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Spine fusion

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https://www.readbyqxmd.com/read/28922278/defining-the-critical-elements-for-the-most-common-procedures-in-spine-surgery-a-consensus-of-orthopaedic-and-neurosurgical-surgeons
#1
Joseph L Laratta, Samuel Cohen-Tanugi, Jamal N Shillingford, Joseph M Lombardi, Lawrence G Lenke, K Daniel Riew, Ronald A Lehman, Steven C Ludwig
STUDY DESIGN: Survey. OBJECTIVE: To define the critical elements of common spine surgeries. SUMMARY OF BACKGROUND DATA: Despite significant relevance to the field of spine surgery, the term "critical element" of surgery has not been clearly defined. Every surgical procedure involves numerous steps, each with its own potential for complications and harm to the patient. Despite its crucial role in surgical training, billing, and the ethicality of concurrent surgery, the term "critical element" of surgery has not been defined...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28918465/congenital-lumbar-kyphosis-with-skin-ulceration-and-osteomyelitis-in-a-myelomeningocele-child-a-case-report
#2
Benoit Vibert, Marco Turati, Pierre-Yves Rabattu, Marco Bigoni, Ahmad Eid, Aurélien Courvoisier
INTRODUCTION: Kyphosis is a frequent problem in children with spina bifida, and this deformity may cause different complications as respiratory insufficiency, bowel dysfunction, and skin ulcers. CASE REPORT: We report on a 13-year-old myelomeningocele male with a lumbar kyphoscoliosis associated to a septic skin ulceration that resulted in an acute sepsis. An X-ray revealed a kyphosis of 110° and a scoliosis of 25° between T9 and L5. The wound and blood cultures showed Staphylococcus aureus colonization, and an appropriate antibiotic therapy was started...
September 16, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28915307/the-use-of-bone-morphogenetic-protein-in-spinal-transforaminal-lumbar-interbody-fusion-our-experience
#3
Eduardo Colom-Beauchamp, David Beaton-Comulada, Julio A Rodriguez, José C Pérez-López, José Montañez-Huertas, Enrique Escobar-Medina, José Massanet-Vollrath
OBJECTIVE: Since its introduction and FDA approval, rhBMP-2 has been adopted by spine surgeons as a substitute for ICBG in numerous spinal fusion techniques. As broad clinical use increased, reports on potential complications associated with rhBMP-2 also increased. We provide our experience with TLIF using rhBMP-2 or ICBG in an entirely Hispanic population. METHODS: This was a 2-year retrospective study of 67 patients, with 26 in the rhBMP-2 group and 41 in the ICBG group, who underwent TLIF...
September 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28904564/the-role-of-pre-reduction-mri-in-the-management-of-complex-cervical-spine-fracture-dislocations-an-ongoing-controversy
#4
Sergiu Botolin, Todd F VanderHeiden, Ernest E Moore, Herbert Fried, Philip F Stahel
BACKGROUND: Cervical spine fracture-dislocations in neurologically intact patients represent a surgical challenge due to the risk of inflicting iatrogenic spinal cord compression by closed reduction maneuvers. The use of MRI for early advanced imaging in these injuries remains controversially debated. CASE PRESENTATION: A 54-year old man sustained a fall over the handlebars of his racing bicycle. The helmeted patient sustained a fall on his head which resulted in a hyperflexion injury of the neck...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28898892/posterior-hemi-laminectomy-and-facetectomy-approach-for-the-treatment-of-dumbbell-shaped-schwannomas-in-the-subaxial-cervical-spine-a-retrospective-study-of-26-cases
#5
Yong Huang, Zuowei Wang, Zan Chen, Hao Wu, Fengzeng Jian
OBJECTIVE: It is difficult to completely and safely remove a tumor that is located in the subaxial cervical spine by using the posterior approach because of the anatomical characteristics. Previous reports regarding the total removal of subaxial schwannomas using the one-stage posterior approach are still limited. This study was to evaluate the feasibility and efficacy of treating the dumbbell-shaped schwannomas in the subaxial cervical spine using the one-stage posterior approach. METHODS: Patients with dumbbell-shaped schwannomas in the subaxial cervical spine were treated using the one-stage posterior approach...
September 12, 2017: European Neurology
https://www.readbyqxmd.com/read/28898815/biomechanical-evaluation-of-different-surgical-procedures-in-single-level-transforaminal-lumbar-interbody-fusion-in-vitro
#6
Yuanwu Cao, Fubing Liu, Shengcheng Wan, Yun Liang, Chun Jiang, Zhenzhou Feng, Xiaoxing Jiang, Zixian Chen
BACKGROUNDS: A variety of improved surgical methods were adopted in the transforaminal lumbar interbody fusion. A mechanical stability provides an ideal environment for the formation of a fusion mass and is the basis of their good outcomes. The object of this study is to evaluate the initial similarities and differences of four commonly-used posterior surgical procedures biomechanically. METHODS: Biomechanical testing was performed at L3-4 motion segment in 6 fresh-frozen human cadaveric lumbar spines (L2-L5), including the following sequentially tested configurations: 1) intact motion segment; 2) bilateral pedicle screw fixation; 3) unilateral pedicle screw fixation; 4) unilateral pedicle screw plus contralateral translaminar facet joint screw fixation according to the Magerl technique; and 5) bilateral pedicle screw fixation with bilateral facetectomies...
September 5, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28894687/the-pedicles-are-not-the-densest-regions-of-the-lumbar-vertebrae-implications-for-bone-quality-assessment-and-surgical-treatment-strategy
#7
Eric A Hohn, Bryant Chu, Audrey Martin, Elizabeth Yu, Connor Telles, Jeremi Leasure, Tennyson L Lynch, Dimitriy Kondrashov
STUDY DESIGN: Cadaver study. OBJECTIVE: To determine the bone density of lumbar vertebral anatomic subregions. Bone mineral density (BMD) is a major factor in osseous fixation construct strength. The standard region for implant fixation of the spine is the pedicle; however, other regions may be more viable options with higher bone quality. METHODS: Using computed tomography images, the spine was digitally isolated by applying a filter for adult bone...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28894679/management-of-thoracic-disc-herniations-via-posterior-unilateral-modified-transfacet-pedicle-sparing-decompression-with-segmental-instrumentation-and-interbody-fusion
#8
Daniel A Carr, Andrey A Volkov, David L Rhoiney, Pradeep Setty, Ryan J Barrett, Roderick Claybrooks, Peter L Bono, Doris Tong, Teck M Soo
STUDY DESIGN: Retrospective consecutive case series. OBJECTIVE: The objective of this case series was to demonstrate the safety of a modified transfacet pedicle-sparing decompression and instrumented fusion in patients with thoracic disc herniations (TDHs). METHODS: Consecutive patients undergoing operative management of TDH from July 2007 to December 2011 using a posterior unilateral modified transfacet pedicle-sparing approach were identified...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28891865/opioid-prescription-levels-and-postoperative-outcomes-in-orthopedic-surgery
#9
Crispiana Cozowicz, Ashley Olson, Jashvant Poeran, Eva E Mörwald, Nicole Zubizarreta, Federico P Girardi, Alexander P Hughes, Madhu Mazumdar, Stavros G Memtsoudis
Given the basic need for opioids in the perioperative setting, we investigated associations between opioid prescription levels and postoperative outcomes using population based data of orthopedic surgery patients. We hypothesized that increased opioid amounts would be associated with higher risk for postoperative complications. Data was extracted from the national Premier Perspective database (2006-2013); N=1,035,578 lower joint arthroplasties and N= 220,953 spine fusions. Multilevel multivariable logistic regression models measured associations between opioid dose prescription and postoperative outcomes, studied by quartile of dispensed opioid dose...
September 1, 2017: Pain
https://www.readbyqxmd.com/read/28891440/a-systematic-review-of-mesenchymal-stem-cells-in-spinal-cord-injury-intervertebral-disc-repair-and-spinal-fusion
#10
Shujhat Khan, Pouya Mafi, Reza Mafi, Wasim Khan
Spinal surgery presents a challenge for both neurosurgery and orthopaedic surgery. Due to the heterogeneous differentiation potential of mesenchymal stem cells, there is much interest in the treatment of spine surgery. Animal and human trials focussing on the efficacy of mesenchymal stem cells in spinal cord injury, spine fusion and disc degeneration were included in this systematic review. Published articles up to January 2016 from MEDLINE, PubMed and Ovid were used by searching for specific terms. Of the 2595 articles found, 53 met the selection criteria and were included for analysis (16 on spinal cord injury, 28 on intervertebral disc repair and 9 on spinal fusion)...
September 7, 2017: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28890222/identifying-subsets-of-patients-with-single-level-degenerative-disc-disease-for-lumbar-fusion-the-value-of-prognostic-tests-in-surgical-decision-making
#11
Victor E Staartjes, Pieter-Paul A Vergroesen, Dick J Zeilstra, Marc L Schröder
BACKGROUND CONTEXT: Fusion surgery for degenerative disc disease (DDD) has become a standard of care, albeit not without controversy. Outcomes are inconsistent and a superiority over conservative treatment is debatable. Proper patient selection is key to clinical success, and a comprehensive understanding of prognostic tests does not currently exist. PURPOSE: To investigate the value of prognostic tests and sociodemographic factors in predicting outcomes following lumbar fusion surgery for DDD...
September 7, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28889244/lumbar-subtotal-corpectomy-non-fusion-model-produced-using-a-novel-prosthesis
#12
Jiantao Liu, Feng Zhang, Zhengchao Gao, Yuhuan Li, Binbin Niu, Xijing He
OBJECTIVE: In this study, we aimed to design a movable artificial lumbar complex (MALC) prosthesis for non-fusion reconstruction after lumbar subtotal corpectomy and to establish an in vitro anterolateral lumbar corpectomy non-fusion model for evaluating the biomechanical stability, preservation of segment movements and influence on adjacent inter-vertebral movements of this prosthesis. METHODS: Imaging was performed on a total of 26 fresh goat lumbar spine specimens to determine which of the specimens did not meet the requirements (free of deformity and fractures); the residual specimens were randomly divided into an intact group, a fusion group and a non-fusion group...
September 9, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28889042/marginal-en-bloc-resection-of-c2-3-chordoma-with-bilateral-vertebral-artery-preservation-and-mesh-cage-reconstruction-with-review-of-previously-published-cases
#13
Steven O Tenny, Landon D Ehlers, J Will Robbins, Christopher C Gillis
BACKGROUND: Chordomas arise from remnants of the notocord and occur throughout the neuroaxis. En bloc resection of chordomas can prove especially challenging in the upper cervical spine secondary to the unique structural anatomy and intimate relationship to the vertebral arteries and spinal cord. CASE DESCRIPTION: We describe the resection of a C2-3 chordoma in a 55 year old female in two stage fashion with preservation of the vertebral arteries. First a posterior instrumented fusion and removal of the posterior elements was performed, followed by an anterior transmandibular en bloc resection with cage reconstruction with kick-plate support achievable with off-the-shelf products...
September 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28887690/cervical-sagittal-alignment-after-different-anterior-discectomy-procedures-for-single-level-cervical-degenerative-disc-disease-randomized-controlled-trial
#14
Roland D Donk, Hisse Arnts, Wim I M Verhagen, Hans Groenewoud, Andre Verbeek, Ronald H M A Bartels
BACKGROUND: The effect of anterior cervical discectomy without fusion (ACD), ACD with fusion by stand-alone cage (ACDF) or with arthroplasty (ACDA) on cervical sagittal alignment is not known and is the subject of this study. METHODS: A total of 142 adult patients with single-level cervical disease were at random allocated to different procedures: ACD (45), ACDF (47) and ACDA (50). Upright cervical spine radiographs were obtained. Angles of the involved angle and the angle between C2 and C7 were determined...
September 8, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28887681/pediatric-spine-imaging-post-scoliosis-surgery
#15
Alaa N Alsharief, Ron El-Hawary, Pierre Schmit
Many orthopedic articles describe advances in surgical techniques and implants used in pediatric scoliosis surgery. However, even though postoperative spine imaging constitutes a large portion of outpatient musculoskeletal pediatric radiology, few, if any, radiology articles discuss this topic. There has been interval advancement over the last decades of the orthopedic procedures used in the treatment of spinal scoliosis in adolescents with idiopathic scoliosis. The goal of treatment in these patients is to stop the progression of the curve by blocking the spinal growth and correcting the deformity as much as possible...
September 8, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28887272/establishing-benchmarks-for-the-volume-outcome-relationship-for-common-lumbar-spine-surgical-procedures
#16
Andrew J Schoenfeld, Daniel J Sturgeon, Camden B Burns, Tyler J Hunt, Christopher M Bono
BACKGROUND CONTEXT: The importance of surgeon volume as a quality measure has been defined for a number of surgical specialties. Meaningful procedural volume benchmarks have not been established, however, particularly with respect to lumbar spine surgery. PURPOSE: To establish surgeon volume benchmarks for the performance of four common lumbar spine surgical procedures (discectomy, decompression, lumbar interbody fusion, lumbar posterolateral fusion). STUDY DESIGN: Retrospective review of data in the Florida Statewide Inpatient Dataset (2011-2014)...
September 5, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28887080/a-rare-case-of-metastatic-extramammary-paget-disease-of-the-spine-and-review-of-the-literature
#17
A Karim Ahmed, C Rory Goodwin, Nancy Abu-Bonsrah, Doreen Nguyen, Daniel M Sciubba
Extramammary Paget disease is an intraepithelial neoplasm affecting cells rich in apocrine glands-often located in the vulvar, scrotal, or perianal region. It typically affects older patients, between the ages of 50 and 80years old, and is most often limited to the epidermis. A 47-year-old Asian male first presented with enlargement of the right inguinal lymph node. A subsequent biopsy revealed extrammamary Paget disease of the scrotum. The patient eventually developed significant worsening back pain with bilateral lower extremity numbness and weakness three months later...
September 5, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28887065/pulmonary-function-and-thoracic-deformities-in-adolescent-idiopathic-scoliosis-27-years-or-longer-after-spinal-fusion-with-harrington-instrument
#18
Tsutomu Akazawa, Shingo Kuroya, Masahiro Iinuma, Kota Asano, Yoshiaki Torii, Tasuku Umehara, Toshiaki Kotani, Tsuyoshi Sakuma, Shohei Minami, Sumihisa Orita, Kazuhide Inage, Kazuki Fujimoto, Yasuhiro Shiga, Gen Inoue, Masayuki Miyagi, Wataru Saito, Seiji Ohtori, Hisateru Niki
BACKGROUND: The aim of this study was to conduct an investigation into spinal fusion with Harrington instrument (HI) in patients with adolescent idiopathic scoliosis (AIS) and to survey pulmonary function and thoracic deformity outcomes many years after surgery. METHODS: Subjects comprised 194 patients diagnosed with AIS and treated with spinal fusion using HI between 1968 and 1987. Patients who gave their informed consent were subjected to a complete standing spine X-ray, chest CT, and pulmonary function tests...
September 5, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28885370/usefulness-of-titanium-mesh-cage-for-posterior-c1-c2-fixation-in-patients-with-atlantoaxial-instability
#19
Hwan-Seo Yang, Ki-Wan Kim, Young-Min Oh, Jong-Pil Eun
The aim of this study was to investigate the usefulness of titanium mesh cage as an interlaminar spacer combined with nitinol shape memory loop fixation in patients with atlantoaxial instability.From April 2009 to March 2017, among the patients with atlantoaxial instability, a total of 30 patients were treated by nitinol shape memory loop fixation combined with titanium mesh cage as a spacer. We retrospectively reviewed 30 enrolled patients. Successful fusion was determined as improvement of symptoms and radiologic findings of bone fusion...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28885344/surgical-treatment-for-lumbar-hyperlordosis-after-resection-of-a-spinal-lipoma-associated-with-spina-bifida-a-case-report
#20
Tatsuya Sato, Ikuho Yonezawa, Shingo Onda, Kei Yoshikawa, Hiromitsu Takano, Yukitoshi Shimamura, Takatoshi Okuda, Kazuo Kaneko
RATIONALE: A hyperlordosis deformity of the lumbar spine is relatively rare, and surgical treatment has not been comprehensively addressed. In this case report, we describe the clinical presentation, surgical treatment, and medium-term follow-up of a patient presenting with a progressive lumbar hyperlordosis deformity after resection of a spinal lipoma associated with spina bifida. PATIENT CONCERNS: The patient was a 20-year-old woman presenting with a progressive hyperlordosis deformity of the lumbar spine associated with significant back pain (visual analog pain score of 89/100 mm), but with no neurological symptoms...
September 2017: Medicine (Baltimore)
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