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https://www.readbyqxmd.com/read/29781783/clinical-and-radiological-outcome-of-non-surgical-management-of-thoracic-and-lumbar-spinal-fracture-dislocations-a-historical-analysis-in-the-era-of-modern-spinal-surgery
#1
Andrei Fernandes Joaquim, Gregory D Schroeder, Alpesh A Patel, Alexander R Vaccaro
CONTEXT: It is well established that traumatic spinal dislocations (AO Type C injuries) should be surgically treated. However, no recent comparative study of surgical versus non-surgical management of type C injuries was found attesting the superiority of surgical treatment. OBJECTIVE: Due to the lack of information about the natural history of non-surgical management of type C injuries, we evaluated the outcome of historical conservative treatment of type C injuries...
May 21, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29768358/spastic-paraparesis-caused-by-x-linked-adrenoleukodystrophy-mimicking-vacuolar-myelopathy-in-a-human-immunodeficiency-virus-patient-a-case-report
#2
Jin-Sung Park, Donghwi Park
RATIONALE: Vacuolar myelopathy is one of most common cause of spastic paresis in patients with human immunodeficiency virus (HIV) infection. However, X-linked adrenoleukodystrophy (X-ALD), which is a metabolic disorder caused by impairment of peroxisomal beta-oxidation of very-long-chain fatty acids (VLCFA), also manifests as various neurological deteriorations including adult onset spastic paraparesis. To the best of our knowledge, there has been no report of newly developed spastic paresis due to X-ALD in a patient with HIV infection...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29757755/sinking-skin-flap-syndrome-after-decompressive-craniectomy-a-case-report
#3
Nicholas Fawley, Chiedozie Udeh
Sinking skin flap syndrome is a rare complication of decompressive craniectomy characterized by a sunken skin flap, neurological deterioration, and paradoxical herniation of the brain. An absent cranium allows for external compression via atmospheric pressure, causing alterations in cerebral blood flow, cerebral spinal fluid flow, and glucose metabolism, which ultimately leads to cortical dysfunction. This case report describes a patient with relatively early onset of variable neurological symptoms and imaging correlation, leading to a diagnosis and definitive therapeutic intervention with cranioplasty...
May 11, 2018: A&A practice
https://www.readbyqxmd.com/read/29739239/total-hip-replacement-provokes-endothelial-dysfunction
#4
Peter Poredos, Ana Mavric, Lara Leben, Pavel Poredos, Mateja Kaja Jezovnik
Surgery represents an increased risk of different perioperative complications. Endothelial function (EF) is a key mechanism responsible for cardiovascular homeostasis and is involved in thromboembolic complications. We aimed to follow changes of EF in an early postoperative period in patients undergoing total hip replacement (THR). Endothelial function was assessed noninvasively in 70 consecutive patients who underwent an elective THR under spinal anesthesia. Flow-mediated dilation (FMD) and low flow-mediated constriction capability of the brachial artery, which are indicators of EF were measured before the operation (baseline), 24 hours after the operative procedure, and 5 to 7 days postoperatively...
January 1, 2018: Angiology
https://www.readbyqxmd.com/read/29732436/the-c7-pedicle-as-a-superior-fixation-point-in-spinal-stabilization-for-spinal-metastatic-disease
#5
Harjot Thind, Andrew J Fabiano
Spinal metastatic disease (SMD) often requires spinal stabilization; however, the cervicothoracic junction can be a challenging area to instrument. An anterior approach may require division of the sternum. A posterior or posterolateral approach may rely on cervical lateral mass screws for superior construct fixation that are more prone to pullout than screws placed in a pedicle. The C7 pedicle is able to support pedicle screw fixation in most instances based on morphological features of the vertebra. When the C7 pedicle is used as a superior fixation point, it aligns with the thoracic pedicles below to create a streamlined posterior construct...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29729179/is-delayed-surgery-after-unsuccessful-conservative-treatment-beneficial-for-spinal-cord-injury-following-whiplash-a-retrospective-study-in-elderly-patients
#6
Tengfei Zhao, Bolaky Landish Yishmaan, Dasheng Lin, Kan Xu, Qiankun Zhou, Ge Yang
BACKGROUND The aim of this study was to investigate the clinical outcomes of early and delayed surgery in cervical spinal cord injury following whiplash in elderly patients. MATERIAL AND METHODS Our retrospective review identified elderly patients (≥65 years old) with spinal cord injury following whiplash injury from 2006 to 2015. The neck disability index (NDI), modify Japanese Orthopedics Association (mJOA) score, and visual analogue scale (VAS) score were used to evaluate clinical outcomes preoperatively and during follow-up...
May 5, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29726799/cervical-corpectomy-for-resection-of-ventral-intramedullary-capillary-hemangioma-with-circumferential-involvement-of-the-anterior-spinal-artery-case-report
#7
Jonathan A Forbes, Nathan Teschan, Samuel Hayden Jones, Phillip Parry, Luke Simonet, Narayana K Swamy
There is limited evidence to suggest that anterior approaches for the resection of ventral intramedullary lesions of the cervical spinal cord may result in superior neurological outcomes compared with those following more traditional posterior approaches. To the authors' knowledge, no report of an anterior approach to resect a ventral intramedullary capillary hemangioma exists in the literature. In the following paper, the case of a 75-year-old male who presented with progressive neck and left shoulder pain, weakness of the left hand, myelopathy, and gait imbalance is reported...
May 4, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29725823/esophageal-perforation-caused-by-a-thoracic-pedicle-screw
#8
REVIEW
Stanislas Marouby, Clément Jeandel, Djamel Louahem M'Sabah, Marion Delpont, Jérôme Cottalorda
This grand round raises the risk of a rare complication that can be avoided with the knowledge of the particular anatomy of scoliosis vertebra. Transpedicular screws have been reported to enhance the operative correction in scoliosis surgery. The narrow and inconsistent shape of the thoracic pedicles makes the placement of pedicle screws technically challenging. Furthermore, in thoracic curves, the close proximity of the spinal cord and major soft tissue structures also adds a greater risk to the procedure...
May 3, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29706086/management-of-extranodal-lymphoma-of-the-spine-a-study-of-30-patients
#9
Shamsudini Hashi, Courtney Rory Goodwin, Ali Karim Ahmed, Daniel M Sciubba
Extranodal lymphoma of the spine is often a late manifestation of systemic disease, and may result in symptoms of pain, neurologic compromise or spinal instability. Symptomatic relief is generally achieved by radiotherapy alone, but is not sufficient in addressing spinal instability. The indications for surgery remain controversial, but may be required for spinal stabilization, or refractory disease. Currently, there is a lack of studies that compare the indications and clinical outcomes of patients receiving surgical and nonsurgical management of spinal extranodal lymphoma...
April 30, 2018: CNS Oncology
https://www.readbyqxmd.com/read/29704143/sufentanil-alleviates-intrathecal-lidocaine-induced-prolonged-sensory-and-motor-impairments-but-not-the-spinal-histological-injury-in-rats
#10
Zhong Zhang, Yuan Chen, E Wang, Lei Wu, Ruike Wang, Zongbin Song, Yingqi Weng, Zhihua Sun, Qulian Guo, Yunping Li
Spinal anesthesia has evolved into a safe and widely accepted method of anesthesia. Synergy between opioids and local anesthetics further increases the quality of analgesia and decreases the dose requirement of both local anesthetics and opioids. However, over the last decades compelling evidence suggested that lidocaine could be more neurotoxic than other commonly used local anesthetics. Whether opioids can modify the local anesthetics-induced neurotoxicity is largely unexplored. Here, we investigated the effect of sufentanil on the neurotoxicity induced by intrathecal lidocaine in a rat model...
April 27, 2018: Neurochemical Research
https://www.readbyqxmd.com/read/29689005/perioperative-complications-after-surgery-for-thoracic-ossification-of-posterior-longitudinal-ligament-nationwide-multicenter-prospective-study
#11
Shiro Imagama, Kei Ando, Kazuhiro Takeuchi, Satoshi Kato, Hideki Murakami, Toshimi Aizawa, Hiroshi Ozawa, Tomohiko Hasegawa, Yukihiro Matsuyama, Masao Koda, Masashi Yamazaki, Hirotaka Chikuda, Shigeo Shindo, Yukihiro Nakagawa, Atsushi Kimura, Katsushi Takeshita, Kanichiro Wada, Hiroyuki Katoh, Masahiko Watanabe, Kei Yamada, Takeo Furuya, Takashi Tsuji, Shunsuke Fujibayashi, Kanji Mori, Yoshiharu Kawaguchi, Kota Watanabe, Morio Matsumoto, Toshitaka Yoshii, Atsushi Okawa
STUDY DESIGN: Prospective, multicenter, nationwide study OBJECTIVE.: To investigate perioperative complications and risk factors in surgery for thoracic ossification of the posterior longitudinal ligament (T-OPLL) using data from the registry of the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament. SUMMARY OF BACKGROUND DATA: There is no prospective multicenter study of surgical complications and risk factors for T-OPLL, and previous multicenter retrospective studies have lacked details...
April 23, 2018: Spine
https://www.readbyqxmd.com/read/29689003/comparison-of-the-clinical-accuracy-between-point-to-point-registration-and-auto-registration-using-an-active-infrared-navigation-system
#12
Jingwei Zhao, Yajun Liu, Mingxing Fan, Bo Liu, Da He, Wei Tian
STUDY DESIGN: A model experiment. OBJECTIVE: To measure and compare the clinical accuracy of point-to-point registration (PR) and auto-registration (AR) in an operative set using an active infrared navigation system. SUMMARY OF BACKGROUND DATA: PR and AR are two major registration methods of navigation assisted spinal surgery. No previous study compared the difference between the two methods with respect to clinical accuracy. METHODS: A novel method was used to measure the clinical accuracy of the navigation system under an operative set using a Sawbone model with titanium beads on the surface, which was essential to measure the accuracy numerically, instead of a real patient...
April 23, 2018: Spine
https://www.readbyqxmd.com/read/29686915/the-usefulness-of-dual-layer-spectral-computed-tomography-for-myelography-a-case-report-and-review-of-the-literature
#13
Yuji Iyama, Takeshi Nakaura, Ayumi Iyama, Kazuhiro Katahira, Yasuyuki Yamashita
We describe a case of lumbar stenosis in which retrospective spectral analysis using dual-layer spectral detector computed tomography (CT) had the ability to expand the evaluable region in the spinal canal. Spinal canal stenosis is a common condition whose symptoms (such as lower back and leg pain with walking) deteriorate the quality of life. Generally, magnetic resonance imaging (MRI) and CT myelography are performed to diagnose canal stenosis. Dual-layer spectral detector CT can yield virtual monochromatic imaging and retrospective on-demand spectral analysis without a prescan setting...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29685417/short-segment-percutaneous-pedicle-screw-fixation-after-direct-spinal-canal-decompression-in-thoracolumbar-burst-fractures-an-alternative-option
#14
REVIEW
Seon-Ho Park, Sang-Deok Kim, Bong Ju Moon, Shin-Seok Lee, Jung-Kil Lee
OBJECTIVE: To investigate the surgical results of percutaneous pedicle screw fixation (PPSF) after spinal canal decompression via a small laminectomy for the treatment of thoracolumbar burst fractures. METHOD: Twenty-seven patients underwent PPSF after spinal canal decompression via small laminectomies between April 2009 and April 2015. Inclusion criteria consisted of a single-level, closed, thoracolumbar burst fracture and neurological symptoms. Decompression was performed via a small laminectomy, followed by PPSF, including at the level of the fractured vertebra...
April 20, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29675599/immunoadsorption-plasmapheresis-treatment-for-the-recurrent-exacerbation-of-neuromyelitis-optica-spectrum-disorder-with-a-fluctuating-anti-aquaporin-4-antibody-level
#15
Hiroaki Nishimura, Hideki Enokida, Taiji Sakamoto, Toshiyuki Takahashi, Hiroshi Hayami, Masayuki Nakagawa
The pathogenesis in the exacerbation of neuromyelitis optica spectrum disorder (NMOSD) involves mainly the serum anti-aquaporin-4 (AQP4) immunoglobulin G antibody (anti-AQP4 antibody). If high-dose corticosteroid treatment is not achieved during remission, rescue plasmapheresis is recommended. However, there are few reports on the therapeutic efficacy of repetitive immunoadsorption plasmapheresis (IAPP) for the recurrent exacerbation of NMOSD with a fluctuating anti-AQP4 antibody level. A 36-year-old man presented with a reduction of visual acuity (VA) on the right eye (OD) to 20/250...
April 19, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29666711/creutzfeldt-jakob-disease-presenting-as-expressive-aphasia-and-nonconvulsive-status-epilepticus
#16
Hafiz B Mahboob, Kazi H Kaokaf, Jeremy M Gonda
Creutzfeldt-Jakob disease (CJD), the most common form of human prion diseases, is a fatal condition with a mortality rate reaching 85% within one year of clinical presentation. CJD is characterized by rapidly progressive neurological deterioration in combination with typical electroencephalography (EEG) and magnetic resonance imaging (MRI) findings and positive cerebrospinal spinal fluid (CSF) analysis for 14-3-3 proteins. Unfortunately, CJD can have atypical clinical and radiological presentation in approximately 10% of cases, thus making the diagnosis often challenging...
2018: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29662730/myelopathy-improvement-following-removal-of-cervical-sublaminar-wiring
#17
Hurtis J Tullos, Robert G Briggs, Andrew K Conner, Allison E Williams, John B Maxwell, Michael D Martin
Posterior cervical wiring has been used by spine surgeons in fixation procedures for patients with spinal instability. It is historically considered an effective method of treating cervical instability with a low risk of complications leading to neurological deterioration. We experienced a case of delayed neurological decline associated with myelopathy, lower extremity spasticity, and associated syringomyelia secondary to instrumentation failure and resultant sublaminar wire protrusion into the cervical spinal cord...
February 14, 2018: Curēus
https://www.readbyqxmd.com/read/29651329/ischaemia-of-the-medullary-cone-after-stent-graft-implantation-in-a-patient-with-abdominal-aortic-aneurysm-a-case-study
#18
Mariusz Wachowski, Michał Polguj, Janusz Ścibór, Agata Majos
Preoperative visualization of the Adamkiewicz artery - the vessel which is to a great extent responsible for supplying blood to the medullary cone - is an important step which must be taken before initiating restorative procedures in the aorta. We present a case of a 67-year-old patient who underwent an intravascular stent-graft implantation procedure, due to clinical signs of abdominal aortic aneurysm. Routine pre-operative computed tomography examination failed to demonstrate the Adamkiewicz artery. On the second day after the surgery, as a result of unexpected clinical deterioration, an magnetic resonance imaging examination of the lumbar spine was carried out...
March 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29649647/the-clinical-outcomes-of-primary-and-revision-untethering-surgery-in-patients-with-tethered-cord-syndrome-and-spinal-bifida
#19
Jingchuan Sun, Yao Zhang, Haibo Wang, Yuan Wang, Yong Yang, Qingjie Kong, Ximing Xu, Jiangang Shi
BACKGROUND: Tethered cord syndrome (TCS) is an increasingly recognized clinical condition, with untethering surgery as the classically effective treatment. Yet, as evidence aggregated, the surgical outcome untethering, remains controversial. This study aimed to systematically evaluate the clinical outcomes after untethering surgery in primary and re-tethering patients. METHODS: This retrospective study was conducted by department of spine surgery of Changzheng Hospital from January to December 2016...
April 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29623940/dti-and-pathological-changes-in-a-rabbit-model-of-radiation-injury-to-the-spinal-cord-after-125-i-radioactive-seed-implantation
#20
Xia Cao, Le Fang, Chuan-Yu Cui, Shi Gao, Tian-Wei Wang
Excessive radiation exposure may lead to edema of the spinal cord and deterioration of the nervous system. Magnetic resonance imaging can be used to judge and assess the extent of edema and to evaluate pathological changes and thus may be used for the evaluation of spinal cord injuries caused by radiation therapy. Radioactive125 I seeds to irradiate 90% of the spinal cord tissue at doses of 40-100 Gy (D90) were implanted in rabbits at T10 to induce radiation injury, and we evaluated their safety for use in the spinal cord...
March 2018: Neural Regeneration Research
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