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high risk spine

Petteri Oura, Markus Paananen, Juha Auvinen, Jaakko Niinimäki, Maarit Niinimäki, Jaro Karppinen, Juho-Antti Junno
STUDY DESIGN: A population-based birth cohort study. OBJECTIVE: To investigate the association between gravidity, parity and vertebral geometry among middle-aged women. SUMMARY OF BACKGROUND DATA: Vertebral size is a recognized determinant of vertebral fracture risk. Yet only a few lifestyle factors that influence vertebral size are known. Pregnancy is a labile period which may affect the maternal vertebral size or shape. The lumbar lordosis angle is permanently deepened by pregnancy, but it remains unclear whether vertebral shape or size contribute to this deepened angle...
March 15, 2018: Spine
S Hemmer, H Almansour, W Pepke, M M Innmann, M Akbar
BACKGROUND: In the light of the increasingly aging population and the widespread understanding of the sagittal profile of symptomatic patients with adult spinal deformity (ASD), pervasive utilization of osteotomies on the vertebral column should be expected. These surgeries are accompanied with relatively high complication rates. However, there is no uniform definition or classification in terms of grading the severity or chronological incidence of complications after ASD surgery. OBJECTIVES: The aim of this work is to give an overview of the different classifications described in the literature hitherto and to propose a standardized, clinically utile classification of complications after ASD surgery...
March 15, 2018: Der Orthopäde
Xiao Wu, Ajay Malhotra, Bertie Geng, Vivek B Kalra, Khalid Abbed, Howard P Forman, Pina Sanelli
Importance: Magnetic resonance imaging (MRI) continues to be performed for cervical clearance of obtunded blunt trauma, despite poor evidence regarding its utility after a normal computed tomographic (CT) finding. Objective: To evaluate the utility and cost-effectiveness of MRI vs no follow-up after a normal cervical CT finding in patients with obtunded blunt trauma. Design, Setting and Participants: This cost-effectiveness analysis evaluated an average patient aged 40 years with blunt trauma from an institutional practice...
March 14, 2018: JAMA Surgery
Galateia J Kazakia, Julio Carballido-Gamio, Andrew Lai, Lorenzo Nardo, Luca Facchetti, Courtney Pasco, Chiyuan A Zhang, Misung Han, Amanda Hutton Parrott, Phyllis Tien, Roland Krug
Background: There is evidence that human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) are independent risk factors for osteoporosis and fracture which is not solely explained by changes in bone mineral density. Thus, we hypothesized that the assessment of trabecular microstructure might play an important role for bone quality in this population and might explain the increased fracture risk. In this study, we have assessed bone microstructure in the proximal femur using high-resolution magnetic resonance imaging (MRI) as well as in the extremities using high resolution peripheral quantitative computed tomography (HR-pQCT) in HIV-infected men and healthy controls and compared these findings to those based on areal bone mineral density (aBMD) derived from dual X-ray absorptiometry (DXA) which is the standard clinical parameter for the diagnosis of osteoporosis...
February 2018: Quantitative Imaging in Medicine and Surgery
Xiaoming Liu, Fumin Pan, Zhaoyu Ba, Shanjin Wang, Desheng Wu
BACKGROUND: Diabetes mellitus (DM) and low back pain which is mainly caused by degeneration of the intervertebral discs (IVDs) both are major public health problem worldwide. The present study was designed to investigate the association between type 2 diabetes mellitus (T2D) and severity of lumbar disc degeneration (LDD). METHODS: We retrospectively reviewed patients with low back pain visiting our spine clinic in 2014. Low back pain patients all have the lumbar MRI imaging and no previous treatment...
March 14, 2018: Journal of Orthopaedic Surgery and Research
Helle Km Bergholdt, Morten K Larsen, Anette Varbo, Børge G Nordestgaard, Christina Ellervik
BACKGROUND: Whether a causal relationship exists between milk intake and reduced risk of fractures is unclear. OBJECTIVES: We tested the hypothesis that genetically determined milk intake reduces the risk of fractures and increases bone mineral density(BMD). METHODS: We investigated the association between milk intake, LCT-13910 C/T (rs4988235) which is associated with lactase persistence (TT/TC) in Northern Europeans, and hip fractures in three Danish prospective studies(N=97,811,age ≥20 years)...
March 14, 2018: Journal of Internal Medicine
Soliman Oushy, Lucas P Carlstrom, William E Krauss
BACKGROUND AND IMPORTANCE: Transverse ligament cysts (TLC) are rare, surgically complex lesions arising posterior to the odontoid process of C2. Direct compression of the cervicomedullary junction is a devastating consequence of untreated lesions. We report the first case of spontaneous TLC regression without surgical intervention. CLINICAL PRESENTATION: A 75-yr-old woman presented to an outside hospital with acute episodes of left face and upper extremity numbness...
March 5, 2018: Neurosurgery
Daniel Moreira Pacca, Gustavo Constantino DE-Campos, Alessandro Rozin Zorzi, Elinton Adami Chaim, Jõao Batista DE-Miranda
BACKGROUND: High body mass index, as well as maintaining this condition for a long period of time, are important risk factors for the development of osteoarthritis. AIM: To determine joint pain and osteoarthritis prevalence in patients referred to bariatric surgery. METHODS: Morbidly obese patients referred to bariatric surgery responded to the visual analogue pain scale (VAS) and the WOMAC questionnaire. X-rays of the hips and knees were evaluated...
March 1, 2018: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Yutaka Igarashi, Takahiro Kanaya, Shoji Yokobori, Takeshi Tsukamoto, Hiroyuki Yokota
PURPOSE: Cerebrovascular ischaemia is a rare but serious complication of damage to the carotid or vertebral arteries in the neck caused by blunt injury to the neck. Screening for blunt cerebrovascular injury should be performed in patients with certain signs or symptoms and risk factors. We described a case of traumatic bilateral vertebral artery injury (VAI) including unilateral vertebral arterial occlusion that resolved 3 months post-injury with antiplatelet and direct oral anticoagulant therapy...
March 1, 2018: European Spine Journal
Nataliya P Buxbaum, Cemre Robinson, Ninet Sinaii, Alexander Ling, Lauren M Curtis, Steven Z Pavletic, Kristin Baird, Maya B Lodish
Pediatric allogeneic hematopoietic stem cell transplant (AHSCT) recipients with chronic graft-versus-host disease (cGVHD) are at high risk of endocrinopathies, particularly impaired bone mineral density (BMD). However, rates of BMD impairment in pediatric AHSCT recipients with cGVHD have not been well documented. We describe 33 patients with cGVHD that were referred to the NIH for the Natural History of Clinical and Biological Factors Determining Outcomes in Chronic Graft-Versus-Host Disease Study (NCT 0092235) and underwent formal BMD assessments via dual-energy X-ray absorptiometry (DEXA)...
February 26, 2018: Biology of Blood and Marrow Transplantation
David C Viano, Chantal S Parenteau, Roger Burnett
OBJECTIVE: This study analyzed thoracic and lumbar spine responses with "in position" and OOP (out-of-position) seated dummies in 40.2 km/h (25 mph) rear sled tests with conventional and ABTS (all belts to seat) seats. Occupant kinematics and spinal responses were determined with modern (≥2000 MY), older (<2000 MY) and ABTS seats. METHODS: The seats were fixed in a sled buck subjected to a 40.2 km/h (25 mph) rear sled test. The pulse was a 15 g double-peak acceleration with 150 ms duration...
March 1, 2018: Traffic Injury Prevention
Elham Z Movassagh, Adam D G Baxter-Jones, Saija Kontulainen, Susan Whiting, Michael Szafron, Hassan Vatanparast
BACKGROUND: The amount of bone accrued during adolescence is an important determinant of later osteoporosis risk. Little is known about the influence of dietary patterns (DPs) on the bone during adolescence and their potential long-term implications into adulthood. We examined the role of adolescent DPs on adolescent and young adult bone and change in DPs from adolescence to young adulthood. METHODS: We recruited participants from the Saskatchewan Pediatric Bone Mineral Accrual Study (1991-2011)...
February 28, 2018: Nutrition Journal
Dilek Arslan, Mehmet Asım Ozer, Figen Govsa, Omer Kitis
BACKGROUND: Awareness of osseous anomaly of ponticulus posticus (PP) is crucial in avoiding vertebral artery (VA) injuries during the C1 instrumentation. The aim of study is to investigate PP and the relationship between the VA with 3D-CTA. METHODS: The relationship between the PP and VA was investigated as intraoperative landmarks. The intersection of VA to the posterior arch of C1 and the medial line, posterior arch and VA curve around lateral masses were measured as intraoperative reference...
February 24, 2018: World Neurosurgery
S M Masudur Rahman Al Arif, Karen Knapp, Greg Slabaugh
The cervical spine is a highly flexible anatomy and therefore vulnerable to injuries. Unfortunately, a large number of injuries in lateral cervical X-ray images remain undiagnosed due to human errors. Computer-aided injury detection has the potential to reduce the risk of misdiagnosis. Towards building an automatic injury detection system, in this paper, we propose a deep learning-based fully automatic framework for segmentation of cervical vertebrae in X-ray images. The framework first localizes the spinal region in the image using a deep fully convolutional neural network...
April 2018: Computer Methods and Programs in Biomedicine
Ravi K Grandhi, Alan David Kaye, Alaa Abd-Elsayed
PURPOSE OF REVIEW: Cervicogenic headache (CHA) is a secondary headache which has a source in the upper cervical spine. Many traditional analgesic choices lack good efficacy in managing the associated pain. As a result, in management of CHA, radiofrequency ablation (RFA) or pulse radiofrequency (PRF) has been tried with success. Our study investigated the use of RFA and PRF for the management of CHA. RECENT FINDINGS: In the present investigation, a review of the literature was conducted using PubMed (1966 to February 2017)...
February 23, 2018: Current Pain and Headache Reports
Tobias Schmidt, Constantin Schmidt, Felix N Schmidt, Sebastian Butscheidt, Haider Mussawy, Jan Hubert, Thelonius Hawellek, Nicola Oehler, Florian Barvencik, Ansgar W Lohse, Thorsten Schinke, Christoph Schramm, Michael Amling, Tim Rolvien
Primary biliary cholangitis (PBC) is known to be a major risk factor for osteoporosis reflected by a reduction of bone mineral density (BMD). However, both the extent of the macro- and microstructural alterations of bone as well as the causative factors are unknown. We have retrospectively analyzed a total of 96 patients with PBC and 53 healthy controls matched for age, sex and body mass index. In addition to dual-energy X-ray absorptiometry (DXA) measurements at the lumbar spine and hip, high-resolution peripheral quantitative computed tomography (HR-pQCT) was used to assess the geometric, volumetric and microstructural changes of bone at the distal radius and tibia...
February 22, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Ravish Shammi Patel, Chetan Anil Dhamne, Anil Gopinathan, Nishant Kumar, Naresh Kumar
PURPOSE: Aneurysmal bone cysts (ABCs) of spine are conventionally treated with en-bloc resection or intralesional excision/curettage and reconstruction or filling of defects with bone cement. For the treatment of upper cervical ABCs, en-bloc resections are often not desirable considering the risk/benefit ratio while the risk of recurrence after intralesional excision is high. Hence, alternative management options are often necessary. We describe our clinical experience with one such treatment alternative-denosumab for the treatment of ABC of Atlas...
February 22, 2018: European Spine Journal
Alexander B Dru, Paul S Kubilis, Gregory A Murad, Tyler Carney, Daniel J Hoh
BACKGROUND: Spontaneous thoracic ankylosis is a progressive degenerative process that predisposes patients to potentially highly unstable traumatic injuries. Acute hyperextension fractures result in dynamic instability putting the spinal cord at risk. OBJECTIVE: To describe preoperative radiographic characteristics of fractures of the ankylotic thoracic spine and relate findings to early postoperative radiographic and clinical outcomes. METHODS: A single center, retrospective review was performed of 28 surgically treated patients with fractures of the ankylotic thoracic spine...
March 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
M Farshad, D E Bauer, C Wechsler, C Gerber, A Aichmair
BACKGROUND CONTEXT: There is a broad spectrum of complications during or after surgical procedures, with differing incidences reported in the published literature. Heterogeneity can be explained by the lack of an established evidence-based classification system for documentation and classification of complications in a standardized manner. PURPOSE: To identify predictive risk factors for peri- and early post-operative morbidities in spine surgeries of different complexities in a large cohort of consecutive patients...
February 13, 2018: Spine Journal: Official Journal of the North American Spine Society
Joshua L Golubovsky, Haariss Ilyas, Jinxiao Chen, Joseph E Tanenbaum, Thomas E Mroz, Michael P Steinmetz
BACKGROUND CONTEXT: Postoperative Urinary Retention (POUR) is a very common post-operative complication of all surgeries (5 - 70%) that may lead to complications such as urinary tract infection (UTI), bladder over-distention, autonomic dysregulation, and increased postoperative length of stay (LOS). Within the field of spine surgery, the reported incidence of POUR is highly variable (5.6 - 38%). Lack of clear stratification of surgical level, spinal pathology, and inadequate sample size is a major limitation of available studies concerning POUR following spine surgery that may lead to inconsistency in the incidence of POUR and the ability to model its occurrence and consequences...
February 12, 2018: Spine Journal: Official Journal of the North American Spine Society
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