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https://www.readbyqxmd.com/read/28525473/is-total-disk-replacement-a-cost-effective-treatment-for-cervical-degenerative-disk-disease
#1
Bernd Wiedenhöfer, Joachim Nacke, Mike Stephan, Wiltrud Richter, Claus Carstens, Markus Eichler
STUDY DESIGN: A retrospective study. OBJECTIVE: The objective of this study was to assess the cost-effectiveness and clinical outcome of motion-preserving versus fusion procedures in cervical spine surgery. SUMMARY OF BACKGROUND DATA: During the last decade there has been a huge growth in spine surgery with a concurrent increase in the economic burden. Currently, there appear to be no differences in clinical outcome between cervical total disk replacement (TDR) and spinal fusion (SF)...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28520681/delayed-dural-leak-following-posterior-spinal-fusion-for-idiopathic-scoliosis-using-all-posterior-pedicle-screw-technique
#2
Lorena V Floccari, A Noelle Larson, Anthony A Stans, Jeremy Fogelson, Iikka Helenius
BACKGROUND: In pediatric patients, pedicle screws are malpositioned 5% to 15% of the time. Complications associated with malpositioned screws are infrequently reported in the literature. We present a series of adolescent idiopathic scoliosis (AIS) patients who presented in a delayed manner with positional headache and chronic dural leak adjacent to the pedicle screw tract. METHODS: Scoliosis databases at 2 centers were reviewed, and cases of delayed positional headaches following posterior spinal fusion for AIS were identified...
May 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28520623/the-sub-crestal-iliac-screw-a-technical-note-describing-a-free-hand-in-line-low-profile-iliac-screw-insertion-technique-to-avoid-side-connector-use-and-reduce-implant-complications
#3
Gabriel Liu, Muhammed Yaser Hasan, Hee-Kit Wong
STUDY-DESIGN: Case-series. OBJECTIVE: Report our modified iliac-screw insertion technique and its clinical outcomes. SUMMARY OF BACKGROUND DATA: Iliac-screws are one of the preferred methods for modern spinopelvic-fixation. However the technique is not without complications, predominantly due to iliac-screw head prominence, leading to pain and revisions. Conventional iliac-screw entry point is sited superficially at the posterior-superior-iliac-spine (PSIS) contributing to screw-head prominence...
May 17, 2017: Spine
https://www.readbyqxmd.com/read/28501121/validation-of-a-field-spinal-motion-restriction-protocol-in-a-level-i-trauma-center
#4
James M Tatum, Nicolas Melo, Ara Ko, Navpreet K Dhillon, Eric J T Smith, Dorothy A Yim, Galinos Barmparas, Eric J Ley
BACKGROUND: Spinal motion restriction (SMR) after traumatic injury has been a mainstay of prehospital trauma care for more than 3 decades. Recent guidelines recommend a selective approach with cervical spine clearance in the field when criteria are met. MATERIALS AND METHODS: In January 2014, the Department of Health Services of the City of Los Angeles, California, implemented revised guidelines for cervical SMR after blunt mechanism trauma. Adult patients (aged ≥18 y) with an initial Glasgow Coma Scale (GCS) score of ≥13 presented to a single level I trauma center after blunt mechanism trauma over the following 1-y period were retrospectively reviewed...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28488095/extreme-lateral-interbody-fusion-in-spinal-revision-surgery-clinical-results-and-complications
#5
Matteo Formica, Andrea Zanirato, Luca Cavagnaro, Marco Basso, Stefano Divano, Lamberto Felli, Carlo Formica
PURPOSE OF THE STUDY: To evaluate clinical outcomes and complications of extreme lumbar interbody fusion (XLIF) in spinal revision surgery comparing our data with the available literature evidence about other fusion techniques. MATERIALS AND METHODS: Retrospective analysis of patients underwent revision surgery with XLIF as interbody fusion technique. Demographic, comorbidity, surgical data, clinical results, and intraoperative and postoperative complications were recorded...
May 9, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28479791/minimally-invasive-versus-open-spine-surgery-what-does-the-best-evidence-tell-us
#6
Shearwood McClelland, Jeffrey A Goldstein
BACKGROUND: Spine surgery has been transformed significantly by the growth of minimally invasive surgery (MIS) procedures. Easily marketable to patients as less invasive with smaller incisions, MIS is often perceived as superior to traditional open spine surgery. The highest quality evidence comparing MIS with open spine surgery was examined. METHODS: A systematic review of randomized controlled trials (RCTs) involving MIS versus open spine surgery was performed using the Entrez gateway of the PubMed database for articles published in English up to December 28, 2015...
April 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28473095/acr-appropriateness-criteria-%C3%A2-chronic-back%C3%A2-pain%C3%A2-suspected-sacroiliitis-spondyloarthropathy
#7
Stephanie A Bernard, Mark J Kransdorf, Francesca D Beaman, Ronald S Adler, Behrang Amini, Marc Appel, Erin Arnold, R Carter Cassidy, Bennett S Greenspan, Kenneth S Lee, Michael J Tuite, Eric A Walker, Robert J Ward, Daniel E Wessell, Barbara N Weissman
Inflammatory sacroiliitis or the seronegative axial spondyloarthropathies often presents as back pain or sacroiliac joint pain of more than 3-month duration with inflammatory symptoms and typically in patients younger than 45 years of age. Imaging plays an important role in diagnosis and disease monitoring. This article addresses the appropriate sequence of initial imaging for evaluation of a suspected spondyloarthropathy, the imaging follow-up of treatment response and the special considerations for imaging of trauma in patients with ankylosis of the spine...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473089/acr-appropriateness-criteria-%C3%A2-suspected-osteomyelitis-septic-arthritis-or-soft-tissue-infection-excluding-spine-and-diabetic-foot
#8
Francesca D Beaman, Paul F von Herrmann, Mark J Kransdorf, Ronald S Adler, Behrang Amini, Marc Appel, Erin Arnold, Stephanie A Bernard, Bennett S Greenspan, Kenneth S Lee, Michael J Tuite, Eric A Walker, Robert J Ward, Daniel E Wessell, Barbara N Weissman
Infection of the musculoskeletal system is a common clinical problem. Differentiating soft tissue from osseous infection often determines the appropriate clinical therapeutic course. Radiographs are the recommend initial imaging examination, and although often not diagnostic in acute osteomyelitis, can provide anatomic evaluation and alternative diagnoses influencing subsequent imaging selection and interpretation. MRI with contrast is the examination of choice for the evaluation of suspected osteomyelitis, and MRI, CT, and ultrasound can all be useful in the diagnosis of soft tissue infection...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473078/acr-appropriateness-criteria-%C3%A2-plexopathy
#9
Julie Bykowski, Joseph M Aulino, Kevin L Berger, R Carter Cassidy, Asim F Choudhri, A Tuba Kendi, Claudia F E Kirsch, Michael D Luttrull, Aseem Sharma, Vilaas S Shetty, Khoi Than, Christopher J Winfree, Rebecca S Cornelius
MRI without and with contrast is the most accurate imaging method to determine whether a process is intrinsic or extrinsic to a nerve of the brachial or lumbosacral plexus. However, there are no Current Procedural Terminology codes to correspond to imaging studies of the brachial or lumbar plexus discretely. This assessment uses "MRI of the brachial plexus" or "MRI of the lumbosacral plexus" as independent entities given that imaging acquisition for the respective plexus differs in sequences and planes compared with those of a routine neck, chest, spine, or pelvic MRI, yet acknowledges the potential variability of ordering practices across institutions...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473075/acr-appropriateness-criteria-%C3%A2-osteoporosis%C3%A2-and%C3%A2-bone-mineral-density
#10
Robert J Ward, Catherine C Roberts, Jenny T Bencardino, Erin Arnold, Steven J Baccei, R Carter Cassidy, Eric Y Chang, Michael G Fox, Bennett S Greenspan, Soterios Gyftopoulos, Mary G Hochman, Douglas N Mintz, Joel S Newman, Charles Reitman, Zehava S Rosenberg, Nehal A Shah, Kirstin M Small, Barbara N Weissman
Osteoporosis is a considerable public health risk, with 50% of women and 20% of men >50 years of age experiencing fracture, with mortality rates of 20% within the first year. Dual x-ray absorptiometry (DXA) is the primary diagnostic modality by which to screen women >65 years of age and men >70 years of age for osteoporosis. In postmenopausal women <65 years of age with additional risk factors for fracture, DXA is recommended. Some patients with bone mineral density above the threshold for treatment may qualify for treatment on the basis of vertebral body fractures detected through a vertebral fracture assessment scan, a lateral spine equivalent generated from a commercial DXA machine...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473069/acr-appropriateness-criteria-%C3%A2-back-pain-child
#11
Timothy N Booth, Ramesh S Iyer, Richard A Falcone, Laura L Hayes, Jeremy Y Jones, Nadja Kadom, Abhaya V Kulkarni, John S Myseros, Sonia Partap, Charles Reitman, Richard L Robertson, Maura E Ryan, Gaurav Saigal, Bruno P Soares, Aylin Tekes-Brady, Andrew T Trout, Nicholas A Zumberge, Brian D Coley, Susan Palasis
It is now generally accepted that nontraumatic back pain in the pediatric population is common. The presence of isolated back pain in a child has previously been an indication for imaging; however, recently a more conservative approach has been suggested using clinical criteria. The presence of constant pain, night pain, and radicular pain, alone or in combination, lasting for 4 weeks or more, constitute clinical red flags that should prompt further imaging. Without these clinical red flags, imaging is likely not indicated...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28463620/robotic-versus-fluoroscopy-guided-pedicle-screw-insertion-for-metastatic-spinal-disease-a-matched-cohort-comparison
#12
Volodymyr Solomiichuk, Julius Fleischhammer, Granit Molliqaj, Jwad Warda, Awad Alaid, Kajetan von Eckardstein, Karl Schaller, Enrico Tessitore, Veit Rohde, Bawarjan Schatlo
OBJECTIVE Robot-guided pedicle screw placement is an established technique for the placement of pedicle screws. However, most studies have focused on degenerative disease. In this paper, the authors focus on metastatic spinal disease, which is associated with osteolysis. The associated lack of dense bone may potentially affect the automatic recognition accuracy of radiography-based surgical assistance systems. The aim of the present study is to compare the accuracy of the SpineAssist robot system with conventional fluoroscopy-guided pedicle screw placement for thoracolumbar metastatic spinal disease...
May 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28461275/isolated-transverse-process-fractures-and-markers-of-associated-injuries-the-ucla-experience
#13
Timothy T Bui, Daniel T Nagasawa, Carlito Lagman, Cheng Hao Jacky Chen, Lawrance K Chung, Brittany L Voth, Joel S Beckett, Alexander M Tucker, Tianyi Niu, Bilwaj Gaonkar, Isaac Yang, Luke Macyszyn
OBJECTIVES: To report a single-institution experience with isolated transverse process fractures (ITPFs) and provide increasing support for the development of evidence-based guidelines. Additionally, the authors evaluate the presence of concerning symptoms or red flags that may indicate additional, underlying injuries in the setting of ITPFs. METHODS: The Ronald Reagan UCLA Medical Center patient database was queried (years 2005 to 2016) using International Classification of Diseases, Ninth Revision code 805: fracture of the vertebral column without mention of spinal cord injury...
April 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28458818/lumbar-vertebral-body-and-pars-fractures-following-laminectomy
#14
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/28456674/bone-morphogenetic-protein-use-in-spine-surgery-in-the-united-states-how-have-we-responded-to-the-warnings
#15
Javier Z Guzman, Robert K Merrill, Jun S Kim, Samuel C Overley, James E Dowdell, Sulaiman Somani, Andrew C Hecht, Samuel K Cho, Sheeraz A Qureshi
BACKGROUND CONTEXT: Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been widely adopted as a fusion adjunct in spine surgery since its approval in 2002. A number of concerns regarding adverse effects and potentially devastating complications of rhBMP-2 use led to an FDA advisory issued in 2008 cautioning its use, and a separate warning about its potential complications was published by The Spine Journal in 2011. PURPOSE: To compare trends of rhBMP-2 use in spine surgery after the FDA advisory in 2008 and The Spine Journal warning in 2011...
April 26, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28452631/the-role-of-revision-surgery-and-adjuvant-therapy-following-subtotal-resection-of-osteosarcoma-of-the-spine-a-systematic-review-with-meta-analysis
#16
Ganesh M Shankar, Michelle J Clarke, Tamir Ailon, Laurence D Rhines, Shreyaskumar R Patel, Arjun Sahgal, Ilya Laufer, Dean Chou, Mark H Bilsky, Daniel M Sciubba, Michael G Fehlings, Charles G Fisher, Ziya L Gokaslan, John H Shin
OBJECTIVE Primary osteosarcoma of the spine is a rare osseous neoplasm. While previously reported retrospective studies have demonstrated that overall patient survival is impacted mostly by en bloc resection and chemotherapy, the continued management of residual disease remains to be elucidated. This systematic review was designed to address the role of revision surgery and multimodal adjuvant therapy in cases in which en bloc excision is not initially achieved. METHODS A systematic literature search spanning the years 1966 to 2015 was performed on PubMed, Medline, EMBASE, and Web of Science to identify reports describing outcomes of patients who underwent biopsy alone, neurological decompression, or intralesional resection for osteosarcoma of the spine...
April 28, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28451511/autograft-versus-allograft-for-cervical-spinal-fusion-a-systematic-review
#17
REVIEW
Alexander Tuchman, Darrel S Brodke, Jim A Youssef, Hans-Jörg Meisel, Joseph R Dettori, Jong-Beom Park, S Tim Yoon, Jeffrey C Wang
STUDY DESIGN: Systematic review. OBJECTIVE: To compare the effectiveness and safety between iliac crest bone graft (ICBG), non-ICBG autologous bone, and allograft in cervical spine fusion. To avoid problems at the donor site, various allograft materials have been used as a substitute for autograft. However, there are still questions as to the comparative effectiveness and safety of cadaver allograft compared with autologous ICBG. METHODS: A systematic search of multiple major medical reference databases was conducted to identify studies evaluating spinal fusion in patients with cervical degenerative disk disease using ICBG compared with non-ICBG autograft or allograft or non-ICBG autograft compared with allograft in the cervical spine...
February 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28451491/misplaced-cervical-screws-requiring-reoperation
#18
Jeremy C Peterson, Paul M Arnold, Zachary A Smith, Wellington K Hsu, Michael G Fehlings, Robert A Hart, Alan S Hilibrand, Ahmad Nassr, Ra'Kerry K Rahman, Chadi A Tannoury, Tony Tannoury, Thomas E Mroz, Bradford L Currier, Anthony F De Giacomo, Jeremy L Fogelson, Bruce C Jobse, Eric M Massicotte, K Daniel Riew
STUDY DESIGN: A multicenter, retrospective case series. OBJECTIVE: In the past several years, screw fixation of the cervical spine has become commonplace. For the most part, this is a safe, low-risk procedure. While rare, screw backout or misplaced screws can lead to morbidity and increased costs. We report our experiences with this uncommon complication. METHODS: A multicenter, retrospective case series was undertaken at 23 institutions in the United States...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28451490/incidence-and-outcomes-of-acute-implant-extrusion-following-anterior-cervical-spine-surgery
#19
Gabriel A Smith, Jonathan Pace, Mark Corriveau, Sungho Lee, Thomas E Mroz, Ahmad Nassr, Michael G Fehlings, Robert A Hart, Alan S Hilibrand, Paul M Arnold, David B Bumpass, Ziya Gokaslan, Mohamad Bydon, Jeremy L Fogelson, Eric M Massicotte, K Daniel Riew, Michael P Steinmetz
STUDY DESIGN: Multi-institutional retrospective case series of 8887 patients who underwent anterior cervical spine surgery. OBJECTIVE: Anterior decompression from discectomy or corpectomy is not without risk. Surgical morbidity ranges from 9% to 20% and is likely underreported. Little is known of the incidence and effects of rare complications on functional outcomes following anterior spinal surgery. In this retrospective review, we examined implant extrusions (IEs) following anterior cervical fusion...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28449962/posterior-versus-three-column-osteotomy-for-late-correction-of-residual-coronal-deformity-in-patients-with-previous-fusions-for-idiopathic-scoliosis
#20
Stephen J Lewis, Sam G Keshen, So Kato, Aaron M Gazendam
STUDY DESIGN: Retrospective case series. OBJECTIVE: To compare the early results of posterior column (PCO) and three-column (3CO) osteotomies performed in patients with previously fused idiopathic scoliosis and review their abilities to achieve coronal correction of residual deformities. SUMMARY OF BACKGROUND DATA: Residual deformity of previously fused AIS can accelerate adjacent segment degeneration secondary to lowest instrumented vertebra (LIV) tilt and rotation...
May 2017: Spine Deformity
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