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Lumbar laminectomy

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https://www.readbyqxmd.com/read/28721002/mobile-schwannomas-of-lumbar-spine-a-diagnostic-dilemma
#1
Ajay Kothari, Navdeep Singh, Rashid Anjum
Mobile Schwannoma is a very rare entity and is reported sparsely in literature, with most of them occurring in lumbar spine region. We present a case of seventy-year-old male patient who had pain in lower back radiating to ipsilateral thigh. A diagnosis of migratory tumour was made based on findings of plain and contrast MRI preoperatively. We did a two level laminectomy and tumour excision. In this report, we intend to discuss various likely causes of tumour migration and various diagnostic methods to tackle this surgical dilemma, we have also attempted to review the sparse literature available till date on migratory lumber schwannoma...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28719446/tophaceous-gout-of-the-lumbar-spine-mimicking-malignancy-on-fdg-pet-ct
#2
Qian Zhao, Aisheng Dong, Yushu Bai, Yang Wang, Changjing Zuo
A 46-year-old man with over a 10-year history of gout complained of progressive bilateral buttock pain with numbness of legs for 4 months. Serum uric acid level was elevated. Lumbar radiographs showed decreased density of the bilateral L4-L5 facet joints. CT showed lytic lesions of the facet joints with hyperdense periarticular lesions. Enhanced MRI showed marked enhancement of these lesions. FDG PET/CT showed avid FDG uptake of the bony and periarticular lesions with SUVmax of 16.8. A decompressive posterior lumbar laminectomy with periarticular lesion resection was performed...
July 17, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28713528/the-double-transforaminal-lumbar-interbody-fusion-an-innovative-one-stage-surgical-technique-for-posterior-kyphosis-correction
#3
Marcus Jäger, Tjark Tassemeier
Posttraumatic deformities after vertebral fractures are challenging for orthopedic surgeons in the non-operative and operative field. Especially osteoporotic fractures may cause a hyperkyphosis resulting in segmental or global sagittal imbalance and chronic back pain. Different vertebral osteotomies are potent to restore sagittal profile but show a very high perioperative risk including neurological and soft tissue complications. In addition, some of these extensive operations require a two-step procedure including posterior and anterior approaches...
June 23, 2017: Orthopedic Reviews
https://www.readbyqxmd.com/read/28705700/incidental-primary-intradural-carcinoid-tumor-in-a-patient-with-lumbar-radiculopathy
#4
Stavros Koustais, Philip O'Halloran, Alfrazdaq Hassan, Francesca Brett, Steven Young
BACKGROUND: Carcinoid tumors are neuroendocrine neoplasms derived from enterochromaffin cells. Central nervous system involvement is rare. The reported cases include metastases to brain or spinal cord, as well as primary skeletal or extradural disease resulting in compressive myelo-radiculopathy. There are two previously reported cases of primary intradural extramedullary carcinoid tumor, presenting with compressive symptoms. We report the first case of primary incidental intradural extramedullary carcinoid tumor...
July 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28705591/effectiveness-of-surgery-versus-conservative-treatment-for-lumbar-spinal-stenosis-a-system-review-and-meta-analysis-of-randomized-controlled-trials
#5
REVIEW
Xin-Long Ma, Xing-Wen Zhao, Jian-Xiong Ma, Fei Li, Yin Wang, Bin Lu
PURPOSE: Lumbar spinal stenosis (LSS) was a common degenerative disease that affected the lumbar spine function and quality of life, which can be treated both surgery and conservative treatment. We did this study to compare the effectiveness of surgery versus conservative treatment for LSS. METHODS: We searched PubMed as well as other databases in September.18th.2016. Randomized controlled trials compared surgery versus conservative treatment for patients with LSS were enrolled...
July 10, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28694593/experimental-study-on-pressure-response-to-graded-spinal-canal-compromise-in-an-in-vitro-burst-fracture-mode
#6
Jonathan Bourget-Murray, Mahdi Bassi, Ariana Frederick, Jerod Hines, Peter F Jarzem
BACKGROUND: Spinal cord compression is a known cause of spinal cord injury. The purpose of this study is to measure pressure response during graded spinal cord compression. This information will be important in evaluating the amount of canal compromise that can be tolerated before risking neurological injury secondary to cord compression. To date, there is no published study that has evaluated pressure response to graded canal compromise in the thoracic and lumbar spine. MATERIALS AND METHODS: A comparative biomechanical investigation using an in vitro burst fracture model of graded spinal canal compromise was performed...
April 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28680731/lumbar-laminectomy-in-a-captive-adult-polar-bear-ursus-maritimus
#7
John F Morrison, Kunal Vakharia, Douglas B Moreland
BACKGROUND: Animals held in captivity tend to live longer than do their wild counterparts, and as such, are prone to developing age-related degenerative injuries. Here, we present a case of an adult female polar bear with symptomatic lumbar stenosis. There is a paucity of literature on large mammalian spine surgery, and anatomical differences between humans and other vertebrates must be taken into consideration. CASE DESCRIPTION: A 24-year-old female polar bear residing at the zoo was found to have decreased motor function in her hind legs...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28670409/traumatic-spinal-cord-injury-long-term-motor-sensory-and-urinary-outcomes
#8
Rouzbeh Motiei-Langroudi, Homa Sadeghian
STUDY DESIGN: Retrospective study. PURPOSE: To evaluate how motor, sensory, and urinary outcomes of spinal cord injury (SCI) patients were influenced in the long term. OVERVIEW OF LITERATURE: SCI is a potentially disabling and devastating neurological outcome that can occur because of spinal column fractures. Most studies have not evaluated or have failed to show the influence of different surgical approaches and other parameters on neurological recovery...
June 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28660102/impact-of-the-economic-downturn-on-elective-lumbar-spine-surgery-in-the-united-states-a-national-trend-analysis-2003-to-2013
#9
David N Bernstein, David Brodell, Yue Li, Paul T Rubery, Addisu Mesfin
STUDY DESIGN: Retrospective database analysis. OBJECTIVE: The impact of the 2008-2009 economic downtown on elective lumbar spine surgery is unknown. Our objective was to investigate the effect of the economic downturn on the overall trends of elective lumbar spine surgery in the United States. METHODS: The Nationwide Inpatient Sample (NIS) was used in conjunction with US Census and macroeconomic data to determine historical trends. The economic downturn was defined as 2008 to 2009...
May 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28650883/iliac-crest-bone-graft-a-minimally-invasive-harvesting-technique
#10
Gregory D Lopez, Fady Y Hijji, Ankur S Narain, Kelly H Yom, Kern Singh
Typical sources for graft material utilized in minimally invasive transforaminal lumbar interbody fusion include both autograft and allograft. Autograft is frequently utilized due to its theorized benefits in promoting fusion. During minimally invasive transforaminal lumbar interbody fusion, autograft is often obtained locally during the laminectomy and facetectomy. However, this locally obtained bone graft has exhibited questionable osteoconductive properties, often necessitating the addition of biologics to improve fusion rates...
June 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28642180/obese-bmi-30-patients-have-greater-functional-improvement-and-reach-equivalent-outcomes-at-12-months-following-decompression-surgery-for-symptomatic-lumbar-stenosis
#11
Galal Elsayed, Matthew C Davis, Esther C Dupépé, Samuel G McCluggage, Paul Szerlip, Beverly C Walters, Mark N Hadley
OBJECTIVE: Here we evaluate the effect of obesity on 12-month functional outcomes following surgery for lumbar stenosis in an adult population. METHODS: Data were collected prospectively on patients treated with lumbar laminectomy for symptomatic lumbar spinal stenosis as part of an observational registry at a single institution from 2012 through 2014, and analyzed using a retrospective cohort study design. Patients with BMI>30 were compared to patients with BMI <30 with respect to baseline, 3-month, and 12-month functional status, adjusted for potential confounders...
June 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28634709/incidental-durotomy-in-decompression-for-lumbar-spinal-stenosis-incidence-risk-factors-and-effect-on-outcomes-in-the-spine-tango-registry
#12
Christian Herren, Rolf Sobottke, Anne F Mannion, Thomas Zweig, Everard Munting, Philippe Otten, Tim Pigott, Jan Siewe, Emin Aghayev
PURPOSE: The three aims of this Spine Tango registry study of patients undergoing decompression for spinal stenosis were to: report the rate of dural tear (DT) stratified by treatment centre; find factors associated with an increased likelihood of incurring a DT; and compare treatment outcomes in relation to DT (none vs. repaired vs. unrepaired DT). METHODS: Multivariate logistic regression was used to assess the association between DT and patient and treatment characteristics...
June 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28633540/benign-ependymoma-with-extensive-intracranial-and-spinal-cerebrospinal-fluid-dissemination-case-report-and-literature-review
#13
Fangmei Zhu, Jurong Ding, Yumei Li, Dewang Mao, Xianglei He, Wanyuan Chen, Lin Lou, Zhongxiang Ding
Myxopapillary ependymoma (MPE) is a rare variant of ependymoma that is most commonly located in the cauda equina and filum terminale. We present a case of 23-year-old man diagnosed with MPE in the fourth ventricle and sacral canal area with extensive disseminated lesions along the cerebrospinal ventricular system. Additionally, a molecular pathological diagnosis was performed. The patient underwent a craniotomy and a lumbar laminectomy. In the course of 18 months of follow-up, the patient have recovered very well...
June 21, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28633411/surgeon-level-variability-in-outcomes-cost-and-comorbidity-adjusted-cost-for-elective-lumbar-decompression-and-fusion
#14
Silky Chotai, Ahilan Sivaganesan, John A Sielatycki, Kristin R Archer, Richard Call, Matthew J McGirt, Clinton J Devin
BACKGROUND: The costs and outcomes following degenerative spine surgery may vary from surgeon to surgeon. Patient factors such as comorbidities may increase the health care cost. These variations are not well studied. OBJECTIVE: To understand the variation in outcomes, costs, and comorbidity-adjusted cost for surgeons performing lumbar laminectomy and fusions surgery. METHODS: A total of 752 patients undergoing laminectomy and fusion, performed by 7 surgeons, were analyzed...
June 14, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28632550/suture-choice-in-lumbar-dural-closure-contributes-to-variation-in-leak-pressures-experimental-model
#15
George M Ghobrial, Christopher M Maulucci, Matthew J Viereck, Sara Beygi, Ameet Chitale, Srinivas Prasad, Jack Jallo, Joshua Heller, Ashwini D Sharan, James S Harrop
STUDY DESIGN: Open-label laboratory investigational study; non-animal surgical simulation. OBJECTIVE: The authors perform a comparison of dural closure strength in a durotomy simulator across 2 different suture materials. SUMMARY OF BACKGROUND DATA: Incidental durotomy leading to persistent cerebrospinal fluid leak adds considerable morbidity to spinal procedures, often complicating routine elective lumbar spinal procedures. Using an experimental durotomy simulation, the authors compare the strength of closure using Gore-Tex with other suture types and sizes, using various closure techniques...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28628969/comparative-induction-of-controlled-hypotension-by-electroacupuncture-at-du20-acupoint-and-remifentanil-in-lumbar-laminectomy
#16
Mehdi Ghaemi, Majid Ansari, Kourosh Amini
Hypotensive anesthesia is utilized to reduce bleeding during orthopedic surgery. One of the various drugs that have been used to reduce blood pressure is remifentanil. This study was an attempt to compare the effect of remifentanil with that of electroacupuncture (EA) at DU20 on reducing blood pressure. In this randomized controlled clinical trial, 54 patients undergoing lumbar laminectomy were allocated to two groups. Hypotensive anesthesia was performed through infusion of remifentanil 100 μg/kg/min for the control group, and EA at DU20 acupoint with a frequency of 2-10 Hz and intensity of 1-5 mA for the intervention group...
June 30, 2017: Chinese Journal of Physiology
https://www.readbyqxmd.com/read/28618974/cystic-dilation-of-a-ventriculus-terminalis-case-report-and-review-of-the-literature
#17
Masoud Zeinali, Hosein Safari, Saleh Rasras, Reza Bahrami, Mahdi Arjipour, Nima Ostadrahimi
The ventriculus terminalis (VT) is a small ependyma-lined cavity within the conus medullaris that is in direct continuity with the central canal of the spinal cord. Cystic dilatation of the ventriculus terminalis on its own is an extremely rare pathological event in adults whose pathogenesis is uncertain. VT has been described in children as a normal developmental phenomenon. These lesions are often diagnosed incidentally during imaging and are in most cases asymptomatic, especially in children. Symptomatic dilatation of VT in adults is a rare condition with 61cases being reported to date...
June 15, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28614233/discordant-lumbar-epidural-hematoma-after-caudal-steroid-injection-a-case-report-care-compliant
#18
Jung Ju Choi, Young Jin Chang, Wol Seon Jung, Kyung Cheon Lee, Ju Ho Kim, Youn Yi Jo
RATIONALE: Caudal epidural injection is one of the conventional treatments of chronic back pain. Even though spinal epidural hematoma after caudal epidural injection is rare but it can cause serious neurologic complication. PATIENT CONCERNS: An 83-year-old woman taking cilostazol received caudal epidural steroid injection because of her chronic back pain. Six hours later, she experienced an acute hip pain which worsened with time. DIAGNOSIS: Magnetic resonance image showed acute cord compression due to a spinal epidural hematoma at L2-S1 level with concomitant central canal compromise at L2/3, L3/4 level...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28600008/lumbar-radiculopathy-in-the-setting-of-degenerative-scoliosis-mis-decompression-and-limited-correction-are-better-options
#19
REVIEW
Ricardo B Fontes, Richard G Fessler
Surgery for adult spinal deformity (ASD) has emerged as an efficient treatment alternative, but it is fraught with potential perioperative morbidity, incompletely mitigated by emerging minimally invasive surgical techniques. In mild-to-moderate ASD balanced in the sagittal plane, there are situations in which the counterintuitive simple decompression through a foraminotomy or laminectomy, or even a short-segment fusion may be an attractive treatment. This article presents a case example and the authors' treatment rationale and reviews the limited available literature supporting it...
July 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28598927/intraoperative-analgesia-nociception-index-guided-fentanyl-administration-during-sevoflurane-anesthesia-in-lumbar-discectomy-and-laminectomy-a-randomized-clinical-trial
#20
Henry D Upton, Guy L Ludbrook, Andrew Wing, Jamie W Sleigh
BACKGROUND: The "Analgesia Nociception Index" (ANI; MetroDoloris Medical Systems, Lille, France) is a proposed noninvasive guide to analgesia derived from an electrocardiogram trace. ANI is scaled from 0 to 100; with previous studies suggesting that values ≥50 can indicate adequate analgesia. This clinical trial was designed to investigate the effect of intraoperative ANI-guided fentanyl administration on postoperative pain, under anesthetic conditions optimized for ANI functioning...
July 2017: Anesthesia and Analgesia
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