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Non-surgical spine

Xin Jiang, Dong Chen, Yahao Lou, Zhongshi Li
BACKGROUND: Postoperative delirium is a common complication following various operative procedures with an incidence rate of 10-77 %. AIM: To analyze various risk factors for postoperative delirium after spine surgery in the middle- and old-aged patients. METHODS: This study retrospectively reviewed 451 patients (226 males and 225 females, an average age of 65.1 ± 18.3 years) who underwent spinal surgery in our hospital between January 2010 and August 2015...
October 20, 2016: Aging Clinical and Experimental Research
Haruki Funao, Khaled M Kebaish, Norihiro Isogai, Takahiro Koyanagi, Morio Matsumoto, Ken Ishii
BACKGROUND: Spondylodiscitis still remains a serious problem especially in immunocompromised patients. Surgery is necessary when non-surgical treatment is unsuccessful. Although minimally invasive spine stabilization (MISt) with percutaneous pedicle screws is less invasive, percutaneous sacropelvic fixation techniques are not common practice. Here, we describe two cases in which spondylodiscitis in the lumbosacral spine was treated with a percutaneous stabilization using S2 alar-iliac (S2AI) screw technique...
October 15, 2016: World Neurosurgery
Monique Mostert, Anthony Bonavia
BACKGROUND Besides providing anesthesia for surgery, the anesthesiologist's role is to optimize the patient for surgery and for post-surgical recovery. This involves timely identification and treatment of medical comorbidities and abnormal laboratory values that could complicate the patient's perioperative course. There are several potential causes of anion and non-anion gap metabolic acidosis in surgical patients, most of which could profoundly affect a patient's surgical outcome. Thus, the presence of an acute acid-base disturbance requires a thorough workup, the results of which will influence the patient's anesthetic management...
October 18, 2016: American Journal of Case Reports
Andreas Kiilerich Andresen, Carsten Ernst, Mikkel Ø Andersen
Lumbar spinal stenosis is the most common reason for spinal surgery in Denmark. Lumbar spinal stenosis is a clinical syndrome of pain in the buttocks or lower extremities, with or without back pain. It is associated with reduced space available for the neural and vascular elements of the lumbar spine. The condition is often exacerbated by standing, walking or lumbar extension and relieved by forward flexion. The options for non-surgical management include drugs and physiotherapy. Treatment outcomes seem to be better for surgical neural decompression than for non-operative treatment...
October 10, 2016: Ugeskrift for Laeger
Ikemefuna Onyekwelu, Steven D Glassman, Anthony L Asher, Christopher I Shaffrey, Praveen V Mummaneni, Leah Y Carreon
OBJECTIVE Prior studies have shown obesity to be associated with higher complication rates but equivalent clinical outcomes following lumbar spine surgery. These findings have been reproducible across lumbar spine surgery in general and for lumbar fusion specifically. Nevertheless, surgeons seem inclined to limit the extent of surgery, perhaps opting for decompression alone rather than decompression plus fusion, in obese patients. The purpose of this study was to ascertain any difference in clinical improvement or complication rates between obese and nonobese patients following decompression alone compared with decompression plus fusion for lumbar spinal stenosis (LSS)...
October 14, 2016: Journal of Neurosurgery. Spine
Marcus Ohlsson, Jaime H Nieto, Kari L Christe, J Pablo Villablanca, Leif A Havton
The anatomy of the vertebral column in mammals may differ between species and between subjects of the same species, especially with regards to the composition of the thoracolumbar spine. We investigated, using several non-invasive imaging techniques, the thoracolumbar spine of a total of 44 adult rhesus macaques of both genders. Radiographic examination of the vertebral column showed a predominant spine phenotype with 12 rib-bearing thoracic vertebrae and 7 lumbar vertebrae without ribs in 82% of subjects, whereas a subset of subjects demonstrated 13 rib-bearing thoracic vertebrae and 6 lumbar vertebrae without ribs...
October 12, 2016: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
B Fink, R Lass
Background: Total hip arthroplasty (THA) is one of the most common and successful surgical procedures in orthopedic surgery and clinical success can be characterized by the revision rate and improvement of function, as well as the patient's satisfaction and pain. Despite the clinical success of primary THA with 10-year survival rates as high as 96 % (Swedish Hip Arthroplasty Register, 2011), the prevalence of groin pain after conventional total hip replacement ranges from 0.4 to 18.3 % and activity-limiting thigh pain is still an existing problem linked to the femoral component of uncemented hip replacement in up to 1...
October 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
A I Macfarlane, D Rudd, E Knight, L A G Marshman, E P Guazzo, D S Anderson
: Prior studies have suggested that elevated serum Troponin-I (TnI) levels immediately after non-cardiac surgical procedures (8-40%) represent subclinical cardiac stress which independently predicts increased 30-day mortality. Routine post-operative TnI monitoring has therefore been suggested as a standard of care. However, no prior studies have focussed on elective degenerative spine surgery, whilst few have measured pre-op TnI. Further, prolonged prone positioning could represent an additional, independent, cardiac stress...
October 1, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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
Marie Bangstrup, Martin Brummerstedt, Toke S Barfod
Spondylodiscitis, infection of the spine and intervertebral discs, is a rare condition with increasing incidence. Early diagnosis can be challenging due to the non-specific symptoms such as back pain and fever. Diagnosis is verified by MRI. Microbial aetiology is pursued by blood cultures or surgical biopsy, however, some cases remain culture-negative. Long-term antibiotic treatment is standard of care. Some patients receive surgical treatment. One-year mortality is up to 20%. Recently, published data suggest that six weeks of antibiotics equals 12 weeks in culture-positive cases...
September 26, 2016: Ugeskrift for Laeger
Stefan Hartveldt, Stein J Janssen, Kirkham B Wood, Thomas D Cha, Joseph H Schwab, Christopher M Bono, Louis G Jenis
STUDY DESIGN: Retrospective study. OBJECTIVE: To assess the relation between exposure to epidural steroid injection (ESI) before surgery and occurrence of surgical site infection (SSI) for degenerative lumbar spine conditions. SUMMARY OF BACKGROUND DATA: The effect of local ESI on the occurrence of SSI is controversial. METHODS: Patients who underwent surgery for degenerative lumbar spine conditions at two centers between 2005 and 2015 were identified...
October 1, 2016: Spine
Ciara Clancy, Alison Quinn, Fiona Wilson
PURPOSE: Four to fifty percent of patients will develop Failed Back Surgery Syndrome (FBSS) following lumbar spine surgery. Repeated surgeries lead to escalating costs and subsequent decreases in success rate. Much of the research to date has focused on the psychosocial factors associated with FBSS. All factors including physical and pathological aetiologies should be examined. These factors may be independent, co-exist with or predispose patients to the psychological factors associated with FBSS...
September 23, 2016: Journal of Back and Musculoskeletal Rehabilitation
Donita I Bylski-Austrow, David L Glos, Anne C Bonifas, Max F Carvalho, Matthew C Coombs, Peter F Sturm
BACKGROUND: Surgical treatments for early onset scoliosis (EOS) correct curvatures and improve respiratory function but involve many complications. A distractible, or 'growing rod,' implant construct that is more flexible than current metal rod systems may sufficiently correct curves in small children and reduce complications due to biomechanical factors. The purpose of this pilot study was to determine ranges of motion (ROM) after implantation of simulated growing rod constructs with a range of clinically relevant structural properties...
2016: Scoliosis and Spinal Disorders
Gauri Tendulkar, Phillip Grau, Patrick Ziegler, Alfred Buck, Alfred Buck, Andreas Badke, Hans-Peter Kaps, Sabrina Ehnert, Andreas K Nussler
Intervertebral disc degeneration and disc herniation is one of the major causes of lower back pain. Depletion of extracellular matrix, culminating in nucleus pulposus (NP) extrusion leads to intervertebral disc destruction. Currently available surgical treatments reduce the pain but do not restore the mechanical functionality of the spine. In order to preserve mechanical features of the spine, total disc or nucleus replacement thus became a wide interest. However, this arthroplasty era is still in an immature state, since none of the existing products have been clinically evaluated...
2016: Journal of Visualized Experiments: JoVE
Aladine A Elsamadicy, Timothy Y Wang, Adam G Back, Amanda Sergesketter, Hunter Warwick, Isaac O Karikari, Oren N Gottfried
BACKGROUND: The effects and use of intra-operative steroids is relatively unknown and remains controversial. The aim of this is to determine if the effect of intra-operative steroid use on post-operative complications and length of hospital stay after spine surgery. METHODS: Medical records of 1200 adult patients undergoing spine surgery at Duke University Medical Center from 2008 to 2010 were retrospectively reviewed. There were 495 (41.25%) patients who were administered intra-operative steroids, and 705 (58...
September 22, 2016: World Neurosurgery
Aleksandr Rozenberg, Jonathan C Weinstein, Adam E Flanders, Pranshu Sharma
Reformatted CTs of the thoracic and lumbar spine (CT T/L) from CTs of the chest, abdomen, and pelvis (CT body) may be performed for screening the thoracolumbar spine in patients sustaining blunt trauma. The purpose of this study was to determine whether there was a difference in the rate of detection of spinal fractures on CTs of the body compared to the reformatted T/L spine. A secondary endpoint was to evaluate whether cases dictated by trainees improved fracture detection rate. We reviewed the records of 250 consecutive blunt trauma patients that received CTs of the chest, abdomen, and pelvis (CT body) with concurrent CT T/L reformats...
September 23, 2016: Emergency Radiology
Nihat Acar, Ahmet Karakasli, Ahmet A Karaarslan, Mehmet Hilal Ozcanhan, Fatih Ertem, Mehmet Erduran
OBJECTIVE: Rod-screw fixation systems are widely used for spinal instrumentation. Although many biomechanical studies on rod-screw systems have been carried out, but the effects of rod contouring on the construct strength is still not very well defined in the literature. This work examines the mechanical impact of straight, 20° kyphotic, and 20° lordotic rod contouring on rod-screw fixation systems, by forming a corpectomy model. METHODS: The corpectomy groups were prepared using ultra-high molecular weight polyethylene samples...
September 2016: Journal of Korean Neurosurgical Society
Eric B Laxer, Craig D Brigham, Bruce V Darden, P Bradley Segebarth, R Alden Milam, Alfred L Rhyne, Susan M Odum, Leo R Spector
PURPOSE: Many investigators have reported the financial conflicts of interest (COI), which could result in potential bias in the reporting of outcomes for patients undergoing total disc replacement (TDR) rather than anterior cervical discectomy and fusion (ACDF). This bias may be subconsciously introduced by the investigator in a non-blinded radiographic review. The purpose of this study was to determine if bias was present when a group of spine specialists rated adjacent segment degeneration (ASD) following cervical TDR or ACDF...
September 20, 2016: European Spine Journal
R Ghermandi, S Terzi, A Gasbarrini, S Boriani
OBJECTIVE: Aneurysmal Bone Cyst (ABC) is a cystic lesion of bone, occurring in 70% of cases as a primary lesion. Even if the metaphyseal region of long bones is more frequently involved, vertebral localization is not rare: ABC represents 15% of all primary spine and sacral tumours. Selective arterial embolization (SAE) represents the first treatment option for vertebral ABC. However, in few cases, multiple SAEs are not possible. The aim of this work is to report two cases of vertebral ABC unresponsive to SAE positively treated with Denosumab...
September 2016: European Review for Medical and Pharmacological Sciences
A Y Mushkin, E Y Malyarova, V A Evseev, P K Yablonskii
DESIGN: Case report. INTRODUCTION: The combination of severe post-infectious kyphosis and diaphragm relaxation is extremely rare in patient early than 1 year old. Its no publications concerning their simultaneous surgical treatment. CASE DESCRIPTION: 7-Month-old girl had simultaneous spinal reconstruction with anterior and posterior instrumentation and plastic of diaphragm because of sequelae of non-granulenatous spondylitis complicated by severe kyphosis (54°) and diaphragm relaxation...
2016: Neurologia i Neurochirurgia Polska
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