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https://www.readbyqxmd.com/read/29164038/timing-of-decompression-in-patients-with-acute-spinal-cord-injury-a-systematic-review
#1
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/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
#2
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/29155111/surgical-treatment-of-spinal-synovial-cysts-in-the-elderly-symptoms-treatment-course-and-outcome-in-patients-over-75-years
#3
Markus Bruder, Florian Gessler, Adriano Cattani, Christian Droste, Volker Seifert, Matthias Setzer, Gerhard Marquardt
OBJECTIVE: The ongoing aging of our society leads to a rising number of elderly patients with progressive degeneration of the spine, associated with synovial cysts. In the elderly, surgical treatment may be particularly challenging because of comorbidities. METHODS: Patients treated in our department between 1999 and 2014 for spinal synovial cysts were screened. The 28 patients aged 75 years and older were classified as "elderly". Those were compared with 96 patients between 50 and 74 years...
November 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29142158/computed-tomography-magnetic-resonance-imaging-and-a-novel-surgical-approach-of-atlanto-axial-instability-with-incongruence-in-dogs
#4
Mario Dolera, Luca Malfassi, Simone Pavesi, Sara Finesso, Giovanni Mazza, Silvia Marcarini, Massimo Sala, Nancy Carrara, Cristina Bianchi, Jennifer M Gambino
Atlanto-axial (AA) instability due to ligament insufficiency is a common cause of cervical spinal cord compression in toy breeds. However, in some dogs a difference in size between the atlas and the axis leads to joint incongruence that exacerbates AA subluxation and makes surgical treatment challenging. Twelve dogs with AA instability with incongruence were enrolled in a single institution prospective observational study. Computed tomography (CT) and magnetic resonance imaging (MRI) of the AA joint were compared to a retrospectively reviewed control group...
November 15, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/29141498/incidence-and-natural-progression-of-neurogenic-shock-following-traumatic-spinal-cord-injury
#5
Ian A Ruiz, Jordan W Squair, Aaron A Phillips, Christine D Lukac, Dayan Huang, Patrick Oxciano, Dong Yan, Andrei V Krassioukov
Neurogenic shock, a distributive type of circulatory shock following spinal cord injury (SCI), results in profound hypotension. The consequent hemodynamic instability complicates clinical management, delays surgical intervention, and impacts neurological outcome. Moreover, the reported incidence of this condition varies significantly. Here, we establish the true incidence of neurogenic shock by comparing the most common clinical definitions used to diagnose the condition. Further, we characterize the acute progression and recovery of neurogenic shock...
November 15, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29137084/vertebral-column-decortication-for-the-management-of-sharp-angular-spinal-deformity-in-pott-disease-case-report
#6
Hong-Tao Hu, Feng-Yu Liu, Jin-He Yu, Liang Ren, Zhen-Fang Gu, Xian-Ze Sun
RATIONALE: Extremely sharp angular spinal deformity of healed tuberculosis can be corrected by vertebral column resection (VCR). However, the VCR techniques have many limitations including spinal column instability, greater blood loss, and greater risk of neurologic deficit. PATIENT CONCERNS: We described a new spinal osteotomy technique to collect sharp angular spinal deformity in Pott disease. A 52-year-old woman presented with back pain and gait imbalance. DIAGNOSIS: The kyphosis of healed tuberculosis was diagnosed based on history and imaging examinations...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29116380/trunk-proprioception-adaptations-to-creep-deformation
#7
Jacques Abboud, Benjamin Rousseau, Martin Descarreaux
PURPOSE: This study aimed at identifying the short-term effect of creep deformation on the trunk repositioning sense. METHODS: Twenty healthy participants performed two different trunk-repositioning tasks (20° and 30° trunk extension) before and after a prolonged static full trunk flexion of 20 min in order to induce spinal tissue creep. Trunk repositioning error variables, trunk movement time and erector spinae muscle activity were computed and compared between the pre- and post-creep conditions...
November 8, 2017: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/29114511/the-study-of-trunk-and-pelvic-movement-on-mediolateral-ramps-of-various-ramp-angles-during-one-legged-standing
#8
Sang-Yeol Lee, Se-Yeon Park
The purpose of this study was to identify the instability of the trunk and the pelvis of subjects who were standing on differently angled ramps under conditions in which the ramps were crossed. Changes in the trunk and the pelvis while each subject was standing on one leg in the direction of the cross ramps at four angles (0°, 5°, 10°, and 15°) were measured. To identify instability, the trunk inclination, trunk imbalance, pelvic position, pelvic rotation, and pelvic torsion of 20 healthy male subjects were measured...
August 2017: Journal of Exercise Rehabilitation
https://www.readbyqxmd.com/read/29113855/holospinal-epidural-abscesses-institutional-experience
#9
REVIEW
Kelly J Bridges, Khoi D Than
PURPOSE: The authors present a holospinal epidural abscesses (HEA) case series and a single institution's experience with varied surgical approaches and outcomes. METHODS: Medical records were queried and reviewed (6 years) for patients with a spinal abscess diagnosis; HEA were selected. Medical history, comorbidities, blood and epidural pathogens, presentation symptoms, abscess location, presence of mass effect, surgical procedures, treatment regimens, and neurological outcomes were collected...
November 4, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29113764/effect-of-two-level-pedicle-screw-fixation-with-different-rod-materials-on-lumbar-spine-a-finite-element-study
#10
Jayanta Kumar Biswas, Masud Rana, Santanu Majumder, Santanu Kumar Karmakar, Amit Roychowdhury
BACKGROUND: Pedicle-screw-rod fixation system is very popular surgical remedy for degenerative disc disease. It is important to observe load vs. spinal motion characteristic for better understanding of clinical problems and treatment of spinal instability associated with low-back pain. OBJECTIVE: The objective of this study is to understand the effect [range of motion (ROM) and intervertebral foramen height] of pedicle-screw fixation with three rod materials on lumbar spine under three physiological loading conditions...
November 4, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29111396/limitations-and-pitfalls-of-the-pedicle-screw-testing-monitoring-technique-an-in-vivo-and-in-vitro-study
#11
Julie Zyss, Isabelle Bernat, Stéphane Wolff, Guillaume Riouallon, Hugues Pascal-Moussellard
OBJECTIVES: Pedicle screw testing is a widely used technique in the field of neuromonitoring for spinal surgery. It was designed by Calancie et al. (1992) in order to detect pedicle breach, one of the major complications of pedicle screw fixation, which can lead to neurological impairment. However, numerous false negative and equivocal results led to its clinical relevance being questioned. We aimed to clarify these discrepancies and characterize electrical parameters underlying this technique...
October 27, 2017: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/29105726/complications-of-2-level-dynamic-stabilization
#12
Mert Ciplak, Tuncer Suzer, Salim Senturk, Onur Yaman, Mehdi Sasani, Tunc Oktenoglu, Atilla Yilmaz, Deniz Ufuk Erbulut, Ali Fahir Özer
AIM: A retrospective chart and a radiographic review. Evaluation of postoperative complications, clinical improvements and radiological parameters in patients who underwent surgery using a dynamic system for 2-level lumbar stabilization. We aimed to investigate the postoperative complications, such as screw loosening, screw breakage and ASD, in patients who underwent surgery with 2-level dynamic stabilization systems. MATERIALS AND METHODS: Dynamic lumbar systems enable the stabilization of unstable degenerative spines, while preventing fusion-related complications, such as adjacent segment disease(ASD) and pseudarthrosis...
September 25, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29103428/overview-of-inflammation-in-neurometabolic-diseases
#13
Gregory A Grabowski
Neuroinflammation is an intrinsic component of the neurodegeneration of inborn errors of neurometabolic diseases. Diseases resulting in lysosomal, peroxisomal, and autophagocytic disruption lead to neuroinflammation by different mechanisms relating to accumulated substrates and/or downstream deficiencies that cause presymptomatic microglial activation, axonal instabilities and/or direct hyperactivation of intrinsic inflammatory mechanisms. Only in selected diseases is the blood-brain barrier (BBB) breached, thereby permitting peripheral adaptive immune mechanisms to amplify intrinsic immune reactions in the central nervous system...
August 2017: Seminars in Pediatric Neurology
https://www.readbyqxmd.com/read/29100675/skull-base-plasmacytoma-a-unique-case-of-poems-syndrome-with-a-plasmacytoma-causing-craniocervical-instability
#14
Hannah Gilder, Meghan E Murphy, Mohammed Ali Alvi, Panagiotis Kerezoudis, Daniel Shepherd, Patrick R Maloney, Michael J Yaszemski, Jonathan M Morris, Angela Dispenzieri, Jane M Matsumoto, Mohamad Bydon
INTRODUCTION: Plasmacytomas, considered to be the solitary counterparts of multiple myeloma, are neoplastic monoclonal plasma cell proliferations within soft tissue or bone. Plasmacytomas often present as a collection of findings known as POEMS-syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, M-Protein spike, and Skin changes). CASE DESCRIPTION: We present a report of a 47 yo male diagnosed with POEMS-syndrome secondary to a skull base plasmacytoma. The mass resulted in marked instability of the cranio-cervical junction due to bony erosion...
October 31, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29095296/the-treatment-strategies-for-spine-fractures-in-patients-with-ankylosing-spondylitis-a-case-report
#15
RuSen Zhu, WenYe Song, Wei Hu, ZeHua Jiang, JianJun Yuan, ZiJian Cui, Jun Wan, Yan Liu, ShiQing Feng, XueLi Zhang
PURPOSE: The aim of the study was to explore surgical strategies for effectively treating spine fractures in patients with ankylosing spondylitis (AS) and investigate the postoperative outcomes. METHODS: We retrospectively analyzed 9 patients with AS that was complicated by spine fractures, who underwent surgery at our spine and spinal cord clinic between 2005 and 2012. The surgical methods included posterior instrumentation and bone grafting, with or without decompression...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29076042/interbody-fusion-techniques-in-the-surgical-management-of-degenerative-lumbar-spondylolisthesis
#16
REVIEW
Peter B Derman, Todd J Albert
PURPOSE OF REVIEW: The various lumbar interbody fusion (IBF) techniques and the evidence for their use in the treatment of degenerative lumbar spondylolisthesis (DLS) are described in this review. RECENT FINDINGS: The existing evidence is mixed regarding the indications for and utility of IBF in DLS, but its use in the setting of pre-operative instability is most strongly supported. Anterior (ALIF), lateral (LLIF), posterior (PLIF), transforaminal (TLIF), and axial (AxiaLIF) lumbar IBF approaches have been described...
December 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29075895/cerebral-ischaemia-following-anterior-upper-thoracic-spinal-surgery-utilizing-a-partial-manubrial-resection
#17
David Christopher Kieser, Derek Thomas Cawley, Takashi Fujishiro, Cecile Roscop, Louis Boissiere, Ibrahim Obeid, Olivier Gille, Jean-Marc Vital, Vincent Pointillart
PURPOSE: Firstly, to describe two cases of cerebral ischaemia complicating anterior upper thoracic spinal surgery and define the likely cause of this complication. Secondly, to describe preventative measures and the effect these have had in reducing this complication within our institution. METHODS: Firstly, a review of two cases of cerebral ischaemia complicating anterior upper thoracic spinal surgery utilizing a partial manubrial resection. Secondly, cadaveric dissections of the carotid arteries to determine the effect of neck positioning and aortic arch retraction during a simulated procedure...
October 26, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29071375/-influence-of-trauma-mechanisms-on-thoracic-and-lumbar-spinal-fractures
#18
Cornelius Jacobs, Tony Hartwig, Philip P Rößler, Dan Meila, Igor Nikiforov, Milena M Plöger, Christof Burger, Sebastian Scheidt
BACKGROUND: Vertebral body fractures (VBF) can be caused by various trauma mechanisms. The AOSpine classification system differentiates three main types of fractures according to the grade of instability. How the increasing energy of various accident mechanisms changes the complexity of the individual fracture, its localization and the occurrence of further fractures has not yet been finally investigated. OBJECTIVE: What influence do traumatic events with different kinematics have on the localization, complexity and number of VBF in the thoracic and lumbar spine? MATERIAL AND METHODS: In this retrospective study data from patients with a freshly traumatized VBF were analyzed...
October 25, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29066036/diagnosis-and-management-of-spinal-infections
#19
Hideki Nagashima, Shinji Tanishima, Atsushi Tanida
The number of spinal infections has been increasing due to aging populations and larger numbers of immunocompromised hosts and intravenous drug users. Magnetic resonance imaging is a useful tool for the early diagnosis of spinal infections, and can yield positive findings just 3-5 days after disease onset. Before antibiotic administration, cultures must be initiated from blood and from specimens collected from the locus of infection. Based on the pathogens identified by culture, appropriate antibiotics should be selected with careful consideration of antimicrobial susceptibility and spinal tissue penetration...
October 20, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29065645/effect-of-graded-facetectomy-on-lumbar-biomechanics
#20
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
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