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https://www.readbyqxmd.com/read/28340495/residents-learning-curve-of-lumbar-transforaminal-epidural-steroid-injections
#1
Holger Joswig, Sarah Roberta Haile, Gerhard Hildebrandt, Martin Nikolaus Stienen
Background and Study Aims There is a paucity of literature on beginners' training and on its connection with patient safety for transforaminal epidural steroid injections (TFESIs). This study retrospectively assessed the learning curves and associated complications of neurosurgery residents never previously exposed to TFESI and compared them with experienced board-certified faculty neurosurgeons (BCFNs). Material and Methods Procedure time in minutes, dose-area product (DAP) in cGy*cm(2), periprocedural observations, and complications in 354 TFESIs for radicular pain secondary to lumbar disk herniation or lumbar spinal stenosis were extracted from operative notes and the electronic infiltration logbook in the per-injection format...
March 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28340364/cervical-facet-force-analysis-after-disc-replacement-versus-fusion
#2
Vikas V Patel, Zachary R Wuthrich, Kirk C McGilvray, Matthew C Lafleur, Emily M Lindley, Derrick Sun, Christian M Puttlitz
BACKGROUND: Cervical total disc replacement was developed to preserve motion and reduce adjacent-level degeneration relative to fusion, yet concerns remain that total disc replacement will lead to altered facet joint loading and long-term facet joint arthrosis. This study is intended to evaluate changes in facet contact force, pressure and surface area at the treated and superior adjacent levels before and after discectomy, disc replacement, and fusion. METHODS: Ten fresh-frozen human cadaveric cervical spines were potted from C2 to C7 with pressure sensors placed into the facet joints of C3-C4 and C4-C5 via slits in the facet capsules...
March 18, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28339551/anticoagulant-and-antiplatelet-management-for-spinal-procedures-a-prospective-descriptive-study-and-interpretation-of-guidelines
#3
Bradly S Goodman, L McLean House, Sridhar Vallabhaneni, Srinivas Mallempati, Matthew R Willey, Matthew Thomas Smith
Setting.:  Epidural hematoma rarely complicates interventional spine procedures. While anticoagulant and antiplatelet drugs increase bleeding risk, cessation may precipitate serious thromboembolic events. The Spine Intervention Society (SIS) and American Society of Regional Anesthesia and Pain Medicine (ASRA) put forth guidelines that dissent with regard to management of hemostatically active agents during commonly performed spinal injections. Objective.:  To validate an antiplatelet/anticoagulant management table based on modifications of the SIS 2013 and ASRA 2015 guidelines...
October 6, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339441/the-role-of-the-ligamentum-flavum-area-as-a-morphological-parameter-of-lumbar-central-spinal-stenosis
#4
Young Uk Kim, Jun Young Park, Doo Hwan Kim, Myung-Hwan Karm, Jae-Young Lee, Jee In Yoo, Sung Won Chon, Jeong Hun Suh
BACKGROUND: Hypertrophy of the ligamentum flavum (LF) has been considered as a major cause of lumbar central spinal stenosis (LCSS). Previous studies have found that ligamentum flavum thickness (LFT) is correlated with aging, disc degeneration, and lumbar spinal stenosis. However, hypertrophy is different from thickness. Thus, to evaluate hypertrophy of the whole LF, we devised a new morphological parameter, called the ligamentum flavum area (LFA). OBJECTIVES: We hypothesized that the LFA is a key morphologic parameter in the diagnosis of LCSS...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28330756/femoral-articular-geometry-and-patellofemoral-stability
#5
Farhad Iranpour, Azhar M Merican, Seow Hui Teo, Justin P Cobb, Andrew A Amis
BACKGROUND: Patellofemoral instability is a major cause of anterior knee pain. The aim of this study was to examine how the medial and lateral stability of the patellofemoral joint in the normal knee changes with knee flexion and measure its relationship to differences in femoral trochlear geometry. METHODS: Twelve fresh-frozen cadaveric knees were used. Five components of the quadriceps and the iliotibial band were loaded physiologically with 175N and 30N, respectively...
March 19, 2017: Knee
https://www.readbyqxmd.com/read/28324211/comparison-of-in-vitro-osteogenic-potential-of-iliac-crest-and-degenerative-facet-joint-bone-autografts-for-intervertebral-fusion-in-lumbar-spinal-stenosis
#6
Jeroen Geurts, Daniela Ramp, Stefan Schären, Cordula Netzer
PURPOSE: The promotion of spinal fusion using bone autografts is largely mediated by the osteoinductive potential of progenitors/mesenchymal stem cells (MSC) that reside in the marrow spaces of cancellous bone. Iliac crest is the common autograft donor site, but its use presents an increased risk for donor site pain, morbidity and infection. Degenerative bone samples harvested during facetectomy might provide an alternative viable source of osteoinductive autografts. In this study, we conducted an intra-individual comparison of the osteogenic potential of isolated low passage MSC from both sources...
March 21, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28323695/superior-recess-access-of-the-lumbar-facet-joint
#7
Sibel Demir-Deviren, Sukhminder Singh, Joshua Hanelin
STUDY DESIGN: Descriptive approach to accessing the lumbar facet joint by superior recess. OBJECTIVE: This study is aimed to describe an approach to accessing the lumbar facet joint through targeting the superior recess during lumbar facet joint injections. SUMMARY OF BACKGROUND DATA: Lumbar facet joint injections are routinely performed for both the diagnosis and treatment of chronic low back pain. Previous studies either did not specify which part of the joint to target, or recommended targeting the inferior aspect of the joint to access the inferior recess...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323692/hyperlordosis-is-associated-with-facet-joint-pathology-at-the-lower-lumbar-spine
#8
Thorsten Jentzsch, James Geiger, Matthias A König, Clément M L Werner
STUDY DESIGN: A retrospective study. OBJECTIVE: Our study opted to clarify the remaining issues of lumbar lordosis (LL) with regard to (1) its physiological values, (2) age, (3) sex, and (4) facet joint (FJ) arthritis and orientation using computed tomography (CT) scans. SUMMARY OF BACKGROUND DATA: Recent studies have questioned whether LL really decreases with age, but study sample sizes have been rather small and mostly been based on x-rays...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28321382/understanding-the-course-of-vertebral-artery-at-craniovertebral-junction-in-occipital-assimilation-of-atlas-made-simplified-using-conventional-angiography
#9
Anita Jagetia, Tushit Mewda, Ishu Bishnoi, Manoj Bhutte, Hukum Singh, A K Srivastava, Daljit Singh
Introduction Preoperative assessment of vertebral artery (VA) is important to avoid its injury during surgery at craniovertebral junction (CVJ). The main concern is the course of third segment of VA (V3) while performing instrumentation at CVJ, that is, segment of VA from its course through transverse foramen of C2 to its course along the posterior arch of C1. This segment of VA includes its passage through C1 transverse foramen as well. This observational study was done to analyze the course, curvature, and termination of VA in patients with occipital assimilation of atlas at CVJ, a complex congenital anomaly, and compared with the normal course for better understanding especially by young neurosurgeons and spine surgeons...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321187/steps-to-health-in-cognitive-aging-effects-of-physical-activity-on-spatial-attention-and-executive-control-in-the-elderly
#10
Giancarlo Condello, Roberta Forte, Simone Falbo, John B Shea, Angela Di Baldassarre, Laura Capranica, Caterina Pesce
The purpose of this study was to investigate whether physical activity (PA) habits may positively impact performance of the orienting and executive control networks in community-dwelling aging individuals and diabetics, who are at risk of cognitive dysfunction. To this aim, we tested cross-sectionally whether age, ranging from late middle-age to old adulthood, and PA level independently or interactively predict different facets of the attentional performance. Hundred and thirty female and male individuals and 22 adults with type 2 diabetes aged 55-84 years were recruited and their daily PA (steps) was objectively measured by means of armband monitors...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28315990/model-based-registration-of-preprocedure-mr-and-intraprocedure-us-of-the-lumbar-spine
#11
Delaram Behnami, Alireza Sedghi, Emran Mohammad Abu Anas, Abtin Rasoulian, Alexander Seitel, Victoria Lessoway, Tamas Ungi, David Yen, Jill Osborn, Parvin Mousavi, Robert Rohling, Purang Abolmaesumi
PURPOSE: Epidural and spinal needle insertions, as well as facet joint denervation and injections are widely performed procedures on the lumbar spine for delivering anesthesia and analgesia. Ultrasound (US)-based approaches have gained popularity for accurate needle placement, as they use a non-ionizing, inexpensive and accessible modality for guiding these procedures. However, due to the inherent difficulties in interpreting spinal US, they yet to become the clinical standard-of-care...
March 18, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28315817/a-figure-eight-suture-loop-with-kirschner-wires-for-fixation-of-anteromedial-coronoid-process-fractures-a-case-series
#12
Longxiang Shen, Xingang Yu, Biao Zhong, Jian Ding
PURPOSE: Sufficient fixation of an anterior or anteromedial facet fracture of the coronoid process in fracture-dislocation of elbow is important to maintain joint stability. The purpose of this study was to report our experience with 11 patients who were managed with an original fixation technique using a "figure-eight" suture loop. METHODS: From February 2010 to March 2011, 11 cases with a fracture of the anterior or anteromedial facet of the coronoid process were treated by coronoid fixation using a figure-eight suture loop...
February 21, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28300721/characterization-of-facet-joint-cartilage-properties-in-the-human-and-interspecies-comparisons
#13
Siobhan A O'Leary, Jarrett M Link, Eric O Klineberg, Jerry C Hu, Kyriacos A Athanasiou
The facet joint, a synovial joint located on the posterior-lateral spine, is highly susceptible to degenerative changes and plays a significant role in back-related morbidities. Despite its significance, the facet is rarely studied and thus current treatment strategies are lacking. This study aimed to characterize, for the first time, the properties of human, pig, monkey, and rabbit lumbar facet cartilage providing much-needed design criteria for tissue engineering approaches. In this study, where possible, the facet's morphological, histological, mechanical, and biochemical properties were evaluated...
March 11, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28298941/in-vivo-feasibility-of-real-time-mr-us-fusion-imaging-lumbar-facet-joint-injections
#14
Riccardo Sartoris, Davide Orlandi, Angelo Corazza, Luca Maria Sconfienza, Alice Arcidiacono, Silvia Perugin Bernardi, Simone Schiaffino, Giovanni Turtulici, Pietro Caruso, Enzo Silvestri
OBJECTIVES: Traditionally, facet joint injections (FJI) are performed under fluoroscopic or computed tomography (CT) guidance, mainly due to the deep anatomical location and the presence of bony landmarks. Fusion imaging technology, which couples the ultrasound scan with the corresponding CT or magnetic resonance (MR) image obtained from the diagnostic examination and reformatted in real time according to the ultrasound scanning plane, allows to combine the panoramic view and the elevated anatomical detail of MR or CT with the ease of use of ultrasound without patient exposure to ionizing radiation...
March 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28298062/traumatic-patellar-dislocation-and-cartilage-injury
#15
Essi E Salonen, Teemu Magga, Petri J Sillanpää, Tommi Kiekara, Heikki Mäenpää, Ville M Mattila
BACKGROUND: Patellofemoral cartilage deterioration and osteoarthritis are reported to be associated with recurrent patellar dislocation. However, the association between first-time traumatic patellar dislocation and cartilage deterioration is unknown. PURPOSE: The aim of this study was to assess long-term cartilage deterioration in the patellofemoral and tibiofemoral joint after conservatively treated traumatic lateral patellar dislocation. STUDY DESIGN: Case series; Level of evidence, 4...
February 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28290397/endoscopic-technique-for-single-stage-anterior-decompression-and-anterior-fusion-by-transcervical-approach-in-atlantoaxial-dislocation
#16
Yad Ram Yadav, Shailendra Ratre, Vijay Parhihar, Amitesh Dubey, Neil M Dubey
Although posterior approaches are being used frequently in most atlantoaxial dislocations (AAD), anterior decompression is also required in some patients in whom the C1-2 dislocation is not properly reduced by the posterior approach. Transnasal and transoral approaches need an additional posterior approach to perform atlantoaxial fusion. They also have an added risk of infection. The endoscopic transcervical approach can be used for single-stage cervical decompression and stabilization that includes an odontoidectomy and anterior fusion...
March 2017: Neurology India
https://www.readbyqxmd.com/read/28268027/a-feasibility-study-to-assess-vibration-and-sound-from-zygapophyseal-joints-during-motion-before-and-after-spinal-manipulation
#17
Gregory D Cramer, Matthew Budavich, Preetam Bora, Kim Ross
OBJECTIVE: This feasibility study used novel accelerometry (vibration) and microphone (sound) methods to assess crepitus originating from the lumbar spine before and after side-posture spinal manipulative therapy (SMT). METHODS: This study included 5 healthy and 5 low back pain (LBP) participants. Nine accelerometers and 1 specialized directional microphone were applied to the lumbar region, allowing assessment of crepitus. Each participant underwent full lumbar ranges of motion (ROM), bilateral lumbar SMT, and repeated full ROM...
March 3, 2017: Journal of Manipulative and Physiological Therapeutics
https://www.readbyqxmd.com/read/28261429/radiological-parameters-of-undegenerated-cervical-vertebral-segments-in-a-korean-population
#18
Sung Hoon Choi, HeeSang Lee, Jae Hwan Cho, Jin Il Jung, Dong-Ho Lee
BACKGROUND: Several scoring systems for cervical disc and facet joint degeneration, using radiography or computed tomography, have been developed and tested for reliability. However, definitions of disc height and facet joint space narrowing vary. To our knowledge, no study has reported quantitative data for normal radiologic values of the cervical spine in the Korean population. The purpose of this study is to determine normal cervical disc height, disc height ratio, and facet joint space values, and investigate the correlation between demographic data and these values...
March 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28254420/comparison-of-the-technique-of-anterior-cervical-distraction-and-screw-elevating-pulling-reduction-and-conventional-anterior-cervical-reduction-technique-for-traumatic-cervical-spine-fractures-and-dislocations
#19
REVIEW
Haoxi Li, Yufeng Huang, Changzhi Cheng, Zhoudan Lin, Desheng Wu
INTRODUCTION: To analyze and confirm the advantages of anterior cervical distraction and screw elevating-pulling reduction which are absent in conventional anterior cervical reduction for traumatic cervical spine fractures and dislocations. MATERIALS AND METHODS: A retrospective study was conducted on 86 patients with traumatic cervical spine fractures and dislocations who received one-stage anterior approach treatment for a distraction-flexion injury with bilateral locked facet joints between January 2010 and June 2015...
February 22, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28254376/preoperative-patellofemoral-chondromalacia-is-not-a-contraindication-for-fixed-bearing-medial-unicompartmental-knee-arthroplasty
#20
Alexander J Adams, Gregory S Kazarian, Jess H Lonner
BACKGROUND: Patellofemoral chondromalacia (PFCM) has historically been considered a contraindication for unicompartmental knee arthroplasty (UKA), but there is limited data assessing PFCM's impact on the results of fixed-bearing UKA. Our objective was to assess the impact of medial patellar and/or medial trochlear PFCM on overall and patellofemoral-specific 2-year outcomes after fixed-bearing medial UKA. METHODS: Intraoperative notes defined the presence and location of PFCM during fixed bearing medial UKA...
January 16, 2017: Journal of Arthroplasty
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