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SPINE STENOSIS

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https://www.readbyqxmd.com/read/28535546/cost-utility-analysis-of-lumbar-interlaminar-epidural-injections-in-the-treatment-of-lumbar-disc-herniation-central-spinal-stenosis-and-axial-or-discogenic-low-back-pain
#1
Laxmaiah Manchikanti, Vidyasagar Pampati, Ramsin M Benyamin, Joshua A Hirsch
BACKGROUND: Cost utility or cost effective analysis continues to take center stage in the United States for defining and measuring the value of treatments in interventional pain management. Appropriate cost utility analysis has been performed for caudal epidural injections, percutaneous adhesiolysis, and spinal cord stimulation. However, the literature pertaining to lumbar interlaminar epidural injections is lacking, specifically in reference to cost utility analysis derived from randomized controlled trials (RCTs) with a pragmatic approach in a practical setting...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28533943/etiology-and-treatment-of-amyotrophic-lateral-sclerosis
#2
Hernando Rafael, Juan Oscar David, Antonio Santiago Vilca
BACKGROUND: To date all researchers conclude that the etiology of Amyotrophic lateral sclerosis (ALS) is not known. On the contrary, since August 2009, we believe that disease is of ischemic origin in the anterior surface of the medulla oblongata. MATERIAL AND METHOD: We present our surgical experience into 45 patients with ALS (bulbar form in 36 cases and spinal form in 9). Preoperative MRI scans revealed microinfarcts in the medulla oblongata and/or cervical cord...
2017: American Journal of Neurodegenerative Disease
https://www.readbyqxmd.com/read/28528480/full-endoscopic-treatment-of-dural-tears-in-lumbar-spine-surgery
#3
Joachim M Oertel, Benedikt W Burkhardt
PURPOSE: An incidental durotomy is a common complication of spinal surgery. Its treatment remains challenging, especially in endoscopic procedures. The objective of this study is to describe a technique for endoscopic dural closure which is safe and effective. METHODS: From a prospective database all endoscopic spinal procedures with incidental durotomy were identified. Retrospectively, video recordings were analysed with a special reference to the applied technique of dural closure...
May 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28527756/radiological-lumbar-stenosis-severity-predicts-worsening-sagittal-malalignment-on-full-body-standing-stereoradiographs
#4
Aaron J Buckland, Subaraman Ramchandran, Louis Day, Shay Bess, Themistocles Protopsaltis, Peter G Passias, Bassel G Diebo, Renaud Lafage, Virginie Lafage, Akhila Sure, Thomas J Errico
BACKGROUND CONTEXT: Patients with degenerative lumbar stenosis (DLS) adopt a forward flexed posture in an attempt to decompress neural elements. The relationship between sagittal alignment and severity of lumbar stenosis has not previously been studied. PURPOSE: We hypothesized that patients with increasing radiological severity of lumbar stenosis will exhibit worsening sagittal alignment. STUDY DESIGN: This is a cross-sectional study. PATIENT SAMPLE: Our sample consists of patients who have DLS...
May 17, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28525493/influence-of-myelography-and-postmyelographic-ct-on-therapeutic-decisions-in-degenerative-diseases-of-the-cervical-spine
#5
Thomas Westermaier, Christina Doerr, Christian Stetter, Thomas Linsenmann, Stefan Koehler, Joerg Eriskat, Laszlo Solymosi, Ralf-Ingo Ernestus
STUDY DESIGN: A retrospective analysis of clinical records and radiologic imaging by 3 independent reviewers to assess the indication for surgical treatment with and without myelography and postmyelographic computed tomography (MCT). OBJECTIVE: To evaluate whether myelography and MCT obtained in addition to magnetic resonance imaging (MRI) influence therapeutic decisions in degenerative diseases of the cervical spine. SUMMARY OF BACKGROUND DATA: MRI has become the standard examination in spinal diseases...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525466/facet-preserving-technique-by-en-bloc-flavectomy-in-microscopic-posterior-decompression-surgery-for-lumbar-spinal-stenosis-semicircumferential-decompression-scd
#6
Yasushi Fujiwara, Hideki Manabe, Tadayoshi Sumida, Bunichiro Izumi, Kazuyoshi Nakanishi, Nobuhiro Tanaka, Nobuo Adachi
Posterior decompression surgery which enlarges the spinal canal in cases with lumbar spinal stenosis is the most fundamental technique in spine surgery, but controversy still remains for the exact technique. Because nerve roots run under the ventral side on the superior articular process (SAP), achieving both facet joint preservation and nerve root decompression is problematic. In conventional laminotomies or laminectomies, medial facetectomies are performed to decompress the nerve root, but it is ideal to preserve the facet joints completely for preserving joint stability...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28524126/-impact-of-sagittal-balance-parameters-on-life-quality-in-elderly-and-senile-patients-after-surgery-for-degenerative-lumbar-spine-stenosis
#7
V S Klimov, I I Vasilenko, A V Evsyukov, E V Amelina
INTRODUCTION: As the life span and proportion of people over 65 years increase, the incidence of degenerative lumbar spine stenosis grows proportionally. Various parameters of the spinopelvic relationships are used to predict surgical treatment outcomes in patients with degenerative spine diseases. There are no unified protocols for evaluation, in terms of the sagittal balance, of surgical treatment outcomes in elderly patients. PURPOSE: To study the impact of sagittal balance parameters on the life quality of elderly and senile patients after surgery for degenerative stenosis of the lumbar spine...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28503347/wasting-of-extensor-digitorum-brevis-as-a-decisive-preoperative-clinical-indicator-of-lumbar-canal-stenosis-a-single-center-prospective-cohort-study
#8
S Munakomi, B M Kumar
BACKGROUND: The dilemma in managing patients with low back ache lies in differentiating radiculopathy from lumbar canal stenosis. This has a huge bearing in patients being planned for surgical intervention as underperforming leads to failed back syndrome whereas over-doing leads to instability. There still remains a loophole in clinically diagnosing lumbar canal stenosis. AIM: We opt to utilize a simple bedside clinical examination in routinely assessing patients presenting with low back ache in ruling out underlying canal stenosis...
September 2016: Annals of Medical and Health Sciences Research
https://www.readbyqxmd.com/read/28499364/clinical-classification-in-low-back-pain-best-evidence-diagnostic-rules-based-on-systematic-reviews
#9
Tom Petersen, Mark Laslett, Carsten Juhl
BACKGROUND: Clinical examination findings are used in primary care to give an initial diagnosis to patients with low back pain and related leg symptoms. The purpose of this study was to develop best evidence Clinical Diagnostic Rules (CDR] for the identification of the most common patho-anatomical disorders in the lumbar spine; i.e. intervertebral discs, sacroiliac joints, facet joints, bone, muscles, nerve roots, muscles, peripheral nerve tissue, and central nervous system sensitization...
May 12, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28497668/potential-brain-dead-organ-donation-in-neurocritical-care-mortality
#10
Vera Spatenkova, Ondrej Bradac, Petr Suchomel
BACKGROUND: Mortality is a marker of quality in neurocritical care, but it also provides potential for donors after brain death (DBD) following irreversible acute brain damage. The aim of this study was to analyse the neurointensive care unit (NICU) mortality rate and recovery of potential DBD. METHODS: We performed a 10-year prospective observational cohort computer database analysis of 6138 acute neurological and neurosurgical patients (pts, 58.2% male, mean: age 55...
May 11, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28483706/clinical-classification-criteria-for-radicular-pain-caused-by-lumbar-disc-herniation-the-rapidh-criteria-radicular-pain-caused-by-disc-herniation
#11
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
CONTEXT: Classification criteria are recommended for diseases that lack specific biomarkers in order to improve homogeneity in clinical research studies. Since imaging evidence of lumbar disc herniations (LDH) may not be associated with symptoms, clinical classification criteria based upon patient symptoms and physical examination findings are required. PURPOSE: This study aimed to produce clinical classification criteria to identify patients with radicular pain caused by LDH...
May 5, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28481805/interreader-reliability-and-clinical-validity-of-a-magnetic-resonance-imaging-grading-system-for-cervical-foraminal-stenosis
#12
Jung Eun Lee, Hee Jin Park, So Yeon Lee, Yong Taek Lee, Yong Bum Kim, Kyu Hong Lee, Hyunchul Shin, Young Joon Kwon
OBJECTIVE: Park system is a magnetic resonance imaging (MRI) grading system for cervical neural foraminal stenosis (CNFS) and consists of 4 grades (0-3) based on the foraminal shape of 45-degree T2-weighted oblique sagittal images. The objective of this study was to evaluate the interreader reliability of the Park system among radiologists, residents, and clinicians. This study also assessed the correlations between radiologic and clinical findings. MATERIAL AND METHODS: A total of 289 patients (men:women = 155:134, mean age = 50 years) who underwent oblique sagittal MRI of the cervical spine at our hospital were included...
May 6, 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28459782/mortality-due-to-surgery-for-degenerative-lumbar-spine
#13
Jyrki Salmenkivi, Reijo Sund, Mika Paavola, Iiris Ruuth, Antti Malmivaara
STUDY DESIGN: Register study. OBJECTIVE: The purpose of this study was to assess the safety of lumbar spine surgery for degenerative disorders and to assess the predictive factors for mortality and causes of death. SUMMARY OF BACKGROUND DATA: Growing numbers and relative indications of spine surgery emphasize the importance of patient safety, We assessed the incidence of mortality related to surgery, overall case fatality and factors predicting mortality in elective spinal surgery...
April 28, 2017: Spine
https://www.readbyqxmd.com/read/28459724/anesthetic-challenges-for-posterior-spine-surgery-in-patient-with-left-ventricular-assist-device-a-case-report
#14
J Pablo Kollmar, Douglas A Colquhoun, Julie L Huffmyer
With the growing rate of left ventricular assist device (LVAD) implantation, patients with end-stage heart failure and LVAD support are presenting for a variety of noncardiac surgeries. We describe a case of urgent posterior lumbar decompression for spinal stenosis in a 73-year-old man with HeartMateII LVAD, which presented significant anesthetic challenges in terms of positioning, blood loss, and coagulopathy.
April 28, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28458901/the-management-of-metastatic-radioiodine-refractory-differentiated-thyroid-cancer-requires-an-integrated-approach-including-both-directed-and-systemic-therapies
#15
Shamil D Cooray, Duncan J Topliss
SUMMARY: A 58-year-old man with metastatic radioiodine-refractory differentiated thyroid cancer (DTC) presented with left thigh and right flank numbness. He had known progressive and widespread bony metastases, for which he received palliative radiotherapy, and multiple bilateral asymptomatic pulmonary metastases. CT scan and MRI of the spine revealed metastases at right T10-L1 vertebrae with extension into the central canal and epidural disease at T10 and T11 causing cord displacement and canal stenosis but retention of spinal cord signal...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28458818/lumbar-vertebral-body-and-pars-fractures-following-laminectomy
#16
Akshay Yadhati, Swamy Kurra, Richard A Tallarico, William F Lavelle
A 56-year-old alcoholic male incurred L5 vertebral body and bilateral L4 pars fractures with progressive L4 on L5 anterolisthesis following low-energy falls while intoxicated. Recently, he had a L3-S1 laminectomy for lumbar spinal stenosis with claudication. Preoperative imaging and radiographs were negative for pars defects and instability, so an isolated decompressive surgery was performed. Following low-energy falls, his outpatient work-up revealed fractures through the bilateral L4 pedicles and posterior third of L5 vertebral body, with recurrence of axial back pain and bilateral lower extremity radiculopathy...
February 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28456675/stability-preserving-decompression-in-degenerative-versus-congenital-spinal-stenosis-demographic-patterns-and-patient-outcomes
#17
Philip K Louie, Justin C Paul, Jonathan Markowitz, Joshua A Bell, Bryce A Basques, Alem Yacob, Howard S An
BACKGROUND: Context: Although lumbar spinal stenosis often presents as a degenerative condition, some patients present with symptoms from lifelong narrowing of the spinal canal. These patients have congenital stenosis (CS) and present with symptoms of stenosis at a younger age. CS patients often have a distinct pathophysiology with fewer degenerative changes but present with multi-level involvement. In the setting of neurological symptoms, decompression-alone while preserving stability, has been proposed for both patient populations...
April 26, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28451496/carotid-artery-injury-in-anterior-cervical-spine-surgery-multicenter-cohort-study-and-literature-review
#18
Roger Härtl, Marjan Alimi, Mohamed Abdelatif Boukebir, Connor D Berlin, Rodrigo Navarro-Ramirez, Paul M Arnold, Michael G Fehlings, Thomas E Mroz, K Daniel Riew
STUDY DESIGN: Retrospective study and literature review. OBJECTIVE: To provide more comprehensive data about carotid artery injury (CAI) or cerebrovascular accident (CVA) related to anterior cervical spine surgery. METHODS: We conducted a retrospective, multicenter, case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network. Medical records of 17 625 patients who went through cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, were analyzed...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28447148/absent-pedicles-in-campomelic-dysplasia
#19
Michael M McDowell, Ozgur Dede, Patrick Bosch, Elizabeth C Tyler-Kabara
OBJECTIVES: The objective of the present study is to report a case of campomelic dysplasia illustrating the absence of cervical and thoracic pedicles. This report reiterates the importance of this clinical peculiarity in the setting of spine instrumentation. MATERIALS AND METHODS: A 10-year-old female patient with campomelic dysplasia presented with progressive kyphoscoliosis and signs of neural compromise. Imaging studies confirmed thoracic level stenosis and demonstrated absence of multiple pedicles in cervical and thoracic spine...
April 26, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28443173/qualitative-grading-as-a-tool-in-the-management-of-multilevel-lumbar-spine-stenosis
#20
Shardul Madhav Soman, Jimmy Chokshi, Naitik Chhatrala, Gulam Haider Tharadara, Mukund Prabhakar
STUDY DESIGN: This is a prospective study that was undertaken at a single centre and involved 80 consecutive patients diagnosed with lumbar spinal stenosis (LSS). PURPOSE: The aim of the study was to assess the efficacy of a qualitative grading system as seen on magnetic resonance imaging (MRI) as a tool in the management of multilevel LSS. OVERVIEW OF LITERATURE: LSS diagnosis is clinical but is usually radiologically supplemented. However, there are often multilevel radiological findings with non-specific or atypical clinical features...
April 2017: Asian Spine Journal
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