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https://www.readbyqxmd.com/read/29160005/investigation-of-parameters-predicting-the-need-for-diagnostic-imaging-beyond-computed-tomography-in-the-evaluation-of-dogs-with-thoracolumbar-myelopathy-retrospective-evaluation-of-555-dogs
#1
Lee Emery, Silke Hecht, Xiaocun Sun
Thoracolumbar myelopathy encompasses a number of disease processes such as intervertebral disc disease, discospondylitis, trauma, congenital malformations, neoplasia, and intramedullary spinal cord disease. Compressive disc herniations are most common in dogs and require imaging procedures such as myelography, computed tomography (CT), and/or magnetic resonance imaging (MRI) to determine the need and location for decompressive surgery. The purposes of this retrospective, cross-sectional study were to evaluate all dogs undergoing thoracolumbar CT imaging as the initial diagnostic step between 2010 and 2015 and determine whether any of the imaging characteristics could be used to predict the need for additional imaging in the form of myelography, CT myelography, and/or MRI...
November 20, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/29148922/feasibility-and-safety-of-using-thoracic-and-lumbar-cortical-bone-trajectory-pedicle-screws-in-spinal-constructs-in-children-technical-note
#2
Jonathan N Sellin, Jeffrey S Raskin, Kristen A Staggers, Alison Brayton, Valentina Briceño, Amee J Moreno, Andrew Jea
Thoracic and lumbar cortical bone trajectory pedicle screws have been described in adult spine surgery. They have likewise been described in pediatric CT-based morphometric studies; however, clinical experience in the pediatric age group is limited. The authors here describe the use of cortical bone trajectory pedicle screws in posterior instrumented spinal fusions from the upper thoracic to the lumbar spine in 12 children. This dedicated study represents the initial use of cortical screws in pediatric spine surgery...
November 17, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29145287/transforaminal-endoscopy-in-lumbar-burst-fracture-a-case-report
#3
Yuanyi Wang, Cong Ning, Liyu Yao, Xiuying Huang, Chengliang Zhao, Bin Chen, Nan Zhang
RATIONALE: Lumbar burst fractures are frequent injury resulting from high-energy trauma, and the patients suffer from pain and the neurologic dysfunction. Although minimally invasive techniques have advanced rapidly, it was the first time to apply transforaminal endoscopic combined with percutaneous pedicle screw fixation to treatment of lumbar burst fractures. PATIENT CONCERNS: A 33-year-old man underwent Magerl type A3.1 burst fracture at L2 and compression fractures at L3 due to falling from a height with severe lower back pain, sensory loss, and atony of the right leg...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29137080/a-medium-term-follow-up-of-adult-lumbar-tuberculosis-treating-with-3-surgical-approaches
#4
Qi Hong Zhang, Qiang Guo, Chaofeng Guo, Jianhuang Wu, Jinyang Liu, Qile Gao, Yuxiang Wang
Surgical intervention is an important option for treating lumbar tuberculosis. Previous studies have reported different surgical intervention procedures. To our knowledge, few studies have compared the clinical results of mid-term follow-up of 3 different surgeries in surgical treatment of spinal tuberculosis. This study's purpose is to evaluate the effectiveness of 3 different surgeries for the treatment of lumbar tuberculosis in adult and analyze the mid-term influence of the surgery on quality of life.Between June 2004 and January 2010, a total of 137 adult patients (54 women and 83 men) with lumbar tuberculosis were recruited for this study...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29114089/angiographic-and-clinical-characteristics-of-thoracolumbar-spinal-epidural-and-dural-arteriovenous-fistulas
#5
Hiro Kiyosue, Yuji Matsumaru, Yasunari Niimi, Keisuke Takai, Tomoya Ishiguro, Masafumi Hiramatsu, Kotaro Tatebayashi, Toshinori Takagi, Shinichi Yoshimura
BACKGROUND AND PURPOSE: The purpose of this study is to compare the angiographic and clinical characteristics of spinal epidural arteriovenous fistulas (SEAVFs) and spinal dural arteriovenous fistulas (SDAVFs) of the thoracolumbar spine. METHODS: A total of 168 cases diagnosed as spinal dural or extradural arteriovenous fistulas of the thoracolumbar spine were collected from 31 centers. Angiography and clinical findings, including symptoms, sex, and history of spinal surgery/trauma, were retrospectively reviewed...
November 7, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29107721/the-correlation-between-vertical-laminar-fractures-and-the-severity-of-associated-burst-fractures
#6
Jian-Xiang Xu, Cheng-Wei Zhou, Qian Tang, Cheng-Gui Wang, Jia-Wei Li, Li-Lian Zhang, Hua-Zi Xu, Nai-Feng Tian
BACKGROUND: Patients with laminar fractures have a higher chance to suffer severe traumas and neurological deficits. In previous studies, laminar fractures were divided into different types based on the axial plane of computed tomographic scans. No report described the morphology of vertical laminar fractures in the coronal plane. Furthermore, the correlation between a specific type of laminar fracture and the extent of severity of TL burst fractures has rarely been mentioned. METHODS: A retrospective evaluation of 341 patients with TL burst fractures with or without laminar fractures were divided into six groups based on the morphology observed across reconstructed coronal and axial computed tomographic planes...
October 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29095327/cerebral-venous-sinus-thrombosis-due-to-low-molecular-weight-heparin-induced-thrombocytopenia
#7
Ezequiel Gleichgerrcht, Ming Y Lim, Tanya N Turan
INTRODUCTION: Heparin-induced thrombocytopenia (HIT) is an immune-mediated complication of heparin exposure. A limited number of studies have reported cerebral venous sinus thrombosis (CVST) as the presenting thrombotic event induced by HIT, only one of which occurred with exposure to low-molecular-weight heparin (LMWH), with death as outcome. Here, we present a unique case of LMWH-induced HIT leading to CVST but resulting in good clinical outcome. CASE REPORT: A 52-year-old woman received subcutaneous LMWH for deep vein thrombosis prophylaxis while in rehabilitation following kyphoplasty for spinal fracture related to recent trauma...
November 2017: Neurologist
https://www.readbyqxmd.com/read/29095302/spontaneous-spinal-epidural-hematomas-one-case-report-and-rehabilitation-outcome
#8
Hang Xian, Li-Wei Xu, Cong-Han Li, Jian-Ming Hao, Wei-Xia Wan, Guo-Dong Feng, Ke-Jian Lian, Lin Li
RATIONALE: Spontaneous spinal epidural hematoma (SSEH) is a relatively rare but potentially disabling disease, and the classical presentation of it includes an acute onset of severe, sometimes radiating back or neck pain, followed by signs and symptoms of rapidly evolving nerve root or spinal cord compression. PATIENT CONCERNS: Here, we report a 26-year-old female patient presented with weakness in bilateral lower extremities, progressing to intense paraplegia and anesthesia without recent medical history of trauma, infection, surgery, or drug use...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29091065/the-3d-characteristics-of-post-traumatic-syringomyelia-in-a-rat-model-a-propagation-based-synchrotron-radiation-microtomography-study
#9
Shenghui Liao, Shuangfei Ni, Yong Cao, Xianzhen Yin, Tianding Wu, Hongbin Lu, Jianzhong Hu, Hao Wu, Ye Lang
Many published literature sources have described the histopathological characteristics of post-traumatic syringomyelia (PTS). However, three-dimensional (3D) visualization studies of PTS have been limited due to the lack of reliable 3D imaging techniques. In this study, the imaging efficiency of propagation-based synchrotron radiation microtomography (PB-SRµCT) was determined to detect the 3D morphology of the cavity and surrounding microvasculature network in a rat model of PTS. The rat model of PTS was established using the infinite horizon impactor to produce spinal cord injury (SCI), followed by a subarachnoid injection of kaolin to produce arachnoiditis...
November 1, 2017: Journal of Synchrotron Radiation
https://www.readbyqxmd.com/read/29089670/complications-exclusive-to-long-strut-grafts-used-following-multilevel-cervical-corpectomy-utilization-of-advanced-imaging-techniques
#10
Pushpa B Thippeswamy, Sunitha P Kumaran, Vinay Hegde, Sanjaya Viswamitra
When surgical decompression of cervical spine is considered, multilevel cervical corpectomy with long strut grafts is the preferred treatment. This procedure is used in a variety of pathologies including degenerative disease, tumors, trauma and infection. Corpectomy with interbody grafting helps in adequate spinal canal and neural decompression compared to multilevel discectomy, which could be difficult as well as inadequate. Fibular/iliac strut grafts are used for reconstruction along with a stabilizing hardware in this procedure...
July 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/29088951/update-on-critical-care-for-acute-spinal-cord-injury-in-the-setting-of-polytrauma
#11
John K Yue, Ethan A Winkler, Jonathan W Rick, Hansen Deng, Carlene P Partow, Pavan S Upadhyayula, Harjus S Birk, Andrew K Chan, Sanjay S Dhall
Traumatic spinal cord injury (SCI) often occurs in patients with concurrent traumatic injuries in other body systems. These patients with polytrauma pose unique challenges to clinicians. The current review evaluates existing guidelines and updates the evidence for prehospital transport, immobilization, initial resuscitation, critical care, hemodynamic stability, diagnostic imaging, surgical techniques, and timing appropriate for the patient with SCI who has multisystem trauma. Initial management should be systematic, with focus on spinal immobilization, timely transport, and optimizing perfusion to the spinal cord...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29079071/occult-spinal-cord-injury-after-blunt-force-trauma-in-a-patient-with-achondroplasia-a-case-report-and-review-of-trauma-management-strategy
#12
Martin Huecker, Zach Harris, Eric Yazel
BACKGROUND: Achondroplastic dwarfism is associated with anatomic abnormalities that can predispose to occult injury and challenges in trauma management. Airway anatomy is problematic due to macrocephaly, midface hypoplasia, and a narrow nasopharynx. Manipulation of the neck is very dangerous due to the high likelihood of preexisting cervicomedullary stenosis. Restrictive lung disease and obstructive sleep apnea may complicate respiratory status. Peripheral and central venous access can be difficult to obtain...
October 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29074467/vertebral-body-spread-in-thoracolumbar-burst-fractures-can-predict-posterior-construct-failure
#13
Federico De Iure, Giorgio Lofrese, Pasquale De Bonis, Michele Cappuccio, Francesco Cultrera, Sofia Battisti
BACKGROUND CONTEXT: The Load Sharing Classification (LSC) laid foundations for a scoring system able to indicate which thoracolumbar fractures, after short-segment posterior-only fixations, would need for longer instrumentations or additional anterior supports. PURPOSE: We analyzed surgically treated thoracolumbar fractures, quantifying the vertebral body's fragments displacement with the aim of identifying a new parameter which could predict the posterior-only construct failure...
October 23, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29071375/-influence-of-trauma-mechanisms-on-thoracic-and-lumbar-spinal-fractures
#14
Cornelius Jacobs, Tony Hartwig, Philip P Rößler, Dan Meila, Igor Nikiforov, Milena M Plöger, Christof Burger, Sebastian Scheidt
BACKGROUND: Vertebral body fractures (VBF) can be caused by various trauma mechanisms. The AOSpine classification system differentiates three main types of fractures according to the grade of instability. How the increasing energy of various accident mechanisms changes the complexity of the individual fracture, its localization and the occurrence of further fractures has not yet been finally investigated. OBJECTIVE: What influence do traumatic events with different kinematics have on the localization, complexity and number of VBF in the thoracic and lumbar spine? MATERIAL AND METHODS: In this retrospective study data from patients with a freshly traumatized VBF were analyzed...
October 25, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29027857/is-there-added-value-in-obtaining-cervical-spine-mri-in-the-assessment-of-nontraumatic-angiographically-negative-subarachnoid-hemorrhage-a-retrospective-study-and-meta-analysis-of-the-literature
#15
Gelareh Sadigh, Chad A Holder, Jeffrey M Switchenko, Seena Dehkharghani, Jason W Allen
OBJECTIVE Diagnostic algorithms for nontraumatic angiographically negative subarachnoid hemorrhage (AN-SAH) vary, and the optimal method remains subject to debate. This study assessed the added value of cervical spine MRI in identifying a cause for nontraumatic AN-SAH. METHODS Consecutive patients 18 years of age or older who presented with nontraumatic SAH between February 1, 2009, and October 31, 2014, with negative cerebrovascular catheter angiography and subsequent cervical MRI were studied. Patients with intraparenchymal, subdural, or epidural hemorrhage; recent trauma; or known vascular malformations were excluded...
October 13, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29026667/lumbar-chronic-subdural-hematoma-mimicking-an-intradural-extramedullary-tumor-a-case-report
#16
Hyeun Sung Kim, Nitin Adsul, Yoon Seok Ju, Ki Joon Kim, Sung Ho Choi, Jeong Hoon Kim, Sung Kyun Chung, Jeong-Hoon Choi, Jee-Soo Jang, Il-Tae Jang, Seong-Hoon Oh, Jae Eun Park, Sol Lee
BACKGROUND: Chronic spinal subdural hematomas are extremely rare with only 28 cases reported in the literature. Nevertheless, they should be considered among the differential diagnoses for spinal intradural/extramedullary lesions. CASE REPORT: A 65-year-old male presented with progressive back pain and right S1 radiculopathy. Magnetic resonance imaging scan revealed a right-sided posterolateral intradural/extramedullary lesion at the L5-S1 level. It was hyperintense on T1 and hypointense on T2-weighted images; on the short TI inversion recovery sequence it was hyperintense...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29019639/spine-conditions-cervical-spine-conditions
#17
Marc A Childress
There are a variety of causes of neck pain, including trauma and degenerative changes. The history of onset helps to direct evaluation, including the need for imaging or ancillary testing. Patterns of pain, weakness, and other specific physical examination findings also aid in diagnosis. Management of most soft tissue injuries involves early mobilization, whereas fractures are managed based on patterns of instability. Acute spinal cord injury requires emergent care, to include possible decompressive surgery...
October 2017: FP Essentials
https://www.readbyqxmd.com/read/28993912/the-utility-of-magnetic-resonance-imaging-in-addition-to-computed-tomography-scans-in-the-evaluation-of-cervical-spine-injuries-a-study-of-obtunded-blunt-trauma-patients
#18
Bernard Puang Huh Lau, Hwee Weng Dennis Hey, Eugene Tze-Chun Lau, Pei Yi Nee, Kimberly-Anne Tan, Wah Tze Tan
PURPOSE: Evidence guiding the use of CT and MRI scans in blunt trauma patients who are obtunded remains controversial. This study aims to determine and predict if computed tomography (CT) scans alone can be performed without risking oversight of substantial injuries found on follow-up magnetic resonance imaging (MRI). METHODS: This is a retrospective cohort study of 63 blunt trauma patients with a Glasgow Coma Scale of < 8. Data were collated from electronic medical records and included patient demographics, premorbid mobility, mechanism of injury, suspected level of injury and neurological examination findings...
October 9, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28973360/motor-evoked-potentials-correlate-with-magnetic-resonance-imaging-and-early-recovery-after-acute-spinal-cord-injury
#19
Sanjay S Dhall, Jenny Haefeli, Jason F Talbott, Adam R Ferguson, William J Readdy, Jacqueline C Bresnahan, Michael S Beattie, Jonathan Z Pan, Geoffrey T Manley, William D Whetstone
BACKGROUND: While the utilization of neurophysiologic intraoperative monitoring with motor evoked potentials (MEPs) has become widespread in surgery for traumatic spine fractures and spinal cord injury (SCI), clinical validation of its diagnostic and therapeutic benefit has been limited. OBJECTIVE: To describe the use of intraoperative MEP at a large level I trauma center and assess the prognostic capability of this technology. METHODS: The SCI REDCap database at our institution, a level I trauma center, was queried for acute cervical SCI patients who underwent surgery with intraoperative monitoring between 2005 and 2011, yielding 32 patients...
July 7, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28966827/spontaneous-pseudomeningocele-associated-with-lumbar-spondylolisthesis-a-case-report-and-review-of-the-literature
#20
Gonçalo Novais, Bernardo Ratilal, Lia Pappamikail, Pedro Branco, Nuno Reis
BACKGROUND: Pseudomeningocele, an extradural collection of cerebrospinal fluid (CSF), has only been rarely reported to occur spontaneously in conjunction with isthmic spondylolisthesis (with lysis) in the lumbar spine. CASE DESCRIPTION: A 68-year-old male presented with low back pain and neurogenic claudication of several years duration without any history of trauma, epidural spine injections, or spine surgery. Lumbosacral magnetic resonance imaging (MRI) revealed a grade-I L4-L5 isthmic spondylolisthesis with spinal canal narrowing and a posterior paravertebral collection consistent with CSF...
2017: Surgical Neurology International
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