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https://www.readbyqxmd.com/read/29167992/slow-correction-of-severe-spastic-hyperlordosis-in-an-adult-by-means-of-magnetically-expandable-rods
#1
Christof Birkenmaier, Melvin D'Anastasi, Bernd Wegener, Carolin Melcher
BACKGROUND: We describe a case of severe and progressive lumbar hyperlordosis (160°) in a 28-year-old female university student with cerebral palsy. Her main complaints were abdominal wall pain and increasing inability to sit in her custom wheelchair. METHOD: When deciding on our opinion about the most promising treatment strategy, we contemplated slow continued correction by means of percutaneously expandable magnetic rods (MAGEC) after the index surgery as a key component of a satisfactory correction in this severe and rigid curve...
November 22, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29167977/thoracic-epidural-haematoma-due-to-a-subclavian-steal-syndrome-and-secondary-formed-thoracic-collateral-circuits-coincidence-or-consequence-a-case-report
#2
Ravian K R W Wettstein, Bas F W van der Kallen, Wouter A Moojen, Rishi Nandoe Tewarie
Despite profound diagnostics, the aetiology of spinal epidural haematoma (SEH) often remains unknown. In this case, diagnostics revealed an SEH at the fifth and sixth thoracic levels due to a subclavian steal syndrome with a tortuous vascular loop between the sixth thoracic intercostal artery and the costocervical arteries deriving from the left subclavian artery with plump arteries in the epidural space. The patient underwent decompression surgery and a percutaneous transluminal angioplasty. The patient showed good recovery at follow-up...
November 22, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29167085/factors-leading-to-persistent-postsurgical-pain-in-adolescents-undergoing-spinal-fusion-an-integrative-literature-review
#3
REVIEW
Mallory Perry, Angela Starkweather, Kyle Baumbauer, Erin Young
PROBLEM: Adolescent idiopathic scoliosis (AIS) is the most common spinal deformity among children and adolescents and the most frequent reason for corrective spinal fusion (SF). Of the children and adolescents who undergo SF, a significant number will experience persistent postoperative pain (PPP). This integrative literature review was conducted to identify and synthesize perioperative factors that may contribute to risk of developing PPP. ELIGIBILITY CRITERIA: Articles which addressed PPP within the last 10years and primary research on postoperative pain outcomes in adolescents after SF were selected for review...
November 13, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29166400/chronic-post-traumatic-intramedullary-lesions-in-dogs-a-translational-model
#4
Neringa Alisauskaite, Ingo Spitzbarth, Wolfgang Baumgärtner, Peter Dziallas, Sabine Kramer, Ricarda Dening, Veronika Maria Stein, Andrea Tipold
OBJECTIVES: Post-traumatic intramedullary myelopathies and cavitations are well described lesions following spinal cord injury (SCI) in humans and have been described in histopathological evaluations in dogs. Human intramedullary myelopathies/cavitations are associated with severe initial SCI and deterioration of clinical signs. Canine intervertebral disc extrusions share similarities with SCI in humans. In this descriptive study, magnetic resonance imaging (MRI) findings in spinal cords of dogs suffering from chronic post-traumatic myelopathies, including cavitations, are elucidated...
2017: PloS One
https://www.readbyqxmd.com/read/29165794/leptomeningeal-metastasis-from-systemic-cancer-review-and-update-on-management
#5
REVIEW
Nancy Wang, Mia S Bertalan, Priscilla K Brastianos
Leptomeningeal metastasis is an uncommon and typically late complication of cancer with a poor prognosis and limited treatment options. Diagnosis is often challenging, with nonspecific presenting symptoms ranging from headache and confusion to focal neurologic deficits, such as cranial nerve palsies. Standard diagnostic evaluation involves a neurologic examination, magnetic resonance imaging of the brain and spine with gadolinium, and cytologic evaluation of the cerebral spinal fluid. Therapy entails a multimodal approach focused on palliation with surgery, radiation, and/or chemotherapy, which may be administered systemically or directly into the cerebral spinal fluid...
November 22, 2017: Cancer
https://www.readbyqxmd.com/read/29165630/an-eight-branched-aortic-graft-for-reconstruction-of-visceral-and-intercostal-arteries-during-extent-ii-thoraco-abdominal-aortic-surgery
#6
Sung Jun Park, Joon Bum Kim
Reconstruction of the visceral and intercostal arteries is the most challenging part in the open repair of thoraco-abdominal aortic aneurysm. For efficient and expeditious reconstruction of these branching vessels, a technique of using a pre-handsewn 8-branch aortic graft (octopod technique) has been adopted. The octopod graft was manually constructed using commercially available two 4-branch aortic grafts that were spatially oriented based on the preoperative computed tomographic images and connected each other prior to surgery...
November 20, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29165431/spinal-accessory-nerve-preservation-in-modified-neck-dissections-surgical-and-functional-outcomes
#7
V Popovski, A Benedetti, D Popovic-Monevska, A Grcev, A Stamatoski, J Zhivadinovik
The spinal accessory nerve (SAN) or XI cranial nerve is frequently encountered during neck surgery, and as such is at risk of iatrogenic injury, resulting in "shoulder syndrome". Modified neck dissection (MND) with preservation of the SAN is based on desire to minimise the functional deformity associated with section of the eleventh nerve. The aim of this study was to analyse the intra-operative variations of the spinal accessory nerve pathway and to evaluate shoulder dysfunction postoperatively. The cross-sectional demonstration analysis was created through the medical records retrospectively of 165 consecutive patients who underwent neck dissections at our institution in the past 5 years with attention to ultrasound and MRI preoperative findings, type of neck dissection, type of identification and dissection of SAN, postoperative morbidity and survival rate...
October 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/29165239/does-smoking-affect-the-outcomes-of-lumbar-decompression-surgery
#8
Radha Mehta, Himanshu Sharma
INTRODUCTION: Lumbar decompressions and micro-discectomies are commonly performed non-complex spinal surgeries that do not involve the insertion of metalwork into the spine and are done for symptomatic disc prolapse and lumbar spinal stenosis, whereas complex-spinal surgery does require metalwork [1]. Studies of complex-spinal surgeries show that smoking has a significant negative impact on the outcome of the surgery [2] therefore, the cessation of smoking is advised prior to surgery [3]...
2017: SICOT-J
https://www.readbyqxmd.com/read/29164328/metallosis-after-traumatic-loosening-of-bryan-cervical-disc-arthroplasty-a-case-report-and-literature-review
#9
Chih-Chan Yang, Chien-Lun Tang, Chung-Yuh Tzeng, Hsi-Kai Tsou
PURPOSE: Cervical disc arthroplasty has been a popular alternative to traditional arthrodesis treatment for maintaining postoperative cervical spine mobility. However, certain adverse reactions to cervical disc arthroplasty have emerged during the last few decades. METHODS: Metallosis or metalloma is a rarely reported complication after spinal fusion or spinal arthroplasty surgery. We report on the first metallosis case occurring in a patient who received Bryan Disc implantation approximately 8 years earlier...
November 21, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29164038/timing-of-decompression-in-patients-with-acute-spinal-cord-injury-a-systematic-review
#10
REVIEW
Jefferson R Wilson, Lindsay A Tetreault, Brian K Kwon, Paul M Arnold, Thomas E Mroz, Christopher Shaffrey, James S Harrop, Jens R Chapman, Steve Casha, Andrea C Skelly, Haley K Holmer, Erika D Brodt, Michael G Fehlings
Study Design: Systematic review. Objective: To conduct a systematic review and synthesis of the literature to assess the comparative effectiveness, safety, and cost-effectiveness of early (≤24 hours) versus late decompression (>24 hours) in adults with acute spinal cord injury (SCI). Methods: A systematic search was conducted of Medline, EMBASE, the Cochrane Collaboration Library, and Google Scholar to identify studies published through November 6, 2014...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29164036/a-clinical-practice-guideline-for-the-management-of-acute-spinal-cord-injury-introduction-rationale-and-scope
#11
Michael G Fehlings, Lindsay A Tetreault, Jefferson R Wilson, Brian K Kwon, Anthony S Burns, Allan R Martin, Gregory Hawryluk, James S Harrop
Acute spinal cord injury (SCI) is a traumatic event that results in disturbances to normal sensory, motor, or autonomic function and ultimately affects a patient's physical, psychological, and social well-being. The management of patients with SCI has drastically evolved over the past century as a result of increasing knowledge on injury mechanisms, disease pathophysiology, and the role of surgery. There still, however, remain controversial areas surrounding available management strategies for the treatment of SCI, including the use of corticosteroids such as methylprednisolone sodium succinate, the optimal timing of surgical intervention, the type and timing of anticoagulation prophylaxis, the role of magnetic resonance imaging, and the type and timing of rehabilitation...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29164024/a-clinical-practice-guideline-for-the-management-of-patients-with-acute-spinal-cord-injury-and-central-cord-syndrome-recommendations-on-the-timing-%C3%A2-24-hours-versus-24-hours-of-decompressive-surgery
#12
Michael G Fehlings, Lindsay A Tetreault, Jefferson R Wilson, Bizhan Aarabi, Paul Anderson, Paul M Arnold, Darrel S Brodke, Anthony S Burns, Kazuhiro Chiba, Joseph R Dettori, Julio C Furlan, Gregory Hawryluk, Langston T Holly, Susan Howley, Tara Jeji, Sukhvinder Kalsi-Ryan, Mark Kotter, Shekar Kurpad, Ralph J Marino, Allan R Martin, Eric Massicotte, Geno Merli, James W Middleton, Hiroaki Nakashima, Narihito Nagoshi, Katherine Palmieri, Anoushka Singh, Andrea C Skelly, Eve C Tsai, Alexander Vaccaro, Albert Yee, James S Harrop
Objective: To develop recommendations on the timing of surgical decompression in patients with traumatic spinal cord injury (SCI) and central cord syndrome. Methods: A systematic review of the literature was conducted to address key relevant questions. A multidisciplinary guideline development group used this information, along with their clinical expertise, to develop recommendations for the timing of surgical decompression in patients with SCI and central cord syndrome...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29161465/neuromuscular-electrical-stimulation-for-the-prevention-of-venous-thromboembolism
#13
REVIEW
Shahab Hajibandeh, Shahin Hajibandeh, George A Antoniou, James Rh Scurr, Francesco Torella
BACKGROUND: Venous thromboembolism (VTE) is a serious but preventable cause of morbidity and mortality. Neuromuscular electrical stimulation systems (NMES) for the prevention of VTE may be beneficial for patients in whom pharmacological or standard mechanical prophylaxis methods are contraindicated or are regarded as unsafe or impractical. Although findings of experimental studies suggest that NMES reduce venous stasis, the clinical utility and effectiveness of NMES in VTE prevention remain controversial...
November 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29160101/postoperative-analgesia-using-peripheral-anesthetic-block-of-the-foot-and-ankle
#14
Kelly Cristina Stéfani, Gabriel Ferraz Ferreira, Miguel Viana Pereira Filho
BACKGROUND: Anesthetic block of the peripheral nerves in the foot and ankle is generally used as anesthesia. The increased use of anesthetic blocks has made this technique an increasingly safe method, and its use has been expanded to postoperative analgesia in foot and ankle surgeries. The objective of this study was to evaluate the analgesia time and pain intensity, using objective scores, after peripheral nerve block in foot and ankle surgeries. METHODS: Patients who underwent surgery by the foot and ankle group of our institution from March 2016 to January 2017 were invited to participate in this prospective, randomized, and blinded study after signing an informed consent form...
November 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/29160005/investigation-of-parameters-predicting-the-need-for-diagnostic-imaging-beyond-computed-tomography-in-the-evaluation-of-dogs-with-thoracolumbar-myelopathy-retrospective-evaluation-of-555-dogs
#15
Lee Emery, Silke Hecht, Xiaocun Sun
Thoracolumbar myelopathy encompasses a number of disease processes such as intervertebral disc disease, discospondylitis, trauma, congenital malformations, neoplasia, and intramedullary spinal cord disease. Compressive disc herniations are most common in dogs and require imaging procedures such as myelography, computed tomography (CT), and/or magnetic resonance imaging (MRI) to determine the need and location for decompressive surgery. The purposes of this retrospective, cross-sectional study were to evaluate all dogs undergoing thoracolumbar CT imaging as the initial diagnostic step between 2010 and 2015 and determine whether any of the imaging characteristics could be used to predict the need for additional imaging in the form of myelography, CT myelography, and/or MRI...
November 20, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/29158954/the-relationship-between-segmental-rolling-ability-and-lumbar-multifidus-activation-time
#16
Nicole Clark, Michael L Voight, Ashley M Campbell, Sherry Pierce, Pat Sells, Ryan Cook, Clint Henley, Lindsey Schiller
Background: Segmental rolling has been utilized as an assessment and intervention tool to identify and affect dysfunction of the upper quarter, core, and lower quarter. One theory to explain dysfunctional segmental rolling is a lack of segmental spinal control / stabilization. Faulty muscle firing sequencing has been related to poor spinal stability, however to date, no assessment tool exists to evaluate a patient's motor coordination of local and global musculature. Purpose: The purpose of this study was to assess the temporal sequence of lumbar multifidus activation associated with anterior deltoid activation, and to determine if faulty sequencing was associated with the inability to segmentally roll in subjects without mobility restrictions...
November 2017: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/29158692/pulsed-radiofrequency-of-brachial-plexus-under-ultrasound-guidance-for-refractory-stump-pain-a-case-report
#17
Bixin Zheng, Li Song, Hui Liu
The post-amputation (pain) syndrome, including stump pain, phantom limb sensation, and phantom limb pain is common but difficult to treat. Refractory stump pain in the syndrome is an extremely challenging and troublesome clinical condition. Patients respond poorly to drugs, nerve blocks, and other effective treatments like spinal cord stimulation and surgery. Pulsed radiofrequency (PRF) technique has been shown to be effective in reducing neuropathic pain. This report describes a patient with persistent and refractory upper limb stump pain being successfully relieved with PRF of brachial plexus under ultrasound guidance after a 6-month follow-up period, suggesting that PRF may be considered as an alternative treatment for refractory stump-neuroma pain...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29157682/outcomes-of-thoracic-endovascular-aortic-repair-for-chronic-aortic-dissections
#18
Allan M Conway, Khalil Qato, Laurie R Mondry, Guillaume J Stoffels, Gary Giangola, Alfio Carroccio
BACKGROUND: Open surgical repair remains the "gold standard" treatment for chronic type B aortic dissection (cTBD) with aneurysm. Thoracic endovascular aortic repair (TEVAR) has gained popularity in recent years for the treatment of thoracic aortic diseases, including cTBD. We assessed the effectiveness of TEVAR in the treatment of cTBD using the Vascular Quality Initiative (VQI) database. METHODS: The VQI registry identified 4713 patients treated with TEVAR from July 2010 to November 2015, including 125 repairs for cTBD...
November 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29155958/effect-of-preoperative-opioid-dosage-on-postoperative-period-after-thoracic-spinal-cord-stimulator-surgery
#19
Ravichandra A Madineni, Colin M Smith, Shannon W Clark, David W Boorman, Chengyuan Wu, Dajie Wang, James S Harrop, Ashwini D Sharan
Objective: We aim to study the impact of preoperative opioid dosage on postoperative length of stay (LOS) in patients undergoing thoracic spinal cord stimulator (SCS) placement surgery as a primary objective. Secondary objectives of this study include investigating patient-controlled analgesia (PCA) usage and postoperative complications like fever in relation to patients' preoperative opioid dosage and postoperative LOS. Methods: A total of 47 patients who underwent thoracic SCS for first time were retrospectively studied through chart review...
November 16, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29155935/early-and-late-outcomes-of-open-repair-for-dissecting-aneurysms-of-the-descending-or-thoraco-abdominal-aorta
#20
Atsushi Omura, Kenji Minatoya, Jiro Matsuo, Yosuke Inoue, Yoshimasa Seike, Kyokun Uehara, Hiroaki Sasaki, Hitoshi Matsuda, Junjiro Kobayashi
OBJECTIVES: Although open repair is the standard surgical option for dissecting descending thoracic aneurysms (DTAs) and thoraco-abdominal aorta aneurysms (TAAAs), it remains a significant challenge with considerable perioperative morbidity and mortality. We retrospectively analysed early and late outcomes of open repair for these aortic aneurysms. METHODS: Early and late outcomes were investigated for 223 consecutive patients who underwent open repair for dissecting DTA or TAAA between January 2003 and December 2014 (mean age 55 ± 16 years)...
October 9, 2017: Interactive Cardiovascular and Thoracic Surgery
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