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https://www.readbyqxmd.com/read/28527225/clinical-feasibility-of-gait-training-with-a%C3%A2-robotic-exoskeleton-wpal-in-an-individual-with-both-incomplete-cervical-and-complete-thoracic-spinal-cord-injury-a%C3%A2-case-study
#1
Shigeo Tanabe, Soichiro Koyama, Eiichi Saitoh, Satoshi Hirano, Kanan Yatsuya, Tetsuya Tsunoda, Masaki Katoh, Takeshi Gotoh, Ayako Furumoto
BACKGROUND: Patients with tetraplegia can achieve independent gait with lateral-type powered exoskeletons; it is unclear whether medial-type powered exoskeletons allow for this. OBJECTIVE: To investigate gait training with a medial-type powered exoskeleton wearable power-assist locomotor (WPAL) in an individual with incomplete cervical (C5) and complete thoracic (T12) spinal cord injury (SCI). METHODS: The 60-session program was investigated retrospectively using medical records...
May 19, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28524753/continuous-mapping-of-the-corticospinal-tracts-in-intramedullary-spinal-cord-tumor-surgery-using-an-electrified-ultrasonic-aspirator
#2
Ori Barzilai, Zvi Lidar, Shlomi Constantini, Khalil Salame, Yifat Bitan-Talmor, Akiva Korn
Intramedullary spinal cord tumors (IMSCTs) represent a rare entity, accounting for 4%-10% of all central nervous system tumors. Microsurgical resection of IMSCTs is currently considered the primary treatment modality. Intraoperative neurophysiological monitoring (IONM) has been shown to aid in maximizing tumor resection and minimizing neurological morbidity, consequently improving patient outcome. The gold standard for IONM to date is multimodality monitoring, consisting of both somatosensory evoked potentials, as well as muscle-based transcranial electric motor evoked potentials (tcMEPs)...
May 19, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28523940/delay-in-estrogen-commencement-is-associated-with-lower-bone-mineral-density-in-turner-syndrome
#3
H H Nguyen, P Wong, B J Strauss, G Jones, P R Ebeling, F Milat, A Vincent
OBJECTIVE: Turner syndrome (TS) is associated with hypogonadism, osteoporosis and fractures. We investigated the prevalence and risk factors for low bone density and fractures in a TS cohort. METHODS: We included 76 TS patients (median age 28.5 years) attending a tertiary hospital between 1998 and 2015 who underwent dual-energy X-ray absorptiometry. Spine and femoral neck (FN) areal bone mineral density (aBMD) were compared with those of a control group. To adjust for smaller bone size, bone mineral apparent density (BMAD) was calculated...
May 19, 2017: Climacteric: the Journal of the International Menopause Society
https://www.readbyqxmd.com/read/28522962/alterations-in-cd200-cd200r1-system-during-eae-already-manifest-at-presymptomatic-stages
#4
Tony Valente, Joan Serratosa, Unai Perpiñá, Josep Saura, Carme Solà
In the brain of patients with multiple sclerosis, activated microglia/macrophages appear in active lesions and in normal appearing white matter. However, whether they play a beneficial or a detrimental role in the development of the pathology remains a controversial issue. The production of pro-inflammatory molecules by chronically activated microglial cells is suggested to contribute to the progression of neurodegenerative processes in neurological disease. In the healthy brain, neurons control glial activation through several inhibitory mechanisms, such as the CD200-CD200R1 interaction...
2017: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/28520819/in-vitro-analysis-of-the-segmental-flexibility-of-the-thoracic-spine
#5
Hans-Joachim Wilke, Andrea Herkommer, Karin Werner, Christian Liebsch
Basic knowledge about the thoracic spinal flexibility is limited and to the authors' knowledge, no in vitro studies have examined the flexibility of every thoracic spinal segment under standardized experimental conditions using pure moments. In our in vitro study, 68 human thoracic functional spinal units including the costovertebral joints (at least n = 6 functional spinal units per segment from T1-T2 to T11-T12) were loaded with pure moments of ±7.5 Nm in flexion/extension, lateral bending, and axial rotation in a custom-built spine tester to analyze range of motion (ROM) and neutral zone (NZ)...
2017: PloS One
https://www.readbyqxmd.com/read/28516217/prenatal-surgery-for-myelomeningocele-review-of-the-literature-and-future-directions
#6
Gregory G Heuer, Julie S Moldenhauer, N Scott Adzick
Open spina bifida or myelomeningocele (MMC) is one of the most common serious congenital malformations. Historically, this condition has been treated with closure of the MMC defect shortly after birth. The goal of postnatal closure is to cover the exposed spinal cord and prevent infection. However, postnatal surgery does not reverse or prevent the neurologic injury seen in MMC, reverse hindbrain herniation, or prevent hydrocephalus. The neurologic defects result from primary incomplete neurulation and secondary chronic prenatal damage to the exposed neural elements through mechanical and chemical trauma...
May 17, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28516216/the-role-of-intrauterine-magnetic-resonance-in-the-management-of-myelomenigocele
#7
Denise Trigubo, Mercedes Negri, Rosana Mabel Salvatico, Gustavo Leguizamón
OBJECTIVE: To assess the role of magnetic resonance imaging (MRI) in the management of myelomenigocele. BACKGROUND: Spinal dysraphism or neural tube defects (NTD) encompass a heterogeneous group of congenital spinal anomalies that result from the defective closure of the neural tube early in gestation. Myelomeningocele is the most common type of NTD that is compatible with life, with high survival rates but lifelong physical impairments. CONCLUSION: MRI is an important adjunct to ultrasound in assessing NTD, as it pertains to pre-surgical planning and perinatal management...
May 17, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28515516/changes-in-cardiac-index-during-labour-analgesia-a-double-blind-randomised-controlled-trial-of-epidural-versus-combined-spinal-epidural-analgesia-a-preliminary-study
#8
Stephanie Yacoubian, Corrina M Oxford, Bhavani Shankar Kodali
BACKGROUND AND AIMS: Combined spinal-epidural (CSE) analgesia for labour and delivery is occasionally associated with foetal bradycardia. Decreases in cardiac index (CI) and/or uterine hypertonia are implicated as possible aetiological factors. No study has evaluated CI changes following combined spinal analgesia for labour and delivery. This prospective, double-blind, randomised controlled trial evaluates haemodynamic trends during CSE and epidural analgesia for labour. METHODS: Twenty-six parturients at term requesting labour analgesia were randomised to receive either epidural (E) or CSE analgesia...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28511802/-a-continuous-series-of-27-adult-patients-treated-for-l5-s1-isthmic-spondylolisthesis-by-combined-approach-clinical-and-radiological-outcomes-at-1-year-follow-up
#9
N Koné, E Freitas Olim, P Coloma, A Rusconi, L Chenin, O Sy, I S Souaré, C Barrey
Through this single-center consecutive prospective study, we evaluated the results of a combined approach for L5-S1 isthmic spondylolisthesis, using a polyetheretherketone (PEEK) interbody lordotic cage during anterior approach and pedicle screw-based posterior fixation. Between 2010 and 2014, 27 adult patients were treated for L5-S1 isthmic spondylolisthesis (high and low grades) by a combined approach with a minimum follow-up of one year. Clinical outcome was assessed before surgical treatment and at four months and one year after surgery by: VAS, Oswestry Index (ODI) and Rolland-Morris scores...
May 13, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28507886/racial-disparities-in-elderly-patients-receiving-lumbar-spinal-stenosis-surgery
#10
Doniel Drazin, Faris Shweikeh, Carlito Lagman, Beatrice Ugiliweneza, Maxwell Boakye
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To evaluate for racial disparities in elderly patients having undergone lumbar spinal stenosis surgery. METHODS: The US Medicare Provider Analysis and Review database (records from 2005 to 2011) was used to identify patients over the age of 65 years, diagnosed with lumbar spinal stenosis, and having undergone lumbar laminectomy or fusion surgery. Blacks were compared to Whites in both unmatched and propensity score-matched populations...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28506404/-dural-sinus-thrombosis-following-epidural-analgesia-for-delivery-a-clinical-case
#11
Marco Aurelio Dornelles, Luis M Pereira
BACKGROUND AND OBJECTIVES: Neurological complications of spinal anesthesia are rare conditions. Headache caused by low pressure of the cerebrospinal fluid is one of the most frequent, which occurs after post-dural puncture. A comprehensive history and physical exam must be carried out before making the diagnosis of Post-Dural Puncture Headache (PDPH) and additional tests are necessary to exclude the possibility of developing serious neurological complications such as Dural Sinus Thrombosis (DST)...
May 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28505991/lower-extremity-robotic-exoskeleton-training-case-studies-for-complete-spinal-cord-injury-walking
#12
Edward D Lemaire, Andrew J Smith, Andrew Herbert-Copley, Vidya Sreenivasan
BACKGROUND: Recent advances in exoskeleton technology has made lower extremity powered exoskeletons (LEPE) a viable treatment tool to restore upright walking mobility to persons with spinal cord injury (SCI). OBJECTIVE: Evaluate ARKE exoskeleton training within a rehabilitation centre environment. METHODS: Case studies are presented for two male participants, age 41 and 30, motor complete SCI at T6 (N01) and T12 (N02), respectively, as they progress from new LEPE users to independent walking...
May 10, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28505029/treatment-options-for-failed-back-surgery-syndrome-fbss-patients-with-refractory-chronic-pain-an-evidence-based-approach
#13
Kasra Amirdelfan, Lynn Webster, Lawrence Poree, Vishad Sukul, Porter McRoberts
STUDY DESIGN: A significant number of lumbar post-surgical patients continue to suffer persistent pain and limited function and are termed to have "Failed back surgery syndrome" (FBSS). This review evaluates clinical trial data for the treatment of FBSS patients. OBJECTIVE: Using an evidence-based approach to evaluate FBSS treatments will assist clinicians in choosing the most effective options for FBSS patients. Furthermore, reducing the utilization of less effective therapies may result in substantial financial savings for this patient population...
April 12, 2017: Spine
https://www.readbyqxmd.com/read/28504991/tablet-e-logbooks-four-thousand-clinical-cases-and-complications-e-logged-by-14-nondoctor-anesthesia-providers-in-nepal
#14
Shristi Shah, Oliver Ross, Stephen Pickering, Stephen Knoble, Indra Rai
BACKGROUND: To meet the need for essential surgery across rural Nepal, anesthesia at district level is delivered by nondoctor anesthetists. They require support to maintain confidence and competence, and upgraded professional registration to secure their status. To meet these needs, a distance-blended learning course was pioneered and delivered. A core course requirement was to log all clinical cases; these were logged on a new e-logbook. METHODS: Fourteen nondoctor anesthesia providers working in 12 different districts across Nepal were enrolled in the 1-year course...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28503316/recovery-of-supraspinal-control-of-leg-movement-in-a-chronic-complete-flaccid-paraplegic-man-after-continuous-low-frequency-pelvic-nerve-stimulation-and-fes-assisted-training
#15
Marc Possover, Axel Forman
INTRODUCTION: More than 30 years ago, functional electrical stimulation (FES) was developed as an orthotic system to be used for rehabilitation for SCI patients. In the present case report, FES-assisted training was combined with continuous low-frequency stimulation of the pelvic somatic nerves in a SCI patient. CASE PRESENTATION: We report on unexpected findings in a 41-year-old man with chronic complete flaccid paraplegia, since he was 18 years old, who underwent spinal stem cell therapy and a laparoscopic implantation of neuroprosthesis (LION procedure) in the pelvic lumbosacral nerves...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28503292/historical-influence-on-the-practice-of-chiropractic-radiology-part-i-a-survey-of-diplomates-of-the-american-chiropractic-college-of-radiology
#16
Kenneth J Young
BACKGROUND: It is known that not all chiropractors follow mainstream guidelines on the use of diagnostic ionising radiation. Various reasons have been discussed in the literature, including using radiography to screen for congenital anomalies, to perform postural analysis, to search for contraindications to spinal manipulation, and to document chiropractic subluxations, i.e., tiny anatomical displacements of vertebrae thought to affect nerves and health. The visualisation of subluxations was the reason chiropractic first adopted the x-ray in 1910...
2017: Chiropractic & Manual Therapies
https://www.readbyqxmd.com/read/28499420/continuous-femoral-nerve-blockade-and-single-shot-sciatic-nerve-block-promotes-better-analgesia-and-lower-bleeding-for-total-knee-arthroplasty-compared-to-intrathecal-morphine-a-randomized-trial
#17
Nora Elizabeth Rojas Álvarez, Rosemberg Jairo Gomez Ledesma, Adilson Hamaji, Marcelo Waldir Mian Hamaji, Joaquim Edson Vieira
BACKGROUND: Knee arthroplasty leads to postoperative pain. This study compares analgesia and postoperative bleeding achieved by intrathecal morphine with a continuous femoral plus single-shot sciatic nerve block. METHODS: A randomized non-blinded clinical trial enrolled patients aged over 18 years old, ASA I to III who underwent total knee arthroplasty. All patients underwent spinal anesthesia with isobaric bupivacaine, 20 mg. One group received 100 mcg of intrathecal morphine (M group), and the other received a femoral nerve block by continuous infusion plus a "single shot" block of the sciatic nerve at the end of the surgery (FI group)...
May 12, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28492437/continuous-intrathecal-infusion-of-cannabinoid-receptor-agonists-attenuates-nerve-ligation-induced-pain-in-rats
#18
Sheng-Jie Shiue, Hsien-Yu Peng, Chung-Ren Lin, Shih-Wei Wang, Ruey-Horng Rau, Jen-Kun Cheng
BACKGROUND AND OBJECTIVES: Cannabinoid receptors (CB1R/CB2R) are known to play important roles in pain transmission. In this study, we investigated the effects of continuous intrathecal infusion of CB1/2R agonists in the L5/6 spinal nerve ligation pain model. METHODS: Under isoflurane anesthesia, rats received nerve ligation and intrathecal catheter connected to an infusion pump. After surgery, saline (1 μL/h), CB1/2R agonist WIN55,212-2, CB1R agonist ACEA, or CB2R agonist AM1241 (1 μmol/h) was given intrathecally for 7 days...
May 10, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28490682/-association-of-lower-limb-neuropathy-with-lumboperitoneal-shunt-transection-a-case-report
#19
Kenichiro Ono, Hirohiko Arimoto, Hidenori Okawa, Takashi Takahara, Hiroaki Kobayashi, Yusuke Morinaga
A 49-year-old woman suffered hydrocephalus after subarachnoid hemorrhage, and underwent a lumboperitoneal(LP)shunt operation. X-ray imaging revealed that a spinal catheter inserted into the cranial side from L2/3 turned caudally at the Th12 level. Postoperative numbness and pain of the left buttocks and posterior femoral region persisted. The spinal catheter was pulled about 5 cm to improve flexure, and was reconnected 10 months after the shunt procedure. Symptoms improved, but a similar symptom developed one and a half years later...
May 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28484529/secondary-communicating-hydrocephalus-management-by-implantation-of-external-ventricular-shunt-and-minimal-gradual-increase-of-cerebrospinal-fluid-pressure
#20
Keyvan Mostofi, Madjid Samii
BACKGROUND: This paper presents a new management strategy explaining the process used by implantation of external ventricular drainage (EVD) and very gradual increase of intracranial pressure for treatment of acute hydrocephalus. During the last 30 years' experience in professional practice, the senior author (M.S.) discovered that there are some options of regulations between cerebral spinal fluid (CSF) production and resorption. This theory shows that minimal continuous increase of the CSF pressure as long as the patient general neurological condition is unchanged and appears as normal can lead to definitive treatment of hydrocephalus without needing to set a shunt...
April 2017: Asian Journal of Neurosurgery
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