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https://www.readbyqxmd.com/read/28640778/a-cohort-study-of-blunt-cerebrovascular-injury-screening-in-children-are-they-just-little-adults
#1
Mackenzie R Cook, Cordelie E Witt, Robert H Bonow, Eileen M Bulger, Ken F Linnau, Saman Arbabi, Bryce R H Robinson, Joseph Cuschieri
BACKGROUND: Blunt cerebrovascular injuries (BCVI) are rare with nonspecific predictors, making optimal screening critical. Radiation concerns magnify these issues in children. The Eastern Association for the Surgery of Trauma (EAST) criteria, the Utah score (US) and the Denver criteria (DC) have been advocated for pediatric BCVI screening, though direct comparison is lacking. We hypothesized that current screening guidelines inaccurately identify pediatric BCVI. METHODS: This was a retrospective cohort study of pediatric trauma patients treated from 2005-2015 with radiographically confirmed BCVI...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28637303/management-of-acute-unilateral-nondisplaced-subaxial-cervical-facet-fractures
#2
Aditya Vedantam, Jared Steven Fridley, Jovany Cruz Navarro, Shankar P Gopinath
BACKGROUND: Few studies have focused on the management of patients with nondisplaced cervical facet fractures. OBJECTIVE: To determine the rate of successful nonoperative management and risk factors for instability in patients with acute traumatic, unilateral, nondisplaced cervical facet fractures. METHODS: We reviewed patients with single or multilevel unilateral nondisplaced or minimally displaced subaxial cervical facet fractures between 2008 and 2014...
June 14, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28637120/is-tutobone-an-efficient-alternative-to-other-implants-used-in-anterior-cervical-discectomy-and-fusion-surgeries
#3
Savithru Kumar Prakash, Nitin Mukerji, Fredrik Prem Nath
BACKGROUND: The graft site morbidity following iliac crest harvesting is significant. To overcome this, different bone substitutes like coral dowels, solvent dissolved bovine/human bone substitutes, and carbon fiber/titanium cages have been used. This study was undertaken to assess the postoperative radiological fusion rates and symptom relief in patients who had Tutobone used as an interbody spacer compared to autologous bone graft (ABG), cages, surgibone and coral dowels. METHODS: This was a retrospective, observational study...
March 6, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28632646/the-utility-of-adding-magnetic-resonance-imaging-to-computed-tomography-alone-in-the-evaluation-of-cervical-spine-injury-a-propensity-matched-analysis
#4
Andrew J Schoenfeld, Daniel G Tobert, Hai V Le, Dana A Leonard, Allan L Yau, Prashant Rajan, Charles H Cho, James D Kang, Christopher M Bono, Mitchel B Harris
STUDY DESIGN: Adult patients who received CT alone or CT-MRI for the evaluation of cervical OBJECTIVE.: To evaluate the utility of CT-MRI in the diagnosis of cervical spine injury using propensity matched techniques. SUMMARY OF BACKGROUND DATA: The optimal evaluation (computed tomography [CT] alone vs CT and magnetic resonance imaging [MRI]) for patients with suspected cervical spine injury in the setting of blunt trauma remains controversial. METHODS: The primary outcome was the identification of a cervical spine injury, with decision for surgery and change in management considered secondarily...
June 19, 2017: Spine
https://www.readbyqxmd.com/read/28632552/comparative-study-of-c-arms-for-intraoperative-3-dimensional-imaging-and-navigation-in-minimally-invasive-spine-surgery-part-ii-radiation-exposure
#5
Jan-Helge Klingler, Ronen Sircar, Christian Scheiwe, Evangelos Kogias, Marie T Krüger, Christoph Scholz, Ulrich Hubbe
STUDY DESIGN: A radiation exposure study in vitro. OBJECTIVE: This study aimed to compare the radiation exposure of 2 different 3-dimensional (3D) C-arm devices on an anthropomorphic phantom. SUMMARY OF BACKGROUND DATA: Minimally invasive pedicle screw placement requires intraoperative imaging techniques for visualization of the unexposed spine. Mobile 3D C-arms compose a 3D image data set out of multiple successive fluoroscopic images. METHODS: We compared the 3D C-arm devices Siremobil Iso-C 3D (Siemens Sector Healthcare, Erlangen, Germany) and Vision FD Vario 3D (Ziehm Imaging, Nuremberg, Germany) regarding their radiation exposure...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28632551/comparative-study-of-c-arms-for-intraoperative-3-dimensional-imaging-and-navigation-in-minimally-invasive-spine-surgery-part-i-applicability-and-image-quality
#6
Jan-Helge Klingler, Ronen Sircar, Christian Scheiwe, Evangelos Kogias, Florian Volz, Marie T Krüger, Ulrich Hubbe
STUDY DESIGN: This was a retrospective analysis. OBJECTIVE: This study compares 2 different 3-dimensional (3D) C-arm devices for intraoperative imaging and navigation with regard to clinical applicability and image quality. SUMMARY OF BACKGROUND DATA: Minimally invasive spine surgery requires intraoperative imaging techniques to adequately visualize the unexposed spine. For this purpose, mobile 3D C-arms became available along with the evolution of intraoperative navigation techniques...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28627291/early-complications-morbidity-and-mortality-in-octo-and-nonagenarians-undergoing-posterior-intraoperative-spinal-navigation-based-c1-2-fusion-for-type-ii-odontoid-process-fractures
#7
Basem Ishak, Till Schneider, Valerie Gimmy, Andreas W Unterberg, Karl L Kiening
Type II odontoid fractures represent the most common cervical spine injury in the elderly. The decision for surgical treatment is still controversial, particularly with regard to the elevated perioperative risk attributed to frequent comorbidities and poor bone quality. Purpose of this study was to assess both short-term mortality and mid-term clinical and radiological outcome in the elderly. Between January 2007 and December 2015, 35 patients with type II odontoid process fractures who underwent posterior atlanto-axial instrumentation using a modified Goel-Harms technique were retrospectively analyzed and prospectively examined clinically and radiologically...
June 18, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28625903/the-need-for-clinical-practice-guidelines-in-assessing-and-managing-perioperative-neurologic-deficit-results-from-a-survey-of-the-aospine-international-community
#8
A Nater, J C Murray, A R Martin, A Nouri, L Tetreault, M G Fehlings
OBJECTIVES: There is no standardized approach to assess and manage perioperative neurologic deficit (PND) in patients undergoing spinal surgery. This survey aimed to evaluate the awareness and usage of clinical practice guidelines (CPGs) as well as investigate how surgeons performing spine surgeries feel about and manage PND, and how they perceive the value of developing CPGs for the management of PND. METHODS: An invitation to participate was sent to the AOSpine International community...
June 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28620788/comparison-of-intraoperative-neurophysiologic-monitoring-outcomes-between-cervical-and-thoracic-spine-surgery
#9
Shujie Wang, Yuan Tian, Xiangquan Lin, Zhifu Ren, Yu Zhao, Jiliang Zhai, Xiaojuan Zhang, Yanwei Zhao, Yingyue Dong, Congran Zhao, Ye Tian
PURPOSE: The objective is to compare the intraoperative monitoring (IOM) outcomes between degenerative cervical and thoracic spine decompression surgery. METHOD: A total of 97 patients with cervical compression myelopathy (CCM) and 75 patients with thoracic compression myelopathy (TCM) were prospectively collected between December 2012 and June 2015 in our spine center. Somatosensory-evoked potentials (SSEP) and motor-evoked potentials (MEP) were used for IOM. The postoperative neurologic status of each patient was assessed immediately after surgery...
June 15, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28620562/delayed-chyle-leak-following-anterior-cervical-spinal-surgery-a-case-report-and-management-algorithm
#10
Kyle Mueller, Hasan R Syed, Jay W Rhee, Mani N Nair
Injury to the thoracic duct during anterior cervical spine surgery is a rare occurrence. A delayed chyle leak following an elective anterior cervical spinal surgery has not been reported in the literature. We present a report of a 59-year-old female with multiple prior neck surgeries who underwent an anterior cervical corpectomy and fusion (ACCF). The patient developed a delayed thoracic duct injury on postoperative day (POD) one, as no injury was noted intraoperatively. She was managed with conservative care involving a low-fat diet along with octreotide which led to the resolution of her symptoms...
May 9, 2017: Curēus
https://www.readbyqxmd.com/read/28619269/comparing-effects-of-cervical-anterior-approach-and-laminoplasty-in-surgical-management-of-cervical-ossification-of-posterior-longitudinal-ligament-by-a-prospective-nonrandomized-controlled-study
#11
Yang Hou, Lei Liang, Guodong Shi, Peng Xu, Guohua Xu, Jiangang Shi, Wen Yuan
INTRODUCTION: The laminoplasty has been the most widely used surgical method for OPLL. In recent years, increasing attention has been drawn to the anterior operative approaches for surgical treatment of cervical OPLL. However, which method is the optimum selection for therapy of cervical OPLL is still obscure. Therefore, we performed this prospective nonrandomized clinical studyin patients with multilevelcervical myelopathydue to OPLL and compare thetherapeutic efficiencyof laminoplastyand anterior approach (cervical discectomy and/or cervicalcorpectomy) in the management of multi-level cervical OPLL...
June 12, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28614282/clinical-outcomes-of-cervical-spinal-surgery-for-cervical-myelopathic-patients-with-coexisting-lumbar-spinal-canal-stenosis-tandem-spinal-stenosis-a-retrospective-analysis-of-297-cases
#12
Tsuyoshi Yamada, Toshitaka Yoshii, Naoki Yamamoto, Takashi Hirai, Hiroyuki Inose, Tsuyoshi Kato, Shigenori Kawabata, Atsushi Okawa
STUDY DESIGN: Retrospective observational study. OBJECTIVE: We evaluated the prevalence and clinical characteristics of tandem spinal stenosis (TSS) in patients with cervical myelopathy including ossification of the posterior longitudinal ligament of the cervical spine (C-OPLL). SUMMARY OF BACKGROUND DATA: Concurrent cervical and lumbar spinal canal stenosis is generally reported as TSS. Most previous studies have used magnetic resonance imaging to evaluate spinal stenosis in the cervical and lumbar spine...
June 13, 2017: Spine
https://www.readbyqxmd.com/read/28607823/traumatic-spondyloptosis-of-the-cervical-spine-a-case-report-and-discussion-of-worldwide-treatment-trends
#13
Kelly E Wong, Peter S Chang, Mark S Monasky, Rodney M Samuelson
BACKGROUND: Cervical spondyloptosis is defined as the dislocation of the spinal column most often caused by trauma. Due to compression or transection of the spinal cord, severe neurological deficits are common. Here, we review the literature and report a case of traumatic C5-6 spondyloptosis that was successfully treated using an anterior-only surgical approach. METHODS: The patient presented with quadriplegia and absent sensation distal to the C5 dermatome following a rollover motor vehicle accident...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28604497/potential-mechanism-for-some-post-operative-c5-palsies-an-anatomical-study
#14
Fernando Alonso, Vlad Voin, Joe Iwanaga, David Hanscom, Jens R Chapman, Rod J Oskouian, Marios Loukas, R Shane Tubbs
STUDY DESIGN: Anatomical Study. OBJECTIVE: Determine if shoulder depression (e.g., taping the shoulders) might result in C5 nerve traction and subsequent injury. SUMMARY OF BACKGROUND DATA: Postoperative C5 nerve palsy is a recognized entity that is still often enigmatic. Inferior shoulder depression is usually employed to assist with surgical visualization during cervical spine procedures. METHODS: In the supine position, ten adult fresh frozen human cadavers underwent dissection of the spinal cord and its adjacent dorsal, ventral roots and spinal nerves from C4 to T1...
June 9, 2017: Spine
https://www.readbyqxmd.com/read/28601994/radiologic-features-of-dropped-head-syndrome-in-the-overall-sagittal-alignment-of-the-spine
#15
Kazuki Hashimoto, Hiroshi Miyamoto, Terumasa Ikeda, Masao Akagi
PURPOSE: Dropped head syndrome (DHS) is a rare clinical entity which is defined as a chin-on-chest deformity in the standing or sitting position, resulting from sagittal imbalance of the cervical region. The purpose of the present study was to clarify the radiologic features of DHS in the overall sagittal alignment of the spine. We also investigated the changes in sagittal alignment after correction surgery for DHS. METHODS: Twenty DHS patients [1 male and 19 female, with an average age of 78...
June 10, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28597366/finite-element-model-predicts-the-biomechanical-performance-of-cervical-disc-replacement-and-fusion-hybrid-surgery-with-various-geometry-of-ball-and-socket-artificial-disc
#16
Yang Li, Guy R Fogel, Zhenhua Liao, Weiqiang Liu
PURPOSE: Few finite element studies have investigated changes in cervical biomechanics with various prosthesis design parameters using hybrid surgery (HS), and none have investigated those combined different HS strategies. The aim of our study was to investigate the effect of ball-and-socket prosthesis geometry on the biomechanical performance of the cervical spine combined with two HS constructs. METHODS: Two HS strategies were conducted: (1) ACDF at C4-C5 and anterior cervical disc replacement (ACDR) at C5-C6 (ACDF/ACDR), and (2) ACDR/ACDF...
June 8, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28593502/prognostic-factors-in-surgical-patients-with-chordomas-of-the-cervical-spine-a-study-of-52-cases-from-a-single-institution
#17
Hua Zhou, Liang Jiang, Feng Wei, Alexander Joeris, Anahí Hurtado-Chong, Vasiliki Kalampoki, Elke Rometsch, Miao Yu, Fengliang Wu, Lei Dang, Xiaoguang Liu, Zhongjun Liu
BACKGROUND: The recurrence rate of cervical chordomas is high, and hence it is important to discern the prognostic factors for local relapse and overall survival (OS). METHODS: A retrospective review of 52 patients with cervical chordoma operated in our institution from January 1999 to March 2015 was performed. The association of clinicopathologic characteristics with local relapse-free survival (LRFS) and OS was analyzed. Univariate analysis was performed to determine whether tumor characteristics and types of therapy affected prognosis, and a multivariate Cox proportional hazard model was developed to further investigate local recurrence and mortality...
June 7, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28593385/tailor-made-management-of-thoracic-scoliosis-with-cervical-hyperextension-in-muscular-dystrophy
#18
A Angelliaume, L Harper, A Lalioui, A Delgove, Y Lefèvre
PURPOSE: We report the case of a 13-year-old boy managed for fixed cervical hyperextension due to congenital muscular dystrophy with partial merosin deficiency. He presented a right decompensated thoracic scoliosis (T6-L1 Cobb angle 72°) associated with cervical and lumbar lordosis. The spinal extension was accompanied by major flexion of the hip resulting in the trunk being bent forward. This posture caused daily severe back pain responsible for significant loss of quality of life. This led to the decision to perform surgery...
June 7, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28589467/ossification-foci-act-as-stabilizers-in-continuous-type-ossification-of-the-posterior-longitudinal-ligament-a-comparative-study-between-laminectomy-and-laminoplasty
#19
Sunjoon Yoo, Dalsung Ryu, Hong-June Choi, Sung-Uk Kuh, Dong-Kyu Chin, Keun-Su Kim, Yong-Eun Cho
BACKGROUND: In multilevel ossification of the posterior longitudinal ligament (OPLL), laminectomy is an effective surgical technique; however, there is a possibility of kyphotic alignment change after surgery. Nevertheless, in the continuous type of OPLL, the ossification foci are connected and may act as stabilizers preventing alignment change. We here compare the surgical outcome of laminectomy and laminoplasty in continuous-type OPLL of the cervical spine. METHODS: Seventy-three patients who underwent cervical laminectomy or laminoplasty for continuous-type OPLL from 2004 to 2014 were enrolled...
June 6, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28589067/intraoperative-dexmedetomidine-induced-polyuric-syndrome
#20
Shannon Granger, David Ninan
A 23-year-old male trauma patient with a cervical spine fracture underwent an anterior and posterior discectomy and spinal fusion surgery. The patient presented to the operating room with a stabilizing halo fixation device in place, and a fiberoptic intubation was performed with dexmedetomidine for sedation. During the surgical procedure, general anesthesia was maintained with a propofol and remifentanil infusion as the patient was monitored using somatosensory and motor evoked potentials. The patient's urine output increased gradually during the nine-hour surgical procedure from 150 mL/hour to over 700 mL/hour in the eighth hour of the procedure, where it remained until the end of the procedure...
May 3, 2017: Curēus
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