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Spine, pain, neurosurgery

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https://www.readbyqxmd.com/read/29744317/prospective-randomized-comparative-study-to-evaluate-epidural-fibrosis-and-surgical-outcome-in-patients-undergoing-lumbar-laminectomy-with-epidural-autologous-free-fat-graft-or-gelfoam-a-preliminary-study
#1
Shivender Sobti, Ashwani Grover, B Paul S John, Sarvpreet Singh Grewal, Uttam B George
Introduction: Epidural fibrosis (EF) contributes to unsatisfactory relief of symptoms and failed back syndrome after spine surgery. EF around the nerve root can be more refractory to treatment than the original disc herniation itself. Reoperation on the scar can produce more scarring. Few studies have been conducted regarding the type of material to be used for decreasing EF. Materials and Methods: The prospective randomized comparative study was conducted in the Department of Neurosurgery and Radiodiagnosis, of a tertiary care hospital...
April 2018: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/29709757/rapid-recovery-of-spontaneous-spinal-epidural-hematoma-without-surgical-treatment-a-case-reportand-literature-review
#2
Shu Baozhang, Fengyang Geng, Jiyue Wang, Zhiti Zhang, Chigang Du
BACKGROUND: Spontaneousspinal epidural hematoma (SSEH) is a relatively uncommon yet potentially disabling neurological emergency.The classical presentation includes a severe acute attack, sometimes radiating pain at the back,interscapular, or neckareas, followed by neurological deficits. The main treatment is surgical,and self-healing cases are rare. CASE DESCRIPTION: A 17-year-old female was admitted to the department of neurosurgery with neck pain, myasthenia of the limbs, and difficulty moving...
April 27, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29704693/cardiac-arrest-during-spine-surgery-in-the-prone-position-case-report-and-review-of-the-literature
#3
REVIEW
Victor E Staartjes, Shiva A Schillevoort, Patricia G Blum, J Peter van Tintelen, Wouter E Kok, Marc L Schröder
OBJECTIVE: Intraoperative cardiac arrest (CA) is usually attributable to pre-existing disease or intraoperative complications. In rare cases, intraoperative stress can demask certain genetic diseases, such as catecholaminergic polymorphic ventricular tachycardia (CPVT). It is essential that neurosurgeons be aware of the etiologies, risk factors, and initial management of CA during surgery with the patient in the prone position. METHODS: We present a case of CA directly after spinal fusion for lumbar spondylolisthesis and review the literature on cardiac arrests during spinal neurosurgery in the prone position...
April 26, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29695262/hypericum-perforatum-to-improve-post-operative-pain-outcome-after-monosegmental-spinal-microdiscectomy-hypos-a-study-protocol-for-a-randomised-double-blind-placebo-controlled-trial
#4
Christa Raak, Wolfram Scharbrodt, Bettina Berger, Arndt Büssing, René Geißen, Thomas Ostermann
BACKGROUND: Spinal disc herniation is a frequently occurring degenerative disease of the spine. Many patients undergoing surgery suffer from radicular pain, known as memory pain, beginning from the third post-operative day. This results in the prescription of high-dose opioid medications. In homeopathy, Hypericum perforatum is known as a remedy for unbearable, shooting or jabbing pain especially when neural damage is involved. Reduction of pain after application of H. perforatum has been observed in previous studies...
April 25, 2018: Trials
https://www.readbyqxmd.com/read/29691052/assessment-of-cervical-range-of-motion-in-patients-after-axis-fracture
#5
Andżelina Wolan-Nieroda, Andrzej Maciejczak, Grzegorz Przysada, Adrian Kużdżał, Grzegorz Magoń, Michlina Czarnota, Mariusz Drużbicki, Agnieszka Guzik
BACKGROUND: Surgical treatment of odontoid fractures with posterior C1/C2 fusion always leads to severe limitations in mobility of the cervical spine and head. PURPOSE: To assess the mobility of the cervical spine in patients treated with various surgical methods after an axis body fracture. MATERIAL AND METHODS: A group of 61 subjects receiving surgical treatment in a group of 214 subjects treated for odontoid fractures at one ward of neurosurgery at a regional hospital...
December 6, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/29656532/of-lamp-posts-keys-and-fabled-drunkards-a-perspectival-tale-of-4-guidelines
#6
Trisha Greenhalgh
BACKGROUND: Evidence-based medicine is the application of research findings to inform individual clinical decisions. There is a tension-both philosophical and practical-between the average result from a population study and the circumstances and needs of an individual patient. This personal account of "evidence-based" trauma care illustrates and explores this tension. THE CASE: The author, a keen athlete, describes her experience of a high-impact cycle accident that led to limb fractures (which were diagnosed and treated according to evidence-based guidelines) and also an occult injury to the cervical spine (which was not diagnosed at the time)...
April 15, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29576907/spinal-case-of-the-month-with-short-perspective-how-would-you-treat-this-l3-l4-synovial-cyst
#7
REVIEW
Nancy E Epstein
Background: In this new section, Case of the Month with Short Perspective from Surgical Neurology International, we want to see how various spine surgeons would approach different spinal pathologies. In this first case, an elderly male presented with 3 years of lower back pain and progressive neurogenic claudication with bilateral radiculopathy that had exacerbated over the prior 6 months. An outside physician performed a magnetic resonance (MR) study of the lumbar spine that showed a massive synovial cyst filling the spinal canal (e...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29503680/postoperative-assessment-of-pedicle-screws-and-management-of-breaches-a-survey-among-canadian-spine-surgeons-and-a-new-scoring-system
#8
Ahmed Aoude, Saber Ghadakzadeh, Hamzah Alhamzah, Maryse Fortin, Peter Jarzem, Jean A Ouellet, Michael H Weber
Study Design: This study was designed as a survey amongst Canadian spine surgeon to determine a scoring system to standardize pedicle screw placement assessment. Purpose: This study aimed to obtain and analyze the opinions of spine surgeons regarding the assessment of pedicle screw accuracy, with the goal of establishing clinical guidelines for interventions for malpositioned pedicle screws. Overview of Literature: Accurate placement of pedicle screws is challenging, and misalignment can lead to various complications...
February 2018: Asian Spine Journal
https://www.readbyqxmd.com/read/29238637/spinal-instability-neoplastic-score-sins-reliability-among-spine-fellows-and-resident-physicians-in-orthopedic-surgery-and-neurosurgery
#9
Shandy Fox, Michael Spiess, Luke Hnenny, Daryl R Fourney
Study Design: Reliability analysis. Objectives: The Spinal Instability Neoplastic Score (SINS) was developed for assessing patients with spinal neoplasia. It identifies patients who may benefit from surgical consultation or intervention. It also acts as a prognostic tool for surgical decision making. Reliability of SINS has been established for spine surgeons, radiologists, and radiation oncologists, but not yet among spine surgery trainees. The purpose of our study is to determine the reliability of SINS among spine residents and fellows, and its role as an educational tool...
December 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29114274/outcomes-of-minimally-invasive-surgery-compared-to-open-posterior-lumbar-instrumentation-and-fusion
#10
Low Yong Lee, Zamzuri Idris, Tan Boon Beng, Teo Yian Young, Wong Chung Chek, Jafri Malin Abdullah, Wong Sii Hieng
Introduction: Degenerative spine disease is increasingly common. There are many spinal fusion techniques used to treat degenerative spine disease. This study aims to compare the functional outcome of open versus minimally invasive surgery (MIS) technique in posterior lumbar instrumentation and fusion in degenerative spine disease and to evaluate the perioperative outcome and complications between MIS and open surgery. Materials and Methods: This is an observational cross-sectional study conducted on all degenerative spine disease patients who underwent both methods of posterior lumbar instrumentation and fusion from 2010 to 2014 by the Orthopedic and Neurosurgery Department, Sarawak General Hospital...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28933804/concurrent-lumbosacral-and-sacrococcygeal-fusion-a-rare-etiology-of-low-back-pain-and-coccygodynia
#11
Stylianos Kapetanakis, Grigorios Gkasdaris, Pavlos Pavlidis, Panagiotis Givissis
BACKGROUND: Sacrum is a triangular bone placed in the base of the spine and formed by the synostosis of five sacral vertebrae (S1-S5). Its upper part is connected with the inferior surface of the body of L5 vertebra forming the lumbosacral joint, while its lower part is connected with the base of the coccyx forming the sacrococcygeal symphysis, an amphiarthrodial joint. The existence of four pairs of sacral foramen in both anterior and posterior surface of the sacrum is the most common anatomy...
September 21, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/28882606/managing-spine-surgery-referrals-the-consultation-of-neurosurgery-and-its-nuances
#12
B Debono, P Sabatier, A Koudsie, K Buffenoir, O Hamel
INTRODUCTION: Spinal disorders, particularly low back pain, are among the most common reasons for general practitioner (GP) consultation and can sometimes be a source of professional friction. Despite their frequency and published guidelines, many patients are still mistakenly referred by their GP to specialists for spinal surgery consultation which can create colleague relationship problems, suboptimal or unnessary delayed care, as well as the financial implications for patients. PURPOSE: To assess the management of GP lumbar spine referrals made to 4 neurosurgeons from 3 neurosurgical teams specialized in spinal surgery...
September 4, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28868202/a-thoracic-vertebral-localization-of-a-metastasized-cutaneous-merkel-cell-carcinoma-case-report-and-review-of-literature
#13
Rosario Maugeri, Antonella Giugno, Roberto G Giammalva, Carlo Gulì, Luigi Basile, Francesca Graziano, Domenico G Iacopino
BACKGROUND: Merkel cell carcinoma (MCC) is a rare neuroendocrine skin tumor, which may be related to sun exposure. It can metastasize to lungs, liver and bone, leading to severe morbidity and mortality. Vertebral metastases from MCC are rare. The authors report the tenth case in the literature, a 59-year-old patient with MCC, which was primarily localized in the scalp, and later provoked distant metastasis to the thoracic spinal column. CASE DESCRIPTION: A 59-year-old woman was admitted at our Unit of Neurosurgery with a 4-month history of progressive and severe dorsal back pain, without neurological signs...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28766103/protocol-driven-decision-support-within-e-referral-systems-to-streamline-patient-consultation-triaging-and-referrals-from-primary-care-to-specialist-clinics
#14
Ehsan Maghsoud-Lou, Sean Christie, Samina Raza Abidi, Syed Sibte Raza Abidi
Patient referral is a protocol where the referring primary care physician refers the patient to a specialist for further treatment. The paper-based current referral process at times lead to communication and operational issues, resulting in either an unfulfilled referral request or an unnecessary referral request. Despite the availability of standardized referral protocols they are not readily applied because they are tedious and time-consuming, thus resulting in suboptimal referral requests. We present a semantic-web based Referral Knowledge Modeling and Execution Framework to computerize referral protocols, clinical guidelines and assessment tools in order to develop a computerized e-Referral system that offers protocol-based decision support to streamline and standardize the referral process...
September 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28694597/management-of-cervical-monoradiculopathy-due-to-prolapsed-intervertebral-disc-an-institutional-experience
#15
Amresh S Bhaganagare, S A Nagesh, B G Shrihari, Vikas Naik, M N Nagarjun, Balaji S Pai
BACKGROUND: Cervical radiculopathy is the common clinical entity, often caused by "wear and tear" changes that occur in the spine. In the younger population, cervical radiculopathy is a result of a disc herniation or an acute injury causing foraminal impingement of an exiting nerve, whereas in the older individuals, it is due to foraminal narrowing from osteophyte formation, decreased disc height, and degenerative changes of the uncovertebral joints anteriorly and of the facet joints posteriorly...
April 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28632560/preoperative-depression-smoking-and-employment-status-are-significant-factors-in-patient-satisfaction-after-lumbar-spine-surgery
#16
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 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28461275/isolated-transverse-process-fractures-and-markers-of-associated-injuries-the-experience-at-university-of-california-los-angeles
#17
Timothy T Bui, Daniel T Nagasawa, Carlito Lagman, Cheng Hao Jacky Chen, Lawrance K Chung, Brittany L Voth, Joel S Beckett, Alexander M Tucker, Tianyi Niu, Bilwaj Gaonkar, Isaac Yang, Luke Macyszyn
OBJECTIVES: To report a single-institution experience with isolated transverse process fractures (ITPFs) and provide increasing support for the development of evidence-based guidelines. The authors also evaluated the presence of concerning symptoms or red flags that may indicate additional, underlying injuries in the setting of ITPFs. METHODS: The Ronald Reagan UCLA Medical Center patient database was queried (years 2005-2016) using International Classification of Diseases, Ninth Revision, code 805: fracture of the vertebral column without mention of spinal cord injury...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28430048/a-spinal-epidural-abscess-due-to-streptobacillus-moniliformis-infection-following-a-rat-bite-case-report
#18
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...
July 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28338454/impact-of-preoperative-diagnosis-on-patient-satisfaction-following-lumbar-spine-surgery
#19
MULTICENTER STUDY
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...
June 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28254672/is-the-use-of-minimally-invasive-fusion-technologies-associated-with-improved-outcomes-after-elective-interbody-lumbar-fusion-analysis-of-a-nationwide-prospective-patient-reported-outcomes-registry
#20
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...
July 2017: Spine Journal: Official Journal of the North American Spine Society
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