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Spinal surgery

Andrew S Moon, Walter Smith, Sawyer Mullen, Brent A Ponce, Gerald McGwin, Ashish Shah, Sameer M Naranje
BACKGROUND: The association between marijuana use and surgical procedures is a matter of increasing societal relevance that has not been well studied in the literature. The primary aim of this study is to evaluate the relationship between marijuana use and in-hospital mortality, as well as to assess associated comorbidities in patients undergoing commonly billed orthopedic surgeries. METHODS: The National Inpatient Sample (NIS) database from 2010 to 2014 was used to determine the odds ratios for the associations between marijuana use and in-hospital mortality, heart failure (HF), stroke, and cardiac disease (CD) in patients undergoing five common orthopedic procedures: hip (THA), knee (TKA), and shoulder arthroplasty (TSA), spinal fusion, and traumatic femur fracture fixation...
March 20, 2018: Substance Abuse
Alpesh A Patel, Shah-Nawaz M Dodwad, Barrett S Boody, Surabhi Bhatt, Jason W Savage, Wellington K Hsu, Nan E Rothrock
STUDY DESIGN: Prospective, cohort study. OBJECTIVE: Demonstrate validity of PROMIS physical function, pain interference, and pain behavior computer adaptive tests (CATs) in surgically treated lumbar stenosis patients. SUMMARY OF BACKGROUND DATA: There has been increasing attention given to patient reported outcomes associated with spinal interventions. Historical patient outcome measures have inadequate validation, demonstrate floor/ceiling effects, and infrequently used due to time constraints...
March 19, 2018: Spine
(no author information available yet)
No abstract text is available yet for this article.
April 2018: Journal of Trauma and Acute Care Surgery
Samrat Yeramaneni, Jeffrey L Gum, Leah Y Carreon, Eric O Klineberg, Justin S Smith, Amit Jain, Richard A Hostin
BACKGROUND: Readmissions following adult spinal deformity surgical procedures frequently occur, placing a substantial burden on patients and providers. Existing literature on readmission costs, including reason-specific readmission costs, is limited. The purposes of this study were to determine the most expensive reasons for readmission, to assess the impact of reasons and timing on readmission costs, and to estimate the drivers of total costs associated with adult spinal deformity surgical procedures...
March 21, 2018: Journal of Bone and Joint Surgery. American Volume
Hiroshi Takahashi, Yasuchika Aoki, Arata Nakajima, Masato Sonobe, Fumiaki Terajima, Masahiko Saito, Takuya Miyamoto, Keita Koyama, Keiichiro Yamamoto, Takeo Furuya, Masao Koda, Seiji Ohtori, Masashi Yamazaki, Koichi Nakagawa
PURPOSE: To determine levels of biomarkers reflecting damage to axon, myelin, astrocytes, and neuron in cerebrospinal fluid (CSF) of patients with cervical compression myelopathy. METHODS: We collected 69 CSF samples from patients before spinal surgery for acutely worsening compression myelopathy (AM, 20), chronic compression myelopathy (CM, 20), and lumbar canal stenosis (LCS 29; control). We measured levels of phosphorylated neurofilament subunit H (pNF-H), tau (reflecting axonal damage), myelin basic protein (MBP) (reflecting demyelination), S100b (reflecting astrocyte damage), and neuron-specific enolase (NSE) (reflecting neuronal damage)...
March 19, 2018: European Spine Journal
Martin Barth, Christel Weiss, Kirsten Schmieder
BACKGROUND: The extent of red blood cell units (RBC) needed for different neurosurgical procedures and the time point of their administration are widely unknown, which results in generously cross-matching prior to surgery. However, RBC are increasingly requested in the aging western populations, and blood donations are significantly reduced. Therefore, the knowledge of the extent and time point of administration of RBC is of major importance. METHODS: This is a retrospective single center analysis...
March 20, 2018: Acta Neurochirurgica
Bassel G Diebo, Denis Cherkalin, Cyrus M Jalai, Neil V Shah, Greg W Poorman, George A Beyer, Frank A Segreto, Virginie Lafage, Qais Naziri, Jared M Newman, William P Urban, Thomas J Errico, Frank J Schwab, Carl B Paulino, Peter G Passias
Retrospective review of National Inpatient Sample (2000-2012) revealed that 31.28% of musculoskeletal (MSK) patients were found to have in-hospital psychological burdens (PBs). Adult spinal deformity (ASD), degenerative disc disease (DDD) and lung cancer patients had highest PB-prevalence. MSK patients with PB were more often young, white females with increased Deyo index compared to no-PB patients. Patients who underwent spinal revision procedures had higher PB rates than with primary procedures; a converse trend was observed for total hip/knee arthroplasty...
June 2018: Journal of Orthopaedics
M E Yaman, G Ergül, Y Güvenç, Y Öztürk, F K Erbay, T Tolunay, S Şentürk, C Kırçıl, G Bozkurt
Epidural fibrosis is a challenging topic in spinal surgery. Numerous clinical and experimental studies have been focused on this issue to clarify problems faced in spinal procedures for the patient as well as the surgeon and find out new methodologies. Dense cytokines and growth factors which are released from inflammatory cells have been suggested to play a major role in the inception and progression of fibrosis. One of the most investigated and important actor in epidural fibrosis is assumed to be the transforming growth factor-1β (TGF-1β) formation...
March 16, 2018: International Journal of Surgery
Hong-Fang Chen, Chang-Qing Zhao
Pelvic incidence has become one of the most important sagittal parameters in spinal surgery. Despite its great importance, pelvic incidence can vary from 33° to 85° in the normal population. The reasons for this great variability in pelvic incidence remain unexplored. The objective of this article is to present some possible interpretations for the great variability in pelvic incidence under both normal and pathological conditions and to further understand the determinants of pelvic incidence from the perspective of the functional requirements for bipedalism and genetic backgrounds via a literature review...
March 20, 2018: Journal of Orthopaedic Surgery and Research
Jesse J Liu, Jeffrey S Raskin, Fran Hardaway, Katherine Holste, Sarah Brown, Ahmed M Raslan
BACKGROUND: Delivery of higher value healthcare is an ultimate government and public goal. Improving efficiency by standardization of surgical steps can improve patient outcomes, reduce costs, and lead to higher value healthcare. Lean principles and methodology have improved timeliness in perioperative medicine; however, process mapping of surgery itself has not been performed. OBJECTIVE: To apply Plan/Do/Study/Act (PDSA) cycles methodology to lumbar posterior instrumented fusion (PIF) using lean principles to create a standard work flow, identify waste, remove intraoperative variability, and examine feasibility among pilot cases...
March 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
Taolin Fang, Glenn S Russo, Gregory D Schroeder, Christopher K Kepler
Achieving an osseous fusion across the lumbosacral spine is still challenging in spine surgery. For the long multisegmental fusion surgery, it is crucial to build a robust and substantial foundation, which sometimes necessitates the distal spinal fixation to the pelvis. The pelvic fixation technique involves advancing the screw through the alar, thereby providing more purchase across the sacroiliac joint and into the ilium. The S2 alar iliac screws can obtain immediate stability and proper biomechanical strength of constructs...
March 16, 2018: Clinical Spine Surgery
Tao Yang, Fei Wang, Chaoshi Niu
The majority of spinal cavernous angiomas (CAs) originate from the vertebral bodies with or without epidural space extension. Solitary epidural CAs are rare. In the present study, we retrospectively reviewed the records of 12 patients who underwent microsurgery for solitary spinal epidural CAs. All patients had performed pre- and postoperative magnetic resonance imaging. The patients were 7 females and 5 males with the mean age of 52.1 years. Two tumors were located in the cervicothoracic spine, nine in the thoracic spine and one in the lumbar spine, respectively...
April 2018: Oncology Letters
Sandra Puentes, Hideki Kadone, Shigeki Kubota, Tetsuya Abe, Yukiyo Shimizu, Aiki Marushima, Yoshiyuki Sankai, Masashi Yamazaki, Kenji Suzuki
The Ossification of the Posterior Longitudinal Ligament (OPLL) is an idiopathic degenerative spinal disease which may cause motor deficit. For patients presenting myelopathy or severe stenosis, surgical decompression is the treatment of choice; however, despite adequate decompression residual motor impairment is found in some cases. After surgery, there is no therapeutic approach available for this population. The Hybrid Assistive Limb® (HAL) robot suit is a unique powered exoskeleton designed to predict, support, and enhance the lower extremities performance of patients using their own bioelectric signals...
2018: Frontiers in Neuroscience
Jennifer Luk, Yong Lu, Amanda Ackermann, Xiaoxue Peng, Diane Bogdan, Michelino Puopolo, David E Komatsu, Simon Tong, Iwao Ojima, Mario J Rebecchi, Martin Kaczocha
Background: Metabolism of the endocannabinoid 2-arachidonoylglycerol (2-AG) yields arachidonic acid (AA), the precursor to proalgesic eicosanoids including prostaglandin E2 (PGE2 ). Diacylglycerol lipase β (DAGLβ) is an enzyme that synthesizes 2-AG and its inhibition reduces eicosanoid levels and produces antinociceptive effects in models of inflammatory pain. Here we test whether inhibition of DAGLβ produces antinociceptive effects in a model of postoperative pain. Methods: Rats were administered the selective DAGLβ inhibitor KT109 or vehicle and underwent plantar incision...
2018: Journal of Pain Research
Ida K Fox, Christine B Novak, Emily M Krauss, Gwendolyn M Hoben, Craig Zaidman, Rimma Ruvinskaya, Neringa Juknis, Anke C Winter, Susan E Mackinnon
BACKGROUND: Nerve transfer surgery to restore upper extremity (UE) function in cervical spinal cord injury (SCI) is novel and may transform treatment. Determining candidacy even years post-SCI is ill-defined and deserves investigation. OBJECTIVE: To develop a diagnostic algorithm, focusing on electrodiagnostic studies (EDX), to determine eligibility for nerve transfer surgery. DESIGN: Retrospective descriptive case series SETTING: Tertiary university-based institution PATIENTS: Individuals with cervical SCI (n = 45) METHODS: The electronic medical records of people referred to the Plastic and Reconstructive Surgery UE Surgery in SCI clinic from 2010-2015 were reviewed...
March 15, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Toscane C Noordhoff, Jan Groen, Jeroen R Scheepe, Bertil F M Blok
CONTEXT: Surgical treatment of anatomic bladder outlet obstruction (BOO) may be indicated in males with neurogenic bladder dysfunction. A bothersome complication after surgery is urinary incontinence. OBJECTIVE: To identify the optimal practice in the surgical treatment of anatomic BOO in males with neurogenic bladder dysfunction, due to multiple sclerosis, Parkinson disease, spinal cord injury (SCI), spina bifida, or cerebrovascular accident (CVA). EVIDENCE ACQUISITION: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement...
March 15, 2018: European Urology Focus
John D Koerner, Dessislava Z Markova, Greg D Schroeder, Brian P Calio, Anuj Shah, Corbin W Brooks, Alexander R Vaccaro, D Greg Anderson, Chris K Kepler
BACKGROUND CONTEXT: The systemic response regarding cytokine expression after application of recombinant human Bone Morphogenetic Protein-2 (rhBMP-2) in a rat spinal fusion model has recently been defined1 , but the local response has not. Defining the local cytokine and growth factor response at the fusion site will help explain the roles of these molecules in the fusion process, as well as that of rhBMP-2. Our hypothesis is that application of rhBMP-2 to the fusion site will alter the local levels of cytokines and growth factors throughout the fusion process, in a manner that is different than the systemic response given the tissue-specific effects of rhBMP-2...
March 14, 2018: Spine Journal: Official Journal of the North American Spine Society
Yun-Sik Dho, Hyoungmin Kim, Kyu-Chang Wang, Seung-Ki Kim, Ji Yeoun Lee, Hee Young Shin, Kyung Duk Park, Hyoung Jin Kang, Il Han Kim, Sung-Hye Park, Ji Hoon Phi
PURPOSE: s: Spinal epidural lymphoma with compressive myelopathy is a rarely found condition. The aims of this study are to describe the clinical features and to analyze its treatment outcome and prognostic factors. MATERIALS & METHODS: We searched for all pediatric patients with newly diagnosed spinal epidural lymphoma from 1999 to 2014 in our institution. We evaluated the clinical features, including neurological status, time interval to treatment, treatment modality, and outcomes...
March 14, 2018: World Neurosurgery
Michelle H Chua, Raksmey Hong, Tytim Rydeth, Iv Vycheth, Sam Nang, Din Vuthy, Kee B Park
INTRODUCTION: In recent years, delivery of cost-effective "essential neurosurgery" in resource-limited communities has been recognized as an indispensable part of health care and a global health priority. The purpose of this study was to review outcomes from operative management of spine trauma at a resource limited government hospital in Phnom Penh, Cambodia, and to provide an epidemiologic report to guide prevention programs. METHODS: A retrospective review of a prospective neurosurgical database was performed to identify risk factors for spine trauma and severe spinal cord injury (ASIA A or ASIA B) and to evaluate the cost-effectiveness of surgery for patients treated at Preah Kossamak Hospital for subaxial and thoracolumbar spine trauma from 2013 to 2016...
March 14, 2018: World Neurosurgery
Hsin-Chin Lin, Yu-Lin Tsai, Wen-Chung Tsai
Posttraumatic syringomyelia with an initial presentation of involuntary movement is rare. We describe a 25-year-old patient who sustained complete traumatic spinal cord injury at the thoracic level and presented with rhythmic neck muscle spasms and upper limb muscle myoclonic jerks 1 month after trauma. Magnetic resonance imaging revealed syrinx formation between C3 and T1. Lumbar-peritoneal shunt and decompression were performed. The symptoms completely disappeared after surgery. This report highlights that rhythmic neck muscle spasms and upper limb muscle myoclonic jerks can be the initial and only manifestations of syringomyelia...
March 14, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
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