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Thoracic spinal cord injury

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https://www.readbyqxmd.com/read/28538361/characteristics-of-and-risk-factors-for-severe-neurological-deficit-in-patients-with-pyogenic-vertebral-osteomyelitis-a-case-control-study
#1
Adrien Lemaignen, Idir Ghout, Aurélien Dinh, Guillaume Gras, Bruno Fantin, Virginie Zarrouk, Robert Carlier, Jean-Edouard Loret, Eric Denes, Alix Greder, François-Xavier Lescure, David Boutoille, Pierre Tattevin, Bertrand Issartel, Jean-Philippe Cottier, Louis Bernard
Severe neurological deficit (SND) is a rare but major complication of pyogenic vertebral osteomyelitis (PVO). We aimed to determine the risk factors and the variables associated with clinical improvement for SND during PVO.This case-control study included patients without PVO-associated SND enrolled in a prospective randomized antibiotic duration study, and patients with PVO-associated SND managed in 8 French referral centers. Risk factors for SND were determined by logistic regression.Ninety-seven patients with PVO-associated SND cases, and 297 controls were included...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28532908/the-safety-and-efficiency-of-pvcr-without-anterior-support-applied-in-treatment-of-yang-s-a-type-severe-thoracic-kyphoscoliosis
#2
Wen-Yuan Sui, Zi-Fang Huang, Yao-Long Deng, Heng-Wei Fan, Jing-Fan Yang, Fo-Bao Li, Jun-Lin Yang
OBJECT: To assess the clinical and radiographic outcomes of posterior vertebral column resection (PVCR) without anterior support in treatment of Yang's A type severe rigid thoracic kyphoscoliosis. METHODS: The records of 27 Yang's A type severe thoracic kyphoscoliosis patients treated with PVCR without anterior support from January 2010 to September 2013 were retrospectively analyzed. Intraoperative multimodal neurophysiological monitoring (IONM) (6 modes: Somatosensory evoked potential (SSEP), Motor evoked potential (MEP), Descending neurogenic evoked potential (DNEP), Spinal cord evoked potential (SCEP), and Electromyography, both triggered and free run EMG) was conducted in all patients...
May 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28528073/simple-identification-of-the-adamkiewicz-artery-in-extended-thoracoabdominal-aortic-aneurysm-repair
#3
Kyokun Uehara, Hitoshi Matsuda, Yosuke Inoue, Atsushi Omura, Yoshimasa Seike, Hiroaki Sasaki, Kenji Minatoya, Junjiro Kobayashi
Spinal cord injury remains a major adverse event of extended thoracic and thoracoabdominal aortic surgical procedures. Preoperative identification of the Adamkiewicz artery and prompt reattachment of the targeted intercostal arteries during operation should contribute to preventing spinal cord injury. In this report, we describe a simple and definite identification of the critical intercostal artery during extended descending and thoracoabdominal aortic surgical procedures.
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527225/clinical-feasibility-of-gait-training-with-a%C3%A2-robotic-exoskeleton-wpal-in-an-individual-with-both-incomplete-cervical-and-complete-thoracic-spinal-cord-injury-a%C3%A2-case-study
#4
Shigeo Tanabe, Soichiro Koyama, Eiichi Saitoh, Satoshi Hirano, Kanan Yatsuya, Tetsuya Tsunoda, Masaki Katoh, Takeshi Gotoh, Ayako Furumoto
BACKGROUND: Patients with tetraplegia can achieve independent gait with lateral-type powered exoskeletons; it is unclear whether medial-type powered exoskeletons allow for this. OBJECTIVE: To investigate gait training with a medial-type powered exoskeleton wearable power-assist locomotor (WPAL) in an individual with incomplete cervical (C5) and complete thoracic (T12) spinal cord injury (SCI). METHODS: The 60-session program was investigated retrospectively using medical records...
May 19, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28506502/autonomic-dysreflexia-after-spinal-cord-injury-systemic-pathophysiology-and-methods-of-management
#5
REVIEW
Khalid C Eldahan, Alexander G Rabchevsky
Traumatic spinal cord injury (SCI) has widespread physiological effects beyond the disruption of sensory and motor function, notably the loss of normal autonomic and cardiovascular control. Injury at or above the sixth thoracic spinal cord segment segregates critical spinal sympathetic neurons from supraspinal modulation which can result in a syndrome known as autonomic dysreflexia (AD). AD is defined as episodic hypertension and concomitant baroreflex-mediated bradycardia initiated by unmodulated sympathetic reflexes in the decentralized cord...
May 8, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28503467/medial-lemniscus-tract-lesion-after-high-voltage-electrical-injury-a-case-report
#6
Chul-Hyun Cho, Dong Gyu Lee
We present the case of a 33-year-old man who experienced a 10,000-V electrical shock when working with electrical wiring. He suffered third-degree burns on his scalp at the right occiput (entry wound) and on his left arm (exit would), and a second-degree burn on his left foot (exit wound). He presented with severe spasticity of both lower extremities, motor weakness with a Medical Research Council grade of 3, and sensory impairments below thoracic level 11 that included an inability to sense light touch and defects in proprioception...
April 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28499865/implication-of-altered-autonomic-control-for-orthostatic-tolerance-in-sci
#7
REVIEW
Jill Maria Wecht, William A Bauman
Neural output from the sympathetic and parasympathetic branches of the autonomic nervous system (ANS) are integrated to appropriately control cardiovascular responses during routine activities of daily living including orthostatic positioning. Sympathetic control of the upper extremity vasculature and the heart arises from the thoracic cord between T1 and T5, whereas splanchnic bed and lower extremity vasculature receive sympathetic neural input from the lower cord between segments T5 and L2. Although the vasculature is not directly innervated by the parasympathetic nervous system, the SA node is innervated by post-ganglionic vagal nerve fibers via cranial nerve X...
May 3, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28495240/risk-factors-for-pulmonary-complication-following-operative-fixation-of-spine-fractures
#8
Douglas S Weinberg, Brian Z Hedges, Jonathan E Belding, Timothy A Moore, Heather A Vallier
BACKGROUND CONTEXT: Previous studies have suggested pulmonary complications are common among patients undergoing fixation for traumatic spine fractures. This leads to prolonged hospital stay, worse functional outcomes, and increased economic burden. However, only limited prognostic information exists regarding which patients are at greatest risk for pulmonary complications. PURPOSE: To identify factors predictive of perioperative pulmonary complications in patients undergoing fixation of spine fractures...
May 8, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28488560/-the-effects-of-severe-and-very-severe-injuries
#9
H R Holtslag, E F van Beeck, J A Haagsma, M Olff
- The effects of severe injuries can be charted using the International Classification of Functioning, Disability and Health (ICF) model and the burden of disease model, in which the burden of disease is expressed in 'disability-adjusted life years' (DALYs). - Severe accidents cause 10 DALYs per 1000 people, which is comparable with the burden of disease of mood disorders and lung cancer.- In the Netherlands, severe injury victims are often males aged < 40 years, who are often injured in road traffic accidents...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28487080/astrocytic-expression-of-the-rna-regulator-hur-accentuates-spinal-cord-injury-in-the-acute-phase
#10
Thaddaeus Kwan, Candace L Floyd, Jason Patel, Amanda Mohaimany-Aponte, Peter H King
We recently showed that the RNA regulator, HuR, is translocated to the cytoplasm in astrocytes in the acute phase of spinal cord injury (SCI), consistent with its activation. HuR positively modulates expression of many pro-inflammatory factors, including IL-1β, TNF-α, and MMP-12, which are present at high levels in the early phase of SCI and exacerbate tissue damage. Knockdown of HuR in astrocytes blunts expression of these factors in an in vitro stretch injury model of CNS trauma. In this report, we further investigate the impact of HuR in early SCI using a mouse model in which human HuR is transgenically expressed in astrocytes...
May 6, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28483707/higher-success-rate-with-transcranial-electrical-stimulation-of-motor-evoked-potentials-using-constant-voltage-stimulation-compared-with-constant-current-stimulation-in-patients-undergoing-spinal-surgery
#11
Hideki Shigematsu, Masahiko Kawaguchi, Hironobu Hayashi, Tsunenori Takatani, Eiichiro Iwata, Masato Tanaka, Akinori Okuda, Yasuhiko Morimoto, Keisuke Masuda, Yuu Tanaka, Yasuhito Tanaka
BACKGROUND CONTEXT: During spine surgery, the spinal cord is electrophysiologically monitored via transcranial electrical stimulation motor evoked potentials (TES-MEP) to prevent injury. TES-MEP involves the use of either constant-current or constant-voltage stimulation; however, there are few comparative data available regarding their ability to adequately elicit compound motor action potentials (CMAPs). We hypothesized that the success rates of TES-MEP recordings would be similar between constant-current and constant-voltage stimulation in patients undergoing spine surgery...
May 5, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28469141/serum-micrornas-reflect-injury-severity-in-a-large-animal-model-of-thoracic-spinal-cord-injury
#12
Seth Tigchelaar, Femke Streijger, Sunita Sinha, Stephane Flibotte, Neda Manouchehri, Kitty So, Katelyn Shortt, Elena Okon, Michael A Rizzuto, Ivana Malenica, Amanda Courtright-Lim, Andrew Eisen, Kendall Van Keuren-Jensen, Corey Nislow, Brian K Kwon
Therapeutic development for spinal cord injury is hindered by the difficulty in conducting clinical trials, which to date have relied solely on functional outcome measures for patient enrollment, stratification, and evaluation. Biological biomarkers that accurately classify injury severity and predict neurologic outcome would represent a paradigm shift in the way spinal cord injury clinical trials could be conducted. MicroRNAs have emerged as attractive biomarker candidates due to their stability in biological fluids, their phylogenetic similarities, and their tissue specificity...
May 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28467736/spinal-transection-alters-external-urethral-sphincter-activity-during-spontaneous-voiding-in-freely-moving-rats
#13
Brandon K LaPallo, Jonathan R Wolpaw, Xiang Yang Chen, Jonathan Carp
The rat is a commonly used model for the study of lower urinary tract function before and after spinal cord injury. We have previously reported that in unanesthetized, freely-moving rats, although phasic external urethral sphincter (EUS) activity (bursting) is most common during micturition, productive voiding can occur in the absence of bursting, which differs from results seen in anesthetized or unanesthetized restrained animals. The purpose of the present study was to characterize EUS behavior in unanesthetized, freely-moving rats before and after mid-thoracic (T8) or thoraco-lumbar (T13-L1) spinal transection to determine how EUS behavior after spinal cord injury differs from that seen in anesthetized or unanesthetized restrained rats...
May 3, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28461275/isolated-transverse-process-fractures-and-markers-of-associated-injuries-the-ucla-experience
#14
Timothy T Bui, Daniel T Nagasawa, Carlito Lagman, Cheng Hao Jacky Chen, Lawrance K Chung, Brittany L Voth, Joel S Beckett, Alexander M Tucker, Tianyi Niu, Bilwaj Gaonkar, Isaac Yang, Luke Macyszyn
OBJECTIVES: To report a single-institution experience with isolated transverse process fractures (ITPFs) and provide increasing support for the development of evidence-based guidelines. Additionally, the authors evaluate the presence of concerning symptoms or red flags that may indicate additional, underlying injuries in the setting of ITPFs. METHODS: The Ronald Reagan UCLA Medical Center patient database was queried (years 2005 to 2016) using International Classification of Diseases, Ninth Revision code 805: fracture of the vertebral column without mention of spinal cord injury...
April 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28460036/reoperative-repair-of-descending-thoracic-and-thoracoabdominal-aneurysms%C3%A2
#15
Christopher Lau, Mario Gaudino, Ivancarmine Gambardella, Erin Mills, Monica Munjal, Mohamed Elsayed, Leonard Girardi
OBJECTIVES: To evaluate the results of reoperation on descending thoracic and thoracoabdominal aneurysms. METHODS: Sixty-nine consecutive patients undergoing reoperative aneurysm repair (20 descending thoracic and 49 thoracoabdominal) were compared to 602 contemporary primary repairs. Propensity matching was used to reduce observable differences in preoperative characteristics. RESULTS: The reoperation group was younger (60.2 vs 65.3 years, P  = 0...
April 27, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28458564/radiobiological-evaluation-of-simultaneously-dose-escalated-versus-non-escalated-intensity-modulated-radiation-therapy-for-patients-with-upper-thoracic-esophageal-cancer
#16
Bao-Tian Huang, Li-Li Wu, Long-Jia Guo, Liang-Yu Xu, Rui-Hong Huang, Pei-Xian Lin, Jian-Zhou Chen, De-Rui Li, Chuang-Zhen Chen
OBJECTIVE: To compare the radiobiological response between simultaneously dose-escalated and non-escalated intensity-modulated radiation therapy (DE-IMRT and NE-IMRT) for patients with upper thoracic esophageal cancer (UTEC) using radiobiological evaluation. METHODS: Computed tomography simulation data sets for 25 patients pathologically diagnosed with primary UTEC were used in this study. DE-IMRT plan with an escalated dose of 64.8 Gy/28 fractions to the gross tumor volume (GTV) and involved lymph nodes from 25 patients pathologically diagnosed with primary UTEC, was compared to an NE-IMRT plan of 50...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28446938/minimally-invasive-surgery-for-resection-of-ossification-of-the-ligamentum-flavum-in-the-thoracic-spine
#17
Wei Zhao, Chaoxiong Shen, Ranze Cai, Jianfeng Wu, Yuandong Zhuang, Zhaowen Cai, Rui Wang, Chunmei Chen
INTRODUCTION: Thoracic ossification of the ligamentum flavum (TOLF) is a common cause of progressive thoracic myelopathy. Surgical decompression is commonly used to treat TOLF. AIM: To evaluate the clinical outcomes of microsurgical decompression of TOLF via a paraspinal approach, using a percutaneous tubular retractor system. MATERIAL AND METHODS: First, three-dimensional (3D) image reconstruction and printed models were made from thin computed tomography scans for each patient...
2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/28439446/thoracic-unilateral-spinal-cord-injury-after-spinal-anaesthesia-for-total-hip-replacement-fate-or-mistake
#18
Costa Fabio, Del Buono Romualdo, Agrò Felice Eugenio, Tambone Vittoradolfo, Vitali Andrea Massimiliano, Ricci Giovanna
Spinal anaesthesia is the most preffered anesthesia technique for total hip replacement, and its complications range from low entity (insignificant) to life threatening. The incidence of neurologic complications after neuraxial anaesthesia is not perfectly clear, although there are several described cases of spinal cord ischaemia. We present a case of unilateral T8-T11 spinal cord ischaemia following L2-L3 spinal anaesthesia for total hip replacement. Magnetic resonance imaging showed a hyperintense T8-T11 signal alteration on the leftside of paramedian spinal cord...
April 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28434767/extrarenal-rhabdoid-tumor-presented-with-an-immobile-arm-in-a-one-year-old-boy
#19
Chi-Ting Chung, Yen-Lin Liu, Chien-Jui Cheng, Kevin Li-Chun Hsieh, Min-Lan Tsai, Tai-Tong Wong
Infants with an immobile arm may be easily overlooked in primary care settings. Differential diagnoses include injuries, infections, neuropathies, ischemia and rarely, neoplasms. We report the case of a one-year-old boy with weakness in his left arm after minor trauma with a diagnosis of brachial plexus palsy initially. After rehabilitation for 2months, his weakness progressed to unsteady gait and quadriparesis. MRI revealed a huge solid tumor in the left supraclavicular fossa, which also involved the left brachial plexus, upper thoracic cavity, and left paravertebral space with invasion into the spinal canal...
April 20, 2017: Brain & Development
https://www.readbyqxmd.com/read/28418395/an-analysis-of-ideal-and-actual-time-to-surgery-after-traumatic-spinal-cord-injury-in-canada
#20
R A Glennie, C S Bailey, E C Tsai, V K Noonan, C S Rivers, D R Fourney, H Ahn, B K Kwon, J Paquet, B Drew, M G Fehlings, N Attabib, S D Christie, J Finkelstein, R J Hurlbert, S Parent, M F Dvorak
STUDY DESIGN: Retrospective analysis of a prospective registry and surgeon survey. OBJECTIVES: To identify surgeon opinion on ideal practice regarding the timing of decompression/stabilization for spinal cord injury and actual practice. Discrepancies in surgical timing and barriers to ideal timing of surgery were explored. SETTING: Canada. METHODS: Patients from the Rick Hansen Spinal Cord Registry (RHSCIR, 2004-2014) were reviewed to determine actual timing of surgical management...
April 18, 2017: Spinal Cord
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