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https://www.readbyqxmd.com/read/28448398/intrathecal-morphine-versus-extended-release-epidural-morphine-for-postoperative-pain-control-in-pediatric-patients-undergoing-posterior-spinal-fusion
#1
Mindy Cohen, Jeannie Zuk, Nancy McKay, Mark Erickson, Zhaoxing Pan, Jeffrey Galinkin
BACKGROUND: Posterior spinal fusion for scoliosis is one of the most painful elective pediatric surgeries. Good postoperative pain control allows early ambulation and return of ability to tolerate oral intake. Options for analgesia in this patient population are suboptimal. We hypothesized that extended-release epidural morphine (EREM) would provide better pain control and less adverse effects compared to intrathecal (IT) morphine. METHODS: The primary outcome was total IV morphine consumption during 0-48 hours postoperatively...
April 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28448397/prophylactic-pentazocine-reduces-the-incidence-of-pruritus-after-cesarean-delivery-under-spinal-anesthesia-with-opioids-a-prospective-randomized-clinical-trial
#2
Masato Hirabayashi, Katsushi Doi, Noritaka Imamachi, Tomomune Kishimoto, Yoji Saito
BACKGROUND: The incidence of pruritus after cesarean delivery under spinal anesthesia with opioids is high, ranging from 50% to 100%. Pruritus is difficult to prevent; however, pentazocine has been shown to be an effective treatment. Despite this, the prophylactic effect of pentazocine on pruritus has not been defined. This randomized double-blind trial aimed to evaluate the effect of intraoperative IV pentazocine on the incidence of opioid-induced pruritus within the first 24 hours after administration of neuraxial opioids...
April 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28438431/phantom-to-clinic-development-of-hypofractionated-stereotactic-body-radiotherapy-for-early-stage-glottic-laryngeal-cancer
#3
Chuxiong Ding, Stephen G Chun, Baran D Sumer, Lucien A Nedzi, Ramzi E Abdulrahman, John S Yordy, Pam Lee, Brian Hrycushko, Timothy D Solberg, Chul Ahn, Robert D Timmerman, David L Schwartz
The purpose of this study was to commission and clinically test a robotic stereotactic delivery system (CyberKnife, Sunnyvale, CA) to treat early-stage glottic laryngeal cancer. We enrolled 15 patients with cTis-T2N0M0 carcinoma of the glottic larynx onto an institutional review board (IRB)-approved clinical trial. Stereotactic body radiotherapy (SBRT) plans prescribed 45 Gy/10 fractions to the involved hemilarynx. SBRT dosimetry was compared with (1) standard carotid-sparing laryngeal intensity-modulated radiation therapy (IMRT) and (2) selective hemilaryngeal IMRT...
April 21, 2017: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/28399049/evaluation-of-gabapentin-and-clonidine-use-in-children-following-spinal-fusion-surgery-for-idiopathic-scoliosis-a-retrospective-review
#4
Dinesh K Choudhry, B Randall Brenn, Karen Sacks, Suken Shah
BACKGROUND: Opioids are the mainstay of therapy for pain relief following posterior spinal fusion (PSF) surgery. Various adjunctive medications are being used to augment analgesia and to reduce opioid-related side effects. At our institution, we have sequentially added 2 adjuncts to a standard morphine patient-controlled analgesia (PCA) regimen. The goal of our study was to evaluate pain control and the benefit of gabapentin and the combination of gabapentin and clonidine, whereas morphine PCA was in use in children following PSF surgery...
April 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28365579/the-use-of-magnetic-resonance-imaging-in-axial-spondyloarthritis-time-to-bridge-the-gap-between-radiologists-and-rheumatologists
#5
Alexander N Bennett, Helena Marzo-Ortega, Daljit Kaur-Papadakis, Amer Rehman
OBJECTIVE: Magnetic resonance imaging (MRI) is involved in the assessment of axial spondyloarthritis (axSpA); however, anecdotal evidence suggests diverse practice among radiologists. The objective of this study was to describe current practice in the use of MRI for assessment of axSpA by UK radiologists. METHODS: Six hundred ninety-nine UK radiologists were invited to complete an online survey. Availability of MR scanners, familiarity with axSpA disease-specific lesions, and MRI protocols and definitions of positive sacroiliac joint (SIJ) or spinal MRI were assessed...
April 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28340495/residents-learning-curve-of-lumbar-transforaminal-epidural-steroid-injections
#6
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
#7
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/28338452/differentiation-of-idiopathic-spinal-cord-herniation-from-dorsal-arachnoid-webs-on-mri-and-ct-myelography
#8
Randall Schultz, Andrew Steven, Aaron Wessell, Nancy Fischbein, Charles A Sansur, Dheeraj Gandhi, David Ibrahimi, Prashant Raghavan
OBJECTIVE Dorsal arachnoid webs (DAWs) and spinal cord herniation (SCH) are uncommon abnormalities affecting the thoracic spinal cord that can result in syringomyelia and significant neurological morbidity if left untreated. Differentiating these 2 entities on the basis of clinical presentation and radiological findings remains challenging but is of vital importance in planning a surgical approach. The authors examined the differences between DAWs and idiopathic SCH on MRI and CT myelography to improve diagnostic confidence prior to surgery...
March 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28322240/international-spinal-cord-injury-endocrine-and-metabolic-extended-data-set
#9
W A Bauman, J M Wecht, F Biering-Sørensen
OBJECTIVE: The objective of this study was to develop the International Spinal Cord Injury (SCI) Endocrine and Metabolic Extended Data Set (ISCIEMEDS) within the framework of the International SCI Data Sets that would facilitate consistent collection and reporting of endocrine and metabolic findings in the SCI population. SETTING: This study was conducted in an international setting. METHODS: The ISCIEMEDS was developed by a working group...
March 21, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28301777/vertebral-body-compression-fractures-and-bone-density-automated-detection-and-classification-on-ct-images
#10
Joseph E Burns, Jianhua Yao, Ronald M Summers
Purpose To create and validate a computer system with which to detect, localize, and classify compression fractures and measure bone density of thoracic and lumbar vertebral bodies on computed tomographic (CT) images. Materials and Methods Institutional review board approval was obtained, and informed consent was waived in this HIPAA-compliant retrospective study. A CT study set of 150 patients (mean age, 73 years; age range, 55-96 years; 92 women, 58 men) with (n = 75) and without (n = 75) compression fractures was assembled...
March 16, 2017: Radiology
https://www.readbyqxmd.com/read/28280734/saving-the-on-scene-time-for-out-of-hospital-cardiac-arrest-patients-the-registered-nurses-role-and-performance-in-emergency-medical-service-teams
#11
Ming-Wei Lin, Che-Yu Wu, Chih-Long Pan, Zhong Tian, Jyh-Horng Wen, Jet-Chau Wen
For out-of-hospital cardiac arrest (OHCA) patients, every second is vital for their life. Shortening the prehospital time is a challenge to emergency medical service (EMS) experts. This study focuses on the on-scene time evaluation of the registered nurses (RNs) participating in already existing EMS teams, in order to explore their role and performance in different EMS cases. In total, 1247 cases were separated into trauma and nontrauma cases. The nontrauma cases were subcategorized into OHCA (NT-O), critical (NT-C), and noncritical (NT-NC) cases, whereas the trauma cases were subcategorized into collar-and-spinal board fixation (T-CS), fracture fixation (T-F), and general trauma (T-G) cases...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28279990/hindbrain-herniation-in-chiari-ii-malformation-on-fetal-and-postnatal-mri
#12
U D Nagaraj, K S Bierbrauer, B Zhang, J L Peiro, B M Kline-Fath
BACKGROUND AND PURPOSE: As the practice of in utero repair of myelomeningoceles becomes more prevalent, knowledge of the expected MR imaging findings has become increasingly important. Our aim was to examine neuroimaging findings with a focus on hindbrain herniation and ventricular size in fetuses with open spinal dysraphism and to compare them with postnatal imaging features in groups undergoing prenatal-versus-postnatal repair. MATERIALS AND METHODS: Single-center retrospective analysis was performed on MRIs of fetuses with open spinal dysraphism from January 2004 through July 2015 with available postnatal imaging...
March 9, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28269706/a-stimulation-driven-exoskeleton-for-walking-after-paraplegia
#13
Sarah R Chang, Mark J Nandor, Lu Li, Kevin M Foglyano, John R Schnellenberger, Rudi Kobetic, Roger D Quinn, Ronald J Triolo
An untethered version of a stimulation-driven exoskeleton was evaluated for its ability to restore walking after paralysis from spinal cord injury. The hybrid neuroprosthesis (HNP) combined a passive variable-constraint exoskeleton for stability and support with functional neuromuscular stimulation (FNS) to contract the paralyzed muscles to drive limb movement. This self-contained HNP was operated by an onboard controller that sampled sensor signals, generated appropriate commands to both the exoskeletal constraints and integrated stimulator, and transmitted data wirelessly via Bluetooth to an off-board computer for real-time monitoring and recording for offline analysis...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28239663/radiographic-indices-for-lumbar-developmental-spinal-stenosis
#14
Jason Pui Yin Cheung, Karen Ka Man Ng, Prudence Wing Hang Cheung, Dino Samartzis, Kenneth Man Chee Cheung
BACKGROUND: Patients with developmental spinal stenosis (DSS) are susceptible to developing symptomatic stenosis due to pre-existing narrowed spinal canals. DSS has been previously defined by MRI via the axial anteroposterior (AP) bony spinal canal diameter. However, MRI is hardly a cost-efficient tool for screening patients. X-rays are superior due to its availability and cost, but currently, there is no definition of DSS based on plain radiographs. Thus, the aim of this study is to develop radiographic indices for diagnosing DSS...
2017: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/28227967/a-stimulation-driven-exoskeleton-for-walking-after-paraplegia
#15
Sarah R Chang, Mark J Nandor, Lu Li, Kevin M Foglyano, John R Schnellenberger, Rudi Kobetic, Roger D Quinn, Ronald J Triolo, Sarah R Chang, Mark J Nandor, Lu Li, Kevin M Foglyano, John R Schnellenberger, Rudi Kobetic, Roger D Quinn, Ronald J Triolo, Mark J Nandor, Rudi Kobetic, Roger D Quinn, John R Schnellenberger, Sarah R Chang, Kevin M Foglyano, Lu Li, Ronald J Triolo
An untethered version of a stimulation-driven exoskeleton was evaluated for its ability to restore walking after paralysis from spinal cord injury. The hybrid neuroprosthesis (HNP) combined a passive variable-constraint exoskeleton for stability and support with functional neuromuscular stimulation (FNS) to contract the paralyzed muscles to drive limb movement. This self-contained HNP was operated by an onboard controller that sampled sensor signals, generated appropriate commands to both the exoskeletal constraints and integrated stimulator, and transmitted data wirelessly via Bluetooth to an off-board computer for real-time monitoring and recording for offline analysis...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28195229/international-spinal-cord-injury-bowel-function-basic-data-set-version-2-0
#16
K Krogh, A Emmanuel, B Perrouin-Verbe, M A Korsten, M J Mulcahey, F Biering-Sørensen
STUDY DESIGN: International expert working group. OBJECTIVES: To revise the International Spinal Cord Injury (SCI) Bowel Function Basic Data Set as a standardized format for the collecting and reporting of a minimal amount of information on bowel function in clinical practice and research. SETTING: Working group appointed by the American Spinal injury association (ASIA) and the International Spinal Cord Society (ISCoS). METHODS: The draft prepared by the working group was reviewed by the International SCI Data Set Committee and later by members of the ISCoS Executive and Scientific Committees and the ASIA board...
February 14, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28162204/-evidence-based-clinical-practice-guidelines-for-the-treatment-of-dural-tears-and-the-consequent-cerebrospinal-fluid-leak-during-spine-surgery
#17
(no author information available yet)
Dural tears (DT) and the consequent cerebral spinal fluid (CSF) leak are not rare in spine surgeries. CSF leak can be troublesome, leading to pseudomeningocele, cutaneous CSF fistula, and meningitis. Revision surgery is unavoidable in some cases. The reported incidences of DT and CSF leak are different according to the various pathologies. Ossification of the posterior longitudinal ligament, revision spine surgery and multi-segment laminectomy have higher risks for DT. Various techniques have been described to manage this complication, such as bed rest, repair with dural substitutes, fibrin glue, gelatin sponge, lumbar drain, muscle flap, etc...
February 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28158159/full-endoscopic-assisted-lumbar-decompressive-surgery-performed-in-an-outpatient-ambulatory-facility-report-of-5-years-of-complications-and-risk-factors
#18
Solomon Kamson, Andrea M Trescot, Paul D Sampson, Yiyi Zhang
BACKGROUND: Minimally invasive surgery (MIS) technique is becoming the standard tissue sparing approach for decompression of lumbar central and lateral recess stenosis, intervertebral disc herniation, or any situation that would have required extensive open decompression laminectomy. Full-endoscopic or arthroscopic assisted surgery is arguably the "ultra-MIS" approach to lumbar spinal pathology. Age and body mass index (BMI) are significant risk factors to be considered in full-endoscopic assisted ultra-MIS...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28103119/iatrogenic-spinal-cord-injury-in-a-trauma-patient-with-ankylosing-spondylitis
#19
Ahmad Maarouf, Colleen M McQuown, Jennifer A Frey, Rami A Ahmed, Lisa Derrick
BACKGROUND: The recommended practice for over 30 years has been to routinely immobilize patients with unstable cervical spinal injuries using cervical spinal collars. It is shown that patients with Ankylosing spondylitis (AS) are four times more likely to suffer a spinal fracture compared to the general population and have an eleven-fold greater risk of spinal cord injury. Current protocols of spinal immobilization were responsible for secondary neurologic deterioration in some of these patients...
May 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28094482/real-time-ultrasound-guided-spinal-anesthesia-in-patients-with-predicted-difficult-anatomy
#20
Hesham Elsharkawy, Ankit Maheshwari, Rovnat Babazade, Anahi Perlas, Sherif Zaky, Loran M Soliman
BACKGROUND: There are limited reports of lumbar neuraxial blocks using real-time ultrasound in patients with predicted difficulties. We compared the number of attempts to perform spinal anesthesia using real time ultrasound guidance versus landmark technique in patients meeting predefined criteria for difficult spinal anesthesia. We also compared procedure time, block success, patient satisfaction and difficulty scores between groups. METHODS: Following institutional review board approval patients scheduled for total hip or knee arthroplasty with expected difficulty to perform spinal anesthesia were included...
January 17, 2017: Minerva Anestesiologica
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