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Non-surgical spine

Seong Son, Sang Gu Lee, Woo Kyung Kim, Yong Ahn
BACKGROUND: To prevent the risk of iatrogenic instability after surgery for upper lumbar disc herniation, we adapted a microsurgical translaminar approach (key-hole laminotomy) which allows less destructive laminotomy. We present a microsurgical translaminar approach, and compare the results of the translaminar and interlaminar approaches. METHODS: A total of 48 patients who underwent single level discectomy in the upper lumbar spine (L1-2 or L2-3) were enrolled...
June 11, 2018: World Neurosurgery
Nicole Williams, Alessandro Narducci, Deborah M Eastwood, Maureen Cleary, Dominic Thompson
STUDY DESIGN: Retrospective case series OBJECTIVE.: To review clinical and radiological outcomes of craniovertebral surgery in children with Morquio A syndrome (Mucopolysaccharidosis type IVA) and develop an evidence-based management algorithm. SUMMARY OF BACKGROUND DATA: Myelopathy secondary to craniovertebral pathology is a common cause of neurological disability in Morquio A syndrome. Previously unresolved surgical controversies include the value of surveillance, surgical indications and operative technique...
June 12, 2018: Spine
(no author information available yet)
Cervical spine surgery with many focus and heated topics has gained increasing attention in the field of spine surgery. The surgical treatment has been widely adopted for routine treatment of cervical spondylosis in the various hospitals. According to the progressive research in recent years, the Editorial Board of Chinese Journal of Surgery convened related experts and organized in-depth discussions to standardize the diagonosis, classification and non-surgical treatment of cervical spondylosis, based on the summary of symposiums focusing on cervical spine, published in Chinese Journal of Surgery in 1984, 1992 and 2008 respectively...
June 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
John K Yue, Angel Ordaz, Ethan A Winkler, Hansen Deng, Catherine G Suen, John F Burke, Andrew K Chan, Geoffrey T Manley, Sanjay S Dhall, Phiroz E Tarapore
OBJECTIVE: Predictors of surgical outcomes following traumatic axis (C2) fractures in octogenarians remain undercharacterized. METHODS: Patients aged ≥80-years undergoing cervical spine surgery following traumatic C2 fractures were extracted from the National Sample Program of the National Trauma Data Bank (2003-2012). Outcomes include overall inpatient complications, individual complications >1% incidence, hospital length of stay (HLOS), discharge disposition, and mortality...
June 7, 2018: World Neurosurgery
David C Kieser, Michael C Wyatt, Andrew Beswick, Setor Kunutsor, Gary J Hooper
Aims: Determine whether disposable or reusable drapes are better at reducing surgical site infection (SSI) rates. Methods: A systematic review of the English literature from inception to 2018 with search terms relating to infection and drapes in orthopaedic and spine surgery. Results: No orthopaedic or spinal surgery studies assessed the risk of SSI between reusable or disposable drapes. However, two articles, with conflicting results, compared current reusable and disposable drapes in other surgical disciplines...
June 2018: Journal of Orthopaedics
My Pham, Kevin Phan, Ian Teng, Ralph J Mobbs
OBJECTIVE: Cervical spondylosis affects a huge proportion of the middle-aged population. Degenerative changes can occur in multiple regions of the cervical spine typically affecting the joints, intervertebral discs and endplates. These changes lead to compression of adjacent nervous structures, which results in radiculopathic and myelopathic pain. Various treatment modalities are currently available with non-surgical approaches the initial go to if there is no symptomatic cord compression...
May 2018: Orthopaedic Surgery
Haley Moulton, Tor D Tosteson, Wenyan Zhao, Loretta Pearson, Kristina Mycek, Emily Scherer, James N Weinstein, Adam Pearson, William Abdu, Susan Schwarz, Michael Kelly, Kevin McGuire, Alden Milam, Jon D Lurie
STUDY DESIGN: Prospective evaluation of an informational web-based calculator for communicating estimates of personalized treatment outcomes. OBJECTIVE: To evaluate the usability, effectiveness in communicating benefits and risks, and impact on decision quality of a calculator tool for patients with intervertebral disc herniations, spinal stenosis, and degenerative spondylolisthesis who are deciding between surgical and non-surgical treatments. SUMMARY OF BACKGROUND DATA: The decision to have back surgery is preference-sensitive and warrants shared decision-making...
June 5, 2018: Spine
Subaraman Ramchandran, Louis M Day, Breton Line, Aaron J Buckland, Peter Passias, Themistocles Protopsaltis, John Bendo, Tessa Huncke, Thomas J Errico, Shay Bess
BACKGROUND: Patients undergoing multilevel spine surgery are at risk for delayed extubation. OBJECTIVE: To evaluate the impact of type and volume of intraoperative fluids administered during multilevel thoracic and/or lumbar spine surgery on postoperative extubation status. METHODS: Retrospective evaluation of medical records of patients ≥ 18 yr undergoing ≥ 4 levels of thoracic and/or lumbar spine fusions was performed. Patients were organized according to postoperative extubation status: immediate (IMEX; in OR/PACU) or delayed (DEX; outside OR/PACU)...
May 30, 2018: Neurosurgery
Jean-Yves Lazennec, Jean-Patrick Rakover, Marc-Antoine Rousseau
BACKGROUND CONTEXT: The surgical treatment of degenerative disc disease (DDD) at the lumbar spine may involve fusion. TDR is an alternative treatment to avoid fusion related adverse events, specifically adjacent segment disease. New generation of elastomeric non-articulating devices have been developed to more effectively replicate the shock absorption and flexural stiffness of native disc. PURPOSE: To report 5 years clinical and radiographic outcomes, range of motion and position of the center of rotation after a viscoelastic lumbar total disc replacement (TDR)...
May 22, 2018: Spine Journal: Official Journal of the North American Spine Society
Samantha R Horn, Tiffany C Liu, Jason A Horowitz, Cheongeun Oh, Cole A Bortz, Frank A Segreto, Dennis Vasquez-Montes, Leah M Steinmetz, Chloe Deflorimonte, Shaleen Vira, Bassel G Diebo, Brian J Neuman, Micheal Raad, Daniel M Sciubba, Renaud Lafage, Virginie Lafage, Hamid Hassanzadeh, Peter G Passias
STUDY DESIGN: Retrospective review of prospectively collected data. OBJECTIVE: To assess the clinical impact and economic burden of the three most common hospital-acquired conditions(HACs) that occur within 30-days post-operatively for all spine surgeries and to compare these rates to other common surgical procedures. SUMMARY OF BACKGROUND DATA: HACs are part of a non-payment policy by the Centers for Medicare and Medicaid Services and thus prompt hospitals to improve patient outcomes and safety...
May 22, 2018: Spine
David J Lunardini, Martin H Krag, Nathan S Mauser, Joon Y Lee, William H Donaldson, James D Kang
BACKGROUND: Context: Prior studies have shown common use of post-operative bracing, despite advances in modern day instrumentation rigidity and little evidence of brace effectiveness. PURPOSE: To document current practice patterns of brace use after degenerative cervical spine surgeries among members of the Cervical Spine Research Society (CSRS), to evaluate trends, and to identify areas of further study. STUDY DESIGN: A questionnaire survey METHODS: A 10 question survey was sent to members of the Cervical Spine Research Society to document current routine bracing practices after various common degenerative cervical spine surgical scenarios, including fusion and non-fusion procedures...
May 21, 2018: Spine Journal: Official Journal of the North American Spine Society
Andrei Fernandes Joaquim, Gregory D Schroeder, Alpesh A Patel, Alexander R Vaccaro
CONTEXT: It is well established that traumatic spinal dislocations (AO Type C injuries) should be surgically treated. However, no recent comparative study of surgical versus non-surgical management of type C injuries was found attesting the superiority of surgical treatment. OBJECTIVE: Due to the lack of information about the natural history of non-surgical management of type C injuries, we evaluated the outcome of historical conservative treatment of type C injuries...
May 21, 2018: Journal of Spinal Cord Medicine
Ahmed M Salah El-Din, Hashem M Aboul-Ela, Mohamed F Alsawy, Ahmed Koheil, Ahmed H Ashry
Background: Meningeal melanocytoma is considered a rare lesion arising from leptomeningeal melanocytes. Nearly two thirds of meningeal melanocytomas were reported in the intracranial compartment and the remaining one third in the spine. Spinal melanocytomas can be extradural or intradural, with extradural variant being more common, and the majority of cases have been single reports. Methods: A 5-year-old male presented with a 4-month history of non-radiating low back pain persistent at rest, with otherwise non-remarkable medical history...
2018: The Egyptian journal of neurology, psychiatry and neurosurgery
Pablo Andrés-Cano, Ana Cerván, Miguel Rodríguez-Solera, Jose Antonio Ortega, Natividad Rebollo, Enrique Guerado
OBJECTIVE: To determine the incidence of infection after instrumented lumbar spine surgery, the demographic and surgical variables associated with acute infection, and the influence of infection and debridement on the consolidation of spinal fusion. METHODS: After obtaining approval from the hospital ethics committee, an observational study was made on a prospective cohort of consecutive patients surgically treated by posterolateral lumbar spine arthrodesis (n = 139, 2005-2011)...
May 16, 2018: Orthopaedic Surgery
Mazda K Turel, Mena G Kerolus, Brian T David, Richard G Fessler
Background: The incidence of adjacent segment disease (ASD) after lumbar spine surgery is a condition that has become increasingly common as the rate of lumbar spine surgery continues to rise. Minimally invasive techniques continue to be refined and offer an opportunity to treat ASD with minimal tissue disruption, lower blood loss, a shorter hospital stay, and decreased morbidity. The aim of this report is to describe the various minimally invasive options for ASD with a comprehensive review of the existing literature...
May 2018: Neurology India
Jose Ribas Milanez de Campos, Thomas W White
Blunt trauma to the chest wall and rib fractures are remarkably frequent and are the basis of considerable morbidity and possible mortality. Surgical remedies for highly displaced rib fractures, especially in cases of flail chest, have been undertaken intermittently for more than 50 years. Rib-specific plating systems have started to be used in the last 10 years. These have ushered in the modern era of rib repair with chest wall stabilization (CWS) techniques that are safer, easier to perform, and more efficient...
April 2018: Journal of Thoracic Disease
Weiliang Miao, Xiaojun Ma, Deyong Liang, Yu Sun
OBJECTIVE: Postoperative hematoma is a rare and dangerous complication of cervical spine surgery. The aim of this study was to investigate the incidence and related factors of postoperative hematoma, and to report on 15 cases at our institution over a 6-year period. METHODS: Fifteen cases of postoperative hematoma were retrospectively identified. We investigated their neurological outcomes, characteristics, and surgical data, and identified risk factors associated with postoperative (PO) hematoma...
May 4, 2018: Neuro-Chirurgie
Alyssa K Dennis, Paul A Oakley, Michael T Weiner, Tara A VanVranken, David A Shapiro, Deed E Harrison
[Purpose] To present a case of the therapeutic reversal of a cervical kyphosis into a lordosis in a patient who presented with neck pain and headaches. [Subject and Methods] A 24-year-old male irritated his neck while dancing. Upon examination it was revealed he had an excessive, 45 mm forward head translation and a 15° cervical kyphosis from C3-C6. The patient was treated with Chiropractic BioPhysics® methods aimed at restoring the cervical lordosis by mirror image® , neck extension exercises, cervical extension traction, and spinal manipulative therapy...
April 2018: Journal of Physical Therapy Science
Oliver Gembruch, Elias Lemonas, Yahya Ahmadipour, Ulrich Sure, Nicolai El Hindy, Oliver Müller
OBJECTIVE: The demographic change in the population leads to a rising number of patients presenting with fractures of the cervical spine, especially C-2, due to falls. With an increase of co-morbidities in these elder patients, the risk for intra- and postoperative complications is increased likewise. Thus, an alternative strategy instead of operative management of these fractures should be taken into account whenever possible. Conservative management of dens fractures in the elderly is still a subject of great controversy despite numerous studies on this topic...
June 2018: Clinical Neurology and Neurosurgery
Remi A Kessler, Rafael De la Garza Ramos, Taylor E Purvis, A Karim Ahmed, C Rory Goodwin, Daniel M Sciubba, Muhammad M Abd-El-Barr
OBJECTIVES: It is well-documented that geriatric patients are at risk for serious injuries after fracture due to pre-existing medical conditions, physical changes of aging, and medication effects. Frailty has been demonstrated to be a predictor of morbidity and mortality in inpatient head and neck surgery, and for surgical intervention for adult spinal deformity and degenerative spine disease. However, the impact of frailty on complications following thoracolumbar/thoracic fractures are unknown and has not been previously assessed in the literature, particularly in a nationwide setting...
April 9, 2018: Clinical Neurology and Neurosurgery
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