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https://www.readbyqxmd.com/read/28350946/emerging-techniques-in-degenerative-thoracolumbar-surgery
#1
Theodore J Choma, Thomas E Mroz, Christina L Goldstein, Paul Arnold, Mohammed F Shamji
There continue to be incremental advances in thoracolumbar spine surgery techniques in attempts to achieve more predictable outcomes, minimize risk of complications, speed recovery, and minimize the costs of these interventions. This paper reviews recent literature with regard to emerging techniques of interest in the surgical treatment of lumbar spinal stenosis, fusion fixation and graft material, degenerative lumbar spondylolisthesis, and thoracolumbar deformity and sacroiliac joint degeneration. There continue to be advances in minimal access options in these areas, although robust outcome data are heterogeneous in its support...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28340495/residents-learning-curve-of-lumbar-transforaminal-epidural-steroid-injections
#2
Holger Joswig, Sarah Roberta Haile, Gerhard Hildebrandt, Martin Nikolaus Stienen
Background and Study Aims There is a paucity of literature on beginners' training and on its connection with patient safety for transforaminal epidural steroid injections (TFESIs). This study retrospectively assessed the learning curves and associated complications of neurosurgery residents never previously exposed to TFESI and compared them with experienced board-certified faculty neurosurgeons (BCFNs). Material and Methods Procedure time in minutes, dose-area product (DAP) in cGy*cm(2), periprocedural observations, and complications in 354 TFESIs for radicular pain secondary to lumbar disk herniation or lumbar spinal stenosis were extracted from operative notes and the electronic infiltration logbook in the per-injection format...
March 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28339441/the-role-of-the-ligamentum-flavum-area-as-a-morphological-parameter-of-lumbar-central-spinal-stenosis
#3
Young Uk Kim, Jun Young Park, Doo Hwan Kim, Myung-Hwan Karm, Jae-Young Lee, Jee In Yoo, Sung Won Chon, Jeong Hun Suh
BACKGROUND: Hypertrophy of the ligamentum flavum (LF) has been considered as a major cause of lumbar central spinal stenosis (LCSS). Previous studies have found that ligamentum flavum thickness (LFT) is correlated with aging, disc degeneration, and lumbar spinal stenosis. However, hypertrophy is different from thickness. Thus, to evaluate hypertrophy of the whole LF, we devised a new morphological parameter, called the ligamentum flavum area (LFA). OBJECTIVES: We hypothesized that the LFA is a key morphologic parameter in the diagnosis of LCSS...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28337892/idiopathic-intracranial-hypertension-in-a-paediatric-population-a-retrospective-observational-study-on-epidemiology-symptoms-and-treatment
#4
M Barbagallo, G Vitaliti, F Greco, P Pavone, N Matin, G Panta, R Lubrano, R Falsaperla
Idiopathic intracranial hypertension (IIH) is a disorder of unknown origin, which is characterized by elevated intracranial pressure (ICP) without underlying etiological evidence of neurological disease. The purpose of the current study was to evaluate epidemiological features, clinical presentation, diagnostic findings and treatment of sixteen children (7 males and 9 females) with IIH. Medical records of the patients were obtained from the University Paediatric Hospital of Catania, Italy. Clinical features, investigations and treatment approaches were retrieved...
January 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28336484/lumbar-mri-findings-in-patients-with-and-without-waddell-signs
#5
J S Cox, S Blizzard, H Carlson, J Hiratza, J U Yoo
BACKGROUND CONTEXT: Waddell Signs (WS), introduced as a method to establish patients with substantial psychosocial components to their low back pain, carry a negative association despite no literature evaluating whether physical disease is associated with them. PURPOSE: To compare lumbar MRI findings between the patients with and without Waddell's Signs. STUDY DESIGN: Retrospective cohort study based on prospectively collected data PATIENT SAMPLE: Thirty patients aged 35-55 with an ODI score >50 randomly selected such that there was an even distribution of patients based on number of WS OUTCOME MEASURES: ODI and SF-12 scores, number of WS, presence and severity of spinal pathology METHODS: MRIs were reviewed by three spine specialists blinded to clinical exam findings, number of WS, and patient identity...
March 20, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28332140/interspinous-implants-are-the-new-implants-better-than-the-last-generation-a-review
#6
REVIEW
Michael Pintauro, Alexander Duffy, Payman Vahedi, George Rymarczuk, Joshua Heller
PURPOSE OF REVIEW: Interspinous process devices (IPDs) are used in the surgical treatment of lumbar spinal stenosis. The purpose of this review is to compare the first generation with the next-generation devices in terms of complications, device failure, reoperation rates, symptom relief, and outcome. RECENT FINDINGS: Thirty-seven studies were included from 2011 to 2016. Device failure occurred at a mean of 3.7%, with a lower tendency to happen with next-generation IPDs...
March 22, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28331979/clinical-and-radiological-factors-related-to-the-presence-of-motor-deficit-in-lumbar-disc-prolapse-a-prospective-analysis-of-70-consecutive-cases-with-neurological-deficit
#7
Vibhu Krishnan, Shanmuganathan Rajasekaran, Siddharth N Aiyer, Rishi Kanna, Ajoy Prasad Shetty
PURPOSE: To analyse the clinic-radiological factors associated with neurological deficit following lumbar disc herniation. METHODS: A prospective, cross-sectional study was performed in 140 cases of micro-discectomy following lumbar disc herniation. Group 1 included 70 consecutive patients with motor deficit and group 2 (controls) included 70 patients with intact neurology. Motor deficit was defined as the occurrence of motor power ≤3/5 in L2-S1 myotomes. Multiple clinical and radiological parameters were studied between the two groups...
March 22, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28331931/cranial-thoracic-vertebral-canal-stenosis-in-three-juvenile-large-breed-brachycephalic-dogs-treated-by-unilateral-hemilaminectomy
#8
Amanda Miller, Andrew Marchevsky
OBJECTIVE: To describe the surgical treatment and outcome for juvenile dogs with cranial thoracic vertebral canal stenosis treated by unilateral hemilaminectomy. STUDY DESIGN: Case series. ANIMALS: Three large-breed brachycephalic dogs of various breeds (Dogue de Bordeaux, Australian Bulldog, Boerboel) with neurological signs consistent with a myelopathy of the third thoracic (T) to third lumbar (L) spinal cord segment. METHODS: Information on clinical presentation, diagnostic imaging, surgical procedures, postoperative complications, recovery and outcome is described...
March 23, 2017: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/28331906/associations-between-sarcopenia-and-degenerative-lumbar-scoliosis-in-older-women
#9
Yawara Eguchi, Munetaka Suzuki, Hajime Yamanaka, Hiroshi Tamai, Tatsuya Kobayashi, Sumihisa Orita, Kazuyo Yamauchi, Miyako Suzuki, Kazuhide Inage, Kazuki Fujimoto, Hirohito Kanamoto, Koki Abe, Yasuchika Aoki, Tomoaki Toyone, Tomoyuki Ozawa, Kazuhisa Takahashi, Seiji Ohtori
BACKGROUND: Age-related sarcopenia can cause various forms of physical disabilities. We investigated how sarcopenia affects degenerative lumbar scoliosis (DLS) and lumbar spinal canal stenosis (LSCS). METHODS: Subjects comprised 40 elderly women (mean age 74 years) with spinal disease whose chief complaints were low back pain and lower limb pain. They included 15 cases of DLS (mean 74.8 years) and 25 cases of LSCS (mean age 72.9 years). We performed whole-body dual-energy X-ray absorptiometry (DXA) to analyze body composition, including appendicular and trunk skeletal muscle mass index (SMI; lean mass (kg)/height (m)(2)) and bone mineral density (BMD)...
2017: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/28327997/lumbar-fusion-for-degenerative-disease-a-systematic-review-and-meta-analysis
#10
Daniel Yavin, Steven Casha, Samuel Wiebe, Thomas E Feasby, Callie Clark, Albert Isaacs, Jayna Holroyd-Leduc, R John Hurlbert, Hude Quan, Andrew Nataraj, Garnette R Sutherland, Nathalie Jette
BACKGROUND: Due to uncertain evidence, lumbar fusion for degenerative indications is associated with the greatest measured practice variation of any surgical procedure. OBJECTIVE: To summarize the current evidence on the comparative safety and efficacy of lumbar fusion, decompression-alone, or nonoperative care for degenerative indications. METHODS: A systematic review was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (up to June 30, 2016)...
March 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327114/study-protocol-for-a-randomized-controlled-trial-comparing-clinical-and-radiological-results-after-three-different-posterior-decompression-techniques-for-lumbar-spinal-stenosis-the-spinal-stenosis-trial-sst-part-of-the-nordsten-study
#11
Erland Hermansen, Ivar Magne Austevoll, Ulla Kristina Romild, Frode Rekeland, Tore Solberg, Kjersti Storheim, Oliver Grundnes, Jørn Aaen, Jens Ivar Brox, Christian Hellum, Kari Indrekvam
BACKGROUND: There are several posterior decompression techniques for lumbar spinal stenosis (LSS). There is a trend towards performing less invasive surgical procedures, but no multicentre randomized controlled trials have evaluated the relative efficacy of these techniques at short and long-term. METHOD/DESIGN: A multicentre randomized controlled trial [the Spinal Stenosis Trial (SST) (part of the NORDSTEN study)] including 465 patients aged 18-80 years with neurogenic claudication or radiating pain and MRI findings indicating lumbar spinal stenosis without spondylolisthesis is performed to compare three posterior decompression techniques: unilateral laminotomy with crossover, bilateral laminotomy and spinous process osteotomy...
March 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28325465/analysis-or-evaluation-of-risk-factors-and-predictability-of-postoperative-urinary-retention-following-spinal-surgery
#12
Bikash Bose
Lee S, Kim CH, Chung CK, Park SB, Yang SH, et al. Risk factor analysis for postoperative urinary retention after surgery for degenerative lumbar spinal stenosis. Spine J 2017:17:469-77 (in this issue).
April 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28324328/interspinous-implants-to-treat-spinal-stenosis
#13
REVIEW
Raj J Gala, Glenn S Russo, Peter G Whang
PURPOSE OF REVIEW: Lumbar spinal stenosis has historically been treated with open decompressive surgery which is associated with significant morbidity and may give rise to various complications. Interspinous spacers (ISS) have been developed as a less invasive strategy which may serve to avoid many of these risks. The two current spacers that are FDA approved and commercially available are the Coflex and Superion devices. The goal is to review these two implants, their indications, and patient selection...
March 21, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28324211/comparison-of-in-vitro-osteogenic-potential-of-iliac-crest-and-degenerative-facet-joint-bone-autografts-for-intervertebral-fusion-in-lumbar-spinal-stenosis
#14
Jeroen Geurts, Daniela Ramp, Stefan Schären, Cordula Netzer
PURPOSE: The promotion of spinal fusion using bone autografts is largely mediated by the osteoinductive potential of progenitors/mesenchymal stem cells (MSC) that reside in the marrow spaces of cancellous bone. Iliac crest is the common autograft donor site, but its use presents an increased risk for donor site pain, morbidity and infection. Degenerative bone samples harvested during facetectomy might provide an alternative viable source of osteoinductive autografts. In this study, we conducted an intra-individual comparison of the osteogenic potential of isolated low passage MSC from both sources...
March 21, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28323698/hypertrophy-and-fibrosis-of-the-ligamentum-flavum-in-lumbar-spinal-stenosis-is-associated-with-increased-expression-of-lpa-and-lpar1
#15
Kai Zhang, Wei Sun, Xin-Yu Liu, Chang-Qing Zhao, Hua Li, Xiao-Jiang Sun, Xie You-Zhuan, Wei Ding, Jie Zhao
STUDY DESIGN: Histologic, immunohistochemical (IHC), and enzyme-linked immunosorbent assay analysis of the human ligamentum flavum (LF). OBJECTIVE: The purpose of this study was to determine the level of expression of lysophosphatidic acid (LPA) in the LF from lumbar spinal stenosis (LSS) patients and to analyze the relationship among LPA, LPA receptors (LPARs), and LF hypertrophy. SUMMARY OF BACKGROUND DATA: LF hypertrophy and fibrosis are important causes of LSS...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323696/a-new-angled-chisel-for-microendoscopic-decompressive-laminotomy
#16
Shu Nakamura, Motohide Shibayama, Fujio Ito, Yasushi Miura
STUDY DESIGN: A retrospective comparative series study. OBJECTIVE: The aim of the study was to describe a new angled chisel (NAC) that facilitates the osteotomy in microendoscopic decompressive laminotomy (MEDL), and to analyze the clinical and radiologic outcomes using the tool. SUMMARY OF BACKGROUND DATA: MEDL for lumbar spinal stenosis is a minimally invasive surgery. The paraspinous unilateral approach for bilateral decompression can preserve the posterior structure better than other methods...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323238/preoperative-retrolisthesis-as-a-predictive-risk-factor-of-reoperation-due-to-delayed-onset-symptomatic-foraminal-stenosis-after-central-decompression-for-lumbar-canal-stenosis-without-fusion
#17
Daisuke Ikegami, Noboru Hosono, Yoshihiro Mukai, Kosuke Tateishi, Takeshi Fuji
BACKGROUND CONTEXT: For patients diagnosed with lumbar central canal stenosis with asymptomatic foraminal stenosis (FS), surgeons occasionally only decompress central stenosis and preserve asymptomatic FS. These surgeries have the potential risk of converting preoperative asymptomatic FS into symptomatic FS postoperatively by accelerating spinal degeneration, which requires reoperation. However, little is known about delayed onset symptomatic FS postoperatively. PURPOSE: This study aimed to evaluate the rate of reoperation for delayed onset symptomatic FS after lumbar central canal decompression in patients with preoperative asymptomatic FS, and determine the predictive risk factors of those reoperations...
March 17, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28320256/internal-decompression-for-spinal-stenosis-idss-for-decompression-and-use-of-interlaminar-dynamic-device-coflextm-for-stabilization-in-the-surgical-management-of-degenerative-lumbar-canal-stenosis-with-or-without-mild-segmental-instability-our-initial-results
#18
Sumeet G Pawar, Arjun Dhar, Apurva Prasad, Satyashiva Munjal, P S Ramani
INTRODUCTION: Internal decompression of spinal stenosis (IDSS) and Posterior dynamic stabilization (PDS) form a bridge between decompression laminectomy alone and rigid fusion, by attempting to sustain beneficial effects of decompression and stabilization in an attempt to prevent bad effects of relentless degeneration. OBJECTIVE: To evaluate the clinical outcome in operated patient of posterior dynamic stabilization. DESIGN: Data were collected over 1 year in prospective, nonrandomized follow-up study using outcome scales...
March 21, 2017: Neurological Research
https://www.readbyqxmd.com/read/28320028/extent-of-decompression-of-lumbar-spinal-canal-after-endoscopic-surgery
#19
Naresh Kumar Dewanngan, Yad Ram Yadav, Vijay Singh Parihar, Shailendra Ratre, Yatin Kher, Pushpraj Bhatele
Introduction Endoscopic techniques are being used in lumbar disk disease and lumbar canal stenosis to decompress the spinal canal. The present study analyzed pre- and postoperative magnetic resonance imaging (MRI) measurements of the lumbar canal. Material and Methods This was a prospective study of 30 lumbar levels. Patients < 18 years of age with unilateral compression, previous surgery at the same level, and spinal instability were excluded. Endoscopic posterior decompression was used. Pre- and postoperative MRIs of all the patients were performed...
March 20, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28296723/surgical-treatment-for-bacterial-meningitis-after-spinal-surgery-a-case-report
#20
Li-Min Zhang, Liang Ren, Zhen-Qi Zhao, Yan-Rui Zhao, Yin-Feng Zheng, Jun-Lin Zhou
RATIONALE: Bacterial meningitis (BM) has been recognized as a rare complication of spinal surgery. However, there are few reports on the management of postoperative BM in patients who have undergone spinal surgery. The initial approach to the treatment of patients suspected with acute BM depends on the stage at which the syndrome is recognized, the speed of the diagnostic evaluation, and the need for antimicrobial and adjunctive therapy. PATIENT CONCERNS: Here, we report the case of a patient with lumbar spinal stenosis and underwent a transforaminal lumbar interbody fusion at L4-L5...
March 2017: Medicine (Baltimore)
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