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https://www.readbyqxmd.com/read/28192259/impact-of-intraoperative-monitoring-during-elective-complex-spinal-fusions-%C3%A2-4-levels-on-30-day-complication-and-readmission-rates-a-single-institutional-study-of-643-adult-spinal-deformity-patients
#1
Aladine A Elsamadicy, Owoicho Adogwa, Emily Lydon, Gireesh Reddy, Rayan Kaakati, Amanda Sergesketter, Oren N Gottfried, Isaac O Karikari
OBJECTIVE: The aim of this study is to determine if there are differences in 30-day postoperative complication and readmission rates between spinal deformity patients undergoing complex spinal fusion with and without intraoperative monitoring. METHODS: The medical records of 643 adult spine deformity patients undergoing elective complex spinal fusion (≥4 levels) at a major academic institution from 2005 to 2015 were reviewed. We identified 122 (19%) cases that involved intraoperative monitoring (IOM) including EMG, SSEP, and/or TcMEP and 521 (81%) that did not (IOM: n=122; No-IOM: n=521)...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28190553/cervical-spine-imaging-for-young-children-with-inflicted-trauma-expanding-the-injury-pattern
#2
Joanne Baerg, Arul Thirumoorthi, Rosemary Vannix, Asma Taha, Amy Young, Alexander Zouros
AIM: The purpose of this study was to document the incidence and pattern of cervical spine (c-spine) injuries in children below 36months with inflicted trauma. METHODS: An IRB approved, prospective cohort study was performed between July 2011 and January 2016. Inclusion criteria were: age below 36months, loss of consciousness after inflicted trauma, and one initial head computed tomography finding: a subdural, intraventricular, intraparenchymal, subarachnoid hemorrhage, diffuse axonal injury, hypoxic injury, or cerebral edema...
January 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28187806/diagnosis-and-management-of-spinal-cord-emergencies
#3
E P Flanagan, S J Pittock
Most spinal cord injury is seen with trauma. Nontraumatic spinal cord emergencies are discussed in this chapter. These myelopathies are rare but potentially devastating neurologic disorders. In some situations prior comorbidity (e.g., advanced cancer) provides a clue, but in others (e.g., autoimmune myelopathies) it may come with little warning. Neurologic examination helps distinguish spinal cord emergencies from peripheral nervous system emergencies (e.g., Guillain-Barré), although some features overlap...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187803/management-of-acute-traumatic-spinal-cord-injuries
#4
C D Shank, B C Walters, M N Hadley
Acute traumatic spinal cord injury (SCI) is a devastating disease process affecting tens of thousands of people across the USA each year. Despite the increase in primary prevention measures, such as educational programs, motor vehicle speed limits, automobile running lights, and safety technology that includes automobile passive restraint systems and airbags, SCIs continue to carry substantial permanent morbidity and mortality. Medical measures implemented following the initial injury are designed to limit secondary insult to the spinal cord and to stabilize the spinal column in an attempt to decrease devastating sequelae...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186470/image-guidance-based-on-mri-for-spinal-interstitial-laser-thermotherapy-technical-aspects-and-accuracy
#5
Claudio E Tatsui, Clarissa N G Nascimento, Dima Suki, Behrang Amini, Jing Li, Amol J Ghia, Jonathan G Thomas, R Jason Stafford, Laurence D Rhines, Juan P Cata, Ashok J Kumar, Ganesh Rao
OBJECTIVE Image guidance for spinal procedures is based on 3D-fluoroscopy or CT, which provide poor visualization of soft tissues, including the spinal cord. To overcome this limitation, the authors developed a method to register intraoperative MRI (iMRI) of the spine into a neuronavigation system, allowing excellent visualization of the spinal cord. This novel technique improved the accuracy in the deployment of laser interstitial thermal therapy probes for the treatment of metastatic spinal cord compression...
February 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28168635/imaging-of-post-surgical-treatment-and-of-related-complications-in-spinal-trauma
#6
REVIEW
F Caranci, G Leone, L Ugga, E Cesarano, R Capasso, S Schipani, A Bianco, P Fonio, F Briganti, L Brunese
Spinal trauma is a devastating event with a high morbidity and mortality. The rationale of imaging is to diagnose the traumatic abnormalities and characterize the type of injury, to estimate the severity of the lesions, to evaluate the potential spinal instability. In case of spinal instability, the goals of operative treatment are decompression of the spinal cord canal and stabilization of the disrupted vertebral column. Particularly, diagnostic imaging, mainly by CT and MR, has a main role in the post-treatment evaluation...
February 6, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28152039/individualized-3d-printing-navigation-template-for-pedicle-screw-fixation-in-upper-cervical-spine
#7
Fei Guo, Jianhao Dai, Junxiang Zhang, Yichuan Ma, Guanghui Zhu, Junjie Shen, Guoqi Niu
PURPOSE: Pedicle screw fixation in the upper cervical spine is a difficult and high-risk procedure. The screw is difficult to place rapidly and accurately, and can lead to serious injury of spinal cord or vertebral artery. The aim of this study was to design an individualized 3D printing navigation template for pedicle screw fixation in the upper cervical spine. METHODS: Using CT thin slices data, we employed computer software to design the navigation template for pedicle screw fixation in the upper cervical spine (atlas and axis)...
2017: PloS One
https://www.readbyqxmd.com/read/28150118/clinical-outcomes-following-spinal-fracture-in-patients-with-ankylosing-spondylitis
#8
M Nugent, M J Berney, S Morris
BACKGROUND: Ankylosing spondylitis is a seronegative rheumatoid condition mainly affecting the axial skeleton. It leads to progressive deformity and stiffening of the spine with an increased risk of vertebral fractures and significant neurological deficits compared to the general population. AIM: This study aimed to evaluate the outcomes of patients with ankylosing spondylitis who sustained acute vertebral fractures over a 10-year period. METHODS: A retrospective review of patient records and radiographic images was performed...
February 1, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28134070/earthquake-related-orthopedic-injuries-in-adult-population-a-systematic-review
#9
Michelangelo Bortolin, Ilaria Morelli, Amalia Voskanyan, Nina R Joyce, Gregory R Ciottone
: Introduction Earthquake-related trauma results in crush injuries and bony- and soft-tissue trauma. There are no systematic reviews analyzing the typical injury patterns and treatments in "Mega-Mass-Casualty" earthquakes. The characterization of an injury pattern specific to disaster type, be it natural or manmade, is imperative to build an effective disaster preparedness and response system. METHODS: The systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)...
January 30, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28125935/atraumatic-spine-distraction-induces-metabolic-distress-in-spinal-motor-neurons
#10
Jennifer Elizabeth Bell, Jennifer L Seifert, Eileen Nicole Shimizu, Daniel J Sucato, Mario Romero-Ortega
Correction forces during spine deformity surgery including distraction, impart significant stresses to the spinal cord, which may result in permanent injury. Intraoperative neuromonitoring (IONM) is commonly used by surgeons to recognize possible damage to the spinal cord in cases of evident traumatic or vascular damage to the spinal cord. However, mild insult to the spinal cord, which does not result in obvious trauma or electrophysiological changes, present a major clinical challenge as the mechanisms of this type of spinal cord injury (SCI) remain largely unknown, and thus preventive strategies are lacking...
January 26, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28125522/post-traumatic-spinal-hygroma-causing-cord-compression-in-type-iii-odontoid-fracture-with-vertical-atlanto-axial-instability
#11
Salvatore Russo, Antonio Belli, Andy Eynon, Ali Nader-Sepahi
STUDY DESIGN: Case-Report OBJECTIVE.: To report the first case in the literature of a traumatic cervical spine subdural cerebrospinal fluid (CSF) collection (hygroma) under tension causing cord compression. We suggest etio-pathogenesis and modality of treatment. SUMMARY OF BACKGROUND DATA: Hygromas are subdural cranial CSF collection. A literature review showed no previous published case of post-traumatic spinal hygroma. This was a potential life threatening sequelae of a high cervical injury that warranted early diagnosis and emergency treatment...
January 25, 2017: Spine
https://www.readbyqxmd.com/read/28123022/tnf-%C3%AE-differentially-regulates-synaptic-plasticity-in-the-hippocampus-and-spinal-cord-by-microglia-dependent-mechanisms-after-peripheral-nerve-injury
#12
Yong Liu, Li-Jun Zhou, Jun Wang, Dai Li, Wen-Jie Ren, Jiyun Peng, Xiao Wei, Ting Xu, Wen-Jun Xin, Rui-Ping Pang, Yong-Yong Li, Zhi-Hai Qin, Madhuvika Murugan, Mark P Mattson, Long-Jun Wu, Xian-Guo Liu
: Clinical studies show that chronic pain is accompanied by memory deficits and reduction in hippocampal volume. Experimental studies show that spared nerve injury (SNI) of the sciatic nerve induces long-term potentiation (LTP) at C-fiber synapses in spinal dorsal horn, but impairs LTP in the hippocampus. The opposite changes may contribute to neuropathic pain and memory deficits, respectively. However, the cellular and molecular mechanisms underlying the functional synaptic changes are unclear...
January 25, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28121977/bilateral-upper-extremity-hyperesthesia-and-absence-of-neck-tenderness-in-four-adolescent-athletes-with-cervical-spine-injuries
#13
Jay Douglas Fisher, Elizabeth Lewis Thorpe
Cervical spine injury in the pediatric athlete is an uncommon but potentially devastating condition that can require a heightened index of suspicion to correctly diagnose. Although some cervical spine injuries present overtly with paraplegia due to cord transection, others can present more subtly with symptoms suggestive of bilateral peripheral neuropathy. Patients with traumatic brachial neuropraxia or "stinger" physiology can present similarly, but symptoms are exclusively unilateral. We present 4 patients with bilateral upper extremity hyperesthesias and absence of tenderness over the cervical vertebral landmarks who were subsequently diagnosed with cervical spine injuries...
January 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28120082/intraoperative-neurophysiological-monitoring-in-spine-surgery-a-significant-tool-for-neuronal-protection-and-functional-restoration
#14
Antonino Scibilia, Giovanni Raffa, Vincenzo Rizzo, Angelo Quartarone, Massimiliano Visocchi, Antonino Germanò, Francesco Tomasello
Although there is recent evidence for the role of intraoperative neurophysiological monitoring (IONM) in spine surgery, there are no uniform opinions on the optimal combination of the different tools. At our institution, multimodal IONM (mIONM) approach in spine surgery involves the evaluation of somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) with electrical transcranial stimulation, including the use of a multipulse technique with multiple myomeric registration of responses from limbs, and a single-pulse technique with D-wave registration through epi- and intradural recording, and free running and evoked electromyography (frEMG and eEMG) with bilateral recording from segmental target muscles...
2017: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/28111622/cruciate-paralysis-in-a-20-year-old-male-with-an-undisplaced-type-iii-odontoid-fracture
#15
Mansukhani Sameer A, Tuteja Sanesh V, Dhar Sanjay B
INTRODUCTION: Cruciate Paralysis is a rare incomplete spinal cord syndrome presenting as brachial diplegia with minimal or no involvement of the lower extremities. It occurs as a result of trauma to the cervical spine and is associated with fractures of the axis and/or atlas. Diagnosis is confirmed on MRI and is managed by treatment of the underlying pathology. Prognosis depends on the extent of spinal cord injury and the exact cause. CASE PRESENTATION: A 20-year-old male presented to the casualty with a history of an injury to the back of the head as a result of a fall...
April 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28107239/management-of-pharyngeal-fistulas-after-anterior-cervical-spine-surgery-a-treatment-algorithm-for-severe-complications
#16
Christian Simon, Carl H Fürstenberg, Markus Eichler, Stefan Rohde, Cem Bulut, Bernd Wiedenhöfer
STUDY DESIGN: This study is a retrospective database query to identify all anterior spinal approaches. OBJECTIVES: The objectives were to assess all patients with pharyngocutaneous fistulas (PCFs) after anterior cervical spine surgery. SUMMARY OF BACKGROUND DATA: Patients with the diagnosis of PCFs were treated at the University of Heidelberg Spine Medical Center, Spinal Cord Injury Unit and Department of Otolaryngology (Germany), between 2005 and 2011...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28099187/a-comparative-study-of-anterior-decompression-with-fusion-and-posterior-decompression-with-laminoplasty-for-the-treatment-of-cervical-spondylotic-myelopathy-patients-with-large-anterior-compression-of-the-spinal-cord
#17
Takashi Hirai, Toshitaka Yoshii, Yoshiyasu Arai, Kenichiro Sakai, Ichiro Torigoe, Hidetsugu Maehara, Masaki Tomori, Takashi Taniyama, Hirokazu Sato, Atsushi Okawa
STUDY DESIGN: This is a retrospective observational single-center study. OBJECTIVES: To compare anterior decompression and fusion (ADF) and laminoplasty (LAMP) for the treatment of cervical spondylotic myelopathy (CSM) patients with large anterior compression in terms of clinical and radiologic outcomes. SUMMARY OF BACKGROUND DATA: We have reported that insufficient posterior decompression could be often seen after laminoplasty for CSM patients with preoperative anterior clearance of the spinal cord, defined as an interval <4 mm between the preoperative the modified K-line and anterior structure of the spinal canal at most compressive segment on sagittal T1-weighted magnetic resonance imaging...
January 17, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28089422/low-magnitude-mechanical-signals-and-the-spine-a-review-of-current-and-future-applications
#18
REVIEW
Martin H Pham, Zorica Buser, Jeffrey C Wang, Frank L Acosta
Animal and human studies demonstrate the anabolic properties of low-magnitude mechanical stimulation (LMMS) in its ability to improve bone formation by enhancing the proliferation of mesenchymal stem cells and their subsequent commitment down an osteoblastic lineage. Response to mechanical strains as low as 10μɛ have been seen, illustrating the sensitivity of mechanosensory cells to mechanotransduction pathways. Applications to the spine include treatment of osteoporosis in preparation for instrumented fusion, fracture reduction in spinal cord injury patients to slow bone mineral density loss, and bone tissue engineering and enhancement of bone-implant osseointegration for pseudarthrosis and hardware failure...
January 12, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28072809/optimal-angle-of-contralateral-oblique-view-in-cervical-interlaminar-epidural-injection-depending-on-the-needle-tip-position
#19
Jun Young Park, Myung-Hwan Karm, Doo Hwan Kim, Jae-Young Lee, Hye-Joo Yun, Jeong Hun Suh
BACKGROUND: Chronic neck and upper extremity pain associated with cervical origin is common, and cervical interlaminar epidural steroid injections (CILESIs) are frequently used to manage the symptoms of cervical spinal disorders. However, CILESIs are associated with risks such as dural puncture and cord injury. OBJECTIVES: We aimed to determine the optimal needle tip visualization, in order to minimize CILESIs-induced complications. STUDY DESIGN: Retrospective observational study...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28072744/posterior-arthrodesis-of-c1-c3-for-the-stabilization-of-multiple-unstable-upper-cervical-fractures-with-spinal-cord-compromise-a-case-report-and-literature-review
#20
Deting Xue, Qixin Chen, Gang Chen, Wenhai Zhuo, Fangcai Li
BACKGROUND: Multiple fractures of the atlas and axis are rare. The management of multiple fragment axis fractures and unstable atlas fractures is still challenging for the spinal surgeon. There are no published reports of similar fractures with 3-part fracture of axis associated with an unstable atlas fracture. CASE SUMMARY: We present a patient with concurrent axis and atlas fractures, which have not been reported. The patient suffered hyperextension injury with neck pain and numbness of the bilateral upper extremity associated with weakness after a 2-m fall...
January 2017: Medicine (Baltimore)
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