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Spine fusion

Nikhil Jain, Frank M Phillips, Tristan Weaver, Safdar N Khan
STUDY DESIGN: Retrospective, economic analysis. OBJECTIVE: To study patient profile associated with preoperative chronic opioid therapy (COT), and study COT as a risk factor for 90-day complications, emergency department (ED) visits, and readmission after primary one- to two-level posterior lumbar fusion (PLF) for degenerative spine disease. We also evaluated associated costs, risk factors, and adverse events related to long-term postoperative opioid use. SUMMARY OF BACKGROUND DATA: Chronic opioid use is associated with poor outcomes and dependence after spine surgery...
March 20, 2018: Spine
Yu Zhou, Zhenyu Zhou, Lifeng Liu, Xuecheng Cao
BACKGROUND: Skeletal and soft tissue damage are often associated with unilateral facet dislocations, which undoubtedly lead to instability of the spine and further increase difficulties in cervical reduction. This type of irreducible facet dislocation is usually accompanied with potential catastrophic consequences including neurological deficit and severe disability. Therefore, a consistent and evidence-based treatment plan is imperative. CASE PRESENTATION: The literature regarding the management of traumatic unilateral locked cervical facet dislocations was reviewed...
March 21, 2018: Journal of Medical Case Reports
Joshua M Peterson, Carolyn Chlebek, Ashley M Clough, Alexandra K Wells, Kathleen E Batzinger, John M Houston, Katerina Kradinova, Joseph C Glennon, Darryl J DiRisio, Eric H Ledet
STUDY DESIGN: Real time in vivo measurement of forces in the cervical spine of goats following anterior cervical discectomy and fusion (ACDF). OBJECTIVE: To measure interbody forces in the cervical spine during the time course of fusion following ACDF with plates of different stiffnesses. SUMMARY OF BACKGROUND DATA: Following ACDF, the biomechanics of the arthrodesis is largely dictated by the plate. The properties of the plate prescribe the extent of load-sharing through the disc space versus the extent of stress-shielding...
March 19, 2018: Spine
George H Thompson, Connie Poe-Kochert, Christina K Hardesty, Jochen Son-Hing, R Justin Mistovich
BACKGROUND: Vancomycin powder has been demonstrated to be safe in children, and yet there are no data on its use to reduce surgical site infections (SSIs) in surgery for early-onset scoliosis. METHODS: We performed a retrospective study of our patients treated for early-onset scoliosis in the period of 2010 to 2016. In 2010, we updated our standardized perioperative growing spine care path. The only later change was the gradual introduction of intrawound vancomycin powder...
March 21, 2018: Journal of Bone and Joint Surgery. American Volume
Martin Barth, Christel Weiss, Kirsten Schmieder
BACKGROUND: The extent of red blood cell units (RBC) needed for different neurosurgical procedures and the time point of their administration are widely unknown, which results in generously cross-matching prior to surgery. However, RBC are increasingly requested in the aging western populations, and blood donations are significantly reduced. Therefore, the knowledge of the extent and time point of administration of RBC is of major importance. METHODS: This is a retrospective single center analysis...
March 20, 2018: Acta Neurochirurgica
Taolin Fang, Glenn S Russo, Gregory D Schroeder, Christopher K Kepler
Achieving an osseous fusion across the lumbosacral spine is still challenging in spine surgery. For the long multisegmental fusion surgery, it is crucial to build a robust and substantial foundation, which sometimes necessitates the distal spinal fixation to the pelvis. The pelvic fixation technique involves advancing the screw through the alar, thereby providing more purchase across the sacroiliac joint and into the ilium. The S2 alar iliac screws can obtain immediate stability and proper biomechanical strength of constructs...
March 16, 2018: Clinical Spine Surgery
Che-Wei Hung, Ming-Fang Wu, Gwo-Fane Yu, Chin-Chu Ko, Cheng-Hsing Kao
PURPOSE: To analyze sagittal balance of the cervical spine after three operative methods for three consecutive levels. METHODS: A retrospective case selection and observational study was performed from December 2012 to December 2015: 20 patients underwent anterior cervical discectomy and fusion, 22 patients underwent hybrid surgery (HS), and 20 patients underwent total disc replacement (TDR). Perioperative parameters, clinical outcomes, and preoperative and postoperative sagittal parameters were recorded...
March 9, 2018: Clinical Neurology and Neurosurgery
Kunal C Shah, Akshay Gadia, Premik Nagad, Shekhar Bhojraj, Abhay Nene
Buckling collapse is the term typically used to describe severe kyphosis more than 100 degrees, characteristically seen in thoracolumbar tuberculosis. Neurofibromatosis is rarely associated with severe cervical kyphosis. Dystrophic changes in vertebra make surgical correction and fusion challenging. Single stage cervical osteotomies (pedicle subtraction osteotomy, vertebral column resection etc) are commonly done in cervico-thoracic junction. However it is technically challenging and associated with high risk of vertebral artery injury, neural injury etc when performed in higher cervical spine...
March 14, 2018: World Neurosurgery
Christian B Theodotou, George M Ghobrial, Andrew L Middleton, Michael Y Wang, Allan D Levi
BACKGROUND: Cervical facet dislocations are among the most common traumatic spinal injuries. Posterior, anterior, and combined surgical approaches have been described and are widely debated. OBJECTIVE: To demonstrate efficacy in anterior-only surgical management for subaxial cervical facet dislocations. METHODS: A consistent surgical algorithm for cervical facet dislocation was applied over a 19-yr period and analyzed retrospectively in adults with acute unilateral or bilateral facet dislocation of the subaxial cervical spine...
March 14, 2018: Neurosurgery
Joshua M Peterson, Carolyn Chlebek, Ashley M Clough, Alexandra K Wells, Eric H Ledet
STUDY DESIGN: In vitro biomechanical testing of human cadaveric cervical and goat cervical motion segments. OBJECTIVE: To measure the effects of plate stiffness on load-sharing, instantaneous axis of rotation (IAR), and posterior element loading after anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA: ACDF is intended to create an environment which facilitates sufficient stability and biomechanical conditions to promote bone formation...
March 15, 2018: Spine
Yang Xiong, Lin Xu, Xing Yu, Yongdong Yang, Dingyan Zhao, Zhengguo Hu, Chuanhong Li, He Zhao, Lijun Duan, Bingbing Zhang, Sixue Chen, Tao Liu
STUDY DESIGN: A retrospective study. OBJECTIVE: To compare the mid-term outcomes of hybrid surgery and anterior cervical discectomy and fusion for the treatment of contiguous 2-segment cervical degenerative disc diseases. SUMMARY OF BACKGROUND DATA: Hybrid surgery has become one of the most controversial subjects in spine communities, and the comparative studies of hybrid surgery and anterior cervical discectomy and fusion in the mid- and long-term follow-up are rarely reported...
March 15, 2018: Spine
Francesca Salamanna, Simona Cepollaro, Deyanira Contartese, Gianluca Giavaresi, Giovanni Barbanti Brodano, Cristiana Griffoni, Alessandro Gasbarrini, Milena Fini
STUDY DESIGN: Laboratory study. OBJECTIVE: Mesenchymal stem cells (MSCs) derived from whole bone marrow aspirate (BMA) and MSCs derived from density-gradient centrifugation were isolated from vertebral bodies and cultured under either hypoxic or normoxic conditions to evaluate their biological characteristics and HOX and TALE signature able to improve spinal surgery procedures. SUMMARY OF BACKGROUND DATA: The use of spinal fusion procedures has increased over the last decades; however, failed fusion still remains an important problem...
March 15, 2018: Spine
Yad Ram Yadav, Shailendra Ratre, Vijay Parihar, Amitesh Dubey, Mashoo N Dubey
Symptomatic ventral cervical cord compressions have been treated by anterior discectomy with fusion, anterior corpectomy and fusion, discectomy with an artificial disc, and minimally invasive techniques. There are complications associated with the fusion procedure, especially when a long segment fusion is undertaken. Partial removal of the vertebral body without fusion could help in avoiding fusion and its associated complications. We are describing the detailed surgical technique, indications, limitations, and early results of endoscopic partially corpectomy...
March 2018: Neurology India
Heeren Makanji, Andrew J Schoenfeld, Amandeep Bhalla, Christopher M Bono
PURPOSE: Lumbar fusion for degenerative disorders is among the most common spine surgical procedures performed. The purpose of this study was to analyze fusion, complications, and clinical success for lumbar fusion performed with various surgical techniques as reported in the literature from 2000 to 2015 and compare with previous critical analysis of outcomes from 1980 to 2000. METHODS: A systematic review of the literature to identify all studies of adult lumbar fusion for degenerative disorders published between January 1, 2000, and August 31, 2015, was performed adhering to PRISMA guidelines...
March 15, 2018: European Spine Journal
Bharat R Dave, Devanand Degulmadi, Shreekant Dahibhate, Ajay Krishnan, Denish Patel
PURPOSE: Anterior cervical corpectomy and fusion (ACCF) is a technically challenging surgery. Use of conventional instruments like high-speed burr and kerrison rongeurs is associated with high complication rates such as increased blood loss and incidental durotomy. Use of ultrasonic bone scalpel (UBS) in cervical corpectomy helps to minimize such adverse events. METHODS: We performed a retrospective study based on the data of 101 consecutive patients who underwent cervical corpectomies with UBS for different cervical spine pathologies from December 2014 to December 2016...
March 14, 2018: European Spine Journal
Ahilan Sivaganesan, Brandon Hirsch, Frank M Phillips, Matthew J McGirt
Here, we systematically review clinical studies that report morbidity and outcomes data for cervical and lumbar surgeries performed in ambulatory surgery centers (ASCs). We focus on anterior cervical discectomy and fusion (ACDF), posterior cervical foraminotomy, cervical arthroplasty, lumbar microdiscectomy, lumbar laminectomy, and minimally invasive transforaminal interbody fusion (TLIF) and lateral lumbar interbody fusion, as these are prevalent and surgical spine procedures that are becoming more commonly performed in ASC settings...
March 12, 2018: Neurosurgery
Krzysztof Kucharz, Martin Lauritzen
Cortical spreading depolarization waves, the cause underlying migraine aura, are also the markers and mechanism of pathology in the acutely injured human brain. Propagation of spreading depolarization wave uniquely depends on the interaction between presynaptic and postsynaptic glutamate N-methyl-d-aspartate receptors (NMDARs). In the normally perfused brain, even a single wave causes a massive depolarization of neurons and glia, which results in transient loss of neuronal function and depression of the ongoing electrocorticographic activity...
March 12, 2018: Brain: a Journal of Neurology
Stephen Clark, Alysa Nash, Mark Shasti, Luke Brown, Julio J Jauregui, Katherine Mistretta, Eugene Koh, Kelley Banagan, Steven Ludwig, Daniel Gelb
STUDY DESIGN: Retrospective cohort study OBJECTIVE.: To assess 30-day and one-year mortality rates as well as the most common complications associated with posterior C1-2 fusion in an octogenarian cohort. SUMMARY OF BACKGROUND DATA: Treatment of unstable type II odontoid fractures in elderly patients can present challenges. Recent evidence indicates in patients older than 80 years, posterior C1-2 fusion results in improved survival as compared to other modes of treatment...
March 13, 2018: Spine
Ibrahim Hussain, Theodore H Schwartz, Jeffrey P Greenfield
Basilar invagination is defined as abnormal upward and/or posterior displacement of the odontoid leading to ventral compression of the cervicomedullary junction. This condition leads to lower cranial neuropathies, sensorimotor deficits, and myelopathy. These symptoms can persist even after posterior decompression, which is an indication for ventral decompression. Transoral approaches to the upper cervical spine carry significant morbidity, limiting their utility. The endonasal approach to the upper cervical spine presents an alternative for patients with amenable anatomy...
March 13, 2018: Clinical Spine Surgery
Kivanc Atesok, Nobuhiro Tanaka, Andrew O'Brien, Yohan Robinson, Dachling Pang, Donald Deinlein, Sakthivel Rajaram Manoharan, Jason Pittman, Steven Theiss
"Spinal Cord Injury without Radiographic Abnormality" (SCIWORA) is a term that denotes objective clinical signs of posttraumatic spinal cord injury without evidence of fracture or malalignment on plain radiographs and computed tomography (CT) of the spine. SCIWORA is most commonly seen in children with a predilection for the cervical spinal cord due to the increased mobility of the cervical spine, the inherent ligamentous laxity, and the large head-to-body ratio during childhood. However, SCIWORA can also be seen in adults and, in rare cases, the thoracolumbar spinal cord can be affected too...
2018: Advances in Orthopedics
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