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Spine, pain, neurosurgery

Alexander Hammer, Dorit Wolff, Walter Geißdörfer, Michael Schrey, Renate Ziegler, Hans-Herbert Steiner, Christian Bogdan
The authors describe the case of a 40-year-old man suffering from an epidural abscess in the thoracic spine due to a rarely isolated pathogen, Streptobacillus moniliformis, the causative agent of rat bite fever. Besides diffuse abdominal pain, ataxia, paresthesia, hypesthesia, and enhanced reflexes of the lower extremities, the patient suffered from a decreased sensation of bladder filling. His history was also positive for a rat bite 6 weeks earlier. Magnetic resonance imaging showed an epidural, space-occupying lesion compressing the spinal cord at the vertebral levels of T6-8...
April 21, 2017: Journal of Neurosurgery. Spine
Charles H Crawford, Leah Y Carreon, Mohamad Bydon, Anthony L Asher, Steven D Glassman
OBJECTIVE Patient satisfaction is a commonly used metric in the current health care environment. While factors that affect patient satisfaction following spine surgery are complex, the authors of this study hypothesized that specific diagnostic groups of patients are more likely to be satisfied after spine surgery and that this is reflected in patient-reported outcome measures. The purpose of this study was to determine if the preoperative diagnosis-disc herniation, stenosis, spondylolisthesis, adjacent segment degeneration, or mechanical disc collapse-would impact patient satisfaction following surgery...
March 24, 2017: Journal of Neurosurgery. Spine
Matthew J McGirt, Scott L Parker, Praveen Mummaneni, John Knightly, Deborah Pfortmiller, Kevin Foley, Anthony L Asher
BACKGROUND CONTEXT: Over the last decade, clinical investigators and biomedical industry groups have used significant resources to develop advanced technologies that enable less invasive spine fusions. These minimally invasive surgery (MIS) technologies often require increased expenditures by hospitals and payers. Although several small single center studies have suggested MIS technologies decrease surgical morbidity and reduce hospital stay, evidence documenting benefit from a patient perspective remains limited...
February 27, 2017: Spine Journal: Official Journal of the North American Spine Society
Nuno Rui Paulino Pereira, Stein J Janssen, Kevin A Raskin, Francis J Hornicek, Marco L Ferrone, John H Shin, Jos A M Bramer, Cornelis Nicolaas van Dijk, Joseph H Schwab
BACKGROUND CONTEXT: Assessing quality of life, functional outcome, and pain has become important in assessing the effectiveness of treatment for metastatic spine disease. Many questionnaires are able to measure these outcomes; few are validated in patients with metastatic spine disease. As a result, there is no consensus on the ideal questionnaire to use in these patients. PURPOSE: Our study aim was to assess whether certain questionnaires measuring quality of life, functional outcome, and pain (1) correlated with each other, (2) measured the construct they claim to measure, (3) had good coverage-floor and ceiling effects, (4) were reliable, and (5) whether there were differences in completion time between them...
February 24, 2017: Spine Journal: Official Journal of the North American Spine Society
David C Sing, Lionel N Metz, Stefan Dudli
STUDY DESIGN: Retrospective review. OBJECTIVE: To identify the top 100 spine research topics. SUMMARY OF BACKGROUND DATA: Recent advances in "machine learning," or computers learning without explicit instructions, have yielded broad technological advances. Topic modeling algorithms can be applied to large volumes of text to discover quantifiable themes and trends. METHODS: Abstracts were extracted from the National Library of Medicine PubMed database from five prominent peer-reviewed spine journals (European Spine Journal [ESJ], The Spine Journal [SpineJ], Spine, Journal of Spinal Disorders and Techniques [JSDT], Journal of Neurosurgery: Spine [JNS])...
January 25, 2017: Spine
Ikemefuna Onyekwelu, Steven D Glassman, Anthony L Asher, Christopher I Shaffrey, Praveen V Mummaneni, Leah Y Carreon
OBJECTIVE Prior studies have shown obesity to be associated with higher complication rates but equivalent clinical outcomes following lumbar spine surgery. These findings have been reproducible across lumbar spine surgery in general and for lumbar fusion specifically. Nevertheless, surgeons seem inclined to limit the extent of surgery, perhaps opting for decompression alone rather than decompression plus fusion, in obese patients. The purpose of this study was to ascertain any difference in clinical improvement or complication rates between obese and nonobese patients following decompression alone compared with decompression plus fusion for lumbar spinal stenosis (LSS)...
February 2017: Journal of Neurosurgery. Spine
A G Nazarenko, N A Konovalov, A V Krut'ko, T N Zamiro, I B Geroeva, R R Gubaidullin, N E Khoreva, A N Komarov, M A Stepanyan, M V Konstantinova, A M Kazachonok, R A Onoprienko, V A Korolishin, T N Kubynina, M A Martynova
TOPICALITY: The fast track technology means a complex of targeted measures involving rational preoperative preparation, minimally invasive surgery, regional anesthesia and short-acting anesthetics, and early postoperative rehabilitation. Elucidating the possibility of applying the fast track technology in neurosurgery, in particular in spinal surgery, is extremely topical. This is associated with the epidemiological data and the fact that minimally invasive techniques used in neurosurgery are highly expensive...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Nardin Samuel, Mark Bernstein, Naif M Alotaibi, Suneil K Kalia, Mohammed F Shamji
OBJECTIVE: The aim of this study is to better understand perspectives of patients with persistent postoperative neuropathic pain (PPNP) and assess perceptions of the ethical issues surrounding their structural spinal surgeon also performing spinal cord stimulation (SCS). METHODS: Semistructured face-to-face interviews with 20 neurosurgical spine patients were conducted. Patients were recruited from the neurosurgery clinics at Toronto Western Hospital and were seen in consultation for PPNP...
April 2017: Neuromodulation: Journal of the International Neuromodulation Society
Anthony L Asher, Silky Chotai, Clinton J Devin, Kristen Archer-Swygert, Scott L Parker, Mohamad Bydon, Nian Hui, Frank Harrell, Theodore Speroff, Robert Dittus, Sharon Philips, Christopher I Shaffrey, Kevin T Foley, Matthew J McGirt
INTRODUCTION: The current costs associated with spine care are unsustainable. The productivity loss and time away from work in gainfully employed patients contributes greatly to the financial burden. Therefore, it is vital to identify the factors associated with returning to work after lumbar spine surgery. We present a predictive model of ability to return to work (RTW) after lumbar spine surgery for degenerative spine disease. METHODS: Total 4694 patients undergoing elective spine surgery for degenerative lumbar disease who were employed were entered into a prospective multicenter registry (N2QOD)...
August 2016: Neurosurgery
Osman Tanriverdi, Abuzer Gungor, Mustafa Kemal Coban, Onder Okay, Umit Kamaci
Aim Spinal epidural hematomas are rare entity in neurosurgery practice. Most of them are spontaneous due to anticoagulant therapy and called spontaneous spinal epidural hematomas (SSEHs). Laminectomy or hemilaminectomy for affected levels is still the first choice in the operative treatment of an SSEH. We describe a new less invasive surgical technique, performing single-level laminectomy and washing with 0.9% sodium chloride through a thin soft catheter for a 12-level thoracic-cervical SSEH in a patient under anticoagulant therapy...
March 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Pardis Noormohammadpour, Azime Dehghani-Firouzabadi, Mohammad Ali Mansournia, Mohammad Ali Mohseni-Bandpei, Navid Moghaddam, Mojtaba Miri, Ramin Kordi
BACKGROUND: Previous studies have shown atrophy of paravertebral lumbar muscles in patients with lumbar radicular pain and have proposed rehabilitative approaches based on these findings. However, changes in cervical paravertebral muscles in patients with cervical radicular pain are still unknown. OBJECTIVE: The aim of this study was to compare the cross-sectional area (CSA) of the longus colli muscle (LCM) in patients with cervical radicular pain and healthy controls via ultrasound measurement...
June 23, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Kuo-Wei Wang, Hao-Kuang Wang, Kang Lu, Cheng-Loong Liang, Ya-Wen Chen, Po-Chou Liliang
BACKGROUND: C2 vertebroplasty is more challenging than transpedicular percutaneous vertebroplasty in the thoracic and lumbar spine. OBJECTIVE: We report an anterior ascending approach for C2 percutaneous vertebroplasty to avoid potential injury to vital structures surrounding the C2 vertebra. STUDY DESIGN: A technique note with 5 consecutive cases. SETTING: Neurosurgery department of a university hospital. METHODS: Fluoroscopically guided manual compression was applied using 3 fingers at the C5 level between the muscle and trachea...
2016: Pain Physician
Justin S Smith, Eric Klineberg, Christopher I Shaffrey, Virginie Lafage, Frank J Schwab, Themistocles Protopsaltis, Justin K Scheer, Tamir Ailon, Subaraman Ramachandran, Alan Daniels, Gregory Mundis, Munish Gupta, Richard Hostin, Vedat Deviren, Robert Eastlack, Peter Passias, D Kojo Hamilton, Robert Hart, Douglas C Burton, Shay Bess, Christopher P Ames
OBJECTIVE: Although previous reports suggest that surgery can improve the pain and disability of cervical spinal deformity (CSD), techniques are not standardized. Our objective was to assess for consensus on recommended surgical plans for CSD treatment. METHODS: Eighteen CSD cases were assembled, including a clinical vignette, cervical imaging (radiography, computed tomography/magnetic resonance imaging), and full-length standing radiography. Fourteen deformity surgeons (10 orthopedic, 4 neurosurgery) were queried regarding recommended surgical plans...
July 2016: World Neurosurgery
Kathryn T Weber, D Olivier Alipui, Cristina P Sison, Ona Bloom, Shaheda Quraishi, M Chris Overby, Mitchell Levine, Nadeen O Chahine
BACKGROUND: Many intervertebral disc diseases cause low back pain (LBP). Proinflammatory cytokines and matrix metalloproteinases (MMPs) participate in disc pathology. In this study, we examined levels of serum cytokines and MMPs in human subjects with diagnoses of disc herniation (DH), spinal stenosis (SS), or degenerative disc disease (DDD) relative to levels in control subjects. Comparison between subjects with DH and those with other diagnoses (Other Dx, grouped from SS and DDD) was performed to elaborate a pathological mechanism based on circulating cytokine levels...
January 7, 2016: Arthritis Research & Therapy
Laura Chapin, Kelly Ward, Timothy Ryken
STUDY DESIGN: Prospective cohort study. OBJECTIVE: To determine whether comorbidities and demographics, identified preoperatively, can impact patient outcomes and satisfaction after lumbar spine surgery. SUMMARY OF BACKGROUND DATA: The surgical treatment of lower back pain does not always eliminate a patient's pain and symptoms. Revision surgeries are costly and expose the patient to additional risk. We aim to identify patient characteristics that may suggest a greater or lesser likelihood of postsurgical success by examining patient-reported measures and outcomes after surgery...
July 14, 2016: Clinical Spine Surgery
C Rory Goodwin, Atman Desai, Mohamed H Khattab, Benjamin D Elder, Ali Bydon, Jean-Paul Wolinsky
BACKGROUND: Absent congenital pedicle syndrome is a posterior arch defect characterized by numerous congenital and mechanical abnormalities that result from disconnection of the anterior and posterior columns of the spinal canal. Absent congenital pedicle syndrome is a rare anomaly that is most commonly diagnosed incidentally, after evaluation of minor trauma, or after complaints of chronic neck pain. We report a case of absent congenital pedicle syndrome in a patient who presented with myelopathy and lower extremity weakness and review the literature on the surgical management of this entity...
February 2016: World Neurosurgery
Matthew J McGirt, Scott L Parker, Alan Hilibrand, Praveen Mummaneni, Steven D Glassman, Clinton J Devin, Anthony L Asher
BACKGROUND: Lumbar spine degenerative pathologies are prevalent in the United States. The health benefit of spine surgery in the elderly has been questioned. OBJECTIVE: To compare effectiveness, morbidity, and quality of care associated with surgical management of degenerative lumbar spinal disorders in elderly vs nonelderly patients. METHODS: The National Neurosurgery Quality and Outcomes Database registry prospectively collects measures of surgical safety and patient-reported outcomes for 1 year after surgery...
October 2015: Neurosurgery
Abdul Ahad, Mohammed Elsayed, Hassaan Tohid
A large number of patients do not have cauda equina syndrome (CES) on MRI to account for their clinical findings; consequently, the majority of urgent scans requested are normal. We aimed to determine whether any clinical manifestation of CES, as stated in Royal College of Radiology guidelines, could predict the presence of established CES on MRI. We also aimed to support a larger study to develop a more universal assessment tool for acute lower back pain.A retrospective analysis of consecutive patients who warranted urgent MRI was conducted...
August 2015: Neuroradiology Journal
Daisy Torres-Miranda, Farah Al-Saffar, Saif Ibrahim, Stephanie Diaz-Font
Methicillin-sensitive Staphylococcus aureus (MSSA) meningitis is a rare disease when not related to neurosurgery: there are only few reported cases in the literature to date. We describe a case that highlights not only meningeal but also diffuse and rapidly progressive systemic involvement with multi-organ failure. A 64-year-old male presented to our hospital with a chief complaint of acute worsening of his usual chronic lower back pain, progressive weakness in lower extremities and subjective fevers at home...
April 15, 2015: Infectious Disease Reports
Sümeyye Çoruh Kaplan, Murat Şakir Ekşi
OBJECTIVE: Cervical spine encompasses a bridge role between the head and the lower parts of the spine and therefore has unique properties. Our aim in this study was to evaluate the cervical sagittal alignment parameters in pediatric and adult non-surgical patients and to find any differences in respect of age, sex and admission type. METHODS: All patients who were admitted to emergency and neurosurgery clinics of Diyarbakir Bismil State Hospital due to cervical spine problems (trauma, radiculopathy, paraspinal pain) in 2014 were enrolled retrospectively into the study...
June 2015: Korean Journal of Spine
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