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spinal instability

Panupol Rajinda, Sirisomboon Towiwat, Piyawat Chirappapha
PURPOSE: To compare the clinical and radiological outcomes of posterior atlantoaxial fixation and fusion using C1 lateral mass-C2 pedicle screws (screw-rod constructs, SRC) with C1-C2 transarticular screws (TAS). METHODS: A retrospective review was conducted of 105 patients with atlantoaxial instability who underwent posterior C1-C2 fixation and fusion by SRC group (60 pt) and TAS group (45 pt). The follow-up period was minimum 2 years. Clinical outcomes measurements included the Numeric Rating Scale (NRS) for pain assessment, the Neck Disability Index (NDI), the Japanese Orthopedic Association (JOA) score and the American Spinal Injury Association (ASIA) impairment scale for the functional and neurological outcomes that were assessed...
October 22, 2016: European Spine Journal
Je Hoon Jeong, Hee Kyung Kim, Soo Bin Im
BACKGROUND: Atlantoaxial spondyloarthropathy is most often resulted from rheumatoid arthritis, cancer metastasis and basilar invagination. Dialysis-related spondyloarthropathy is a rare cause of spinal deformity and cervical myelopathy at the atlantoaxial joint. We report two long-term hemodialysis patients who presented with atlantoaxial spondyloarthropathy. CASE DESCRIPTION: Two patients with end-stage renal failure (ESRD) presented with history of progressively worsening neck pain and motion limitation, and gait disturbance...
October 19, 2016: World Neurosurgery
Dennis Hey, Eugene Tze Chun Lau, Joel-Louis Lim, Denise Choong, Chuen-Seng Tan, Gabriel Ka-Po Liu, Hee-Kit Wong
BACKGROUND CONTEXT: Flexion radiographs have been used to identify cases of spinal instability. However, current methods are not standardized and are not sufficiently sensitive/specific to identify instability. PURPOSE: Introduction of a new slump sitting method for performing lumbar spine flexion radiographs and comparison of the angular range of motions and displacements between the conventional method and this new method. STUDY DESIGN: Prospective study on radiologic evaluation of the lumbar spine flexion range of motions and displacements using dynamic radiographs PATIENT SAMPLE: 60 patients were recruited from a single spine tertiary centre...
October 17, 2016: Spine Journal: Official Journal of the North American Spine Society
Carl B Gillombardo, Rebecca Darrah, Thomas E Dick, Michael Moore, Nathan Kong, Michael J Decker, Fang Han, Motoo Yamauchi, Mathias Dutschmann, Sausan Azzam, Kingman P Strohl
RATIONALE: Brainstem apolipoprotein AII (apoa2) mRNA expression correlates with apnea in breathing present in the adult C57Bl/6J (B6) sleep apnea model. OBJECTIVES: To test the hypothesis that the B6 apoa2 gene contributes to the trait, we performed plethysmographic testing in apoa2 knock out (KO: -/-) mice, an in situ brainstem-spinal cord preparation comparing KO to WT (+/+) mice, and B6xDBA recombinant inbred strains (RISs). MEASUREMENTS AND MAIN RESULTS: Apoa2 WT do, but KO and heterozygote (+/-) mice do not exhibit apnea during post-hypoxic breathing, measured in vivo...
October 15, 2016: Respiratory Physiology & Neurobiology
Scott L Zuckerman, Ilya Laufer, Arjun Sahgal, Yoshiya J Yamada, Meic H Schmidt, Dean Chou, John H Shin, Naresh Kumar, Daniel M Sciubba
STUDY DESIGN: Systematic review. OBJECTIVE: The aim of this study was to review the techniques, indications, and outcomes of minimally invasive surgery (MIS) and separation surgery with subsequent radiosurgery in the treatment of patients with metastatic spine disease. SUMMARY OF BACKGROUND DATA: The utilization of MIS techniques in patients with spine metastases is a growing area within spinal oncology. Separation surgery represents a novel paradigm where radiosurgery provides long-term control after tumor is surgically separated from the neural elements...
October 15, 2016: Spine
Maarten van Dijke, Stein J Janssen, Thomas D Cha, Kirkham B Wood, Lawrence F Borges, Mitchel B Harris, Christopher M Bono, Joseph H Schwab
STUDY DESIGN: This is a retrospective study. OBJECTIVE: To compare (1) recurrence of radiculopathy and (2) back pain after decompression with and without fusion for patients with a symptomatic synovial cyst. BACKGROUND: Previous work described favorable outcomes following cyst excision with and without fusion. Because of the association of facet cysts with spinal instability it is hypothesized that a decompression with fusion will lead to better outcomes...
October 6, 2016: Clinical Spine Surgery
Janan Abbas, Viviane Slon, Hila May, Nathan Peled, Israel Hershkovitz, Kamal Hamoud
BACKGROUND: The condition of paraspinal muscles is known to be associated with some variables such as age, gender, and low back pain. It is generally agreed that these muscles play an important role in the stability and functional movements of the lumbar vertebral column. Although spinal instability has been shown to play an essential role in degenerative lumbar spinal stenosis (DLSS), the role of paraspinal muscles remains elusive. The main purpose of this study was to shed light on the relationship between the condition of paraspinal muscles and symptomatic DLSS...
October 10, 2016: BMC Musculoskeletal Disorders
Bradley H Stephens, Neill M Wright
Spinal involvement occurs frequently in cases of eosinophilic granuloma (EG), but surgical treatment is limited primarily to those with spinal instability. Involvement of the cervical spine is rare, but primarily occurs in the vertebral bodies, and is normally amenable to anterior corpectomy and spinal reconstruction. The authors describe a 27-year-old man with pathologically proven EG who presented with complete destruction of the C-1 lateral mass requiring spinal stabilization. A titanium expandable cage was used to reconstruct the weight-bearing column from the occipital condyle to the superior articular surface of C-2 from a posterior approach, with preservation of the traversing vertebral artery...
October 7, 2016: Journal of Neurosurgery. Spine
Brianne Bordes, David Martin, Brian Schloss, Allan Beebe, Walter Samora, Jan Klamar, David Stukus, Joseph D Tobias
When hemodynamic or respiratory instability occurs intraoperatively, the inciting event must be determined so that a therapeutic plan can be provided to ensure patient safety. Although generally uncommon, one cause of cardiorespiratory instability is anaphylactic reactions. During anesthetic care, these most commonly involve neuromuscular blocking agents, antibiotics, or latex. Floseal is a topical hemostatic agent that is frequently used during orthopedic surgical procedures to augment local coagulation function and limit intraoperative blood loss...
July 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Claudio E Tatsui, Telmo A B Belsuzarri, Marilou Oro, Laurence D Rhines, Jing Li, Amol J Ghia, Behrang Amini, Heron Espinoza, Paul D Brown, Ganesh Rao
OBJECTIVE An emerging paradigm for treating patients with epidural spinal cord compression (ESCC) caused by metastatic tumors is surgical decompression and stabilization, followed by stereotactic radiosurgery. In the setting of rapid progressive disease, interruption or delay in return to systemic treatment can lead to a negative impact in overall survival. To overcome this limitation, the authors introduce the use of spinal laser interstitial thermotherapy (sLITT) in association with percutaneous spinal stabilization to facilitate a rapid return to oncological treatment...
October 2016: Neurosurgical Focus
Daniel Brian Scherman, Prashanth J Rao, Winny Varikatt, Gordon Dandie
BACKGROUND: The spinal cord intramedullary cavernoma (SCIC) is a rare form of hemangioma that typically behaves as a space-occupying lesion resulting in neurological symptoms, including bladder and bowel dysfunction. To date, there have been few reports characterizing the clinical presentations and surgical outcomes of cavernomas at the C2 spinal level or the potential for resolution of bladder and bowel symptoms postoperatively. This case details the clinical course of a patient with a C2 cavernoma with an atypical neurological presentation and rapid improvement in both bladder and bowel function postoperatively...
June 2016: J Spine Surg
Darweesh O Al-Khawaja, Tamadur Mahasneh, Jonathan C Li
Lumbar discectomy is one of the most commonly performed neurosurgical procedure. Far lateral disc herniations (FLDH) make up a minor portion of the total discectomy workload for spine surgeons. Due to their lower incidence, as well as their different anatomical positioning compared to the more common para-median disc herniation, the surgical procedures involved in releasing the neural compression caused by FLDHs are often challenging and at times frustrating to most spine surgeons, resulting in suboptimal outcomes for the patient related to the higher risk of spinal instability from facet joint disruption and may even be associated with nerve root injury...
March 2016: J Spine Surg
Charlotte Pineau, Brice Lavrard, François Boyer, Laëtitia Percebois-Macadré
OBJECTIVE: MRI has highly changed the assessment of post-traumatic syringomyelia (PTS), roughly estimated at 30% nowadays. Times to onset (TTO) symptoms are random. This case report describes how hyperhidrosis appeared and revealed PTS diagnosis. OBSERVATIONS: Mr M., 43-year-old, is rehabilitation inpatient after T10 AIS A spinal cord injury (SCI). Three months after this event, Mr M complains of acute hyperhidrosis crisis always located below the injury, which can occur at any time of the day, particularly when he moves...
September 2016: Annals of Physical and Rehabilitation Medicine
David Gasq, Morgane Lainard, Laure Kaluza, Philippe Dupui, David Amarantini
OBJECTIVE: When subjects present medically unexplained postural instability, a voluntary overcontrol of postural sway is often suspected. Aphysiologic postural imbalance may be detected in dynamic conditions on a servo-controlled platform (Equitest), but it remains difficult to objectify from static stabilometric evaluation. Our objective was to identify the key stabilometric parameters that allow to discriminate subjects with voluntary postural instability, control subjects and neurological patients with organic postural instability...
September 2016: Annals of Physical and Rehabilitation Medicine
Andrew A Fanous, Nathan P Olszewski, Lindsay J Lipinski, Jingxin Qiu, Andrew J Fabiano
The differential diagnoses for spinal cord lesions include spinal tumors and inflammatory processes. The distinction between these pathologies can be difficult if solely based on imaging. We report for the first time to our knowledge a case of idiopathic transverse myelitis (ITM) mimicking a discrete cervical spinal lesion in a 66-year-old man who presented with gait instability and neck pain. The patient's symptoms failed to resolve after an initial course of steroid therapy. Surgical biopsy confirmed the diagnosis of ITM...
2016: Case Reports in Pathology
M M van Rijsbergen, V M P Barthelemy, A C T Vrancken, S P M Crijns, H-J Wilke, W Wilson, B van Rietbergen, K Ito
The two main load bearing tissues of the intervertebral disc are the nucleus pulposus and the annulus fibrosus. Both tissues are composed of the same basic components, but differ in their organization and relative amounts. With degeneration, the clear distinction between the two tissues disappears. The changes in biochemical content lead to changes in mechanical behaviour of the intervertebral disc. The aim of the current study was to investigate if well-documented moderate degeneration at the biochemical and fibre structure level leads to instability of the lumbar spine...
September 23, 2016: Biomechanics and Modeling in Mechanobiology
Stefan Schraag
Most patients undergoing major aortic surgery have multiple comorbidities and are at high risk of postoperative complications that affect multiple organ systems. Different aortic pathologies and surgical repair techniques have specific impact on the postoperative course. Ischemia-reperfusion injury is the common denominator in aortic surgery and influences the integrity of end-organ function. Common postoperative problems include hemodynamic instability due to the immediate inflammatory response, renal impairment, spinal cord ischemia, respiratory failure with prolonged mechanical ventilation, and gastrointestinal symptoms such as ileus or mesenteric ischemia...
September 2016: Best Practice & Research. Clinical Anaesthesiology
Christian Liebsch, Nicolas Graf, Hans-Joachim Wilke
PURPOSE: The influence of the anterior rib cage on the stability of the human thoracic spine is not completely known. One of the most common surgical interventions on the anterior rib cage is the longitudinal median sternotomy and its fixation by wire cerclage. Therefore, the purpose of this in vitro study was to examine, if wire cerclage can restore the stability of the human thoracic spine after longitudinal median sternotomy. METHODS: Six fresh frozen human thoracic spine specimens (C7-L1, 56 years in average, range 50-65), including the intact rib cage without intercostal muscles, were tested in a spinal loading simulator and monitored with an optical motion tracking system...
September 17, 2016: European Spine Journal
Seonhong Hwang, Yen-Sheng Lin, Nathan S Hogaboom, Lin-Hwa Wang, Alicia M Koontz
Wheelchair propulsion is a major cause of upper limb pain and injuries for manual wheelchair users with spinal cord injuries (SCIs). Few studies have investigated wheelchair turning biomechanics on natural ground surfaces. The purpose of this study was to investigate the relationship between tangential push force and linear velocity of the wheelchair during the turning portions of propulsion. Using an instrumented handrim, velocity and push force data were recorded for 25 subjects while they propel their own wheelchairs on a concrete floor along a figure-eight-shaped course at a maximum velocity...
August 17, 2016: Biomedizinische Technik. Biomedical Engineering
Luigi La Barbera, Fabio Galbusera, Hans-Joachim Wilke, Tomaso Villa
PURPOSE: To discuss whether the standard test method for preclinical evaluation of posterior spine stabilization devices with an anterior support correctly describes the effect of two short-segment posterior stabilization techniques frequently used in clinical practice for the treatment of traumatic, degenerative and iatrogenic instabilities. METHODS: A finite element study compared a validated instrumented L2-L4 segment undergoing standing, upper body flexion and extension to ISO 12189 standards model under a compressive load...
September 16, 2016: European Spine Journal
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