Gábor Fodor, Béla Gartner, Gabriella Kecskés
A 21 year female polytraumatized patient was admitted to our unit after a serious motorbike accident. We carried out CT imaging, which confirmed the fracture of the C-II vertebra and compression of spinal cord. Futhermore, the diagnostic investigations detected the compound and comminuted fracture of the left humerus and femur; the sacrum and the pubic bones were broken as well. After the stabilization of the cervical vertebra, a tracheotomy and the fixation of her limbs were performed. She spent 1.5 years in our unit...
July 30, 2020: Ideggyógyászati Szemle
Isabel Graul, Sophia Vogt, Patrick Strube, Alexander Hölzl
STUDY DESIGN: Retrospective observational study. OBJECTIVE: The aim of the present study was to evaluate the role of lumbar magnetic resonance imaging (MRI) in the diagnostic algorithm of sacral insufficiency fractures (SIF). The primary objective was to compare the sensitivity in fracture detection and correct fracture classification according to MRI and computed tomography (CT). The secondary objective was to identify differences of additional pathologies found in MRI of the lumbar spine and the pelvis and their rates...
August 4, 2020: Global Spine Journal
Ping-Guo Duan, Praveen V Mummaneni, Joshua Rivera, Jeremy M V Guinn, Minghao Wang, Zhuo Xi, Bo Li, Hao-Hua Wu, Christopher P Ames, Shane Burch, Sigurd H Berven, Dean Chou
OBJECTIVE: Patients undergoing long-segment fusions from the lower thoracic (LT) spine to the sacrum for adult spinal deformity (ASD) correction are at risk for proximal junctional kyphosis (PJK). One mechanism of PJK is fracture of the upper instrumented vertebra (UIV) or higher (UIV+1), which may be related to bone mineral density (BMD). Because Hounsfield units (HUs) on CT correlate with BMD, the authors evaluated whether HU values were correlated with PJK after long fusions for ASD...
August 2020: Neurosurgical Focus
Patrick M Flanigan, Anthony L Mikula, Pierce A Peters, Soliman Oushy, Jeremy L Fogelson, Mohamad Bydon, Brett A Freedman, Arjun S Sebastian, Bradford L Currier, Ahmad Nassr, Kurt A Kennel, Paul A Anderson, David W Polly, Benjamin D Elder
OBJECTIVE: Opportunistic Hounsfield unit (HU) determination from CT imaging has been increasingly used to estimate bone mineral density (BMD) in conjunction with assessments from dual energy x-ray absorptiometry (DXA). The authors sought to compare the effect of teriparatide on HUs across different regions in the pelvis, sacrum, and lumbar spine, as a surrogate measure for the effects of teriparatide on lumbosacropelvic instrumentation. METHODS: A single-institution retrospective review of patients who had been treated with at least 6 months of teriparatide was performed...
August 2020: Neurosurgical Focus
David Simbaña-Escobar, Philippe Hellard, Ludovic Seifert
This study investigated the effects of gender and the manipulation of the preferred stroke rate on swimming performance and arm coordination in elite front crawl swimmers. Nineteen swimmers performed a dual task, i.e. imposed stroke rate and maximal speed. They swam nine 25-m trials at maximal speed twice: one trial at the preferential stroke rate, one trial at maximal stroke rate and seven trials at stroke rates between 41 and 59 cycles.min-1 imposed by an Aquapacer. Stroke rate, arm stroke phases and arm coordination were computed from an inertial measurement unit on each forearm and one on the sacrum...
July 31, 2020: Scandinavian Journal of Medicine & Science in Sports
Azeem Tariq Malik, Ryan T Voskuil, Jae Baek, John H Alexander, Thomas J Scharschmidt
BACKGROUND: There has been a considerable rise in the number of musculoskeletal/orthopaedic oncology fellowships and subsequently, orthopaedic oncologists, in the nation. National societies have been concerned that the increasing number of orthopaedic oncologists, coupled with a limited number of patients with bone and soft-tissue sarcomas in the country, may have led to an unintended impact on the training spectrum and/or exposure of orthopaedic oncology fellows-in-training over time...
July 20, 2020: Clinical Orthopaedics and related Research
Mostafa El Dafrawy, Keith Bridwell, Owoicho Adogwa, Max Shlykov, Jonathan Koscso, Lawrence G Lenke, Thamrong Lertudomphonwanit, Michael P Kelly, Munish Gupta
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To investigate the prevalence and incidence rate of rod fractures (RF) in patients undergoing surgery for correction of adult spinal deformity (ASD) with or without the use of interbody fusions in the caudal levels of the fusion construct. BACKGROUND: Data: Pseudarthrosis and rod fracture after long spinal fusion to the sacrum for correction of ASD remain a concern. METHODS: We reviewed clinical records of patients who underwent surgery for correction of ASD between 2004 and 2014...
July 28, 2020: Spine Deformity
Daniel Cabral, Cristina Rodrigues, Teresa Almodovar, Analisa Ribeiro, Leonor Mota, Francisco Félix
Inflammatory myofibroblastic tumours (IMTs) are rare lesions. We report a case of a 55 year-old male, admitted with a pneumonia. Further investigation revealed a left lower lobe mass and enlarged mediastinal lymph nodes. Cytology of the bronchoalveolar lavage suggested a squamous cell carcinoma. He received four cycles of chemotherapy followed by a left lower lobectomy. Pathological analysis was compatible with IMT. Three months after surgery, a new IMT nodule located in the lingula was excised. Four months later,endobronchial involvement and the presence of liver nodules were detected...
April 2020: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
David Cheng, Michael Hall, Bryan Penalosa, Olumide Danisa, Wayne Cheng
Background: Debate on whether to stop fusion at L5 or to extend fusion to S1 in a long spinal construct has been a controversial topic in spine surgery. Fewer data are available to support whether to include a prior solid fusion at L4-L5 or to extend to S1 during a proximal extension of fusion to T10. The purpose of this review is to report and discuss 2 cases of L5 vertebra fracture after proximal extension of solid L4-L5 fusion to T10 and to provide a guideline to surgeons based on the available literature...
June 2020: International Journal of Spine Surgery
Yoshitaka Nagashima, Yusuke Nishimura, Kaoru Eguchi, Takayuki Awaya, Satoshi Yoshikawa, Shoichi Haimoto, Toshihiko Wakabayashi, Masahito Hara
Primary tumors of sacrum are rarely seen, and the differential diagnosis is extensive, such as chordomas, giant cell tumors, and schwannomas. Sacral intraosseous schwannomas (IOSs) are very rare and encompass approximately 1%-5% of all spinal schwannomas. Melanotic schwannomas (MSs) are categorized as an unusual variant of benign schwannomas; however, they sometimes follow a malignant course. The authors present a case of MS with intraosseous extension into sacrum in a 48-year-old male arising from the left S2 nerve root...
July 2020: NMC Case Report Journal
Laura Marie-Hardy, Hugues Pascal-Moussellard, Anne Barnaba, Raphael Bonaccorsi, Caroline Scemama
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Screw loosening in spinal fusion is poorly defined. Accordingly, its prevalence rates range from 1% to 60%, and its risk factors remain undefined. The goal of this study was to assess the prevalence of screw loosening, according to precise definitions, and to identify factors associated with it. METHODS: We retrospectively reviewed records for 166 patients who underwent a posterior spinal fusion in our institution between 2011 and 2016...
August 2020: Global Spine Journal
Ilona Schubert, Andreas Höch, Olaf Pöppelmeier, Christoph Josten, Peter C Strohm
BACKGROUND: Sacral U‑shaped fractures are rare but severe injuries. Due to the resulting spinopelvic dissociation they are highly unstable. Reduction and stabilization are usually required and decompression may be necessary due to frequent concomitant neurological injuries. In the literature there is no consensus with respect to the selection of the surgical approach. CASE PRESENTATIONS: After a road traffic accident an 18-year-old woman suffered a U-fracture of the sacrum type II according to Roy-Camille and was treated with bilateral double sacroiliac screw osteosynthesis and sacral laminectomy...
July 16, 2020: Der Unfallchirurg
Sang-Kyu Im, Jung-Hee Lee, Kyung-Chung Kang, Sung Joon Shin, Ki Young Lee, Jong Jun Park, Man Ho Kim
STUDY DESIGN: Retrospective study. OBJECTIVE: To analyze proximal junctional kyphosis (PJK) occurrence and surgical outcomes according to degree of lumbar lordosis (LL) correction relative to pelvic incidence (PI). In addition, risk factors of PJK including LL and sagittal vertical axis (SVA) correction were investigated. SUMMARY OF BACKGROUND DATA: PJK is a common complication after adult spinal deformity surgery, and many factors are known to be associated with PJK...
August 1, 2020: Spine
Eduardo Cavalcante das Neves, Charles Pelizzari, Romulo Silva de Oliveira, Siham Kassab, Kleber Dos Anjos Lucas, Yuri Karaccas de Carvalho
Purpose To develop a 3D anatomical model for teaching canine epidural anesthesia (3DMEA) and to assess its efficacy for teaching and learning prior to the use of live animals. Methods The creation of 3DMEA was based on 3D optical scanning and 3D printing of canine bone pieces of the fifth to the seventh lumbar vertebrae, sacrum and pelvis. A total of 20 male dogs were scheduled for castration. 20 veterinary students watched a video showing epidural anesthesia in dogs before the clinical attempt and were assigned to control or 3DMEA groups...
2020: Acta Cirúrgica Brasileira
Hua Chen, Bin Jiang, Qun Zhang, Zuhao Chang, Zifeng Yang, Jian Zhang, Haoyang Liu, Peifu Tang
Objective: To introduce the experience of intelligent monitoring system assisted pelvic fracture closed reduction to treat complex pelvic fracture in a minimally invasive method. Methods: A 30-year-old male patient with complex pelvic fracture caused by a falling injury was treated in December 2019. The pelvic fracture was diagnosed by X-ray film and CT three-dimensional reconstruction. The AO/Orthopaedic Trauma Association (AO/OTA) classification was 61-C3.3 type (H-shaped sacrum fracture with pubic symphysis separation)...
July 15, 2020: Chinese Journal of Reparative and Reconstructive Surgery
Ting-Ting Tao, Jun Chen, Qing Hu, Xiao-Jun Huang, Jun Fu, Bo-Dong Lv, Yue Duan
INTRODUCTION: Abundant myxoid stroma rarely occurs in urothelial carcinomas (UCs). We report an 83-year-old woman with UC of the urinary bladder with abundant myxoid stroma. We summarized the clinicopathological features, immunophenotype, diagnosis, and differential diagnosis of this type of bladder cancer, in order to improve the understanding of surgeons and pathologists. PATIENT CONCERNS: An 83-year-old female presented with hematuria and frequent micturition, without odynuria, hypogastralgia, or fever...
July 10, 2020: Medicine (Baltimore)
Young Suk Kwon, Narea Lee, Ho Seok Lee, Eun Ji Youn, Soo Kyung Lee, Youngmi Kim, Jae Jun Lee
During ganglion impar block, the needle may approach the presacral space and the sacrum may be penetrated during caudal anesthesia. Because the rectum is in front of the sacrococcyx and is thus at risk for puncture, it is important to determine the distance between the sacrococcyx and rectum, as well as the thickness of the sacrococcyx.Computed tomography was used to measure the distance between the rectum and sacrococcyx, as well as the thickness of the sacrococcyx. The distances between the coccyx and rectum, sacrococcygeal joint and rectum, sacral level 5 ('sacrum 5') and rectum, and 'sacrum 4 to 5 junction' and rectum were measured...
July 10, 2020: Medicine (Baltimore)
Chao Wu, Jiayan Deng, Jian Pan, Tao Li, Lun Tan, Dechao Yuan
OBJECTIVE: To analyse the anatomical conditions of transverse sacroiliac screw (TSS) about the S1 and S2 segments in order to develop and validate a locked navigational template for TSS placement. METHODS: A total of 22 patients with sacral fractures were involved in this study from May 2018 to February 2019. Patients were divided into two groups according to the surgery procedure: locked template group and conventional group. The CT data of 90 normal sacra were analysed...
July 13, 2020: Journal of Orthopaedic Surgery and Research
Patricia Lang, Manuel Sterneder, Hans-Joachim Riesner, Carsten Hackenbroch, Benedikt Friemert, Hans-Georg Palm
INTRODUCTION: The choice of therapy for fragility fractures of the pelvis (FFP) is largely determined by the diagnosed fracture morphology. It is now unclear whether the change in diagnostic options - sensitive detection of fracture oedema in the sacrum using MRI and dual-energy computed tomography (DECT) - has an impact on the therapeutic consequences. The aim of this retrospective study was therefore to evaluate the change in the diagnostics used and the resulting therapy regimen in our patient population...
July 13, 2020: Zeitschrift Für Orthopädie und Unfallchirurgie
Hiroki Iwai, Yasushi Oshima, Tomoaki Kitagawa, Hirokazu Inoue, Yuichi Takano, Hirohiko Inanami, Hisashi Koga
Background: Full-endoscopic spine surgery (FESS) is a suitable treatment for lumbar disc herniation (LDH) and foraminal stenosis. This study investigated the usefulness of FESS in treating adjacent segment disease (ASD) after lumbar interbody fusion (LIF). Methods: Between September 2015 and March 2019, a total of 13 patients with symptomatic ASD after LIF underwent FESS. Discectomy and foraminoplasty using a 3.5-mm diameter high-speed drill were performed for treating LDH and foraminal stenosis...
June 2020: Journal of Spine Surgery (Hong Kong)
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