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high risk spine

T Meng, Z Zhong, L Meng
Lumbar spinal surgery is most commonly performed under general anaesthesia. However, spinal anaesthesia has also been used. We aimed to systematically review the comparative evidence. We only included randomised, controlled trials in this meta-analysis and calculated the risk ratio or standardised mean difference for haemodynamics, blood loss, surgical time, analgesic requirement, nausea and/or vomiting, and length of hospital stay. Eight studies with a total of 625 patients were included. These were considered to be at high risk of bias...
October 22, 2016: Anaesthesia
Andrew J Teichtahl, Donna M Urquhart, Yuanyuan Wang, Anita E Wluka, Richard O'Sullivan, Graeme Jones, Flavia M Cicuttini
BACKGROUND: Degenerative disc disease of the lumbar spine is common, with severe disease increasing the risk for chronic low back pain. This cross-sectional study examined whether disc degeneration is representative of a 'whole-organ' pathology, by examining its association with bone (vertebral endplate) and soft tissue (paraspinal muscle fat) abnormalities. METHODS: Seventy-two community-based individuals unselected for low back pain, had Magnetic Resonance Imaging (MRI)...
October 21, 2016: BMC Musculoskeletal Disorders
Thomas Beez, Jennifer Brown
BACKGROUND: Atlanto-occipital dislocation (AOD) is a rare but severe sequela of high energy trauma. Children are at increased risk, due to their immature spine and biomechanical characteristics. LITERATURE REVIEW: The prevailing mechanism of injury is motor vehicle collision as passenger. AOD commonly presents with cardiorespiratory arrest, spinal cord injury or cranial nerve deficits. Concomitant injuries, such as traumatic brain injury, are frequently encountered...
October 18, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Janis L Vahldiek, Stefan Thieme, Bernd Hamm, Stefan M Niehues
BACKGROUND: The use of computed tomography (CT) scans of the head and cervical spine has markedly increased in patients with blunt minor trauma. The actual likelihood of a combined injury of head and cervical spine following a minor trauma is estimated to be low. PURPOSE: To determine the incidence of such combined injuries in patients with a blunt minor trauma in order to estimate the need to derive improved diagnostic guidelines. MATERIAL AND METHODS: A total of 1854 patients were retrospectively analyzed...
October 17, 2016: Acta Radiologica
Tamir Ailon, Radmehr Torabi, Charles G Fisher, Laurence D Rhines, Michelle J Clarke, Chetan Bettegowda, Stefano Boriani, Yoshiya J Yamada, Norio Kawahara, Peter P Varga, John H Shin, Arjun Saghal, Ziya L Gokaslan
STUDY DESIGN: Systematic review. OBJECTIVE: To determine evidence-based guidelines for the management of locally recurrent spinal chordoma. SUMMARY OF BACKGROUND DATA: Chordoma of the spine is a low-grade malignant tumor with a strong propensity for local recurrence. Salvage therapy is challenging due to its relentless nature and refractoriness to adjuvant therapies. There are currently no guidelines regarding the best management of recurrent chordoma...
October 15, 2016: Spine
Leo Fradet, Xiaoyu Wang, Lawrence G Lenke, Carl-Eric Aubin
BACKGROUND: Proximal junctional failure is a severe proximal junctional complication following adult spinal instrumentation and involving acute proximal junctional kyphotic deformity, mechanical failure at the upper instrumented vertebra or just above, and/or proximal junctional osseoligamentous disruption. Clinical studies have identified potential risk factors, but knowledge on their biomechanics is still lacking for addressing the proximal junctional failure issues. The objective of this study was to develop comprehensive computational modeling and simulation techniques to investigate proximal junctional failure...
October 11, 2016: Clinical Biomechanics
V A Nevzorova, E A Kochetkova, L G Ugai, Yu V Maistrovskaya, E A Khludeeva
AIM: To define the role of circulating biomarkers for the metabolism of collagen and intercellular substance and vascular remodeling in the development of osteoporosis (OP) in idiopathic pulmonary arterial hypertension (IPAH). MATERIAL AND METHODS: Functional hemodynamic parameters, bone mineral density (BMD) in the lumbar spine and femoral neck and the serum levels of matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), MMP-9/TIMP-1 complex, C-terminal telopeptide of collagen type 1 (CITP), and endothelin-1 (ET-1) were determined in 27 high-risk IPAH patients and 30 healthy volunteers...
2016: Terapevticheskiĭ Arkhiv
S Farmer, V V Shanbhogue, S Hansen, C I Stahlberg, H Vestergaard, A P Hermann, H Frederiksen
: In this cross-sectional study of 45 patients with myeloproliferative neoplasms, we found no evidence of secondary osteoporosis. INTRODUCTION: Patients with essential thrombocythemia (ET) and polycythaemia vera (PV) are at increased risk of fractures but the underlying mechanisms have not been settled. We conducted a study to assess bone mineral density, microarchitecture, estimated bone strength and global bone turnover in 45 patients with ET or PV. METHODS: Patients were evaluated in a cross-sectional study with dual energy X-ray absorptiometry (DXA) at the hip and spine; high-resolution peripheral quantitative computed tomography (HR-pQCT) at the distal radius and distal tibia; and biochemical markers of bone turnover including pro-collagen type 1 N-terminal pro-peptide, osteocalcin, C-terminal cross-linking telopeptide of type 1 collagen and bone-specific alkaline phosphatase...
October 13, 2016: Osteoporosis International
Serena Bugatti, Laura Bogliolo, Barbara Vitolo, Antonio Manzo, Carlomaurizio Montecucco, Roberto Caporali
BACKGROUND: Autoantibodies such as anti-citrullinated protein antibodies (ACPA) are major risk factors for articular bone destruction from the earliest phases of rheumatoid arthritis (RA). The aim of the current study was to determine whether RA-associated autoantibodies also impact on systemic bone loss in patients with early disease. METHODS: Systemic bone mineral density (BMD) was measured in the lumbar spine and the hip in 155 consecutive treatment-naïve patients with early RA (median symptom duration 13 weeks)...
October 6, 2016: Arthritis Research & Therapy
Dong Gyu Jang, Ji Young Kwon, Sae Kyung Choi, Hyun Sun Ko, Jong Chul Shin, In Yang Park
Although pregnancy is a medical condition that contributes to bone loss, little information is available regarding bone mineral density (BMD) in puerperal women. This cross sectional study aimed to evaluate the prevalence of low BMD in puerperal women and to identify associated risk factors. We surveyed all puerperal women who had BMD measurements taken 4-6 weeks after delivery in a tertiary university hospital, and did not have any bone loss-related comorbidities. Among the 1,561 Korean puerperal women, 566 (36...
November 2016: Journal of Korean Medical Science
Eunjin Bae, Eun Yong Seong, Byoung-Geun Han, Dong Ki Kim, Chun Soo Lim, Shin-Wook Kang, Cheol Whee Park, Chan-Duck Kim, Byung Chul Shin, Sung Gyun Kim, Wookyung Chung, Jae Yoon Park, Joo Yeon Lee, Yon Su Kim
Introduction Patients with chronic kidney disease have an extremely high risk of developing cardiovascular disease (CVD). In patients with end-stage renal disease (ESRD), coronary artery calcification (CAC) is associated with increased mortality from CVD. Methods The present study aimed to investigate the risk factors for CAC in Korean patients with incident dialysis. Data on 423 patients with ESRD who started dialysis therapy between December 2012 and March 2014 were obtained from 10 university-affiliated hospitals...
October 5, 2016: Hemodialysis International
Dilek Solmaz, Didem Kozacı, İsmail Sarı, Ali Taylan, Fatoş Önen, Nurullah Akkoç, Servet Akar
OBJECTIVE: Ankylosing spondylitis (AS) is a chronic inflammatory disease of the spine and sacroiliac joints of unknown etiology. Recent studies have reported increased oxidative stress, which is implicated in the pathogenesis of a number of diseases, in AS. The purpose of this study was to investigate oxidative stress and related factors in AS. MATERIAL AND METHODS: Eighty-five patients with AS [36 (16-64) years; 65 male/20 female] and 56 healthy subjects [36 (21-63) years; 39 male/17 female] with no known cardiovascular risk factors were enrolled...
March 2016: Eur J Rheumatol
William P Hedges, Marwan Bukhari
OBJECTIVE: Low body mass index (BMI) is a known risk factor for osteoporosis and is part of the FRAX™ 10-year fracture risk stratification tool for predicting fragility fractures. Little is known regarding the effects of changing body composition on bone mineral density (BMD). However, increasing fat mass (FM) improves BMD in young women with anorexia nervosa. This study aimed to assess whether changes in FM over time affected BMD in the general population. MATERIAL AND METHODS: Data was collected from patients who underwent dual-energy X-ray absorptiometry (DEXA) assessment between 2004 and 2011...
March 2016: Eur J Rheumatol
Claire S Allen, James Hs Yeung, Ben Vandermeer, Joanne Homik
BACKGROUND: This is an update of a Cochrane Review first published in 1999. Corticosteroids are widely used in inflammatory conditions as an immunosuppressive agent. Bone loss is a serious side effect of this therapy. Several studies have examined the use of bisphosphonates in the prevention and treatment of glucocorticosteroid-induced osteoporosis (GIOP) and have reported varying magnitudes of effect. OBJECTIVES: To assess the benefits and harms of bisphosphonates for the prevention and treatment of GIOP in adults...
October 5, 2016: Cochrane Database of Systematic Reviews
Nicole K Behnke, Dustin K Baker, Shin Xu, Thomas E Niemeier, Shawna L Watson, Brent A Ponce
PURPOSE: The skeleton is the third most common site of cancer metastases. Approximately 10 % of patients with bone metastases will develop a pathologic fracture, with significant associated morbidity and mortality. The purpose of this study was to identify risk factors for same-admission mortality after pathologic fractures secondary to metastatic cancer. METHODS: The Nationwide Inpatient Sample database was queried from 2002 to 2013 for hospitalized patients with diagnoses of pathologic fracture and a primary cancer at high risk for skeletal metastasis...
October 4, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Charline Estublier, Roland Chapurlat, Pawel Szulc
OBJECTIVE: Data on the relationship between disc degeneration (DD) and fragility fractures in men are limited. The aim of this study was to prospectively analyse the risk of vertebral and non-vertebral fractures in men with thoracolumbar DD according to the severity of its radiological signs: disc space narrowing (DSN), osteophytes and endplate sclerosis. METHODS: Men >50 years of age (n = 765) had lateral spine radiographs and DXA and were monitored prospectively...
October 3, 2016: Rheumatology
Joshua P Halfpap, Aaron A Cho, Michael D Rosenthal
A 51-year-old man presented to a direct-access physical therapy clinic with persistent neck pain for 5 days after a fall in shallow water while surfing. Based on "dangerous mechanism of injury" from the Canadian cervical spine rule as being a high risk factor, the physical therapist ordered radiographs of the cervical spine, which were suggestive of a more serious injury. Computed tomography suggested and magnetic resonance imaging confirmed vertebral artery dissection. J Orthop Sports Phys Ther 2016;46(10):929...
October 2016: Journal of Orthopaedic and Sports Physical Therapy
M Atteritano, E Di Mauro, V Canale, A M Bruzzese, C A Ricciardi, V Cernaro, A Lacquaniti, M Buemi, D Santoro
: In hemodialysis patients, vertebral fractures were associated with elevated sclerostin levels, suggesting that sclerostin could reflect bone fragility in these patients. INTRODUCTION: Fragility fractures are common in hemodialysis patients. The aims of our study were to determine the prevalence of vertebral fracture and analyze associations between sclerostin serum levels and vertebral fractures in hemodialysis patients. METHODS: Ninety-two hemodialysis patients and 100 controls matched for age and sex were studied...
September 28, 2016: Osteoporosis International
Richard Eastell, Terence W O'Neill, Lorenz C Hofbauer, Bente Langdahl, Ian R Reid, Deborah T Gold, Steven R Cummings
Osteoporosis is a metabolic bone disorder that is characterized by low bone mass and micro-architectural deterioration of bone tissue. Fractures of the proximal femur, the vertebrae and the distal radius are the most frequent osteoporotic fractures, although most fractures in the elderly are probably at least partly related to bone fragility. The incidence of fractures varies greatly by country, but on average up to 50% of women >50 years of age are at risk of fractures. Fractures severely affect the quality of life of an individual and are becoming a major public health problem owing to the ageing population...
2016: Nature Reviews. Disease Primers
Jean-Claude Bernard, Karimann Abelin-Genevois, Isabelle Courtois
This is a national retrospective study realized by the Study Group of Scoliosis (GES) with the support of 7 competence centers about the follow up of the spine for patients with Marfan's disease. The sample consists of 167 patients: 99 women and 67 men. It is composed of children and adults and the mean age is 31 years. In this sample, we find 72% of spine deformity (scoliosis and kyphosis): in the literature, 63% for Sponseller and al, (JBJSa 1995), and 56% for Garreau and al, (JBJS, 2006). The discovery of the spine problem is effective of 12,8 years old (ET=4,2; range=1-53)...
September 2016: Annals of Physical and Rehabilitation Medicine
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