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revision spine

Hannah M Carl, A Karim Ahmed, Nancy Abu-Bonsrah, Rafael De la Garza Ramos, Eric W Sankey, Zachary Pennington, Ali Bydon, Timothy F Witham, Jean-Paul Wolinsky, Ziya L Gokaslan, Justin M Sacks, C Rory Goodwin, Daniel M Sciubba
OBJECTIVE Resection of metastatic spine tumors can improve patients' quality of life by addressing pain or neurological compromise. However, resections are often complicated by wound dehiscence, infection, instrumentation failures, and the need for reoperation. Moreover, when reoperations are needed, the most common indication is surgical site infection and wound breakdown. In turn, wound reoperations increase morbidity as well as the length and cost of hospitalization. The aim of this study was to examine perioperative risk factors associated with increased rate of wound reoperations after metastatic spine tumor resection...
March 16, 2018: Journal of Neurosurgery. Spine
Weiwei Lin, Hongtao Xu, Guman Duan, Jinjin Xie, Yisheng Chen, Baohua Jiao, Haitao Lan
Purpose Tethered cord syndrome (TCS) is the clinical manifestation of an abnormal stretch on the spinal cord, caused by several pathological conditions. Tethered cord release is the gold standard treatment for TCS. However, direct untethering carries potential risks of spinal cord injury, post-operative retethering, and CSF-related complications. Spine-shortening osteotomy (SSO) has recently been performed as an alternative technique to avoid these risks. We aimed to systematically review the literature on indications and outcome of SSO in TCS patients...
March 12, 2018: Neurological Research
Danika Paulo, Alexa Semonche, Rachana Tyagi
BACKGROUND: Giant invasive spinal schwannomas (GISS) comprise a rare, specific subtype of schwannomas that extend over two spinal levels, erode vertebral bodies and invade extraspinal tissues. Optimal surgical management of resulting spinal instability has yet to be determined, and overall there is limited published literature on GISS. We report an innovative method used to treat a rare case of lumbosacral GISS using a triangular frame reconstruction to reconnect the spinal column to the pelvis after tumor debulking...
March 3, 2018: World Neurosurgery
Gilles Norotte, Carlos Barrios
OBJECTIVE: Recent improvements in cage designs with integral fixation and screw attachments have made stand-alone ALIF a viable option with several possible advantages. The aim of this study was to confirm the efficacy and safety of a PEEK cage filled with hydroxyapatite nanoparticles without adding a bone graft for stand-alone ALIF in the treatment of L5-S1 isolated degenerative disc discopathy (DDD). PATIENTS AND METHODS: Sixty-five patients who required surgery for DDD were evaluated...
January 31, 2018: Clinical Neurology and Neurosurgery
Jing Wang, Adam E M Eltorai, J Mason DePasse, Wesley Durand, Daniel Reid, Alan H Daniels
BACKGROUND: Cervical spine injuries are a common cause of morbidity and mortality, but optimal treatment is debated. Prior studies showed substantial variation in treatment. We examined treatment variation in arthrodesis and halo/tong placement in cervical spine injury patients. METHODS: We used the Healthcare Cost and Utilization Project National Inpatient Sample, 2000-2011. Patients were identified based on International Classification of Diseases, 9th Revision diagnosis codes...
February 28, 2018: World Neurosurgery
Siobhan A O'Leary, Nikolaos K Paschos, Jarrett M Link, Eric O Klineberg, Jerry C Hu, Kyriacos A Athanasiou
The zygapophyseal joint, a diarthrodial joint commonly referred to as the facet joint, plays a pivotal role in back pain, a condition that has been a leading cause of global disability since 1990. Along with the intervertebral disc, the facet joint supports spinal motion and aids in spinal stability. Highly susceptible to early development of osteoarthritis, the facet is responsible for a significant amount of pain in the low-back, mid-back, and neck regions. Current noninvasive treatments cannot offer long-term pain relief, while invasive treatments can relieve pain but fail to preserve joint functionality...
March 1, 2018: Annual Review of Biomedical Engineering
X Kang, L Dong, T Yang, Z Wang, G Huang, X Chen
The aim of this study was to evaluate the clinical and radiographic outcomes of upper thoracic (UT) versus lower thoracic (LT) upper instrumented vertebrae (UIV) for adult scoliosis by meta-analysis. We conducted a literature search in three databases to retrieve related studies up to March 15, 2017. The preliminary screened studies were assessed by two reviewers according to the selection criteria. All analyses were carried out using the statistical software package R version 2.31. Odds ratios (OR) with 95% confidence intervals (CI) were used to describe the results...
2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Christopher J Kleck, Evalina L Burger
CASE: We report the development of bilateral symptomatic facet joint cysts in a 78-year-old man who had been treated with decompression and placement of a coflex device (Paradigm Spine) at L3-L4 and L4-L5. Preoperative imaging clearly demonstrated fluid in the facet joints without cysts. He underwent standard surgical treatment, but developed symptomatic facet joint cysts at 4 months postoperatively. The patient was treated with a revision decompression and replacement of the devices; there were no issues at the 32-month follow-up...
February 28, 2018: JBJS Case Connector
Julia Page, Robin Traver, Sital Patel, Christopher Saliba
BACKGROUND: In 2016, the Oregon Health Authority and the Health Evidence Review Commission implemented guidance for Oregon Medicaid members who were taking opioids for chronic pain related to conditions of the back and spine. This guidance required that an individualized taper plan be developed and initiated by January 1, 2017, and a discontinuation date for all chronic opioid therapy of January 1, 2018. PROGRAM DESCRIPTION: This program evaluated the effect of a proactive and voluntary health plan-driven opioid tapering program on morphine equivalent daily dose (MEDD) before the implementation of governmental guidance...
March 2018: Journal of Managed Care & Specialty Pharmacy
Jason A Horowitz, Varun Puvanesarajah, Amit Jain, Xudong J Li, Adam L Shimer, Francis H Shen, Hamid Hassanzadeh
STUDY DESIGN: Retrospective review OBJECTIVE.: To identify the incidence and analyze the risk of postoperative complications amongst elderly patients with rheumatoid arthritis undergoing anterior cervical fusion. SUMMARY OF BACKGROUND DATA: Previous studies have reported elevated risks of postoperative complications for rheumatoid arthritis patients undergoing orthopaedic procedures. However, little is known about the risk of postoperative complications in rheumatoid arthritis patients following spine surgery...
February 23, 2018: Spine
Mohamed Macki, Mohamed Fakih, Pridvi Kandagatla, Ilan Rubinfeld, Victor Chang
OBJECTIVE: Because of the healthcare initiative on quality improvement projects in academic healthcare, this study explores the impact of different postgraduate years (PGYs) on unexpected re-operation rates. METHODS: Using National Surgical Quality Improvement Program 2005-2014, adult neurosurgical cases were divided into subspecialties: spine, open-vascular, cranial, and functional. Comparison groups: cases involving junior residents [PGY 1-PGY 3], mid-level residents [PGY 4+PGY 5], and senior residents [PGY 6+PGY 7]...
February 21, 2018: World Neurosurgery
Caroline E Vonck, Joseph E Tanenbaum, Thomas T Bomberger, Edward C Benzel, Jason W Savage, Iain H Kalfas, Thomas E Mroz, Michael P Steinmetz
BACKGROUND: Context: Degenerative changes in the cervical spine occur in an age-dependent manner. As the U.S. population continues to age, the incidence of age-dependent, multi-level, degenerative cervical pathologies is expected to increase. Similarly, the average age of patients with cervical spondylotic myelopathy (CSM) will likely trend upward. Posterior cervical fusion (PCF) is often the treatment modality of choice in the management of multi-level cervical spine disease. Although outcomes following anterior cervical fusion for degenerative disease have been studied among older patients (aged 80 years and older), it is unknown if these results extend to octogenarian patients undergoing PCF for the surgical management of CSM...
February 14, 2018: Spine Journal: Official Journal of the North American Spine Society
Jeffrey Loh-Doyle, Mukul B Patil, Hari Sawkar, Kevin Wayne, Stuart D Boyd
BACKGROUND: After radical cystoprostatectomy (RC), postoperative erectile dysfunction (ED) is a common consequence with multiple contributing etiologies. The inflatable penile prosthesis (IPP) offers patients a definitive treatment option when ED is refractory to medical therapies. Because of the hostile postoperative anatomy of these patients, a careful surgical approach is necessary for successful outcomes and to avoid adjacent organ injury. To date, there is no series describing the outcomes of 3-piece IPP placement in patients with urinary diversions...
February 13, 2018: Journal of Sexual Medicine
Jin-Sung Park, Kyu-Dong Shim, Young-Sik Song, Ye-Soo Park
BACKGROUND CONTEXT: The influence of rheumatoid arthritis (RA) on the lumbar spine has received relatively little attention compared with cervical spine, and few studies have been conducted for adjacent segment disease (ASD) after lumbar fusion in the patients with RA. PURPOSE: To determine the incidence of ASD requiring surgery (ASDrS) after short lumbar fusion and to evaluate risk factors of ASDrS, including RA. STUDY DESIGN: Retrospective cohort study PATIENT SAMPLE: This study included 479 patients who underwent lumbar spinal fusion of 3 or fewer levels, with the mean follow-up period of 51...
February 13, 2018: Spine Journal: Official Journal of the North American Spine Society
M Farshad, D E Bauer, C Wechsler, C Gerber, A Aichmair
BACKGROUND CONTEXT: There is a broad spectrum of complications during or after surgical procedures, with differing incidences reported in the published literature. Heterogeneity can be explained by the lack of an established evidence-based classification system for documentation and classification of complications in a standardized manner. PURPOSE: To identify predictive risk factors for peri- and early post-operative morbidities in spine surgeries of different complexities in a large cohort of consecutive patients...
February 13, 2018: Spine Journal: Official Journal of the North American Spine Society
Jun Zhang, Rongming Xu, Zheng Li, Weibin Zha
RATIONALE: Malposition of cervical pedicle screw (CPS) has a risk of vertebral artery (VA) injury which sometimes may cause unexpected and catastrophic outcome. A rare case of delayed onset of cerebral infarction caused by malposition of CPS was reported. PATIENT CONCERNS: A 23-year-old man who underwent a posterior cervical reduction and fusion of C4-5 using CPS fixation and allograft for cervical spine injury is presented. The patient suffered progressively weakness and numbness for both of upper and lower extremities 1 day after the operation...
February 2018: Medicine (Baltimore)
Yair Hillman, Josh Kim, Indrin Chetty, Ning Wen
PURPOSE: Mobius 3D (M3D) provides a volumetric dose verification of the treatment planning system's calculated dose using an independent beam model and a collapsed cone convolution superposition algorithm. However, there is a lack of investigation into M3D's accuracy and effectiveness for stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) quality assurance (QA). Here, we collaborated with the vendor to develop a revised M3D beam model for SRS/SBRT cases treated with a 6X Flattening Filter Free (FFF) beam and high definition multiple leaf collimator (HDMLC) on an Edge linear accelerator...
February 12, 2018: Medical Physics
Frederick Galla, Dirk Wähnert, Ulf Liljenqvist
INTRODUCTION: A balanced ratio of the main parameters of lumbar lordosis (LL) and pelvic incidence (PI) has high clinical relevance. A postoperative mismatch of LL and PI has been described in the literature to be associated with an inferior clinical outcome and higher postoperative revision rates. The aim of this retrospective, radiological study is to evaluate the magnitude of relordosing in mono-/bisegmental TLIF spondylodesis affecting the spino-pelvic alignment and the main contributing factors...
February 7, 2018: European Spine Journal
Anne L Versteeg, Arjun Sahgal, Laurence D Rhines, Daniel M Sciubba, James M Schuster, Michael H Weber, Peter Pal Varga, Stefano Boriani, Chetan Bettegowda, Michael G Fehlings, Michelle J Clarke, Paul M Arnold, Ziya L Gokaslan, Charles G Fisher
BACKGROUND: The Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ) was developed as the first spine oncology-specific health-related quality of life (HRQOL) measure. This study evaluated the psychometric properties and clinical validity of the SOSGOQ in a diverse cohort of patients with spinal metastases. METHODS: An international, multicenter, prospective observational cohort study including patients with spinal metastases who underwent surgery and/or radiotherapy was conducted by the AOSpine Knowledge Forum Tumor...
February 6, 2018: Cancer
Deeptee Jain, Sigurd Berven, John Carter, Alan L Zhang, Vedat Deviren
BACKGROUND CONTEXT: Severely obese patients with operative spinal pathology present a challenge to the spine surgeon, given the increased complication risk. PURPOSE: Determine the impact of bariatric surgery on perioperative complications of posterior lumbar fusion. STUDY DESIGN: Retrospective cohort study. PATIENT SAMPLE: Patients undergoing posterior lumbar fusion surgery in the State Inpatient Databases (SID) of New York, Florida, North Carolina, Nebraska, Utah, and California...
February 2, 2018: Spine Journal: Official Journal of the North American Spine Society
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