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Spine injections

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https://www.readbyqxmd.com/read/28339551/anticoagulant-and-antiplatelet-management-for-spinal-procedures-a-prospective-descriptive-study-and-interpretation-of-guidelines
#1
Bradly S Goodman, L McLean House, Sridhar Vallabhaneni, Srinivas Mallempati, Matthew R Willey, Matthew Thomas Smith
Setting.:  Epidural hematoma rarely complicates interventional spine procedures. While anticoagulant and antiplatelet drugs increase bleeding risk, cessation may precipitate serious thromboembolic events. The Spine Intervention Society (SIS) and American Society of Regional Anesthesia and Pain Medicine (ASRA) put forth guidelines that dissent with regard to management of hemostatically active agents during commonly performed spinal injections. Objective.:  To validate an antiplatelet/anticoagulant management table based on modifications of the SIS 2013 and ASRA 2015 guidelines...
October 6, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339449/reversal-of-progressive-conscious-disturbance-with-epidural-blood-patch-for-cerebrospinal-fluid-leakage-at-c2-level
#2
Yi-Chen Lai, Yuan-Yi Chia, Wei-Hung Lien
Intracranial hypotension syndrome (IHS) is generally caused by cerebrospinal fluid (CSF) leakage. Complications include bilateral subdural hygroma or haematoma and herniation of the cerebellar tonsils. Epidural blood patch (EBP) therapy is indicated if conservative treatment is ineffective. We reported the case of a 46-year-old man with a history of postural headache and dizziness. The patient was treated with bed rest and daily hydration with 2000 mL of fluid for 2 weeks. However, dizziness and headache did not resolve, and he became drowsy and disoriented with incomprehensible speech...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339319/intrathecal-magnetic-drug-targeting-for-localized-delivery-of-therapeutics-in-the-cns
#3
Indu Venugopal, Nazia Habib, Andreas Linninger
AIM: The challenge in treating neurological diseases is not lack of drug potency, but ineffective targeting techniques. We propose a technique called intrathecal magnetic drug targeting (IT-MDT), in which intrathecally injected magnetic nanoparticles (MNPs) are targeted to specific sites using external magnets. MATERIALS & METHODS: MRI and histology confirmed localization of MNPs via IT-MDT at target sites along the spine of Sprague-Dawley rats. RESULTS: MRI results confirmed greater MNP localization when the duration of magnet application was extended...
March 24, 2017: Nanomedicine
https://www.readbyqxmd.com/read/28336441/chronic-stress-induced-dendritic-reorganization-and-abundance-of-synaptosomal-pka-dependent-cp-ampa-receptor-in-the-basolateral-amygdala-in-a-mouse-model-of-depression
#4
Eun-Surk Yi, Seikwan Oh, Jang-Kyu Lee, Yea-Hyun Leem
Chronic stress is a precipitating factor for disorders including depression. The basolateral amygdala (BLA) is a critical substrate that interconnects with stress-modulated neural networks to generate emotion- and mood-related behaviors. The current study shows that 3 h per day of restraint stress for 14 days caused mice to exhibit long-term depressive behaviors, manifested by disrupted sociality and despair levels, which were rescued by fluoxetine. These behavioral changes corresponded with morphological and molecular changes in BLA neurons, including chronic stress-elicited increases in arborization, dendritic length, and spine density of BLA principal neurons...
March 20, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28332593/injections-through-skin-colonized-with-staphylococcus-aureus-biofilm-introduce-contamination-despite-standard-antimicrobial-preparation-procedures
#5
Yi Wang, Valery Leng, Viraj Patel, K Scott Phillips
While surgical site preparation has been extensively studied, there is little information about resistance of skin microbiota in the biofilm form to antimicrobial decontamination, and there are no quantitative models to study how biofilm might be transferred into sterile tissue/implant materials during injections for joint spine and tendon, aspiration biopsies and dermal fillers (DF). In this work, we develop two in vitro models to simulate the process of skin preparation and DF injection using pig skin and SimSkin (silicone) materials, respectively...
March 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28331936/ultrasound-guidance-for-difficult-lumbar-puncture-in-children-pearls-and-pitfalls
#6
REVIEW
Prakash Muthusami, Ashley James Robinson, Manohar M Shroff
Pediatric lumbar puncture can be challenging or unsuccessful for several reasons. At the same time, the excellent sonographic window into the pediatric spine provides a distinct opportunity for ultrasound-guided lumbar puncture. Minimal cerebrospinal fluid and thecal displacement by subdural or epidural hematomas are common after failed clinical attempts. Ultrasound is useful for determining a safe infraconal level for subarachnoid access. Real-time guidance increases not only the success rate but also the safety of diagnostic lumbar puncture and injections for chemotherapy and myelography...
March 22, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28326303/current-role-and-application-of-teriparatide-in-fracture-healing-of-osteoporotic-patients-a-systematic-review
#7
Sang-Min Kim, Kyung-Chung Kang, Ji Wan Kim, Seung-Jae Lim, Myung Hoon Hahn
BACKGROUND: The use of osteoanabolic agents to facilitate fracture healing has been of heightened interest to the field of orthopaedic trauma. This study aimed to evaluate the evidence of teriparatide for fracture healing and functional recovery in osteoporotic patients. METHODS: We performed a literature search in PubMed, EMBASE, Web of Science, and the Cochrane Library using terms including "Fracture" [tiab] AND "Teriparatide [tiab] OR "PTH" [tiab]. RESULTS: This systematic review included 6 randomized clinical trials, 4 well-controlled retrospective studies, and 1 retrospective post hoc subgroup analysis...
February 2017: Journal of Bone Metabolism
https://www.readbyqxmd.com/read/28319997/intradiscal-glucocorticoid-injection-for-patients-with-chronic-low-back-pain-associated-with-active-discopathy-a-randomized-trial
#8
Christelle Nguyen, Isabelle Boutron, Gabriel Baron, Katherine Sanchez, Clémence Palazzo, Raphaël Benchimol, Guillaume Paris, Étienne James-Belin, Marie-Martine Lefèvre-Colau, Johann Beaudreuil, Jean-Denis Laredo, Anne Béra-Louville, Anne Cotten, Jean-Luc Drapé, Antoine Feydy, Philippe Ravaud, François Rannou, Serge Poiraudeau
Background: Active discopathy is associated with a specific phenotype of chronic low back pain (LBP). Local inflammation has a role in active discopathy-associated symptoms. Objective: To assess the efficacy of a single glucocorticoid intradiscal injection (GC IDI) in patients with chronic LBP with active discopathy. Design: Prospective, parallel-group, double-blind, randomized, controlled study. (ClinicalTrials.gov: NCT00804531). Setting: 3 tertiary care centers in France...
March 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28315990/model-based-registration-of-preprocedure-mr-and-intraprocedure-us-of-the-lumbar-spine
#9
Delaram Behnami, Alireza Sedghi, Emran Mohammad Abu Anas, Abtin Rasoulian, Alexander Seitel, Victoria Lessoway, Tamas Ungi, David Yen, Jill Osborn, Parvin Mousavi, Robert Rohling, Purang Abolmaesumi
PURPOSE: Epidural and spinal needle insertions, as well as facet joint denervation and injections are widely performed procedures on the lumbar spine for delivering anesthesia and analgesia. Ultrasound (US)-based approaches have gained popularity for accurate needle placement, as they use a non-ionizing, inexpensive and accessible modality for guiding these procedures. However, due to the inherent difficulties in interpreting spinal US, they yet to become the clinical standard-of-care...
March 18, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28306517/biomechanical-analysis-of-stiffness-and-fracture-displacement-after-using-pmma-augmented-sacroiliac-screw-fixation-for-sacrum-fractures
#10
Andreas Höch, Richard Schimpf, Niels Hammer, Stefan Schleifenbaum, Michael Werner, Christoph Josten, Jörg Böhme
Cement augmentation of pedicle screws is the gold standard for the stabilization of osteoporotic fractures of the spine. In-screw cement augmentation, in which cement is injected through the cannula, is another option for fracture stabilization of fragility fractures of the sacrum. However, biomechanical superiority of this technique compared to conventional sacroiliac screw fixation has not been tested. The present study compares the stability of cement-augmented and non-cement-augmented sacroiliac screw fixation in osteoporotic sacrum fractures under cyclic loading...
March 15, 2017: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/28301408/k-cl-cotransporter-2-mediated-cl-extrusion-determines-developmental-stage-dependent-impact-of-propofol-anesthesia-on-dendritic-spines
#11
Martin Puskarjov, Hubert Fiumelli, Adrian Briner, Timea Bodogan, Kornel Demeter, Claudia-Marvine Lacoh, Martina Mavrovic, Peter Blaesse, Kai Kaila, Laszlo Vutskits
BACKGROUND: General anesthetics potentiating γ-aminobutyric acid (GABA)-mediated signaling are known to induce a persistent decrement in excitatory synapse number in the cerebral cortex when applied during early postnatal development, while an opposite action is produced at later stages. Here, the authors test the hypothesis that the effect of general anesthetics on synaptogenesis depends upon the efficacy of GABA receptor type A (GABAA)-mediated inhibition controlled by the developmental up-regulation of the potassium-chloride (K-Cl) cotransporter 2 (KCC2)...
March 16, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28300056/imbalance-between-tnf%C3%AE-and-progranulin-contributes-to-memory-impairment-and-anxiety-in-sleep-deprived-mice
#12
Kun Zhang, Yu-Jiao Li, Dan Feng, Peng Zhang, Ya-Tao Wang, Xiang Li, Shui-Bing Liu, Yu-Mei Wu, Ming-Gao Zhao
Sleep disorder is becoming a widespread problem in current society, and is associated with impaired cognition and emotional disorders. Progranulin (PGRN), also known as granulin epithelin precursor, promotes neurite outgrowth and cell survival, and is encoded by the GRN gene. It is a tumor necrosis factor α receptor (TNFR) ligand which is implicated in many central nervous system diseases. However, the role PGRN in sleep disorder remains unclear. In the present study, we found that sleep deprivation (S-DEP) impaired the memory and produced thigmotaxis/anxiety-like behaviors in mice...
March 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28296953/a-numerical-investigation-of-intrathecal-isobaric-drug-dispersion-within-the-cervical-subarachnoid-space
#13
Per Thomas Haga, Giulia Pizzichelli, Mikael Mortensen, Miroslav Kuchta, Soroush Heidari Pahlavian, Edoardo Sinibaldi, Bryn A Martin, Kent-Andre Mardal
Intrathecal drug and gene vector delivery is a procedure to release a solute within the cerebrospinal fluid. This procedure is currently used in clinical practice and shows promise for treatment of several central nervous system pathologies. However, intrathecal delivery protocols and systems are not yet optimized. The aim of this study was to investigate the effects of injection parameters on solute distribution within the cervical subarachnoid space using a numerical platform. We developed a numerical model based on a patient-specific three dimensional geometry of the cervical subarachnoid space with idealized dorsal and ventral nerve roots and denticulate ligament anatomy...
2017: PloS One
https://www.readbyqxmd.com/read/28291179/the-influence-of-direct-inoculation-of-propionibacterium-acnes-on-modic-changes-in-the-spine-evidence-from-a-rabbit-model
#14
Zhi Shan, Xuyang Zhang, Shengyun Li, Tianming Yu, Maiwulanjiang Mamuti, Fengdong Zhao
BACKGROUND: Modic changes (inflammatory-like changes visible on magnetic resonance imaging [MRI] scans of a vertebral end plate) are common and are associated with low back pain, but their origin is unclear. To our knowledge, there have been no previous in vivo animal models of Modic changes. We hypothesized that Modic changes may be related to Propionibacterium acnes. METHODS: Ten New Zealand White rabbits were injected percutaneously with 1 mL of P. acnes (1.6 × 10 colony forming units/mL) into the subchondral bone superior to the L4-L5 and L5-L6 discs; 10 other control rabbits received sham injections at L4-L5 and 1 mL of normal saline solution (vehicle) at L5-L6...
March 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28284983/systemic-aav-mediated-%C3%AE-sarcoglycan-delivery-targeting-cardiac-and-skeletal-muscle-ameliorates-histological-and-functional-deficits-in-lgmd2e-mice
#15
Eric R Pozsgai, Danielle A Griffin, Kristin N Heller, Jerry R Mendell, Louise R Rodino-Klapac
Limb-girdle muscular dystrophy type 2E (LGMD2E), resulting from mutations in β-sarcoglycan (SGCB), is a progressive dystrophy with deteriorating muscle function, respiratory failure, and cardiomyopathy in 50% or more of LGMD2E patients. SGCB knockout mice share many of the phenotypic deficiencies of LGMD2E patients. To investigate systemic SGCB gene transfer to treat skeletal and cardiac muscle deficits, we designed a self-complementary AAVrh74 vector containing a codon-optimized human SGCB transgene driven by a muscle-specific promoter...
March 8, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/28284898/role-of-probdnf-and-bdnf-in-dendritic-spine-plasticity-and-depressive-like-behaviors-induced-by-an-animal-model-of-depression
#16
Hui Qiao, Shu-Cheng An, Chang Xu, Xin-Ming Ma
Major depressive disorder (MDD) is one of the most common psychiatric disorder, but the underlying mechanisms are largely unknown. Increasing evidence shows that brain-derived neurotrophic factor (BDNF) plays an important role in the structural plasticity induced by depression. Considering the opposite effects of BDNF and its precursor proBDNF on neural plasticity, we hypothesized that the balance of BDNF and proBDNF plays a critical role in chronic unpredicted mild stress (CUMS)-induced depressive-like behaviors and structural plasticity in the rodent hippocampus...
March 8, 2017: Brain Research
https://www.readbyqxmd.com/read/28273627/ventrogluteal-versus-dorsogluteal-site-selection-a-cross-sectional-study-of-muscle-and-subcutaneous-fat-thicknesses-and-an-algorithm-incorporating-demographic-and-anthropometric-data-to-predict-injection-outcome
#17
Theresa A Larkin, Elfriede Ashcroft, Asmahan Elgellaie, Blake A Hickey
BACKGROUND: The dorsogluteal and ventrogluteal intramuscular injection sites both have their use in clinical practice; however, it has not been established in whom one or the other should be preferentially targeted or avoided. There is a need for an evidence-based approach towards site selection for a successful intramuscular injection outcome and to avoid unwanted injection outcomes of inadvertent subcutaneous injection or bone contact. Injection outcome is dependent on injection site subcutaneous fat thickness and muscle thickness; these are likely influenced by gender and anthropometry...
February 22, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28272292/the-erector-spinae-plane-block-provides-visceral-abdominal-analgesia-in-bariatric-surgery-a-report-of-3-cases
#18
Ki Jinn Chin, Laith Malhas, Anahi Perlas
Postoperative pain after bariatric surgery can be significant and yet difficult to manage. These patients frequently have associated obstructive sleep apnea and are at risk of respiratory depression with opioid analgesia. Abdominal wall blocks such as the subcostal transversus abdominis plane block are not of significant benefit, probably in part because they provide only somatic analgesia. The ultrasound-guided erector spinae plane (ESP) block is a recently described regional anesthetic technique for providing thoracic analgesia when performed at the level of the T5 transverse process...
March 8, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28263890/the-prevalence-of-spinal-epidural-lipomatosis-on-magnetic-resonance-imaging
#19
Nina C Theyskens, Nuno Rui Paulino Pereira, Stein J Janssen, Christopher M Bono, Joseph H Schwab, Thomas D Cha
BACKGROUND: Spinal epidural lipomatosis (SEL) refers to an excessive accumulation of fat within the epidural space. It can be idiopathic or secondary, resulting in significant morbidity. The prevalence of SEL, including idiopathic and secondary SEL, and its respective risk factors are poorly defined. PURPOSE: We sought to: (1) assess the prevalence of SEL among patients who underwent a dedicated magnetic resonance imaging (MRI) scan of the spine-including incidental SEL (ie, SEL without any spine-related symptoms), SEL with spine-related symptoms, and symptomatic SEL (ie, with symptoms specific for SEL); and (2) assess factors associated with overall SEL and subgroups...
March 3, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28259071/epidural-lipomatosis-with-cauda-equina-syndrome-in-chronic-alcoholic-patient-a-case-report
#20
Sung-Soo Kim, Dong-Ju Lim
INTRODUCTION: Epidural lipomatosis of the lumbar spine is a rare condition, which is described as the accumulation of fat in the extradural territory. PRESENTATION OF CASE: We report the case of a 60-year-old, non-obese, and chronic alcoholic man who was transferred to our spine department with cauda equina syndrome (CES) for 4 months. On magnetic resonance imaging (MRI), spinal epidural lipomatosis (SEL) was confirmed in the multilevel lumbar lesion. A decompression surgery was performed and the patient recovered significantly...
February 20, 2017: International Journal of Surgery Case Reports
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