic doses to specific regions of the spine or the brain. Although empiric trialing of intrathecal drugs is critical to determine the sustained side effects, currently there is no inexpensive in vitro method to guide the selection of spinal drug delivery parameters...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28428928/origin-branching-and-communications-of-the-intercostobrachial-nerve-a-meta-analysis-with-implications-for-mastectomy-and-axillary-lymph-node-dissection-in-breast-cancer
#5
REVIEW
Brandon Michael Henry, Matthew J Graves, Jakub R Pękala, Beatrice Sanna, Wan Chin Hsieh, R Shane Tubbs, Jerzy A Walocha, Krzysztof A Tomaszewski
The intercostobrachial nerve (ICBN), which usually originates from the lateral cutaneous branch of the second intercostal nerve, innervates areas of the axilla, lateral chest, and medial arm. It is at risk for injury during operative procedures that are often used in the management of breast cancer and such injury has been associated with postoperative sensory loss and neuropathic pain, decreasing the quality of life. PubMed, Excerpta Medica Database (EMBASE), ScienceDirect, Google Scholar, China National Knowledge Infrastructure (CNKI), Scientific Electronic Library Online (SciELO), Biosciences Information Service (BIOSIS), and Web of Science were searched comprehensively...
March 17, 2017: Curēus
https://www.readbyqxmd.com/read/28425137/three-dimensional-printing-an-aid-to-epidural-access-for-neuromodulation
#6
Murray G Taverner, John P Monagle
OBJECTIVE: The case report details to use of three-dimensional (3D) printing as an aid to neuromodulation. METHODS: A patient is described in whom previous attempts at spinal neuromodulation had failed due to lack of epidural or intrathecal access, and the use of a 3D printed model allowed for improved planning and ultimately, success. RESULTS: Successful spinal cord stimulation was achieved with the plan developed by access to a 3D model of the patient's spine...
April 20, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28413736/targeted-intraspinal-radiofrequency-ablation-for-lumbar-spinal-stenosis
#7
Robert E Jacobson, Michelle Granville, Jesse Hatgis DO
INTRODUCTION: By using a combination of magnetic resonance imaging (MRI) and computed tomography (CT) of the lumbar spine, it is possible to distinguish between spinal stenosis caused by bone compression and specific soft tissue epidural intraspinal lesions that cause localized spinal canal stenosis and neural compression. Examples include facet cysts and yellow ligament hypertrophy. Many of these patients are elderly with medical comorbidities that make open surgery problematic. MATERIALS & METHODS: This is a study of patients with predominantly soft tissue stenosis being treated with targeted intraspinal radiofrequency (RF) heat ablation...
March 10, 2017: Curēus
https://www.readbyqxmd.com/read/28413269/localization-of-epidural-space-a-review-of-available-technologies
#8
REVIEW
Hesham Elsharkawy, Abraham Sonny, Ki Jinn Chin
Although epidural analgesia is widely used for pain relief, it is associated with a significant failure rate. Loss of resistance technique, tactile feedback from the needle, and surface landmarks are traditionally used to guide the epidural needle tip into the epidural space (EDS). The aim of this narrative review is to critically appraise new and emerging technologies for identification of EDS and their potential role in the future. The PubMed, Cochrane Central Register of Controlled Clinical Studies, and Web of Science databases were searched using predecided search strategies, yielding 1048 results...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28405771/sacral-epidural-arteriovenous-fistulas-imitators-of-spinal-dural-arteriovenous-fistulas-with-different-pathologic-anatomy-report-of-three-cases-and-review-of-the-literature
#9
Jan-Karl Burkhardt, Michael M Safaee, Aaron J Clark, Michael T Lawton
BACKGROUND: Sacral epidural arteriovenous fistulas (eAVFs) are rare and often misdiagnosed because of the incongruence between the thoracic level of clinical deficits and the sacral location of the offending pathology. Failure to diagnose this lesion delays treatment, resulting in prolonged venous hypertension in the cord, progressive neurological deterioration, and decreased chances of recovery. METHODS: A single-institution case series and the published literature were reviewed...
April 12, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28380089/relationship-between-articular-eminence-inclination-and-alterations-of-the-mandibular-condyle-a-cbct-study
#10
Saione Cruz Sa, Saulo Leonardo Sousa Melo, Daniela Pita de Melo, Deborah Queiroz Freitas, Paulo Sérgio Flores Campos
This study aimed at verifying the correlation among angulation of the articular eminence (AE), shape of the condyle and its degenerative bone diseases (DBDs), according to age and sex, through Cone Beam Computed Tomography (CBCT). Five hundred and twenty-eight temporomandibular joints (TMJ) were evaluated. The condyles were classified as: flat, convex, angled and rounded, and the AE angulation was measured. The DBDs evaluated were osteophytes, flattening, erosion, subcortical cysts and spinal sclerosis. There was no difference in the mean angulations in relation to age group (p>0...
March 30, 2017: Brazilian Oral Research
https://www.readbyqxmd.com/read/28372341/ultrasonography-of-the-pediatric-hip-and-spine
#11
Yeo Ryang Kang, Joonbum Koo
Ultrasonography (US) is a useful screening method for the diagnosis of developmental dysplasia of the hip (DDH) and congenital spinal anomalies in infants. In addition, US is a useful, noninvasive imaging modality for the diagnosis of transient synovitis in children. The early detection of DDH leads to a better prognosis without surgical intervention. Moreover, spinal US allows the detection of congenital malformations and can also demonstrate normal anatomy and normal variants that may resemble disorders. Therefore, radiologists should be familiar with the sonographic anatomy of the normal infant hip, scanning and measurement techniques for DDH, the US features of transient synovitis in children, spinal US techniques, and the US features of normal anatomical structures, normal variants, and congenital spinal anomalies...
February 22, 2017: Ultrasonography
https://www.readbyqxmd.com/read/28366305/off-the-shelf-multibranched-endograft-for-urgent-endovascular-repair-of-thoracoabdominal-aortic-aneurysms
#12
Enrico Gallitto, Mauro Gargiulo, Antonio Freyrie, Rodolfo Pini, Chiara Mascoli, Stefano Ancetti, Gianluca Faggioli, Andrea Stella
OBJECTIVE: The aim of this paper was to report early and midterm results of endovascular repair of urgent thoracoabdominal aortic aneurysms (TAAAs) by the off-the-shelf multibranched Zenith t-Branch endograft (Cook Medical, Bloomington, Ind). METHODS: Between January 2014 and April 2016, all patients with urgent TAAAs (asymptomatic with diameter >8 cm, symptomatic, or ruptured TAAAs) and aortoiliac anatomic feasibility underwent endovascular repair by t-Branch and were prospectively enrolled...
March 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28350944/navigation-and-robotics-in-spinal-surgery-where-are-we-now
#13
Samuel C Overley, Samuel K Cho, Ankit I Mehta, Paul M Arnold
Spine surgery has experienced much technological innovation over the past several decades. The field has seen advancements in operative techniques, implants and biologics, and equipment such as computer-assisted navigation and surgical robotics. With the arrival of real-time image guidance and navigation capabilities along with the computing ability to process and reconstruct these data into an interactive three-dimensional spinal "map", so too have the applications of surgical robotic technology. While spinal robotics and navigation represent promising potential for improving modern spinal surgery, it remains paramount to demonstrate its superiority as compared to traditional techniques prior to assimilation of its use amongst surgeons...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28347417/vascular-imaging-techniques-of-the-spinal-cord
#14
Maria Isabel Vargas, Isabelle Barnaure, Joanna Gariani, José Boto, Alain Pellaton, Jean-Louis Dietemann, Zsolt Kulcsar
The various imaging techniques used to depict vascular lesions of the spinal cord are described in this article with particular emphasis on magnetic resonance imaging (MRI), vascular sequences, and advantages of high-field MRI. Technical vascular protocols are discussed in computed tomography, MRI, and conventional angiography. The diverse magnetic resonance angiography protocols are presented as well as their findings, specificities, and pitfalls. A review of the vascular anatomy and the most common pathologies analyzed by magnetic resonance angiography and conventional angiography is described...
April 2017: Seminars in Ultrasound, CT, and MR
https://www.readbyqxmd.com/read/28347415/congenital-and-hereditary-diseases-of-the-spinal-cord
#15
Lily L Wang, Karin S Bierbrauer
Congenital anomalies of the spinal cord can pose a diagnostic dilemma to the radiologist. Several classification systems of these anomalies exist. Antenatal ultrasound and fetal magnetic resonance imaging is playing an increasingly important role in the early diagnosis and management of patients. Understanding the underlying anatomy as well as embryology of these disorders can be valuable in correctly identifying the type of spinal cord dysraphic defect. Hereditary spinal cord diseases are rare but can be devastating...
April 2017: Seminars in Ultrasound, CT, and MR
https://www.readbyqxmd.com/read/28334320/interbody-spacer-material-properties-and-design-conformity-for-reducing-subsidence-during-lumbar-interbody-fusion
#16
Lillian S Chatham, Vikas V Patel, Christopher M Yakacki, R Dana Carpenter
There is a need to better understand the effects of intervertebral spacer material and design on the stress distribution in vertebral bodies and endplates to help reduce complications such as subsidence and improve outcomes following lumbar interbody fusion. The main objective of this study was to investigate the effects of spacer material on the stress and strain in the lumbar spine after interbody fusion with posterior instrumentation. A standard spacer was also compared with a custom-fit spacer, which conformed to the vertebral endplates, to determine if a custom fit would reduce stress on the endplates...
May 1, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28330796/chronic-low-back-pain-after-lumbosacral-fracture-due-to-sagittal-and-frontal-vertebral-imbalance
#17
L Boyoud-Garnier, M Boudissa, S Ruatti, G Kerschbaumer, P Grobost, J Tonetti
PROBLEM AND HYPOTHESIS: Over time, some patients with unilateral or bilateral lumbosacral injuries experience chronic low back pain. We studied the sagittal and frontal balance in a population with these injuries to determine whether mismatch in the pelvic and lumbar angles are associated with chronic low back pain. PATIENTS AND METHODS: Patients with posterior pelvic ring fractures (Tile C1, C2, C3 and A3.3) that had healed were included. Foreign patients and those with an associated spinal or acetabular fracture or nonunion were excluded...
March 19, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28328842/three-dimensional-printing-and-computer-navigation-assisted-hemipelvectomy-for-en-bloc-resection-of-osteochondroma-a-case-report
#18
Yaqing Zhang, Lianjiang Wen, Jun Zhang, Guoliang Yan, Yue Zhou, Bo Huang
RATIONALE: Three-dimensional (3D) printed templates can be designed to match an individual's anatomy, allowing surgeons to refine preoperative planning. In addition, the use of computer navigation (NAV) is gaining popularity to improve surgical accuracy in the resection of pelvic tumors. However, its use in combination with 3D printing to assist complex pelvic tumor resection has not been reported. PATIENT CONCERNS: A 36-year-old man presented with left-sided pelvic pain and a fast-growing mass...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328589/cervical-retrograde-spinal-cord-stimulation-lead-placement-to-treat-failed-back-surgery-syndrome-a-case-report
#19
Noud van Helmond, Caroline N Kardaszewski, Kenneth B Chapman
Spinal cord stimulation is an effective treatment modality for refractory neuropathic pain conditions, but the placement of leads can be challenging due to unforeseen anatomical variations. We used a retrograde C7-T1 approach to place a lead at the bottom of T8 in a patient suffering from failed back surgery syndrome. We were able to achieve adequate stimulation in her lower back and legs, which resulted in significant reduction in pain intensity during the spinal cord stimulation trial. Cervical retrograde placement of leads may represent an alternative method for successful placement of percutaneous leads in patients with abnormal anatomy due to thoracic postsurgical changes...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28324328/interspinous-implants-to-treat-spinal-stenosis
#20
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
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