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https://read.qxmd.com/read/30771778/impact-of-decompression-surgery-without-fusion-for-lumbar-spinal-stenosis-on-sagittal-spinopelvic-alignment-minimum-2-year-follow-up
#1
Yoji Ogura, Yoshio Shinozaki, Yoshiomi Kobayashi, Takahiro Kitagawa, Yoshiro Yonezawa, Yohei Takahashi, Kodai Yoshida, Akimasa Yasuda, Jun Ogawa
OBJECTIVEThe importance of global sagittal alignment is well known. Patients with lumbar spinal stenosis (LSS) generally tend to bend forward to relieve their neurological symptoms, i.e., they have a positive sagittal vertical axis (SVA). We hypothesized that the positive SVA associated with LSS is symptom related and should improve after surgery. However, little is known about the changes in sagittal alignment in LSS patients after decompression surgery. In this study the authors aimed to evaluate midterm radiographical changes in sagittal spinopelvic alignment after decompression surgery for LSS and to determine the factors influencing the improvement in sagittal spinopelvic alignment...
February 15, 2019: Journal of Neurosurgery. Spine
https://read.qxmd.com/read/30771759/adverse-events-and-their-risk-factors-90-days-after-cervical-spine-surgery-analysis-from-the-michigan-spine-surgery-improvement-collaborative
#2
Hesham Mostafa Zakaria, Michael Bazydlo, Lonni Schultz, Markian A Pahuta, Jason M Schwalb, Paul Park, Ilyas Aleem, David R Nerenz, Victor Chang
OBJECTIVEThe Michigan Spine Surgery Improvement Collaborative (MSSIC) is a statewide, multicenter quality improvement initiative. Using MSSIC data, the authors sought to identify 90-day adverse events and their associated risk factors (RFs) after cervical spine surgery.METHODSA total of 8236 cervical spine surgery cases were analyzed. Multivariable generalized estimating equation regression models were constructed to identify RFs for adverse events; variables tested included age, sex, diabetes mellitus, disc herniation, foraminal stenosis, central stenosis, American Society of Anesthesiologists Physical Classification System (ASA) class > II, myelopathy, private insurance, anterior versus posterior approach, revision procedures, number of surgical levels, length of procedure, blood loss, preoperative ambulation, ambulation day of surgery, length of hospital stay, and discharge disposition...
February 15, 2019: Journal of Neurosurgery. Spine
https://read.qxmd.com/read/30771048/a-novel-fixation-technique-using-anterior-c1-screw-in-a-pediatric-solitary-cervical-spinal-juvenile-xanthogranuloma
#3
REVIEW
Rekhapalli Rajasekhar, Madhivanan Karthigeyan, Pravin Salunke, Kirti Gupta
PURPOSE: Juvenile xanthogranuloma (JXG) presenting as solitary vertebral body lesion is infrequently seen and usually limited to one or two levels. We report a case of an isolated JXG with extensive cervical spinal (bony and extradural) involvement in a 6-year-old child. There was a diagnostic dilemma as the radiologic and intraoperative picture resembled tuberculosis. The spinal reconstruction was also challenging due to involvement of multiple vertebral levels and necessitated an anterior C1 screw...
February 15, 2019: European Spine Journal
https://read.qxmd.com/read/30762840/navigation-versus-fluoroscopy-in-multilevel-mis-pedicle-screw-insertion-separate-analysis-of-exposure-to-radiation-of-the-surgeon-and-of-the-patients
#4
Markus R Konieczny, Rüdiger Krauspe
STUDY DESIGN: This study was a retrospective radiographic analysis of consecutive patients. OBJECTIVES: To analyze exposure to radiation of the surgeon and-separately-of patients in minimally invasive surgery (MIS) of multilevel posterior stabilization by percutaneous pedicle screw insertion guided by navigation (PIN) versus percutaneous pedicle screw insertion guided by fluoroscopy (PIF). SUMMARY OF BACKGROUND DATA: Spine surgeons are exposed to a 12-fold higher dose of radiation than other nonspinal musculoskeletal surgeons and PIF in MIS leads to a 2-fold higher dose of radiation than in open surgery...
February 12, 2019: Clinical Spine Surgery
https://read.qxmd.com/read/30762746/gouty-spondylodiscitis-with-lumbar-vertebral-body-retrolisthesis-a-case-report
#5
Yunlong Zou, Ye Li, Jingchen Liu, Boyin Zhang, Rui Gu
RATIONALE: Gout occurs mainly in joints, but rarely in the spine. In the spine, urate crystals can cause intervertebral space instability but rarely lead to retrolisthesis. Here, we present an extremely rare disease with gout invaded the intervertebral disc with lumbar retrolisthesis. PATIENT CONCERNS: A 61-years male patient with gout history has suffered from severe low back pain and intermittent claudication. Physical examination showed the level of muscle strength of his left first toe was 3/5...
February 2019: Medicine (Baltimore)
https://read.qxmd.com/read/30761421/preclinical-evaluation-of-a-novel-anterior-non-fusion-fixation-device-for-atlantoaxial-instability-an-in-vivo-comparison-study-in-a-canine-model
#6
Xuan Cai, Xiaoqing Yi, Haopeng Li, Xijing He
PURPOSE: The Anterior Atlantoaxial Non-Fusion Fixation System (AANFS) was a novel motion preservation device for atlantoaxial instability to replace traditional fusion techniques. The purpose of this in vivo study was to evaluate the clinical features and biomechanical properties of this new device in a canine model by comparing it with a conventional method. METHODS: Eighteen adult male canines were randomly divided into group 1, which received the AANFS replacement, group 2 which received the Harms rigid fixation procedures, and group 3, which served as the control group...
February 13, 2019: European Spine Journal
https://read.qxmd.com/read/30758122/continuous-bilateral-erector-of-spine-plane-block-at-t8-for-extensive-lumbar-spine-fusion-surgery-case-report
#7
Carlos Rodrigues Almeida, Ana Raquel Oliveira, Pedro Cunha
Supplementary strategies, in combination with conventional analgesia, for pain control after lumbar fusion surgery remain limited. Here, we describe a 79-year-old woman who experienced pain (10/10 on a numerical rating scale) on post-operative day 1 after undergoing L2 to S1 spine fusion. Erector spinae plane (ESP) blocks were performed at T8 and, after a bolus of ropivacaine 0.2% (20 ml) per side, perineural catheters were placed bilaterally. Continuous infusion (5 ml/h) of ropivacaine 0.2% per side was maintained for 48 h...
February 13, 2019: Pain Practice: the Official Journal of World Institute of Pain
https://read.qxmd.com/read/30755256/tranexamic-acid-in-reducing-gross-hemorrhage-and-transfusions-of-spine-surgeries-targets-study-protocol-for-a-prospective-randomized-double-blind-non-inferiority-trial
#8
Shangyi Hui, Liyuan Tao, Feroze Mahmood, Derong Xu, Zhinan Ren, Xin Chen, Lin Sheng, Qianyu Zhuang, Shugang Li, Yuguang Huang
BACKGROUND: Tranexamic acid (TXA) has been routinely delivered in multisegmental spinal decompression and bone graft fusion surgeries with satisfactory outcomes in minimizing gross blood loss and transfusion demands. However, concerns remain that intravenously delivered TXA (ivTXA) may increase risks of postoperative convulsive seizures and systemic thrombogenicity. Topical use of TXA (tTXA), being more targeted to the surgical bleeding site while minimizing patient systemic exposure to ivTXA, has been successfully applied to attenuate blood losses and transfusion requirements in hip and knee arthroplasty...
February 12, 2019: Trials
https://read.qxmd.com/read/30745263/low-dose-ketamine-infusion-to-decrease-postoperative-delirium-for-spinal-fusion-patients
#9
Sarah S Plyler, Virginia C Muckler, J Frank Titch, Dhanesh K Gupta, Andi N Rice
PURPOSE: The primary aim of this project was to decrease the incidence of postoperative delirium after spine surgery. DESIGN: A prospective preimplementation and postimplementation design was used. METHODS: A reduced dose ketamine protocol was implemented for adult patients undergoing elective spinal fusion surgery. Thirty patients were assessed at five time points for the presence of postoperative delirium in the postanesthesia care unit (PACU) using the 3-Minute Diagnostic Interview for Confusion Assessment Method Defined Delirium tool and opioid requirements were compared...
February 8, 2019: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://read.qxmd.com/read/30744306/comparison-of-surgical-outcomes-of-the-posterior-and-combined-approaches-for-repair-of-cervical-fractures-in-ankylosing-spondylitis
#10
Panya Luksanapruksa, Paul William Millhouse, Victor Carlson, Thanase Ariyawatkul, Joshua Heller, Christopher Keppel Kepler
Study Design: Retrospective cohort study. Purpose: To evaluate surgical outcomes and complications of cervical spine fractures in ankylosing spondylitis (CAS) patients who were treated using either the posterior (P) or combined approach (C). Overview of Literature: Ankylosing spondylitis typically causes progressive spinal stiffness that makes patients susceptible to spinal fractures. CAS is a highly unstable condition. There is contradictory evidence regarding which treatment option, the posterior or the combined approach, yields superior clinical results...
February 13, 2019: Asian Spine Journal
https://read.qxmd.com/read/30742975/biomechanical-effects-on-the-intermediate-segment-of-noncontiguous-hybrid-surgery-with-cervical-disc-arthroplasty-and-anterior-cervical-discectomy-and-fusion-a-finite-element-analysis
#11
Ting-Kui Wu, Yang Meng, Hao Liu, Bei-Yu Wang, Ying Hong, Xin Rong, Chen Ding, Hua Chen
BACKGROUND CONTEXT: Surgery for cervical degenerative disc disorder (CDDD) at two noncontiguous segments is infrequent. Few studies have explored the biomechanical effects on the intermediate adjacent segment of anterior cervical discectomy and fusion (ACDF) or cervical disc arthroplasty (CDA) in this situation. No study has examined biomechanical differences between ACDF and hybrid surgery (HS) constructs for noncontiguous CDDD. Differences in the biomechanical changes between the intermediate and adjacent segments are unknown...
February 8, 2019: Spine Journal: Official Journal of the North American Spine Society
https://read.qxmd.com/read/30739072/impact-of-morbid-obesity-bmi-40-kg-m-2-on-complication-rate-and-outcome-following-minimally-invasive-transforaminal-lumbar-interbody-fusion-mis-tlif
#12
Marie T Krüger, Yashar Naseri, Marc Hohenhaus, Ulrich Hubbe, Christoph Scholz, Jan-Helge Klingler
OBJECTIVES: The negative effects of obesity on the health and quality of life of those afflicted has become an important public concern. Previous studies have shown an association between obesity and higher rates of complications and unfavorable outcomes following spine surgery. This study is to identify peri- and postoperative complication rates as well as short-term and long-term outcomes in morbidly obese patients who underwent minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) in comparison to age-matched normal-weight patients...
February 4, 2019: Clinical Neurology and Neurosurgery
https://read.qxmd.com/read/30738939/perioperative-intravenous-corticosteroids-and-radiographic-prevertebral-soft-tissue-swelling-in-anterior-cervical-fusion-for-degenerative-disease
#13
Juneyoung L Yi, Michael Glover, John Charitable, Harry Ramcharran, Swamy Kurra, Richard Tallarico, Mike Sun, William F Lavelle
OBJECTIVE: Prevertebral soft tissue swelling (PSTS) is a known complication of anterior cervical fusion (ACF). Prior studies have shown perioperative steroids may reduce PSTS following ACF. We retrospectively evaluated the role of perioperative IV corticosteroid administration in minimizing radiographic PSTS measurements in patients receiving ACF for degenerative disease. METHODS: Records of 100 consecutive patients receiving ACF for degenerative disease (CPT code 63075) from January 2010 through December 2012 by two orthopedic spine fellowship-trained surgeons at a single institution retrospectively reviewed...
February 7, 2019: World Neurosurgery
https://read.qxmd.com/read/30738410/an-institutional-intervention-to-modify-opioid-prescribing-practices-after-lumbar-spine-surgery
#14
Francis Lovecchio, Jeffrey G Stepan, Ajay Premkumar, Michael E Steinhaus, Maria Sava, Peter Derman, Han Jo Kim, Todd Albert
OBJECTIVEPatients with lumbar spine pathology are at high risk for opioid misuse. Standardizing prescribing practices through an institutional intervention may reduce the overprescribing of opiates, leading to a decrease in the risk for opioid misuse and the number of pills available for diversion. Without quantitative data on the "minimum necessary quantity" of opioids appropriate for postdischarge prescriptions, the optimal method for changing existing prescribing practices is unknown. The purpose of this study was to determine whether mandatory provider education and prescribing guidelines could modify prescriber behavior and lead to a decreased amount of opioids prescribed at hospital discharge following lumbar spine surgery...
February 5, 2019: Journal of Neurosurgery. Spine
https://read.qxmd.com/read/30722075/-recommendations-for-the-diagnostic-testing-and-therapy-of-atlas-fractures
#15
Philipp Schleicher, Matti Scholz, Frank Kandziora, Andreas Badke, Marc Dreimann, Harry W Gebhard, Erol Gercek, Oliver Gonschorek, René Hartensuer, Jan-Sven Gilbert Jarvers, Sebastian Katscher, Philipp Kobbe, Holger Koepp, Stefan Matschke, Sven Mörk, Christian W Müller, Georg Osterhoff, Ferenc Pécsi, Miguel Pishnamaz, Maximilian Reinhold, Gregor Schmeiser, Klaus John Schnake, Kristian Schneider, Ulrich Josef Albert Spiegl, Bernhard Ullrich
In a consensus process with four sessions in 2017, the working group on "the upper cervical spine" of the German Society for Orthopaedic and Trauma Surgery (DGOU) formulated "Therapeutic Recommendations for the Diagnosis and Treatment of Fractures to the Upper Cervical Spine", incorporating their own experience and current literature. The following article describes the recommendations for the atlas vertebra. About 10% of all cervical spine injuries include the axis vertebra. The diagnostic process primarily aims to detect the injury and to determine joint incongruency and integrity of the atlas ring...
February 5, 2019: Zeitschrift Für Orthopädie und Unfallchirurgie
https://read.qxmd.com/read/30719454/the-usefulness-of-percutaneous-endoscopic-technique-in-multifocal-lumbar-pathology
#16
Chul-Woo Lee, Kang-Jun Yoon
Introduction. The multifocal lumbar pathology including disc herniation and stenosis in the spinal canal or foramen has been considered the most difficult to approach surgically. It often requires mandatory dual approaches and/or fusion techniques. Traditional percutaneous endoscopic lumbar transforaminal and interlaminar approach has been focused on unifocal disc herniation. However, the development of endoscopic spinal instruments and surgical technique has broadened surgical indication and therapeutic boundary in endoscopic spine surgery...
2019: BioMed Research International
https://read.qxmd.com/read/30717051/pedicle-stress-shielding-following-growing-rod-implantation-case-report
#17
Daniel J Cognetti, Amer F Samdani, Joshua M Pahys, Mari L Groves, Steven W Hwang
Growing rod surgery for skeletally immature patients helps correct severe scoliosis while allowing continued spinal column growth. Previous reports have studied vertebral body changes following growing rod surgery, but there are currently no published reports on alterations in pedicle morphology. Given the potential need for definitive spinal fusion with pedicle screw instrumentation, an awareness of changes in pedicle morphology is critical. A morphometric analysis of pedicles was performed using 3D reconstructions of 3 CT scans (preoperative and at 3 and 6 years) obtained in a young girl with infantile idiopathic scoliosis (T7 apex) who underwent unilateral rib-to-spine growing rod (2nd-4th ribs to L1) implantation with lengthening every 6 months for 6 years...
February 1, 2019: Journal of Neurosurgery. Spine
https://read.qxmd.com/read/30717041/treatment-of-only-the-fractional-curve-for-radiculopathy-in-adult-scoliosis-comparison-to-lower-thoracic-and-upper-thoracic-fusions
#18
Dominic Amara, Praveen V Mummaneni, Christopher P Ames, Bobby Tay, Vedat Deviren, Shane Burch, Sigurd H Berven, Dean Chou
OBJECTIVEMany options exist for the surgical management of adult spinal deformity. Radiculopathy and lumbosacral pain from the fractional curve (FC), typically from L4 to S1, is frequently a reason for scoliosis patients to pursue surgical intervention. The purpose of this study was to evaluate the outcomes of limited fusion of the FC only versus treatment of the entire deformity with long fusions.METHODSAll adult scoliosis patients treated at the authors' institution in the period from 2006 to 2016 were retrospectively analyzed...
February 1, 2019: Journal of Neurosurgery. Spine
https://read.qxmd.com/read/30717036/low-rates-of-complications-after-spinopelvic-fixation-with-iliac-screws-in-260-adult-patients-with-a-minimum-2-year-follow-up
#19
James H Nguyen, Thomas J Buell, Tony R Wang, Jeffrey P Mullin, Marcus D Mazur, Juanita Garces, Davis G Taylor, Chun-Po Yen, Christopher I Shaffrey, Justin S Smith
OBJECTIVERecent literature describing complications associated with spinopelvic fixation with iliac screws in adult patients has been limited but has suggested high complication rates. The authors' objective was to report their experience with iliac screw fixation in a large series of patients with a 2-year minimum follow-up.METHODSOf 327 adult patients undergoing spinopelvic fixation with iliac screws at the authors' institution between 2010 and 2015, 260 met the study inclusion criteria (age ≥ 18 years, first-time iliac screw placement, and 2-year minimum follow-up)...
February 1, 2019: Journal of Neurosurgery. Spine
https://read.qxmd.com/read/30714396/biomechanical-comparison-of-the-effects-of-anterior-posterior-and-transforaminal-lumbar-interbody-fusion-on-vibration-characteristics-of-the-human-lumbar-spine
#20
Wei Fan, Li-Xin Guo
Previous studies have compared the effects of different interbody fusion approaches on biomechanical responses of the lumbar spine to static loadings. However, very few have dealt with the whole body vibration (WBV) condition that is typically present in vehicles. This study was designed to determine the biomechanical differences among anterior, posterior and transforaminal lumbar interbody fusion (ALIF, PLIF and TLIF) under vertical WBV. A previously developed and validated finite element (FE) model of the intact L1-sacrum human lumbar spine was modified to simulate ALIF, PLIF and TLIF with bilateral pedicle screw fixation at L4-L5...
February 4, 2019: Computer Methods in Biomechanics and Biomedical Engineering
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