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https://www.readbyqxmd.com/read/28327190/primary-pain-generator-identification-by-ct-spect-in-a-patient-with-low-back-pain-a-case-report
#1
Gabriel Tender, Adriana Constantinescu, Andrew Conger, Anthony DiGiorgio
BACKGROUND: Chronic low back pain is one of the most common conditions encountered in the middle-age population. Identifying the primary pain generator is notoriously difficult. The computed tomography-single-photon emission computed tomography (CT-SPECT) is emerging as a new diagnostic modality for this purpose. CASE PRESENTATION: This 68-year-old Caucasian male presented with intractable low back pain refractory to maximal conservative treatment, including medication and extensive physical therapy...
March 21, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28324327/lumbar-disc-replacement-surgery-successes-and-obstacles-to-widespread-adoption
#2
REVIEW
Stephan N Salzmann, Nicolas Plais, Jennifer Shue, Federico P Girardi
PURPOSE OF REVIEW: Lumbar disc replacement has been a surgical alternative to fusion surgery for the treatment of lumbar degenerative disc disease (DDD) for many years. Despite enthusiasm after the approval of the first devices, implantation rates have remained low, especially in the USA. The goal of this review is to provide a general overview of lumbar disc replacement in order to comprehend the successes and obstacles to widespread adoption. RECENT FINDINGS: Although a large amount of evidence-based data including satisfactory long-term results is available, implantation rates in the USA have not increased in the last decade...
March 21, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28321567/adjacent-segment-pathology-natural-history-or-effect-of-anterior-cervical-discectomy-and-fusion-a-10-year-follow-up-radiological-multicenter-study-using-an-evaluation-scale-of-the-ageing-spine
#3
Alessandro Pesce, Venceslao Wierzbicki, Emanuele Piccione, Alessandro Frati, Antonino Raco, Riccardo Caruso
PURPOSE: Aim of this study is to compare late degenerative MRI changes in a subset of patients operated on with ACDF to a second subset of patients presenting indication to ACDF but never operated on. METHODS: Patients from both subgroups received surgical indication according to the same criteria. Both subgroups underwent a cervical spine MRI in 2004-2005 and 10 years later in 2015. These MRI scans were retrospectively evaluated with a cervical spine ageing scale...
March 20, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28321409/could-the-topping-off-technique-be-the-preventive-strategy-against-adjacent-segment-disease-after-pedicle-screw-based-fusion-in-lumbar-degenerative-diseases-a-systematic-review
#4
REVIEW
Po-Hsin Chou, Hsi-Hsien Lin, Howard S An, Kang-Ying Liu, Wei-Ren Su, Cheng-Li Lin
The "topping-off" technique is a new concept applying dynamic or less rigid fixation such as hybrid stabilization device (HSD) or interspinous process device (IPD) for the purpose of avoiding adjacent segment disease (ASD) proximal to the fusion construct. A systematic review of the literature was performed on the effect of topping-off techniques to prevent or decrease the occurrence of ASD after lumbar fusion surgery. We searched through major online databases, PubMed and MEDLINE, using key words related to "topping-off" technique...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28304237/cervical-disc-arthroplasty-with-the-prestige-lp-disc-versus-anterior-cervical-discectomy-and-fusion-at-2-levels-results-of-a-prospective-multicenter-randomized-controlled-clinical-trial-at-24-months
#5
Matthew F Gornet, Todd H Lanman, J Kenneth Burkus, Scott D Hodges, Jeffrey R McConnell, Randall F Dryer, Anne G Copay, Hui Nian, Frank E Harrell
OBJECTIVE The authors compared the efficacy and safety of arthroplasty using the Prestige LP cervical disc with those of anterior cervical discectomy and fusion (ACDF) for the treatment of degenerative disc disease (DDD) at 2 adjacent levels. METHODS Patients from 30 investigational sites were randomized to 1 of 2 groups: investigational patients (209) underwent arthroplasty using a Prestige LP artificial disc, and control patients (188) underwent ACDF with a cortical ring allograft and anterior cervical plate...
March 17, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28296365/-clinical-and-radiological-results-of-non-fusion-by-static-interspinous-spacer
#6
Juan Enrique Guzmán-Carranza, Amado González-Moga, Leonardo Álvarez-Vázquez, Gabriel Huerta-Hernández, Abraham Isáis-Gómez, Víctor Galicia-Luna, Víctor Hugo Anaya-Contreras
BACKGROUND: The aim of this paper is to demonstrate the clinical and radiological results of non-fusion in patients with degenerative disc disease and lumbar by placing static interspinous spacer. METHODS: A retrospective study was made in the period between January 2010 and January 2013, 130 patients were treated by placing static interspinous spacer. Patients were divided into: Group 1 (treated for diagnosis of degenerative lumbar spinal stenosis), and group 2 (those diagnosed with lumbar disc herniation)...
March 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28291414/is-cervical-disc-arthroplasty-good-for-congenital-cervical-stenosis
#7
Peng-Yuan Chang, Hsuan-Kan Chang, Jau-Ching Wu, Wen-Cheng Huang, Li-Yu Fay, Tsung-Hsi Tu, Ching-Lan Wu, Henrich Cheng
OBJECTIVE Cervical disc arthroplasty (CDA) has been demonstrated to be as safe and effective as anterior cervical discectomy and fusion (ACDF) in the management of 1- and 2-level degenerative disc disease (DDD). However, there has been a lack of data to address the fundamental discrepancy between the two surgeries (CDA vs ACDF), and preservation versus elimination of motion, in the management of cervical myelopathy associated with congenital cervical stenosis (CCS). Although younger patients tend to benefit more from motion preservation, it is uncertain if CCS caused by multilevel DDD can be treated safely with CDA...
March 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28291406/validation-of-the-baseline-severity-stratification-of-objective-functional-impairment-in-lumbar-degenerative-disc-disease
#8
Martin N Stienen, Nicolas R Smoll, Holger Joswig, Marco V Corniola, Karl Schaller, Gerhard Hildebrandt, Oliver P Gautschi
OBJECTIVE The Timed Up and Go (TUG) test is a simple, objective, and standardized method to measure objective functional impairment (OFI) in patients with lumbar degenerative disc disease (DDD). The objective of the current work was to validate the OFI baseline severity stratification (BSS; with levels of "none," "mild," "moderate," and "severe"). METHODS Data were collected in a prospective IRB-approved 2-center study. Patients were assessed with a comprehensive panel of scales for measuring pain (visual analog scale [VAS] for back and leg pain), functional impairment (Roland-Morris Disability Index [RMDI] and Oswestry Disability Index [ODI]), and health-related quality of life (HRQOL; EQ-5D and SF-12)...
March 3, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28279769/lumbar-facet-tropism-a-comprehensive-review
#9
REVIEW
Fernando Alonso, Christina M Kirkpatrick, William Jeong, Christian Fisahn, Sameera Usman, Tarush Rustagi, Marios Loukas, Jens R Chapman, Rod J Oskouian, R Shane Tubbs
Scattered reports exist in the medical literature regarding facet tropism. However, this finding has had mixed conclusions regarding its origin and impact on the normal spine. Herein, we review the anatomy, embryology, biomechanics, and pathology related to lumbar facet tropism. Facet tropism is most commonly found at L4-L5 vertebral segments and there is some evidence that this condition may lead to facet degenerative spondylolisthesis, intervertebral disc disease, and other degenerative conditions.
March 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28278042/a-cell-attracting-composite-of-lumbar-fusion-cage
#10
Busra Gunay, Nesrin Hasirci, Vasif Hasirci
Lumbar fusion cages are devices used in spinal fusion procedures for disorders such as spondylosis and degenerative disc diseases that may occur due to age, trauma or genetic reasons. These devices are most frequently made of metals and polymers. The mechanical properties of such devices should be comparable to the bone to avoid stress shielding. Besides, cages should interact with the cells to prevent extrusion and achieve satisfactory fusion. In this study, poly(methylmethacrylate) (PMMA) and hydroxyapatite (HAp) were compounded to create products with HAp contents up to 40% (w/w), processed by hot melt extrusion and injection molded to produce composites with maximum polymer-mineral interaction...
March 13, 2017: Journal of Biomaterials Science. Polymer Edition
https://www.readbyqxmd.com/read/28272256/a-morphometric-study-of-the-middle-and-lower-cervical-vertebral-endplates-and-their-components
#11
Hang Feng, Xiang-Yi Fang, Da-Geng Huang, Cheng-Cheng Yu, Hou-Kun Li, Song-Chuan Zhao, Chao-Yuan Ge, Ru-Hai Bai, Ding-Jun Hao
Cervical disc arthroplasty is a common method of treating cervical degenerative disease. However, the footprints of most prosthesis dimensions are obtained from data of Caucasian individuals. Besides, there is a large discrepancy between footprints of currently available cervical disc prostheses and anatomic dimensions of cervical endplates. We aimed to detail the three-dimensional (3D) anatomic morphology of the subaxial cervical vertebral endplate, utilizing high-precision, high-resolution scanning equipment, and provide a theoretical basis for designing appropriate disc prostheses for Chinese patients...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28266008/phantom-radicular-pain-treated-with-lumbar-microdiscectomy-a-case-report
#12
Orkun Koban, Ahmet Öğrenci, Onur Yaman, Sedat Dalbayrak
Phantom limb pain in amputee patients is not well defined in the literature. Also there is still no clear information on the definition and treatment of phantom radicular pain, in which amputee patients also have radicular pain. This phenomenon, called phantom radiculitis or phantom radiculopathy, has been described in a limited number of cases. If a pathological condition to cause radicular pain is present in patients with amputee, the phantom pain\'s degree is increasing. Degenerative disc diseases are the most common cause of phantom radicular pain...
February 15, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28262396/a-new-zero-profile-stand-alone-fidji-cervical-cage-for-the-treatment-of-the-single-and-multilevel-cervical-degenerative-disc-disease
#13
Zhonghai Li, Huadong Wang, Li Li, Jiaguang Tang, Dongfeng Ren, Shuxun Hou
To investigate the clinical and radiological results of the new zero-profile, stand-alone Fidji cervical cage to treat single- and multiple-level cervical DDD, and evaluate the safety and efficiency. Between October 2011 and July 2014, 72 consecutive patients (41 males and 31 females; mean age 50.9years [range, 33-68years]) with cervical DDD who underwent surgery and were followed for more than 2years were enrolled in this study (mean 31.1months, range 24-47months). The study compared clinical outcomes, radiologic parameters and complication rates...
March 2, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28259005/removal-of-fixation-construct-could-mitigate-adjacent-segment-stress-after-lumbosacral-fusion-a-finite-element-analysis
#14
Yueh-Ying Hsieh, Chia-Hsien Chen, Fon-Yih Tsuang, Lien-Chen Wu, Shang-Chih Lin, Chang-Jung Chiang
BACKGROUND DATA: Combined usage of posterior lumbar interbody fusion and transpedicular fixation has been extensively used to treat the various lumbar degenerative disc diseases. The transpedicular fixator aims to increase stability and enhance the fusion rate. However, how the fused disc and bridged vertebrae respectively affect adjacent-segment diseases progression is not yet clear. METHODS: Using a validated lumbosacral finite-element model, three variations at the L4-L5 segment were analyzed: 1) moderate disc degeneration, 2) instrumented with a stand-alone cage and pedicle screw fixators, and 3) with the cage only after fusion...
February 23, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28254665/early-stage-autophagy-protects-nucleus-pulposus-cells-from-glucose-deprivation-induced-degeneration-via-the-p-eif2%C3%AE-atf4-pathway
#15
Hongze Chang, Feng Cai, Yan Zhang, Mintao Xue, Liang Liu, Anli Yang, Xiaodong Liu
Autophagy is a double-edged sword in cellular survival, but its effects on nucleus pulposus (NP) cells are yet to be clarified. This study explored the role and molecular mechanisms of autophagy in the survival of NP cells under nutrient deprivation. Glucose limitation induced time-dependent morphological changes, proteoglycan degradation, and apoptosis in NP cells. Glucose deprivation triggered the activation of early-stage autophagy, evident as increases in LC3-II and ATG12-ATG5 expression and the number of GFP-LC3 puncta...
February 27, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28246009/clinical-and-radiographic-features-of-hybrid-surgery-for-the-treatment-of-skip-level-cervical-degenerative-disc-disease-a-minimum-24-month-follow-up
#16
Ting-Kui Wu, Bei-Yu Wang, Ding Cheng, Xin Rong, Ji-Gang Lou, Ying Hong, Hao Liu
We describe the radiographic changes of IS and investigate the safety and feasibility of hybrid surgery (HS) coupling cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) for the treatment of skip-level cervical degenerative disc disease (CDDD). Twenty-seven patients who received HS were retrospectively reviewed. Clinical evaluation based on the Japanese Orthopedic Association (JOA) and Neck Disability Index (NDI) and Visual Analog Scale (VAS) scores. Radiographic parameters included cervical alignment (CA), functional spine unite (FSU) angle of intermediated segment (IS), range of motion (ROM) and intervertebral disc height (IDH)...
February 25, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28244906/role-of-weekly-teriparatide-administration-in-osseous-union-enhancement-within-six-months-after-posterior-or-transforaminal-lumbar-interbody-fusion-for-osteoporosis-associated-lumbar-degenerative-disorders-a-multicenter-prospective-randomized-study
#17
RANDOMIZED CONTROLLED TRIAL
Shigeto Ebata, Jun Takahashi, Tomohiko Hasegawa, Keijiro Mukaiyama, Yukihiro Isogai, Tetsuro Ohba, Yosuke Shibata, Toshiyuki Ojima, Zentaro Yamagata, Yukihiro Matsuyama, Hirotaka Haro
BACKGROUND: For elderly patients, posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF) is usually performed to treat lumbar degenerative diseases. However, some patients exhibit pseudarthrosis following such procedures. The anabolic agent teriparatide is an approved treatment for promoting bone formation in osteoporotic patients. Our multicenter, prospective randomized study assessed the role of once-weekly teriparatide administration on patient outcomes following interbody fusion...
March 1, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28224704/advanced-glycation-end-products-regulate-anabolic-and-catabolic-activities-via-nlrp3-inflammasome-activation-in-human-nucleus-pulposus-cells
#18
Yu Song, Yan Wang, Yukun Zhang, Wen Geng, Wei Liu, Yong Gao, Shuai Li, Kun Wang, Xinghuo Wu, Liang Kang, Cao Yang
Intervertebral disc degeneration is widely recognized as a cause of lower back pain, neurological dysfunction and other musculoskeletal disorders. The major inflammatory cytokine IL-1β is associated with intervertebral disc degeneration; however, the molecular mechanisms that drive IL-1β production in the intervertebral disc, especially in nucleus pulposus (NP) cells, are unknown. In some tissues, advanced glycation end products (AGEs), which accumulate in NP tissues and promote its degeneration, increase oxidative stress and IL-1β secretion, resulting in disorders, such as obesity, diabetes mellitus and ageing...
February 22, 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/28220607/neurological-and-spinal-manifestations-of-the-ehlers-danlos-syndromes
#19
Fraser C Henderson, Claudiu Austin, Edward Benzel, Paolo Bolognese, Richard Ellenbogen, Clair A Francomano, Candace Ireton, Petra Klinge, Myles Koby, Donlin Long, Sunil Patel, Eric L Singman, Nicol C Voermans
The Ehlers-Danlos syndromes (EDS) are a heterogeneous group of heritable connective tissue disorders characterized by joint hypermobility, skin extensibility, and tissue fragility. This communication briefly reports upon the neurological manifestations that arise including the weakness of the ligaments of the craniocervical junction and spine, early disc degeneration, and the weakness of the epineurium and perineurium surrounding peripheral nerves. Entrapment, deformation, and biophysical deformative stresses exerted upon the nervous system may alter gene expression, neuronal function and phenotypic expression...
February 21, 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/28215460/early-experience-with-lateral-lumbar-total-disc-replacement-utility-complications-and-revision-strategies
#20
Gregory M Malham, Rhiannon M Parker
Lumbar total disc replacement (TDR) is an alternative to interbody fusion for the treatment of symptomatic degenerative disc disease. Traditionally, lumbar TDR is performed via an anterior retroperitoneal approach with regional risks of vascular and visceral injury. The direct lateral retroperitoneal, transpsoas approach avoids mobilisation of the great vessels and preserves the anterior longitudinal ligament, thereby maintaining physiological limits on motion. This study aimed to (i) report one site's early experience with lateral lumbar TDR and (ii) provide case examples illustrating the utility, complications and revision strategies of the XL-TDR device...
February 16, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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