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https://www.readbyqxmd.com/read/28735135/endoscope-assisted-abscess-drainage-secondary-to-endoscope-assisted-tlif-1-year-follow-up
#1
Karthik Madhavan, Steven Shelby Burks, Lee Onn Chieng, Anand Veeravagu, Michael Y Wang
INTRODUCTION: Endoscopic discectomy and fusions have been gaining popularity in the recent past and are noted to be safe for its application in elderly population. It involves ultra-small incision for discectomy followed by placement of percutaneous screws in awake patients. Treatment of advanced spinal pathology using endoscope-assisted techniques are challenging. Although not common with endoscopic approach, post-operative infection can be problematic as there are no established guidelines on its management...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28731977/interventions-for-neuropathic-pain-an-overview-of-systematic-reviews
#2
Svjetlana Dosenovic, Antonia Jelicic Kadic, Maja Miljanovic, Marina Biocic, Krste Boric, Marija Cavar, Nikolina Markovina, Katarina Vucic, Livia Puljak
Numerous interventions for neuropathic pain (NeuP) are available, but its treatment remains unsatisfactory. We systematically summarized evidence from systematic reviews (SRs) of randomized controlled trials on interventions for NeuP. Five electronic databases were searched up to March 2015. Study quality was analyzed using A Measurement Tool to Assess Systematic Reviews. The most common interventions in 97 included SRs were pharmacologic (59%) and surgical (15%). The majority of analyzed SRs were of medium quality...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28713631/percutaneous-cervical-laser-diskectomy-thermoannuloplasty-and-thermonucleoplasty-comparable-results-without-surgery
#3
EDITORIAL
Nancy E Epstein
BACKGROUND: Utilizing the literature, the results of three different minimally invasive surgery (MIS) anterior cervical percutaneous operations for neck/mild radicular pain and magnetic resonance (MR)-documented "contained" (not extruded/sequestrated) discs were evaluated. Results were compared with patients treated nonsurgically for comparable/greater neurological compromise, and even more severe cervical disc disease. METHODS: There were three MIS percutaneous anterior cervical discectomy procedures...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28709170/-leptomeningeal-carcinomatosis-as-a-rare-metastatic-spreading-of-braf-mutated-microsatellite-stable-colon%C3%A2-cancer
#4
Aksana Höblinger, Stephanie Weber, Florian Tschirner, Stefan Kröber, Konrad Streetz
Leptomeningeal carcinomatosis is a rare but serious complication of solid tumors such as melanoma, breast and lung cancer, as well as gastrointestinal carcinomas. Its clinical manifestation is highly variable, presenting as radicular pain with or without neurological deficits, as well as with headaches and hallucinatory irritation symptoms. Leptomeningeal carcinomatosis is often misdiagnosed, which delays treatment. Here we report a rare case of a patient with BRAF-mutated microsatellite stable colon carcinoma with lymphatic and skeletal metastases, who developed neurological symptoms one month after the initial diagnosis of malignancy...
July 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28707832/-surgical-management-of-the-spinal-metastases
#5
Dennis E Dominguez, Nicolas Lauper, Alejandro Velastegui, Jermy Reynolds
Seventy per cent of patients with cancer have evidence of metastases and spinal involvement may occur in up to 50 %. Pain is the most frequent symptom and it occurs in 90 % of the patients. It exist three different type of spinal pain : inflammatory, radicular and mechanical pain. Pain could be related to a neurological compromise and treatment becomes urgent. Steroids are introduced even if surgery is indicated. The Spinal Instability Neoplastic Score is a useful tool in order to determine instability in spinal metastases...
December 14, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28704331/mis-single-position-lateral-and-oblique-lateral-lumbar-interbody-fusion-and-bilateral-pedicle-screw-fixation-feasibility-and-perioperative-results
#6
Daniel J Blizzard, J Alex Thomas
STUDY DESIGN: Retrospective review of prospectively collected data of the first 72 consecutive patients treated with single-position one- or two-level lateral (LLIF) or oblique lateral interbody fusion (OLLIF) with bilateral percutaneous pedicle screw and rod fixation by a single spine surgeon. OBJECTIVE: To evaluate the clinical feasibility, accuracy, and efficiency of a single-position technique for LLIF and OLLIF with bilateral pedicle screw and rod fixation...
July 12, 2017: Spine
https://www.readbyqxmd.com/read/28700454/posterior-only-hemivertebra-resection-for-congenital-cervicothoracic-scoliosis-correcting-neck-tilt-and-balancing-the-shoulders
#7
Zhonghui Chen, Yong Qiu, Zezhang Zhu, Song Li, Xi Chen, Liang Xu, Xu Sun
STUDY DESIGN: A retrospective study. OBJECTIVE: To evaluate radiographic and cosmetic outcomes following posterior-only cervicothoracic hemivertebra resection and instrumentation. SUMMARY OF BACKGROUND DATA: Cervicothoracic hemivertebra is a rare congenital deformity. It locates between the mobile cervical spine and the fixed thoracic spine, leading to rapid curve progression, shoulder imbalance, fixed torticollis and facial asymmetry. METHODS: This study reviewed a consecutive series of 18 patients with cervicothoracic hemivertebra...
July 11, 2017: Spine
https://www.readbyqxmd.com/read/28700369/pulsed-radiofrequency-in-chronic-pain
#8
Thibaut Vanneste, Astrid Van Lantschoot, Koen Van Boxem, Jan Van Zundert
PURPOSE OF REVIEW: The increasing number of publications on pulsed radiofrequency (PRF) treatment of chronic pain reflects the interest for this technique. We summarize the literature for PRF in five indications: radicular pain, trigeminal neuralgia (TN), occipital neuralgia, shoulder and knee pain. RECENT FINDINGS: The efficacy and safety of PRF adjacent to the dorsal root ganglion was documented on cervical and on lumbar level.PRF has been used for the treatment of TN...
July 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28680728/intradural-extramedullary-cavernous-malformation-with-extensive-superficial-siderosis-of-the-neuraxis-case-report-and-review-of-literature
#9
Pedram Golnari, Sameer A Ansari, Ali Shaibani, Michael C Hurley, Matthew B Potts, Missia E Kohler, Patrick A Sugrue, Babak S Jahromi
BACKGROUND: Spinal cavernous malformations usually affect the vertebral bodies and are seldom intradural. Here, we report a rare spinal intradural-extramedullary cavernous malformation associated with extensive superficial siderosis along the neuraxis in a patient with radicular complaints. CASE DESCRIPTION: A 60-year-old male presented with subacute headaches, intermittent fever, and acute back and radicular leg pain for 1-2 weeks. Magnetic resonance imaging revealed an intradural-extramedullary lesion just below the conus medullaris (at the L2 level)...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28666403/cervical-myelopathy-in-a-patient-referred-for-lower-extremity-symptoms
#10
Steven M Jackson
The patient was a 38-year-old male referred to physical therapy with complaints of right lower extremity radicular pain and left lower extremity weakness. Following physical therapy examination, the primary care physician referred the patient to a neurologist, who performed electromyography and nerve conduction studies and ordered a magnetic resonance image. Cervical spine imaging revealed a C5-6 disc extrusion with myelopathy. J Orthop Sports Phys Ther 2017;47(7):510. doi:10.2519/jospt.2017.5071.
July 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28659771/cognitive-impairment-in-patients-with-chronic-neuropathic-or-radicular-pain-an-interaction-of-pain-and-age
#11
Orla Moriarty, Nancy Ruane, David O'Gorman, Chris H Maharaj, Caroline Mitchell, Kiran M Sarma, David P Finn, Brian E McGuire
A growing body of empirical research has confirmed an association between chronic pain and cognitive dysfunction. The aim of the present study was to determine whether cognitive function is affected in patients with a diagnosis of chronic neuropathic or radicular pain relative to healthy control participants matched by age, gender, and years of education. We also examined the interaction of pain with age in terms of cognitive performance. Some limitations of previous clinical research investigating the effects of chronic pain on cognitive function include differences in the pain and cognitive scale materials used, and the heterogeneity of patient participants, both in terms of their demographics and pathological conditions...
2017: Frontiers in Behavioral Neuroscience
https://www.readbyqxmd.com/read/28651128/local-up-regulation-of-interferon-%C3%AE-ifn-%C3%AE-following-disc-herniation-is-involved-in-the-inflammatory-response-underlying-acute-lumbar-radicular-pain
#12
Gunn-Helen Moen, Aurora Moen, Elina I Schistad, Johannes Gjerstad
Lumbar radicular pain after disc herniation may be associated with release of pro-inflammatory cytokines from nucleus pulposus (NP) tissue. In the present study we examined the role of interferon-γ (IFN-γ) and cluster of differentiation 68 (CD68) in the acute phase of this process. First, in an animal model mimicking the clinical situation after disc herniation, the role of IFN-γ close to the dorsal nerve roots was studied. Next, in patients with lumbar radicular pain due to disc herniation, we examined how two single nucleotide polymorphisms (SNPs; rs2069705 and rs2069718) are important for the IFN-γ expression influenced the pain behavior...
June 23, 2017: Cytokine
https://www.readbyqxmd.com/read/28646343/clinical-outcome-following-anterior-cervical-discectomy-and-fusion-with-and-without-anterior-cervical-plating-for-the-treatment-of-cervical-disc-herniation-a-25-year-follow-up-study
#13
Benedikt W Burkhardt, Moritz Brielmaier, Karsten Schwerdtfeger, Joachim M Oertel
Extreme long-term clinical outcome studies following anterior cervical discectomy and fusion (ACDF) with an autologous iliac crest with and without Caspar plating (ACDF + CP) for the treatment of radiculopathy caused by cervical disc herniation (CDH) are extremely rare. Hospital records of patients who underwent ACDF or ACDF + CP for the treatment of CDH at least 17 years ago were reviewed. Information about diagnosis, surgery, pre- and postoperative clinical process, and repeated procedure was analyzed...
June 23, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28645597/spinal-arteriovenous-malformation-associated-with-parkes-weber-syndrome-report-of-two-cases-and-literature-review
#14
Zi-Fu Li, Qiang Li, Yi Xu, Bo Hong, Qing-Hai Huang, Jian-Min Liu
OBJECTIVE: To present two cases of Parkes Weber syndrome (PWS) with spinal arteriovenous malformation(AVM), and discuss the radiological features and clinical treatment with literature review. METHODS: Clinical data on two PWS patients with spinal AVM was acquired in a prospective follow-up investigation. Clinical manifestations, radiographic features, procedural results and follow-up outcome were collected and reviewed together with literature review. RESULTS: The first patient presented with limb weakness and urinary dysfunction and the second with repetitive subarachnoid hemorrhage followed by paraplegia...
June 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28632561/early-postoperative-magnetic-resonance-imaging-in-detecting-radicular-pain-after-lumbar-decompression-surgery-retrospective-study-of-the-relationship-between-dural-sac-cross-sectional-area-and-postoperative-radicular-pain
#15
Toshimasa Futatsugi, Jun Takahashi, Hiroki Oba, Shota Ikegami, Yuji Mogami, Syunichi Shibata, Yoshihito Ohji, Hirotaka Tanikawa, Hiroyuki Kato
STUDY DESIGN: A retrospective analysis. OBJECTIVE: To evaluate the association between early postoperative dural sac cross-sectional area (DCSA) and radicular pain. SUMMARY OF BACKGROUND DATA: The correlation between postoperative magnetic resonance imaging (MRI) findings and postoperative neurological symptoms after lumbar decompression surgery is controversial. METHODS: This study included 115 patients who underwent lumbar decompression surgery followed by MRI within 7 days postoperatively...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28606606/potential-risks-of-using-cement-augmented-screws-for-spinal-fusion-in-patients-with-low-bone-quality
#16
M Martín-Fernández, A López-Herrradón, A R Piñera, F Tomé-Bermejo, J M Duart, M D Vlad, M G Rodríguez-Arguisjuela, L Álvarez-Galovich
BACKGROUND CONTEXT: Dramatic increases in the average life expectancy have led to increases in the variety of degenerative changes and deformities observed in the aging spine. The elderly population can present challenges for spine surgeons, not only because of increased comorbidities, but also because of the quality of their bones. Pedicle screws are the implants used most commonly in spinal surgery for fixation, but their efficacy depends directly on bone quality. While PMMA-augmented screws represent an alternative for patients with osteoporotic vertebrae, their use has raised some concerns due to the possible association between cement leakages (CLs) and other morbidities...
June 9, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28600230/cytokine-and-chemokine-profile-changes-in-patients-with-lower-segment-lumbar-degenerative-spondylolisthesis
#17
Juraj Sutovsky, Martin Benco, Martina Sutovska, Michaela Kocmalova, Lenka Pappova, Juraj Miklusica, Andrej Frano, Egon Kurca
BACKGROUND: Lumbar degenerative spondylolisthesis (DS) develops as a result of inflammatory and remodeling processes in facet joints (FJs). Several inflammatory cytokines are involved in the osteoarthritic and remodeling changes that occur and in low-back and/or radicular pain, the most prevalent clinical symptom of disease. This study improves knowledge related to the roles that 27 cytokines, chemokines and growth factors play in the pathophysiology of lumbar DS. MATERIAL AND METHODS: Cytokine levels were examined using capture sandwich immunoassay using the Bio-Plex(®) 200 System and the Bio-PlexTM Human Cytokine Standard 27-Plex, Group I (Bio-Rad, Hercules, California, USA) separately in intervertebral discs (IVDs) and FJ bone tissue...
June 6, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28586588/outcome-analysis-of-two-different-injection-solutions-for-epidural-injection-in-radicular-lumbar-backache-syndromes
#18
Muhammad Saqib, Sajid Nazir Bhatti, Muhammad Ayaz Khan, Khalid Samad, Muhammad Mukhtar Khan, Ehtisham Mukhtar Khan Afridi, Rubaiqa Khan, Muhammad Imran Khan
BACKGROUND: Backache is a significant source of disability and suffering in our society. The treatment modalities need continued enhancement in order to achieve the desired goals of lowering morbidity and financial losses while improving the response of the patient. METHODS: This prospective comparative study was conducted at the department of Orthopaedics and Spine Surgery, Khyber Teaching Hospital Peshawar from July 2013 to June 2015. Two interventional groups were designated; Group 1 was comprised of 54 patients who were injected with epidural bupivacaine plus methylprednisolone while Group 2 included 55 patients who were injected with bupivacaine only...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28575334/characterization-of-peripheral-and-central-sensitization-after-dorsal-root-ganglion-intervention-in-patients-with-unilateral-lumbosacral-radicular-pain-a-prospective-pilot-study
#19
V Mehta, S Snidvongs, B Ghai, R Langford, T Wodehouse
Background.: Quantitative sensory testing (QST) has been used to predict the outcome of epidural steroid injections in lumbosacral radicular pain and has the potential to be an important tool in the selection of appropriate treatment (such as epidural steroid injections vs surgery) for patients with chronic radicular pain. In addition, QST assists in identification of the pain pathways of peripheral and central sensitization in selected groups of patients. Methods.: Twenty-three patients were given dorsal root ganglion (DRG) infiltration with local anaesthesia and steroid ('DRG block'), and those who demonstrated at least 50% pain relief were offered pulsed radiofrequency (PRF) to the DRG...
June 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28567591/ribosomal-pcr-assay-of-excised-intervertebral-discs-from-patients-undergoing-single-level-primary-lumbar-microdiscectomy
#20
Todd F Alamin, Marcus Munoz, Alicia Zagel, Agnes Ith, Eugene Carragee, Ivan Cheng, Gaetano Scuderi, Indre Budvytiene, Niaz Banei
PURPOSE: To determine the presence of infectious microorganisms in the herniated discs of immunocompetent patients, using methodology that we hoped would be of higher sensitivity and specificity than has been reported in the past. Recent studies have demonstrated a significant rate of positive cultures for low virulent organisms in excised HNP samples (range 19-53%). These studies have served as the theoretical basis for a pilot trial, and then, a well done prospective randomized trial that demonstrated that systemic treatment with antibiotics may yield lasting improvements in a subset of patients with axial back pain...
May 31, 2017: European Spine Journal
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