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Pars interarticularis

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https://www.readbyqxmd.com/read/27911229/c-2-arteriovenous-fistula-presenting-as-a-pathologic-hangman-s-fracture-case-report
#1
Rajeev D Sen, Carolina Gesteira Benjamin, Howard A Riina, Donato Pacione
The authors report on an 81-year-old woman with a pathologic hangman's fracture secondary to a complex arteriovenous fistula (AVF). The patient presented with severe, unremitting neck pain and was found to have fractures bilaterally through the pars interarticularis of C-2 with significant anterior subluxation of C-2 over C-3 along with widening of the left transverse foramen. Due to an abnormally appearing left vertebral artery (VA) on CT angiography, the patient underwent conventional angiography, which revealed a complex AVF stemming from the left VA at the level of C-2 with dilated posterior cervical veins and a large venous varix...
December 2, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27904817/transitional-vertebra-and-spina-bifida-occulta-related-with-chronic-low-back-pain-in-a-young-patient
#2
Maryam Kundi, Maham Habib, Sumbal Babar, Asif K Kundi, Salman Assad, Amjad Sheikh
Bertolotti's syndrome (BS) must be considered as a differential diagnosis in a young patient presenting with low back pain (LBP). We present a case of a 26-year-old male complaining of mild chronic LBP for six years, radiating to his left thigh for the past six months. He has been taking non-steroidal anti-inflammatory drugs (NSAIDs) with skeletal muscle relaxants for pain relief. The X-ray and computed tomography (CT) imagings showed congenital enlargement of the left transverse process of the fifth lumbar (L5) vertebra forming pseudo-articulation with the sacrum and unilateral pars interarticularis defect at the L4 level on the left side, respectively...
October 19, 2016: Curēus
https://www.readbyqxmd.com/read/27791830/contralateral-osteotomy-of-the-pedicle-and-posterolateral-elements-for-en-bloc-resection-a-technique-for-oncological-resection-of-posterolateral-spinal-tumors
#3
Viren S Vasudeva, Alexander E Ropper, Samuel Rodriguez, Kyle C Wu, John H Chi
En bloc resection of tumors involving the spinal column is technically challenging and is associated with high morbidity to the patient due to the proximity of critical neurological and vascular structures and the destabilizing nature of this surgery. Nevertheless, evidence has shown improved progression-free survival with en bloc resection for certain low-grade malignant and aggressive benign musculoskeletal tumors. To avoid the morbidity of en bloc spondylectomy in patients with tumors localized to the lateral and posterolateral spinal column, the authors have found that the goals of surgery can be accomplished through a contralateral osteotomy of the pedicle and posterolateral elements for en bloc resection (COPPER)...
October 28, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27790318/significance-of-the-pars-interarticularis-in-the-cortical-bone-trajectory-screw-technique-an-in-vivo-insertional-torque-study
#4
Koshi Ninomiya, Koichi Iwatsuki, Yu-Ichiro Ohnishi, Toshika Ohkawa, Toshiki Yoshimine
STUDY DESIGN: Retrospective study. PURPOSE: Cortical bone trajectory (CBT), a more medial-to-lateral and shorter path than the traditional one for spinal fusion, is thought to be effective for severely degenerated vertebrae because screws are primarily stabilized at the posterior elements. We evaluated the efficacy of this approach through in vivo insertional torque measurement. OVERVIEW OF LITERATURE: There has been only one prior in vivo study on CBT insertional torque...
October 2016: Asian Spine Journal
https://www.readbyqxmd.com/read/27689420/a-novel-minimally-invasive-dorsolateral-tubular-partial-odontoidectomy-and-autologous-bone-augmentation-to-treat-dens-pseudarthrosis-cadaveric-3d-virtual-simulation-study-and-technical-report
#5
Eleftherios Archavlis, Lucas Serrano, Eike Schwandt, Amr Nimer, Moisés Felipe Molina-Fuentes, Tamim Rahim, Maximilian Ackermann, Angelika Gutenberg, Sven Rainer Kantelhardt, Alf Giese
OBJECTIVE The goal of this study was to demonstrate the clinical and technical nuances of a minimally invasive, dorsolateral, tubular approach for partial odontoidectomy, autologous bone augmentation, and temporary C1-2 fixation to treat dens pseudarthrosis. METHODS A cadaveric feasibility study, a 3D virtual reality reconstruction study, and the subsequent application of this approach in 2 clinical cases are reported. Eight procedures were completed in 4 human cadavers. A minimally invasive, dorsolateral, tubular approach for odontoidectomy was performed with the aid of a tubular retraction system, using a posterolateral incision and an oblique approach angle...
September 30, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27683697/far-lateral-microdiscectomy-a-minimally-invasive-surgical-technique-for-the-treatment-of-far-lateral-lumbar-disc-herniation
#6
Kevin Phan, Alexander E Dunn, Prashanth J Rao, Ralph J Mobbs
Lumbar disc herniation arises when the annulus fibrosus of the vertebral disc fails, thus allowing displacement of the nucleus pulposus and other tissue. The term far lateral is used variably in the literature and usually refers to an extraforaminal displacement in the peridiscal zone peripheral to the sagittal plane of the most lateral part of the pedicle at the same level. Non-surgical treatments of far lateral disc herniation include physical therapy, anti-inflammatory medication, and corticosteroid injections...
March 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/27614965/diagnostic-accuracy-of-3-t-magnetic-resonance-imaging-with-3d-t1-vibe-versus-computer-tomography-in-pars-stress-fracture-of-the-lumbar-spine
#7
E C Ang, A F Robertson, F A Malara, T O'Shea, J K Roebert, M E Schneider, A H Rotstein
OBJECTIVE: To compare the diagnostic accuracy of 3-T magnetic resonance imaging (MRI) with thin-slice 3D T1 VIBE sequence to 128-slice computer tomography (CT) in pars stress fractures of the lumbar spine. MATERIALS AND METHODS: 3-T MRI and CT of 24 patients involving 70 pars interarticularis were retrospectively reviewed by four blinded radiologists. The fracture morphology (complete, incomplete, or normal) was assessed on MRI and CT at different time points. Pars interarticularis bone marrow edema (present or absent) was also evaluated on MRI...
November 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/27559443/significance-of-coronal-proset-magnetic-resonance-imaging-to-detect-hidden-zone-of-the-mid-zone-stenosis-in-the-lumbar-spine-and-morphometric-analysis-of-the-mid-zone-stenosis
#8
Hyo-Sae Ahn, Whee Sung Son, Ji-Hoon Shin, Myun-Whan Ahn, Gun Woo Lee
STUDY DESIGN: Retrospective exploratory imaging study. PURPOSE: To investigate the significance of the coronal magnetic resonance imaging (MRI) using Proset technique to detect the hidden zone in patients with mid-zone stenosis by comparing with conventional axial and sagittal MRI and to explore the morphologic characteristic patterns of the mid-zone stenosis. OVERVIEW OF LITERATURE: Despite advancements in diagnostic modalities such as computed tomography and MRI, stenotic lesions under the pedicle and pars interarticularis, also called the mid-zone, are still difficult to definitely detect with the conventional axial and sagittal MRI due to its inherited anatomical peculiarity...
August 2016: Asian Spine Journal
https://www.readbyqxmd.com/read/27506400/a-novel-less-invasive-technique-for-the-excision-of-large-intra-and-extra-dural-dumbbell-lumbar-schwannomas-the-dual-approach
#9
Pierluigi Vergara
OBJECTIVE: Large schwannomas with intra- and extra-dural extension are often challenging surgical lesions. A variety of approaches, usually requiring large exposures, removal of facets and pars interarticularis and spinal stabilization, have been described so far. The aim of this study is to describe the "dual approach", a less invasive technique for the excision of such lesions. METHODS: A large intra- and extra- dural schwannoma with paraspinal extension (Eden type II) was removed via a unilateral approach - midline, pars and facet sparing and no supplemental instrumentation...
August 6, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27488290/direct-repair-of-lumbar-pars-interarticularis-defects-by-utilizing-intraoperative-o-arm-based-navigation-and-microendoscopic-techniques
#10
Jia Min, Jian Wang, Zheng Feng Zhang, Wen Jie Zheng, Yue Zhou
STUDY DESIGN: Retrospective analysis of the clinical outcomes of eight patients with the lumbar pars interarticulars defects treated by direct repair with the aid of intraoperative O-arm based navigation and microendoscopic techniques. OBJECTIVE: To investigate the efficacy and safety of direct screw repair by using minimally invasive surgery for the lumbar pars interarticulars defects in a pilot study. SUMMARY OF BACKGROUND DATA: Direct repair of pars interarticulars defects has been used to treat young adult patients...
August 3, 2016: Spine
https://www.readbyqxmd.com/read/27444614/accuracy-and-efficacy-of-fluoroscopy-guided-pars-interarticularis-injections-on-immediate-and-short-term-pain-relief
#11
L Michael Kershen, Nicholas C Nacey, James T Patrie, Michael G Fox
PURPOSE: To determine the accuracy and short-term efficacy of fluoroscopy-guided steroid/anesthetic injections for symptomatic pars interarticularis (pars) defects. MATERIALS AND METHODS: Following IRB approval, all fluoroscopically guided pars injections from a single institution (6/2010 to 3/2016) were retrospectively and independently reviewed by two MSK radiologists. The radiologists evaluated the fluoroscopic images to determine if all of the pars injections associated with each procedure were intra-pars (n = 57 procedures; 106 pars injections), peri-pars (n = 3 procedures; three pars injected), or a combination of intra-pars and peri-pars (n = 6 procedures; 12 pars injected)...
October 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/27327250/direct-c2-pedicle-screw-fixation-for-axis-body-fracture
#12
Jennifer A Reynolds, Joel D MacDonald
BACKGROUND: Acute complex C2 vertebral body fracture specifically does not involve the odontoid process or C2 pars interarticularis. External stabilization can be effective but may prolong healing and increase morbidity. Many traditional surgical techniques can achieve internal stabilization at the expense of normal cervical motion. We describe direct surgical C2 pedicle screw fixation as an option for managing acute complex C2 vertebral body fracture. CASE DESCRIPTION: Three patients were treated with direct pedicle screw fixation of acute traumatic complex C2 vertebral body fractures...
September 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27326963/etiology-of-adult-onset-stress-fracture-in-the-lumbar-spine
#13
Fumitake Tezuka, Koichi Sairyo, Toshinori Sakai, Akira Dezawa
STUDY DESIGN: Case series. OBJECTIVE: The purpose of this paper is to present a case series of fresh stress fractures (spondylolysis) in the lumbar spines of adult athletes. SUMMARY OF BACKGROUND DATA: Lumbar spondylolysis is a stress fracture of the pars interarticularis, which is generally considered a disease of children or adolescence. There is only one case series written in English reporting on adult-onset fresh spondylolysis. METHODS: Eleven patients aged 20-27 years are included in this case series...
June 20, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27261721/electrophysiological-study-for-nerve-root-entrapment-in-patients-with-isthmic-spondylolisthesis
#14
Masahiro Morita, Akira Miyauchi, Shinya Okuda, Takenori Oda, Motoki Iwasaki
STUDY DESIGN: A case series study. OBJECTIVE: To investigate the electrophysiological location of nerve root entrapment in patients with isthmic spondylolisthesis. SUMMARY OF BACKGROUND DATA: Although the lesion of the nerve root in patients with isthmic spondylolisthesis has been thought to be located at the pars interarticularis due to proliferation of fibrous cartilage, there is no electrophysiological study in relation to this accomplished fact...
June 3, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27234265/lumbar-spondylolysis-in-the-adolescent-athlete
#15
Kevin J Lawrence, Tim Elser, Ryan Stromberg
INTRODUCTION: Spondylolysis is a common occurrence for adolescent athletes who have low back pain. The injury involves a defect in the pars interarticularis, occurring as a result of repeated hyperextension and rotation. CLINICAL PRESENTATION: Clinical findings might include tightness of the hip flexors and hamstrings, weakness of the abdominals and gluteals, and an excessive lordotic posture. The validity of several clinical tests were compared alongside magnetic resonance imaging, but were not able to distinguish spondylolysis from other causes of low back pain...
July 2016: Physical Therapy in Sport
https://www.readbyqxmd.com/read/27105462/new-minimally-invasive-technique-for-direct-pars-interarticularis-osteosynthesis-using-cortical-screws-and-spinous-process-modular-link
#16
Matthew J Goldstein, James Bruffey, Robert K Eastlack
STUDY DESIGN: Case report. OBJECTIVE: To report a case of direct pars osteosynthesis using computed topography (CT) navigation, image guided cortically placed screws with curvilinear subspinous modular link. SUMMARY OF BACKGROUND DATA: Spondylolysis fracture is commonly encountered in athletes who subject their spines to repetitive hyperextension stress. Initial treatment is nonoperative, consisting of rest, activity modification, physical therapy, and/or bracing...
December 1, 2016: Spine
https://www.readbyqxmd.com/read/27099816/management-of-typical-and-atypical-hangman-s-fractures
#17
Rafid Al-Mahfoudh, Christopher Beagrie, Ele Woolley, Rasheed Zakaria, Mark Radon, Simon Clark, Robin Pillay, Martin Wilby
Study Design Retrospective study of a prospectively maintained database. Objective Our aim was to retrospectively review management and outcomes of patients with low-grade hangman's fractures, specifically looking at differences in outcomes between collars and halo immobilization. We also studied fracture patterns and their treatment outcomes. Methods Forty-one patients with hangman's fractures were identified from 105 patients with axis fractures between 2007 and 2013. Typical hangman's fractures were defined as traumatic spondylolisthesis of the axis causing a bilateral pars interarticularis fracture...
May 2016: Global Spine Journal
https://www.readbyqxmd.com/read/27064777/prevalence-of-symptomatic-lumbar-spondylolysis-in-pediatric-patients
#18
Akihiro Nitta, Toshinori Sakai, Yuichiro Goda, Yoichiro Takata, Kosaku Higashino, Tadanori Sakamaki, Koichi Sairyo
Lumbar spondylolysis, a stress fracture of the pars interarticularis, is prevalent in adolescent athletes. Recent advances in diagnostic tools and techniques enable early diagnosis before these fractures progress to complete fractures through the pars. However, because patients often consult family physicians for primary care of low back pain and these physicians may not have access to diagnostic modalities such as magnetic resonance imaging (MRI) and computed tomography, stress fractures can be missed. This study surveyed the prevalence of symptomatic spondylolysis in pediatric patients who consulted an orthopedic clinic for primary care and investigated whether such acute stress fractures may be overlooked without MRI...
May 1, 2016: Orthopedics
https://www.readbyqxmd.com/read/27040065/stress-fracture-of-the-thoracic-spine-in-an-elite-rhythmic-gymnast-a-case-report
#19
Subash C Jha, Toshinori Sakai, Mika Hangai, Akiko Toyota, Shoji Fukuta, Akihiro Nagamachi, Koichi Sairyo
Spondylolysis, a defect or stress fracture of the vertebral pars interarticularis, occurs most frequently in the lower lumbar spine and occasionally in the cervical spine, but is extremely rare in the thoracic spine. We report the case of a 17 year-old girl, an elite rhythmic gymnast, who reported with early-stage thoracic spondylolysis at T10 and T11 levels. Physicians should be aware that performance of unusual athletic movements, such as those by gymnasts, may lead to spondylolysis in rare locations.
2016: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/26918333/is-preventative-long-segment-surgery-for-multi-level-spondylolysis-necessary-a-finite-element-analysis-study
#20
Jianqiang Mo, Wen Zhang, Dongyan Zhong, Hao Xu, Lan Wang, Jia Yu, Zongping Luo
OBJECTIVE: For multi-level spondylolysis patients, surgeons commonly choose to fix all the segments with pars interarticularis defect even those without slippage and not responsible for clinical symptoms. In this study, we tried to study the necessity of the preventative long-segment surgery for the defected segment without slippage in treatment of multi-level spondylolysis patients from a biomechanical perspective. METHOD: We established a bi-level spondylolysis model with pars defects at L4 and L5 segments, and simulated posterior lumbar interbody fusion (PLIF) and pedicle screw fixation at L5-S1 level...
2016: PloS One
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