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https://www.readbyqxmd.com/read/28529861/local-intra-wound-administration-of-powdered-antibiotics-in-orthopaedic-surgery
#1
REVIEW
Andrew N Fleischman, Matthew S Austin
Surgical site infection (SSI) is one of the most common complications after orthopaedic surgery, leading to significant morbidity and its associated costs. Surgical guidelines strongly recommend the use of systemic antibiotic prophylaxis to reduce the risk for developing SSI. Locally administered powdered antibiotics have the potential to provide remarkably high intra-wound concentrations without risk for systemic toxicity. However, a paucity of high quality evidence in the orthopaedic literature has prevented widespread adoption of this technique...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529056/prevention-of-thromboembolic-complications-after-spine-surgery-by-the-use-of-low-molecular-weight-heparin
#2
Xiao-Jun Zeng, Hao Peng
AIM: The present study aimed to evaluate the effectiveness and safety of the use of LMWH in the prevention of thromboembolic complications after spine surgery. METHODS: We conducted a retrospective study on two groups of patients receiving spine surgery. A total of 947 patients admitted for surgery from July 2009 to June 2012 were administered therapeutic dose of LMWH daily after the surgery (therapeutic group). Another 814 patients enrolled from July 2006 to June 2009 were not given any heparin treatment (control group)...
May 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28528481/consent-an-event-or-a-memory-in-lumbar-spinal-surgery-a-multi-centre-multi-specialty-prospective-study-of-documentation-and-patient-recall-of-consent-content
#3
William B Lo, Ciaran P McAuley, Martin J Gillies, Patrick J Grover, Erlick A C Pereira
STUDY DESIGN: Prospective, multi-centre, multi-specialty medical notes review and patient interview. PURPOSE: The consenting process is an important communication tool which also carries medico-legal implications. While written consent is a pre-requisite before spinal surgery in the UK, the standard and effectiveness of the process have not been assessed previously. This study assesses standard of written consent for elective lumbar decompressive surgery for degenerative disc disease across different regions and specialties in the UK; level of patient recall of the consent content; and identifies factors which affect patient recall...
May 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28528480/full-endoscopic-treatment-of-dural-tears-in-lumbar-spine-surgery
#4
Joachim M Oertel, Benedikt W Burkhardt
PURPOSE: An incidental durotomy is a common complication of spinal surgery. Its treatment remains challenging, especially in endoscopic procedures. The objective of this study is to describe a technique for endoscopic dural closure which is safe and effective. METHODS: From a prospective database all endoscopic spinal procedures with incidental durotomy were identified. Retrospectively, video recordings were analysed with a special reference to the applied technique of dural closure...
May 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28527756/radiological-lumbar-stenosis-severity-predicts-worsening-sagittal-malalignment-on-full-body-standing-stereoradiographs
#5
Aaron J Buckland, Subaraman Ramchandran, Louis Day, Shay Bess, Themistocles Protopsaltis, Peter G Passias, Bassel G Diebo, Renaud Lafage, Virginie Lafage, Akhila Sure, Thomas J Errico
BACKGROUND CONTEXT: Patients with degenerative lumbar stenosis (DLS) adopt a forward flexed posture in an attempt to decompress neural elements. The relationship between sagittal alignment and severity of lumbar stenosis has not previously been studied. PURPOSE: We hypothesized that patients with increasing radiological severity of lumbar stenosis will exhibit worsening sagittal alignment. STUDY DESIGN: This is a cross-sectional study. PATIENT SAMPLE: Our sample consists of patients who have DLS...
May 17, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28527755/perioperative-neurologic-complications-during-spinal-fusion-surgery-incidence-and-trends
#6
Parthasarathy Thirumala, James Zhou, Piruthiviraj Natarajan, Jeffrey Balzer, Edward Dixon, David Okonkwo, D K Hamilton
BACKGROUND CONTEXT: Perioperative neurologic complications after spine surgery may increase morbidity and healthcare costs related to the procedure. PURPOSE: We estimate the national incidence of perioperative neurologic complications following anterior cervical discectomy and fusion (ACDF), posterior cervical fusion, and thoracolumbar fusion procedures using the Nationwide Inpatient Sample (NIS) data from 1999 to 2011. Additionally, we identify risk factors for developing perioperative neurologic complications and the effects of these injuries on quantifiable patient outcomes...
May 17, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28526641/elimination-of-subsidence-with-26mm-wide-cages-in-extreme-lateral-interbody-fusion
#7
Gernot Lang, Rodrigo Navarro-Ramirez, Lena Gandevia, Ibrahim Hussain, Jonathan Nakhla, Micaella Zubkov, Roger Härtl
BACKGROUND: Extreme lateral interbody fusion (ELIF) has gained popularity as minimally invasive technique for indirect decompression. However, graft subsidence potentially threatens the long-term success of ELIF. The aim of the study was to evaluate whether 26mm wide cages can eliminate subsidence and subsequent loss of decompression in ELIF. METHODS: Patients undergoing ELIF surgery using a 26mm wide cage were analyzed retrospectively. Patient demographics and peri-operative data for radiographic and clinical outcomes were recorded...
May 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28526487/ultrasound-guided-thoracic-paravertebral-injection-in-dogs-a-cadaveric-study
#8
Diego A Portela, Luis Campoy, Pablo E Otero, Manuel Martin-Flores, Robin D Gleed
OBJECTIVE: To describe ultrasound-visualized anatomy and the spread characteristics of a dye injected in the thoracic paravertebral (TPV) space under ultrasound guidance. STUDY DESIGN: Anatomic cadaver study. ANIMALS: Seven dog cadavers. METHODS: One cadaver was used to observe, identify, and describe the relevant TPV anatomy. In the remaining six, the left fifth TPV space was randomly assigned to be injected with either a low volume (LV; 0...
February 16, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28526092/transapical-aortic-perfusion-using-a-deep-hypothermic-procedure-to-prevent-dissecting-lung-injury-during-re-do-thoracoabdominal-aortic-aneurysm-surgery
#9
Yuya Kise, Yukio Kuniyoshi, Mizuki Ando, Hitoshi Inafuku, Takaaki Nagano, Satoshi Yamashiro
BACKGROUND: Avoiding various complications is a challenge during re-do thoracoabdominal aneurysm surgery. CASE PRESENTATION: A 56-year-old man had undergone surgery for type I aortic dissection four times. The residual thoracoabdominal aortic aneurysm that had severe adhesions to lung parenchyma was resected. Since the proximal anastomotic site was buried in lung parenchyma, deep hypothermia was essential to avoid lung dissection and to protect the spinal cord during the proximal anastomosis...
May 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28525553/evaluation-of-conventional-and-frozen-elephant-trunk-techniques-on-spinal-cord-blood-flow-in-an-animal-model%C3%A2
#10
Sergey Leontyev, Maja-Theresa Dieterlen, Michelle Halling, Franziska Schlegel, Alexandro Hoyer, Susann Ossmann, Kerstin Klaeske, Christian D Etz, Friedrich W Mohr
OBJECTIVES: The treatment of patients with extensive thoracic aortic disease involving the arch and descending aorta is often performed using the frozen elephant trunk technique (FET). Spinal cord blood flow (SCBF) in cervical, thoracic and lumbar sections prior, during and after aortic arch surgery were compared in conventional elephant trunk (cET) and FET technique in a pig model. METHODS: German Landrace pigs (75-85 kg) underwent aortic arch surgery using the FET ( n  = 8) or cET ( n  = 8) techniques...
May 18, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28525512/parecoxib-supplementation-to-morphine-analgesia-decreases-incidence-of-delirium-in-elderly-patients-after-hip-or-knee-replacement-surgery-a-randomized-controlled-trial
#11
Dong-Liang Mu, Da-Zhi Zhang, Dong-Xin Wang, Geng Wang, Chun-Jing Li, Zhao-Ting Meng, Ya-Wei Li, Chao Liu, Xue-Ying Li
BACKGROUND: Severe pain and high-dose opioids are both associated with increased risk of postoperative delirium. The authors investigated whether parecoxib-supplemented IV morphine analgesia could decrease the incidence of delirium in elderly patients after total hip or knee replacement surgery. METHODS: In a randomized, double-blind, 2-center trial, patients of 60 years or older who underwent elective total hip or knee replacement surgery were assigned in a 1:1 ratio to receive either parecoxib (40 mg at the end of surgery and then every 12 hours for 3 days) or placebo (normal saline)...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28525493/influence-of-myelography-and-postmyelographic-ct-on-therapeutic-decisions-in-degenerative-diseases-of-the-cervical-spine
#12
Thomas Westermaier, Christina Doerr, Christian Stetter, Thomas Linsenmann, Stefan Koehler, Joerg Eriskat, Laszlo Solymosi, Ralf-Ingo Ernestus
STUDY DESIGN: A retrospective analysis of clinical records and radiologic imaging by 3 independent reviewers to assess the indication for surgical treatment with and without myelography and postmyelographic computed tomography (MCT). OBJECTIVE: To evaluate whether myelography and MCT obtained in addition to magnetic resonance imaging (MRI) influence therapeutic decisions in degenerative diseases of the cervical spine. SUMMARY OF BACKGROUND DATA: MRI has become the standard examination in spinal diseases...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525487/metabolic-imaging-using-proton-magnetic-spectroscopy-as-a-predictor-of-outcome-after-surgery-for-cervical-spondylotic-myelopathy
#13
Langston T Holly, Benjamin M Ellingson, Noriko Salamon
STUDY DESIGN: A single-center magnetic resonance spectroscopy (MRS) imaging and surgical outcome study involving 16 patients with cervical spondylotic myelopathy (CSM). OBJECTIVE: In the present study, we assess the utility of MRS to quantify metabolic changes within the spinal cord and predict surgical outcome in CSM patients. SUMMARY OF BACKGROUND DATA: MRS is an advanced spinal imaging modality that can provide pertinent metabolic and biochemical information regarding spinal cord function...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525482/artificial-cervical-disk-replacement-for-the-treatment-of-adjacent-segment-disease-after-anterior-cervical-decompression-and-fusion
#14
Sheng Bin, Huang Xiangwang, Xiao Sheng, Xiang Tiecheng, Liu Xiangyang, Zhang Yi, Liu Bin
STUDY DESIGN: Retrospective study. OBJECTIVE: To evaluate the outcome of artificial cervical disk replacement (ACDR) for the treatment of adjacent segment disease (ASD) after anterior cervical decompression and fusion (ACDF). SUMMARY OF BACKGROUND DATA: ACDF is the useful procedure for degenerative cervical diseases. However, studies have reported accelerated degeneration of functional spinal units adjacent to the fusion site after ACDF. MATERIALS AND METHODS: Between January 2004 and January 2011, 32 inpatients (18 male, 14 female; age, 38-61 y; mean, 48 y) underwent ACDR for the treatment of ASD after previous ACDF (single-level: n=12; 2-level: n=15; 3-level: n=5)...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525480/a-new-entrance-technique-for-c2-pedicle-screw-placement-and-the-use-in-patients-with-atlantoaxial-instability
#15
Jia-Ming Liu, Jian Jiang, Zhi-Li Liu, Xin-Hua Long, Wen-Zhao Chen, Yang Zhou, Song Gao, Lai-Chang He, Shan-Hu Huang
STUDY DESIGN: A prospective study and a technique note. OBJECTIVES: To introduce a new entrance technique for C2 pedicle screw placement and to measure the related linear and angular parameters about the entrance point on computed tomography (CT) images. The safety of this technique for patients with atlantoaxial instability was also evaluated. BACKGROUND DATA: Although earlier studies have introduced different methods for C2 pedicle screw placement, the entry points and the angular parameters may be variable...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525473/is-total-disk-replacement-a-cost-effective-treatment-for-cervical-degenerative-disk-disease
#16
Bernd Wiedenhöfer, Joachim Nacke, Mike Stephan, Wiltrud Richter, Claus Carstens, Markus Eichler
STUDY DESIGN: A retrospective study. OBJECTIVE: The objective of this study was to assess the cost-effectiveness and clinical outcome of motion-preserving versus fusion procedures in cervical spine surgery. SUMMARY OF BACKGROUND DATA: During the last decade there has been a huge growth in spine surgery with a concurrent increase in the economic burden. Currently, there appear to be no differences in clinical outcome between cervical total disk replacement (TDR) and spinal fusion (SF)...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525466/facet-preserving-technique-by-en-bloc-flavectomy-in-microscopic-posterior-decompression-surgery-for-lumbar-spinal-stenosis-semicircumferential-decompression-scd
#17
Yasushi Fujiwara, Hideki Manabe, Tadayoshi Sumida, Bunichiro Izumi, Kazuyoshi Nakanishi, Nobuhiro Tanaka, Nobuo Adachi
Posterior decompression surgery which enlarges the spinal canal in cases with lumbar spinal stenosis is the most fundamental technique in spine surgery, but controversy still remains for the exact technique. Because nerve roots run under the ventral side on the superior articular process (SAP), achieving both facet joint preservation and nerve root decompression is problematic. In conventional laminotomies or laminectomies, medial facetectomies are performed to decompress the nerve root, but it is ideal to preserve the facet joints completely for preserving joint stability...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525407/validation-and-cross-cultural-adaptation-of-the-korean-version-of-the-zurich-claudication-questionnaire-in-patients-with-lumbar-spinal-stenosis
#18
Ho-Joong Kim, Young-Kyun Lee, Dong Ook Kim, Bong-Soon Chang, Choon-Ki Lee, Jin S Yeom
STUDY DESIGN: Linguistic and psychometric validation of a translated questionnaire OBJECTIVE.: To validate the Korean version of Zurich claudication questionnaire (ZCQ) both linguistically and psychometrically. SUMMARY OF BACKGROUND DATA: The ZCQ is considered as a disease specific and gold standard measure for evaluation of patients with lumbar spinal stenosis (LSS). However, there has been no validated Korean version of the ZCQ. METHODS: The ZCQ was translated forward and backward, culturally adapted by 2 independent translators, and approved by an expert committee...
May 18, 2017: Spine
https://www.readbyqxmd.com/read/28524753/continuous-mapping-of-the-corticospinal-tracts-in-intramedullary-spinal-cord-tumor-surgery-using-an-electrified-ultrasonic-aspirator
#19
Ori Barzilai, Zvi Lidar, Shlomi Constantini, Khalil Salame, Yifat Bitan-Talmor, Akiva Korn
Intramedullary spinal cord tumors (IMSCTs) represent a rare entity, accounting for 4%-10% of all central nervous system tumors. Microsurgical resection of IMSCTs is currently considered the primary treatment modality. Intraoperative neurophysiological monitoring (IONM) has been shown to aid in maximizing tumor resection and minimizing neurological morbidity, consequently improving patient outcome. The gold standard for IONM to date is multimodality monitoring, consisting of both somatosensory evoked potentials, as well as muscle-based transcranial electric motor evoked potentials (tcMEPs)...
May 19, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28524751/pseudogout-of-the-cervical-and-thoracic-spine-mimicking-infection-after-lumbar-fusion-case-report
#20
Kelly J Bridges, Carli L Bullis, Ajay Wanchu, Khoi D Than
Pseudogout is a form of acute calcium pyrophosphate deposition (CPPD) disease that typically afflicts the elderly. CPPD commonly involves larger joints, such as the knees, wrists, shoulders, and hips, and has been known to involve the spine. The authors report the case of a 66-year-old woman with a recent history of lumbar laminectomy and fusion who presented 5 weeks postprocedure with a clinical and radiographic picture consistent with multilevel skip lesions involving the cervical and thoracic spine, thoracic discitis, and epidural abscess...
May 19, 2017: Journal of Neurosurgery. Spine
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