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SPINE STENOSIS

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https://www.readbyqxmd.com/read/29133715/minimally-invasive-lateral-foraminotomy-with-partial-lateral-facetectomy-for-lumbar-radiculopathy-an-evaluation-of-facet-integrity-and-description-of-the-procedure
#1
Akshay Hari, Murali Krishna, Santosh Rajagandhi, Ankit Sharma, Rajakumar V Deshpande
Foraminal stenosis causing nerve root compression and radiculopathy is a relatively common pathology in the lumbar spine. The treatment of choice, when surgery is indicated, is foraminal decompression at the affected level, usually through a conventional midline open foraminotomy. Minimally invasive lateral foraminotomy with partial lateral facetectomy is a potentially effective surgical alternative when such a surgery is warranted. The evaluation of the efficacy and benefits of this approach for treatment of radiculopathy; an assessment of facet integrity; and, a detailed description of the procedure are also provided...
November 2017: Neurology India
https://www.readbyqxmd.com/read/29125823/failure-of-an-expandable-cage-plate-cervical-vertebral-body-replacement-case-report-of-a-device-related-complication
#2
Klemens Trieb, Stephan Koch
Instabilities of the cervical spine after complete or incomplete corpectomy may be the result from resection due to stenosis induced myelopathy, tumors, infections or fractures. In this article, we report a 49-year-old female patient after surgical decompression and stabilization at C5/7 with permanent cervicobrachialgia due to cervical stenosis at C5/7. Corpectomy of C6 and stabilization of C5/7 were performed with a combination of cage and plate. At an outpatient control 16 months after reoperation, the patient complained of neck pain, while the control X-ray showed a fracture of the implant...
December 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/29119045/lumbar-stenosis-surgery-spine-surgeons-not-insurance-companies-should-decide-when-enough-is-better-than-too-much
#3
EDITORIAL
Nancy E Epstein
Background: Lumbar surgery for spinal stenosis is the most common spine operation being performed in older patients. Nevertheless, every time we want to schedule surgery, we confront the insurance industry. More often than not they demand patients first undergo epidural steroid injections (ESI); clearly they are not aware of ESI's lack of long-term efficacy. Who put these insurance companies in charge anyway? We did. How? Through performing too many unnecessary or overly extensive spinal operations (e...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29119044/nursing-review-of-diagnosis-and-treatment-of-lumbar-degenerative-spondylolisthesis
#4
Nancy E Epstein, Renee D Hollingsworth
Background: In the lumbar spine, degenerative spondylolisthesis or degenerative (not traumatic) slippage of one vertebral body over another is divided into 4 grades - grade I (25%), grade II (50%), grade III (75%), and grade IV (100%). Dynamic X-rays, magnetic resonance (MR), and computed tomography (CT) scans document the slip secondary to arthritic changes of the facet joint plus stenosis, ossification of the yellow ligament, disc herniations, and synovial cysts. MR best demonstrates soft tissue pathology whereas CT better delineates ossific/calcified disease...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29098915/neuro-urological-sequelae-of-lumbar-spinal-stenosis
#5
Jason Gandhi, Janki Shah, Gargi Joshi, Sohrab Vatsia, Andrew DiMatteo, Gunjan Joshi, Noel L Smith, Sardar Ali Khan
Lumbar spinal stenosis (LSS) is characterized by the narrowing of the spinal canal, which subsequently induces impingement of neural elements in the lumbar spine. Thus, symptoms of LSS are typically associated with damage to those neural elements. Herewith, we target the genitourinary symptoms of LSS and the importance of differentiating these symptoms from other genitourinary pathologies, namely benign prostatic hyperplasia. Specifically, we review bladder dysfunction, lower urinary tract symptoms (e.g., urinary incontinence, detrusor overactivity and under-activity, as well as frequent urinary tract infections), renal osteodystrophy, and sexual dysfunction (e...
November 3, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/29097954/redundant-nerve-root-in-a-patient-with-chronic-lumbar-degenerative-canal-stenosis
#6
Federico E Villafañe, Allison Harvey, Norman Kettner
Objective: The purpose of this case report is to describe the diagnostic imaging features of redundant nerve roots caused by chronic lumbar degenerative canal stenosis (CLDCS). Clinical Features: A 56-year-old male presented with severe low back pain. He experienced pain during minimal active lumbar range of motion. The patient demonstrated weakness of the right iliopsoas and hypoesthesia of the L-2 dermatome. A working diagnosis of CLDCS was established. The patient's worsening severe low back pain warranted magnetic resonance imaging of the lumbar spine, which was performed for further evaluation...
September 2017: Journal of Chiropractic Medicine
https://www.readbyqxmd.com/read/29095415/diagnostic-accuracy-of-zero-echo-time-mri-for-the-evaluation-of-cervical-neural-foraminal-stenosis
#7
Erin C Argentieri, Matthew F Koff, Ryan E Breighner, Yoshimi Endo, Parina H Shah, Darryl B Sneag
STUDY DESIGN: Cohort Study OBJECTIVE.: Evaluate the clinical utility of Zero-Echo-Time (ZTE) MRI for the assessment of cervical neural foraminal stenosis (CNFS) through the comparison of inter-modality (CT and ZTE-MRI) CNFS grade severity agreements. SUMMARY OF BACKGROUND DATA: Conventional MRI limited in its ability to provide direct visualization of cortical bone. The highly organized tissue structure of cortical bone results in very short T2 values that preclude acquisition of sufficient signal intensity and positive image contrast...
October 31, 2017: Spine
https://www.readbyqxmd.com/read/29095412/cervical-sagittal-range-of-motion-as-a-predictor-of-symptom-severity-in-cervical-spondylotic-myelopathy
#8
Kristen J Nicholson, Paul W Millhouse, Emily Pflug, Barrett Woods, Gregory D Schroeder, D Greg Anderson, Alan S Hilibrand, Christopher K Kepler, Mark F Kurd, Jeffrey A Rihn, Alexander Vaccaro, Kris E Radcliff
STUDY DESIGN: Retrospective review of radiographic data and functional outcomes. OBJECTIVE: Evaluate whether myelopathy symptom severity upon presentation corresponds to sagittal plane alignment or non-myelopathy symptoms, such as pain, in patients with cervical spondylotic myelopathy (CSM). SUMMARY OF BACKGROUND DATA: Cervical sagittal balance is an important parameter in the outcome of surgical reconstruction. However, the effect of sagittal alignment on symptom severity in patients who have not undergone spine surgery is not well defined...
October 31, 2017: Spine
https://www.readbyqxmd.com/read/29079071/occult-spinal-cord-injury-after-blunt-force-trauma-in-a-patient-with-achondroplasia-a-case-report-and-review-of-trauma-management-strategy
#9
Martin Huecker, Zach Harris, Eric Yazel
BACKGROUND: Achondroplastic dwarfism is associated with anatomic abnormalities that can predispose to occult injury and challenges in trauma management. Airway anatomy is problematic due to macrocephaly, midface hypoplasia, and a narrow nasopharynx. Manipulation of the neck is very dangerous due to the high likelihood of preexisting cervicomedullary stenosis. Restrictive lung disease and obstructive sleep apnea may complicate respiratory status. Peripheral and central venous access can be difficult to obtain...
October 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29066098/brown-s%C3%A3-quard-syndrome-and-cervical-post-traumatic-subarachnoid-hematoma
#10
Fernando Rascón-Ramírez, Josué M Avecillas-Chasín, Albert Trondin, M Javier Arredondo
Cervical Traumatic SSH are very rare in literature. They are usually caused by cardiopulmonary diseases that increase vascular pressure causing spinal vessels rupture. In thoracolumbar spine, the spinal puncture is the most common cause. The ventrolateral position is even more unusual. In traumatic brain injury (TBI), an abrupt extension-flexion movement could have caused the rupture of subarachnoid vessels. This, accompanied by the slowed blood "wash out" (probably due to the previous osteoarthrosis and spinal canal stenosis), led to the formation of an organized clot, which caused an acute spinal cord compression syndrome...
October 20, 2017: Neurocirugía
https://www.readbyqxmd.com/read/29065645/effect-of-graded-facetectomy-on-lumbar-biomechanics
#11
Zhi-Li Zeng, Rui Zhu, Yang-Chun Wu, Wei Zuo, Yan Yu, Jian-Jie Wang, Li-Ming Cheng
Facetectomy is an important intervention for spinal stenosis but may lead to spinal instability. Biomechanical knowledge for facetectomy can be beneficial when deciding whether fusion is necessary. Therefore, the aim of this study was to investigate the biomechanical effect of different grades of facetectomy. A three-dimensional nonlinear finite element model of L3-L5 was constructed. The mobility of the model and the intradiscal pressure (IDP) of L4-L5 for standing were inside the data from the literature...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29058135/the-value-of-patient-global-assessment-in-lumbar-spine-surgery-an-evaluation-based-on-more-than-90-000-patients
#12
C Parai, O Hägg, B Lind, H Brisby
PURPOSE: There are two, principally different ways to obtain patient opinions regarding the outcome of spine surgery: using prospective multi-item questionnaires preoperatively and at follow-up, and using a retrospective single-item question at follow-up-both methods have distinct advantages and limitations. The purpose of the study was to explore the utility of using the simple transition question global assessment, GA, ("How is your back/leg pain today as compared to before the surgery?") as an overall patient-reported outcome measure (PROM) based on the large real-life database in the Swedish spine registry (Swespine)...
October 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29056776/cervical-spine-instability-in-the-course-of-rheumatoid-arthritis-imaging-methods
#13
REVIEW
Małgorzata Mańczak, Robert Gasik
Cervical spine is affected in more than a half of patients with rheumatoid arthritis (RA). Depending on the degree of damage to the individual joints and ligaments RA-related cervical spine instability takes the form of atlanto-axial subluxation, subaxial subluxation or cranial settling. In the advanced cases spinal stenosis can occur as well as spinal cord injuries with typical neurological symptoms. The identification of patients with cervical spine instability before the occurrence of neurological complications still constitutes a diagnostic challenge...
2017: Reumatologia
https://www.readbyqxmd.com/read/29050722/adjacent-segment-disease-44-years-following-posterior-spinal-fusion-for-congenital-lumbar-kyphosis
#14
Avionna Baldwin, Addisu Mesfin
STUDY DESIGN: Case report. OBJECTIVE: To report the clinical and imaging findings of a patient with lumbar stenosis 44 years after posterior spinal fusion for congenital lumbar kyphosis. SUMMARY OF BACKGROUND DATA: To our knowledge, there are no long-term follow-up reports after posterior spine fusion (PSF) for congenital kyphosis. Congenital kyphosis is an uncommon deformity with the potential to progress rapidly and result in deformity and neurologic deficits...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29033576/lumbar-spinal-stenosis-attributable-to-tophaceous-gout-case-report-and-review-of-the-literature
#15
Wei Wang, Qingbo Li, Lei Cai, Weijun Liu
OBJECTIVES: Tophaceous gout seldom affects the axial skeleton. Symptoms vary according to the differential localization of urate deposits and the diagnosis is often delayed. Here, we report an unusual case of lumbar spinal stenosis caused by extradural tophaceous deposits. METHODS: We retrospectively reviewed a case of a patient with tophaceous gout of the lumbar spine and reviewed the relevant literature. RESULTS: A 62-year-old man with a 2-year history of lower back pain and a 3-month history of lower limb radiation pain and intermittent claudication was admitted...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29031994/clinical-classification-criteria-for-neurogenic-claudication-caused-by-lumbar-spinal-stenosis-the-n-class-criteria
#16
Stéphane Genevay, Delphine S Courvoisier, Kika Konstantinou, Francisco M Kovacs, Marc Marty, James Rainville, Michael Norberg, Jean-François Kaux, Thomas D Cha, Jeffrey N Katz, Steven J Atlas
BACKGROUND CONTEXT: Since imaging findings of lumbar spinal stenosis (LSS) may not be associated with symptoms, clinical classification criteria based on patient symptoms and physical examination findings are needed. PURPOSE: To develop clinical classification criteria that identify patients with neurogenic claudication (NC) caused by LSS. STUDY DESIGN: Two stage process. Phase 1: Delphi process; Phase 2: cross-sectional study. PATIENT SAMPLE: Outpatients recruited from spine clinics in 5 countries...
October 12, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29028758/mr-neurography-of-lumbosacral-plexus-in-failed-back-surgery-syndrome
#17
Riham Dessouky, Mohammed Khaleel, Dalia N Khalifa, Hazim I Tantawy, Avneesh Chhabra
STUDY DESIGN: Retrospective clinical case series. OBJECTIVE: To study the role of MRN of lumbosacral plexus in management of patients with FBSS. SUMMARY OF BACKGROUND DATA: Failed back surgery syndrome (FBSS) is one of the major problems in health care, affecting up to 40% of patients following spine surgery. To date, no imaging modality has been used to effectively classify nerve compression, since nerve injuries are challenging to detect on conventional lumbar spine MRI...
October 12, 2017: Spine
https://www.readbyqxmd.com/read/29027895/changes-in-foraminal-area-with-anterior-decompression-versus-keyhole-foraminotomy-in-the-cervical-spine-a-biomechanical-investigation
#18
Jacqueline Nguyen, Bryant Chu, Calvin C Kuo, Jeremi M Leasure, Christopher Ames, Dimitriy Kondrashov
OBJECTIVE Anterior cervical discectomy and fusion (ACDF) with or without partial uncovertebral joint resection (UVR) and posterior keyhole foraminotomy are established operative procedures to treat cervical disc degeneration and radiculopathy. Studies have demonstrated reliable results with each procedure, but none have compared the change in neuroforaminal area between indirect and direct decompression techniques. The purpose of this study was to determine which cervical decompression method most consistently increases neuroforaminal area and how that area is affected by neck position...
October 13, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29019641/spine-conditions-lumbar-spinal-stenosis
#19
Steven D Trigg, Zachary Devilbiss
Lumbar spinal stenosis (LSS) is a frequent cause of chronic low back and lower extremity pain in older patients. Symptomatic LSS typically is described as neurogenic claudication consisting of pain, weakness, numbness, and/or fatigue arising in the back and radiating into the buttock, thigh, or lower leg. The diagnosis is complicated by lack of reliable clinical or x-ray criteria. North American Spine Society guidelines recommend magnetic resonance imaging study without contrast to confirm anatomic narrowing of the spinal canal or nerve root impingement...
October 2017: FP Essentials
https://www.readbyqxmd.com/read/29018653/chiari-type-1-malformation-induced-intracranial-hypertension-with-diffuse-brain-edema-treated-with-foramen-magnum-decompression-a-case-report
#20
Toshiki Fukuoka, Yusuke Nishimura, Masahito Hara, Shoichi Haimoto, Kaoru Eguchi, Satoshi Yoshikawa, Toshihiko Wakabayashi, Howard J Ginsberg
Chiari type 1 malformation (CM1) rarely causes papilloedema, which is indicative of high intracranial pressure with or without ventricular dilatation. Furthermore, concomitant brain parenchymal abnormalities have not been reported to date. In this paper, the authors report on a young woman of CM1-induced intracranial hypertension (ICH) with diffuse brain edema with a focus on venous sinus assessment, and discuss the surgical strategy. A 24-year-old woman presented to Nagoya University Hospital complaining of 4-year history of severe occipital headache and blurry vision with slowly progressive worsening...
October 2017: NMC Case Rep J
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