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Spine degenerative disease

Elliott J Kim, Silky Chotai, David P Stonko, Joseph B Wick, Byron J Schneider, Matthew J McGirt, Clint J Devin
BACKGROUND CONTEXT: Non-operative modalities such as lumbar epidural steroid injections (LESI) are often used in the setting of lumbar spine disorders where other conservative measures have failed. Concomitant depression can lead to worse outcomes in lumbar spine pathology. A number of studies have demonstrated an association between preoperative depression and poor outcomes following surgery but the effect of depression on outcomes following non-operative modalities is poorly understood...
October 21, 2016: Spine Journal: Official Journal of the North American Spine Society
Feng Yang, Wen-Xiong Li, Zhu Liu, Li Liu
BACKGROUND: Cervical spondylosis is a very common disorder and cervical spondylotic radiculopathy (CSR) is the most common form of spinal degenerative disease. Its clinical manifestations focus on pain and numbness of the neck and arm as well as restricted movement of the neck, which greatly affect the patient's life and work. The orthopedic of traditional Chinese medicine (TCM) theory holds that the basic pathologic change in spinal degenerative diseases is the imbalance between the dynamic system and the static system of the cervical spine...
October 22, 2016: Trials
Andrew J Teichtahl, Donna M Urquhart, Yuanyuan Wang, Anita E Wluka, Richard O'Sullivan, Graeme Jones, Flavia M Cicuttini
BACKGROUND: Degenerative disc disease of the lumbar spine is common, with severe disease increasing the risk for chronic low back pain. This cross-sectional study examined whether disc degeneration is representative of a 'whole-organ' pathology, by examining its association with bone (vertebral endplate) and soft tissue (paraspinal muscle fat) abnormalities. METHODS: Seventy-two community-based individuals unselected for low back pain, had Magnetic Resonance Imaging (MRI)...
October 21, 2016: BMC Musculoskeletal Disorders
Mohamed Macki, Sbaa Syeda, Kenan Rajjoub, Panagiotis Kerezoudis, Ali Bydon, Jean-Paul Wolinsky, Timothy Witham, Daniel M Sciubba, Mohamad Bydon, Ziya Gokaslan
INTRODUCTION: The primary objective of this study is to examine the effects smoking status on rhBMP-2 supplementation in spinal fusion constructs. METHODS: Patient records were retrospectively reviewed for a consecutive set of patients who underwent first-time posterolateral, instrumented fusion of the lumbar spine for degenerative spinal disease. All operations included arthrodesis supplementation with rhBMP-2. All patients were followed for at least two years...
October 15, 2016: World Neurosurgery
Nicolas Dea, Raphaële Charest-Morin, Daniel M Sciubba, Justin E Bird, Alexander C Disch, Addisu Mesfin, Áron Lazáry, Charles G Fisher, Christopher Ames
STUDY DESIGN: Systematic literature review. OBJECTIVE: To investigate if evidence-based principles of oncologic resection for primary spinal tumors are correlated with an acceptable morbidity and mortality profile and satisfactory health-related quality of life (HRQOL) measures. SUMMARY OF BACKGROUND DATA: Respecting oncologic principles for primary spinal tumor surgery is correlated with lower recurrence rates. These interventions are, however, often highly morbid...
October 15, 2016: Spine
Bodil Arnbak, Rikke Krüger Jensen, Claus Manniche, Oliver Hendricks, Peter Kent, Anne Grethe Jurik, Tue Secher Jensen
BACKGROUND: The aim of this study was to investigate subgroups of magnetic resonance imaging (MRI) findings for the spine and sacroiliac joints (SIJs) using latent class analysis (LCA), and to investigate whether these subgroups differ in their demographic and clinical characteristics. METHODS: The sample included 1037 patients aged 18-40 years with persistent low back pain (LBP). LCA was applied to MRI findings of the spine and SIJs. The resulting subgroups were tested for differences in self-reported demographic and clinical characteristics...
October 13, 2016: Arthritis Research & Therapy
Hang Feng, Xiangyi Fang, Dageng Huang, Chengcheng Yu, Songchuan Zhao, Dingjun Hao
BACKGROUND CONTEXT: Cervical disc arthroplasty has been gradually adopted as an alternative for the treatment of cervical degenerative disease. However, there is a large discrepancy between footprints of currently available cervical disc prostheses and anatomic dimensions of cervical end plates. PURPOSE: This study aimed to accurately and comprehensively quantify the three-dimensional (3D) anatomic morphology of the cervical vertebral end plate and provide a theoretical basis for designing appropriate disc prostheses...
October 3, 2016: Spine Journal: Official Journal of the North American Spine Society
Olaf Suess, Markus Schomacher
Aim. Transpedicular screw fixation is widely used in spinal surgery. But the insertion of pedicle screws can sometimes be challenging because of the variability in pedicle size and the proximity of nerve roots. Methods. We detected intraoperatively the sensitivity for iatrogenic pedicel perforation with a hand-held electronic conductivity measurement device (ECD) that measures electrical conductivity of tissue-medium surrounding the instrument tip. ECD was used to guide the placement of 84 pedicle screws in 15 patients undergoing surgery for tumor or degenerative spinal disease at various spinal levels from T8 to L5...
2016: Advances in Medicine
Amandeep Bhalla, Andrew J Schoenfeld, Jaiben George, Michael Moghimi, Christopher M Bono
BACKGROUND: Context: Understanding the influence of preoperative diagnosis on outcomes for lumbar fusion surgery improves the quality of research and outcomes data, and helps guide treatment decisions. PURPOSE: We sought to perform a systematic review of the literature published between 2000 and 2014 regarding lumbar fusion outcomes for degenerative disorders. An assessment of the influence of subgroup diagnosis on outcomes, as well as the quality of this body of literature was performed...
September 29, 2016: Spine Journal: Official Journal of the North American Spine Society
Stefan Hartveldt, Stein J Janssen, Kirkham B Wood, Thomas D Cha, Joseph H Schwab, Christopher M Bono, Louis G Jenis
STUDY DESIGN: Retrospective study. OBJECTIVE: To assess the relation between exposure to epidural steroid injection (ESI) before surgery and occurrence of surgical site infection (SSI) for degenerative lumbar spine conditions. SUMMARY OF BACKGROUND DATA: The effect of local ESI on the occurrence of SSI is controversial. METHODS: Patients who underwent surgery for degenerative lumbar spine conditions at two centers between 2005 and 2015 were identified...
October 1, 2016: Spine
Young Ri Kim, Ji Won Choi, Woo Seog Sim, Chul Joong Lee, Choohoon Chang
STUDY OBJECTIVE: Elderly patients with degenerative knee disease may have accompanying degenerative spine conditions. There are no studies on lumbar epidural catheter withdrawal forces in these patients. The aim of this study was to investigate withdrawal forces and possible associated risk factors in patients undergoing total knee arthroplasty (TKA). DESIGN: Prospective randomized trial. SETTING: Operating room and ward in a university hospital...
November 2016: Journal of Clinical Anesthesia
Ross C Puffer, Meghan Murphy, Patrick Maloney, Daryl Kor, Ahmad Nassr, Brett Freedman, Jeremy Fogelson, Mohamad Bydon
STUDY DESIGN: A retrospective review of a consecutive series of spinal fusions comparing patient and procedural characteristics of patients who developed surgical site infections (SSIs) after spinal fusion. OBJECTIVE: It is known that increased surgical time (incision to closure) is associated with a higher rate of postoperative SSIs. We sought to determine whether increased total anesthetic time (intubation to extubation) is a factor in the development of SSIs as well...
September 28, 2016: Spine
Mark J Winder, Shanu Gambhir
The incidence of lumbar fusion for the treatment of various degenerative lumbar spine diseases has increased dramatically over the last twenty years. Many lumbar fusion techniques have been developed and popularized, each with its own advantages and disadvantages. Anterior lumbar interbody fusion (ALIF) initially introduced in the 1930's, has become a common and widely accepted technique for lumbar fusions over the last decade offering several advantages over standard posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF)...
March 2016: J Spine Surg
Ralph J Mobbs, Kevin Phan, Greg Malham, Kevin Seex, Prashanth J Rao
Degenerative disc and facet joint disease of the lumbar spine is common in the ageing population, and is one of the most frequent causes of disability. Lumbar spondylosis may result in mechanical back pain, radicular and claudicant symptoms, reduced mobility and poor quality of life. Surgical interbody fusion of degenerative levels is an effective treatment option to stabilize the painful motion segment, and may provide indirect decompression of the neural elements, restore lordosis and correct deformity. The surgical options for interbody fusion of the lumbar spine include: posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), minimally invasive transforaminal lumbar interbody fusion (MI-TLIF), oblique lumbar interbody fusion/anterior to psoas (OLIF/ATP), lateral lumbar interbody fusion (LLIF) and anterior lumbar interbody fusion (ALIF)...
December 2015: J Spine Surg
M Lefranc, J Peltier
The ROSA® robot (Medtech, Montpellier, France) is a new medical device designed to assist the surgeon during minimally invasive spine procedures. The device comprises a patient-side cart (bearing the robotic arm and a workstation) and an optical navigation camera. The ROSA® Spine robot enables accurate pedicle screw placement. Thanks to its robotic arm and navigation abilities, the robot monitors movements of the spine throughout the entire surgical procedure and thus enables accurate, safe arthrodesis for the treatment of degenerative lumbar disc diseases, exactly as planned by the surgeon...
October 2016: Expert Review of Medical Devices
C Josten, C-E Heyde, U J Spiegl
Treating vertebral body fractures is challenging when there is relevant pre-existing spinal degeneration. Both vertebral body fractures and spinal degeneration are related to the physiological aging process. The increases in both are linked to increases in life expectancy. Several factors promote spinal degeneration and increase fracture risk, such as disc degeneration, spinal imbalance and osteoporosis. The main diagnostic and therapeutic challenge is to identify the sources of pain and to start appropriate therapy...
October 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Daniel G Tobert, Valentin Antoci, Shaun P Patel, Ehsan Saadat, Christopher M Bono
Adjacent segment disease (ASD) is disappointing long-term outcome for both the patient and clinician. In contrast to adjacent segment degeneration, which is a common radiographic finding, ASD is less common. The incidence of ASD in both the cervical and lumbar spine is between 2% and 4% per year, and ASD is a significant contributor to reoperation rates after spinal arthrodesis. The etiology of ASD is multifactorial, stemming from existing spondylosis at adjacent levels, predisposed risk to degenerative changes, and altered biomechanical forces near a previous fusion site...
September 16, 2016: Clinical Spine Surgery
Danielle A Simmons, Nadia P Belichenko, Ellen C Ford, Sarah Semaan, Marie Monbureau, Sruti Aiyaswamy, Cameron M Holman, Christina Condon, Mehrdad Shamloo, Stephen M Massa, Frank M Longo
Decreases in the ratio of neurotrophic versus neurodegenerative signaling play a critical role in Huntington's disease (HD) pathogenesis and recent evidence suggests that the p75 neurotrophin receptor (NTR) contributes significantly to disease progression. p75(NTR) signaling intermediates substantially overlap with those promoting neuronal survival and synapse integrity and with those affected by the mutant huntingtin (muHtt) protein. MuHtt increases p75(NTR)-associated deleterious signaling and decreases survival signaling suggesting that p75(NTR) could be a valuable therapeutic target...
September 16, 2016: Human Molecular Genetics
E Pröbsting, S Blumentritt, A Kannenberg
Background: It is often assumed that leg amputations result in a greater risk of degenerative changes to the locomotor system. This paper analysed the extent to which this assumption is supported by the scientific literature. In particular, the study analysed the level of risk of various degenerative diseases in amputees. Method: A systematic literature search was conducted in scientific databases on degenerative changes caused by amputations. All pertinent articles were qualitatively analysed; the available quantitative results were summarised and compared to data for the able bodied population...
September 15, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Kevin Phan, Ralph J Mobbs
Anterior lumbar interbody fusion (ALIF) is one of the surgical procedures for the relief of chronic back pain, radiculopathy and neurogenic claudication in patients with degenerative lumbar spine disease that is refractory to conservative therapy, low-grade spondylolisthesis and pseudo arthrosis. Over the past half century, both the surgical techniques and instrumentation required for ALIF have changed significantly. In particular, the designs of ALIF cage and the materials used have evolved dramatically, the common goal being to improve fusion rates and optimize clinical outcomes...
August 2016: Orthopaedic Surgery
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