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https://www.readbyqxmd.com/read/28319551/a-contemporary-medicolegal-analysis-of-implanted-devices-for-chronic-pain-management
#1
Christopher R Abrecht, Penny Greenberg, Ellen Song, Richard D Urman, James P Rathmell
BACKGROUND: Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years. METHODS: We performed a closed claims analysis for a period January 1, 2009 to December 31, 2013 for cases with pain medicine as the primary service...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28284111/characteristics-and-predictors-of-outcome-of-spontaneous-spinal-epidural-abscesses-treated-conservatively-a-retrospective-cohort-study-in-a-referral-center
#2
Nikolaos Spernovasilis, Stelios Demetriou, Maria Bachlitzanaki, Ioannis Gialamas, Kalliopi Alpantaki, Georgios Hamilos, Apostolos Karantanas, Achilleas Gikas
OBJECTIVE: Recent studies have shown that in carefully selected patients, conservative treatment alone can be an option in the management of spinal epidural abscess (SEA). The aim of this study was to identify prognostic factors of outcome in patients with spontaneous SEA treated conservatively. PATIENTS AND METHODS: A retrospective cohort study of all patients with spontaneous SEA treated with antibiotics alone from January 2012 to December 2015 was conducted in a 1200-bed tertiary referral center...
February 27, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28274020/role-of-cross-sectional-imaging-in-isolated-chest-wall-tuberculosis
#3
Deb Kumar Boruah, Shantiranjan Sanyal, Barun K Sharma, Arjun Prakash, Dhabal D Dhingani, Karobi Bora
INTRODUCTION: Isolated chest wall tuberculosis though a rare entity, the incidence of it has been on rise among immunocompromised population making it an important challenging diagnosis for the physicians. Its clinical presentation may resemble pyogenic chest wall abscess or chest wall soft tissue tumour. Sometimes it is difficult to detect clinically or on plain radiograph. AIM: The present study was conducted with an aim to evaluate the common sites and varying appearances of isolated chest wall tuberculosis...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28253945/-pyogenic-spinal-infections-in-adults-a-5-year-experience-from-a-tertiary-care-centre
#4
O Džupová, R Cihlářová
PURPOSE OF THE STUDY To describe epidemiological and clinical features of pyogenic spinal infections in patients treated at the Department of Infectious, Parasitic and Tropical Diseases of the Hospital Na Bulovce in 2010-2014, and to analyse a predictive significance of selected variables. MATERIAL AND METHODS A single-centre retrospective cohort study carried out from 1.1.2010 to 31.12.2014 enrolled adult patients with septic spondylitis, discitis and facet joint infections. Recorded parameters included: demographics, chronic comorbidities, time to diagnosis, radiological work-up, anatomical level of spinal infection, source of infection, etiological agent, complications, treatment and outcomes...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28251880/choosing-wisely-canada%C3%A2-five-tests-procedures-and-treatments-to-question-in-emergency-medicine
#5
Amy H Y Cheng, Sam Campbell, Lucas B Chartier, Tom Goddard, Kirk Magee, Jill McEwen, Atul K Kapur, Brian R Holroyd, Suneel Upadhye, Stephanie Couperthwaite, Brian H Rowe
OBJECTIVES: Choosing Wisely Canada (CWC) is an initiative to encourage patient-physician discussions about the appropriate, evidence based use of medical tests, procedures and treatments. We present the Canadian Association of Emergency Physicians' (CAEP) top five list of recommendations, and the process undertaken to generate them. METHODS: The CAEP Expert Working Group (EWG) generated a candidate list of 52 tests, procedures, and treatments in emergency medicine whose value to care was questioned...
March 2, 2017: CJEM
https://www.readbyqxmd.com/read/28250635/the-role-of-minimally-invasive-spine-surgery-in-the-management-of-pyogenic-spinal-discitis
#6
Mazda K Turel, Mena Kerolus, Harel Deutsch
BACKGROUND: Diagnostic yields for spondylodiscitis from CT guided biopsy is low. In the recent years, minimally invasive surgery (MIS) has shown to have a low morbidity and faster recovery. For spinal infections, MIS surgery may offer an opportunity for early pain control while obtaining a higher diagnostic yield than CT-guided biopsies. The aim of this study was to review our patients who underwent MIS surgery for spinal infection and report outcomes. METHODS: A retrospective review of seven patients who underwent MIS decompression and/or discectomy in the setting of discitis, osteomyelitis, spondylodiscitis, and/or an epidural abscess was identified...
January 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28239759/primary-acquired-spondylodiscitis-shows-a-more-severe-course-than-spondylodiscitis-following-spine-surgery-a-single-center-retrospective-study-of-159-cases
#7
Anja Tschugg, Sara Lener, Sebastian Hartmann, Andreas Rietzler, Sabrina Neururer, Claudius Thomé
Spondylodiscitis may arise primarily via hematogenous spread or direct inoculation of virulent organisms during spine surgery. To date, no comparative data investigating the differences between primary and postoperative spondylodiscitis is available. Thus, the purpose of this retrospective study was to investigate differences between these two etiologies. One hundred fifty-nine patients that were treated at our department were included in the retrospective analysis. The patients were categorized into two groups based on the etiology of spondylodiscitis: group NS, primary spondylodiscitis without prior spinal surgery; group S, spondylodiscitis following spinal surgery...
February 27, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28226087/cervical-spinal-dermal-sinus-associated-with-intramedullary-spinal-cord-abscess
#8
Bernardo Carvalho Muniz, Bruno Niemeyer de Freitas Ribeiro, Gabriel Mufarrej, Nina Ventura Wilner, Emerson Leandro Gasparetto
No abstract text is available yet for this article.
February 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28220823/treatment-of-stress-urinary-incontinence-in-men-with-spinal-cord-injury-minimally-invasive-minimally-effective
#9
J Pannek, J Wöllner
STUDY DESIGN: Retrospective chart review. OBJECTIVES: To assess the outcome of minimally invasive treatment of stress urinary incontinence with alloplastic slings in patients with neurogenic lower urinary tract dysfunction. SETTING: Switzerland. METHODS: The patient database of a tertiary urologic referral center was screened for male patients with SCI who underwent implantation of a suburethral sling between June 2009 and December 2015...
February 21, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28207621/mri-based-decision-making-of-implant-removal-in-deep-wound-infection-after-instrumented-lumbar-fusion
#10
Masahiro Kanayama, Tomoyuki Hashimoto, Keiichi Shigenobu, Fumihiro Oha, Akira Iwata, Masaru Tanaka
STUDY DESIGN: A retrospective study. OBJECTIVE: The aim of the study was to review the treatment of deep wound infection after posterior instrumented lumbar fusion, and thereby to optimize the decision-making process of implant removal or retention on the basis of magnetic resonance imaging (MRI) assessment. SUMMARY OF BACKGROUND DATA: Biofilm formed on the surface of the spinal implant prevents infiltration of antibiotics and makes the infection treatment more complicated...
March 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28187806/diagnosis-and-management-of-spinal-cord-emergencies
#11
REVIEW
E P Flanagan, S J Pittock
Most spinal cord injury is seen with trauma. Nontraumatic spinal cord emergencies are discussed in this chapter. These myelopathies are rare but potentially devastating neurologic disorders. In some situations prior comorbidity (e.g., advanced cancer) provides a clue, but in others (e.g., autoimmune myelopathies) it may come with little warning. Neurologic examination helps distinguish spinal cord emergencies from peripheral nervous system emergencies (e.g., Guillain-Barré), although some features overlap...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28159488/lateral-lumbar-retroperitoneal-transpsoas-approach-in-the-setting-of-spondylodiscitis-a-technical-note
#12
George M Ghobrial, Fadi Al-Saiegh, Daniel Franco, Daniel Benito, Joshua Heller
Thoracolumbar spondylodiscitis is a morbid disease entity, impacting a sick patient population with multiple comorbidities. Wherever possible, surgical measures in this population should limit the extent of soft tissue disruption and overall morbidity that is often associated with anteroposterior thoracolumbar decompression and fusion. The authors describe the rationale, technique, and use of the lateral lumbar transpsoas retroperitoneal approach in tandem with posterior decompression and instrumented fusion in the treatment of circumferential thoracolumbar spondylodiscitis with or without epidural abscesses...
January 31, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28157811/one-stage-surgical-management-for-lumbar-brucella-spondylitis-by-posterior-debridement-autogenous-bone-graft-and-instrumentation-a-case-series-of-24-patients
#13
Yangbin Chen, Jun-Song Yang, Tao Li, Peng Liu, Tuan-Jiang Liu, Li-Min He, Li-Xiong Qian, Ding-Jun Hao
STUDY DESIGN: Clinical case series. OBJECTIVE: To explore the efficacy and safety of one-stage debridement, autogenous bone graft and instrumentation for lumbar brucella spondylitis (LBS) via a posterior approach. SUMMARY OF BACKGROUND DATA: Reports on LBS are sporadic, and the therapeutic effect and safety of surgical interventions have not been assessed in clinical studies. METHODS: Between January 2012 and January 2014, 24 consecutive patients with symptomatic LBS who underwent a one-stage operation that combined debridement, autogenous bone graft and instrumentation via a posterior approach were enrolled...
February 2, 2017: Spine
https://www.readbyqxmd.com/read/28156637/complications-of-intrathecal-pump-therapy-in-malignancy-related-pain
#14
Egidio Del Fabbro
102 Background: Intrathecal pumps (ITP) are used to manage severe malignancy related pain by delivering analgesics directly into the cerebrospinal fluid, in theory allowing for a reduced opioid dose and fewer complications. Although there is literature to support efficacy in patients with cancer, including improved survival, this mode of drug delivery also carries a risk of serious complications. Reports of complications in non-malignant pain suggest the risks and mortality related to ITP may be under-appreciated and that injury and liability occur with both ITP placement and ITP maintenance...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28143552/abscess-of-the-cervical-spine-secondary-to-injection-site-infection-in-a-heifer
#15
Ueli Braun, Christian Gerspach, Karolin Kühn, Julia Bünter, Monika Hilbe
BACKGROUND: Abscesses in the neck region can result from infection associated with injection of drugs into the neck muscles. To our knowledge, there have been no reports of osteomyelitis of the cervical vertebra and spinal cord compression secondary to an abscess in the neck. This case report describes the findings in a 9.5-month-old heifer with an abscess of the cervical spine secondary to injection site infection. CASE PRESENTATION: The main clinical findings were swelling on the left side of the neck, proprioceptive deficits in all limbs and generalised ataxia...
January 31, 2017: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/28134749/prognostic-factors-for-failure-of-antibiotic-treatment-in-patients-with-osteomyelitis-of-the-spine
#16
Jan Jaap de Graeff, Nuno Rui Paulino Pereira, Olivier D van Wulfften Palthe, Sandra B Nelson, Joseph H Schwab
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Identify factors independently associated with antibiotic treatment failure in patients with spinal osteomyelitis. SUMMARY OF BACKGROUND DATA: There are few studies that have identified risk factors for antibiotic treatment failure in medically-managed spinal osteomyelitis. Identifying such factors could help to identify patients who can be treated solely with antibiotics. METHODS: All patients who underwent antibiotic treatment for spinal osteomyelitis in one of our institutions between January 1 2001 until January 1 2015 were identified...
January 27, 2017: Spine
https://www.readbyqxmd.com/read/28127138/primary-spinal-epidural-b-lymphoblastic-lymphoma
#17
Rakul K Nambiar, Sreejith G Nair, Pranab K Prabhakaran, Sherin P Mathew
Extranodal lymphomas constitute 20% to 30% of all non-Hodgkin's lymphomas. The common sites involved are skin, stomach, brain, and small intestine. Epidural localization is a rare site for lymphomas, accounting for 10% of spinal epidural tumors. Lymphomas occurring primarily in the epidural space without other previously detected lymphomatous foci (i.e., primary spinal epidural lymphomas) represent an even rarer entity. We report a case of primary spinal epidural B-lymphoblastic lymphoma. The patient presented with paraparesis, and a spinal epidural lesion was diagnosed...
January 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28124423/clinical-management-of-brucella-suis-infection-in-dogs-and-implications-for-public-health
#18
D R James, G Golovsky, J M Thornton, L Goodchild, M Havlicek, P Martin, M B Krockenberger, Dje Marriott, V Ahuja, R Malik, S M Mor
BACKGROUND: Brucellosis caused by Brucella suis is a notifiable disease that has recently emerged in dogs in New South Wales (NSW). Given the potential for zoonotic transmission, euthanasia of affected dogs is recommended, but this action is not mandatory. We report the clinical management of three dogs that underwent treatment at their owners' request. CASE REPORTS: A 14-month-old spayed female crossbreed originally obtained from an urban animal shelter underwent extensive investigations in 2011-12 for lameness and back pain, culminating in decompressive laminectomy...
January 2017: Australian Veterinary Journal
https://www.readbyqxmd.com/read/28115866/serratus-anterior-plane-block-for-hybrid-transthoracic-esophagectomy-a-pilot-study
#19
Cinzia Barbera, Pamela Milito, Michele Punturieri, Emanuele Asti, Luigi Bonavina
BACKGROUND: Pain is a major limiting factor in patient's recovery from major thoracic surgical procedures. Thoracic epidural analgesia (TEA), the current gold standard of perioperative management, has contraindications, can technically fail, and carries a risk of complications such as epidural abscess and spinal hematoma. The ultrasound-guided serratus anterior plane (SAP) block is a promising regional analgesia technique. OBJECTIVES: Since the anatomic space involved in the SAP block corresponds to the area exposed by the surgeon during right posterolateral thoracotomy, we investigated the feasibility of a "surgically guided" continuous SAP block as an alternative to TEA in selected esophagectomy patients...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28112788/computed-tomography-guided-catheterization-drainage-to-cure-spinal-tuberculosis-with-individualized-chemotherapy
#20
Jianhua Li, Xuequan Huang, Feifan Chen, Fei Dai, Qiang Zhou, Fei Luo, Jianzhong Xu, Zehua Zhang
The goal of this study was to investigate the effect of individualized chemotherapy delivered via percutaneous catheter drainage on paravertebral abscesses in spinal tuberculosis (TB). Data from 48 patients with spinal TB with paravertebral abscesses who received individualized chemotherapy via computed tomography-guided catheterization between 2009 and 2012 were retrospectively analyzed. The paravertebral abscesses affected the thoracic vertebra (n=12), the lumbar spine (n=20), the thoracolumbar vertebra (n=10), and the lumbosacral (n=6)...
January 20, 2017: Orthopedics
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