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Spinal Adjustment

Julia Freckelton, Daniel Croagh, Darcy Quinn Holt, Adrian Fox, Rachel Wong, Margaret Lee, Gregory Thomas Moore
Combination gemcitabine and nab-paclitaxel (Gem-Nab-P) is a common regimen used to treat metastatic pancreatic ductal adenocarcinoma (PDAC). Toxicity from this regimen is associated with significant morbidity. Currently, Gem-Nab-P is dosed using estimated body surface area, derived from height and weight. This study investigates whether skeletal muscle assessment could be a useful tool in the dosing of Gem-Nab-P in metastatic PDAC. This study included 52 patients who had received first-line treatment with Gem-Nab-P for PDAC...
February 9, 2019: Nutrition and Cancer
Jeffrey J Hebert, Charlotte Leboeuf-Yde, Claudia Franz, Arnaud Lardon, Lise Hestbæk, Neil Manson, Niels Wedderkopp
PURPOSE: To examine the prospective associations of pubertal development and linear growth with spinal pain frequency and duration in children. METHODS: We recruited students from 10 public primary schools. Over 42 months, pubertal development was assessed four times and categorized according to Tanner stages 1-5, and height was measured on seven occasions. Occurrences of spinal pain were reported weekly via text messaging. We constructed variables for spinal pain duration (total weeks with pain) and frequency (number of episodes)...
February 11, 2019: European Spine Journal
Andreas Nørgaard Glud, Steen Jakobsen, Anne M Landau, Aage Kristian Olsen Alstrup, Jens Christian Hedemann Sørensen
BACKGROUND: Intrathecal (IT) delivery is useful in both basic research and clinical treatments. Here we aim to test a new minimally invasive distribution route to the subarachnoid space (SAS) and the flow of IT administrations. We placed a radioligand into SAS during positron emission tomography (PET) scanning as a proof of concept. NEW METHOD: We injected a 11 C-labeled PET-tracer using a surgically placed catheter in the cisterna magna of anesthetized female pigs...
February 7, 2019: Journal of Neuroscience Methods
Sareh Pandamooz, Mohammad Saied Salehi, Mohammad Ismail Zibaii, Anahid Safari, Mohammad Nabiuni, Abolhassan Ahmadiani, Leila Dargahi
Nowadays there are various models of spinal cord injury (SCI) that recreate mechanisms of human SCI. The ex vivo modeling of injury is a robust approach, confronts with less experimental and ethical challenges. Currently almost all ex vivo models are obtained either from embryonic or postnatal animals, which can hardly mimic features of human SCI. This study was designed to develop SCI in slice culture of adult rats. Here, the lumbar enlargement of an adult rat was sliced and cultured. After seven days in vitro, a weight was dropped to simulate the injury...
February 2019: Tissue & Cell
Jason H Gumbel, Casey J Steadman, Robert F Hoey, James E Armstrong, Jason D Fell, Cui Bo Yang, Lynnette R Montgomery, Charles H Hubscher
Spinal cord injury (SCI) results in lasting deficits that include both mobility and a multitude of autonomic-related dysfunctions. Locomotor training (LT) on a treadmill is widely used as a rehabilitation tool in the SCI population with many benefits and improvements to daily life. We utilize this method of activity-based task-specific training (ABT) in rodents after SCI to both elucidate the mechanisms behind such improvements and to enhance and improve upon existing clinical rehabilitation protocols. Our current goal is to determine the mechanisms underlying ABT-induced improvements in urinary, bowel, and sexual function in SCI rats after a moderate to severe level of contusion...
January 16, 2019: Journal of Visualized Experiments: JoVE
Oluwole O Awosika, Marco Sandrini, Rita Volochayev, Ryan M Thompson, Nathan Fishman, Tianxia Wu, Mary Kay Floeter, Mark Hallett, Leonardo G Cohen
BACKGROUND: Ambulation is an essential aspect of daily living and is often impaired after brain and spinal cord injuries. Despite the implementation of standard neurorehabilitative care, locomotor recovery is often incomplete. OBJECTIVE: In this randomized, sham-controlled, double-blind, parallel design study, we aimed to determine if anodal transcutaneous spinal direct current stimulation (anodal tsDCS) could improve training effects on locomotion compared to sham (sham tsDCS) in healthy subjects...
January 29, 2019: Brain Stimulation
Jacquelyn J Cragg, Bobo Tong, Catherine R Jutzeler, Freda M Warner, Neil Cashman, Fred Geisler, John L K Kramer
The objective of our study was to determine whether treatment with baclofen is neurologically safe with respect to exposure during recovery from spinal cord injury. We performed a secondary longitudinal analysis of a cohort of adult patients with traumatic acute spinal cord injury. Cumulative baclofen dose was computed over the first 4 weeks following injury from concomitant medication information from a completed clinical trial. The main outcome measure was neurologic status, which was assessed over 52 weeks with "marked recovery" defined as the conversion to higher sensory and motor function...
February 6, 2019: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
Kam Ho Lee, Ho Yin Chung, Xiaopei Xu, Vince W H Lau, Chak Sing Lau
Background A quantifiable imaging measure to gauge the intensity of individual inflammatory lesions in axial spondyloarthritis (SpA) has not been well established. Previous studies have shown that diffusion-weighted (DW) MRI reflects disease activity in axial SpA. Purpose To determine the association between apparent diffusion coefficient (ADC) at MRI of discovertebral lesions and disease activity in individuals with axial SpA. Materials and Methods In this prospective study, 243 study participants (mean age ± standard deviation, 43...
February 5, 2019: Radiology
Arthur L Malkani, Kevin J Himschoot, Kevin L Ong, Edmund C Lau, Doruk Baykal, John R Dimar, Steven D Glassman, Daniel J Berry
BACKGROUND: Patients undergoing primary total hip arthroplasty (THA) following lumbar spine fusion have an increased incidence of dislocation compared to those without prior lumbar fusion. The purpose of this study is to determine if timing of THA prior to or after lumbar fusion would have an effect on dislocation and revision incidence in patients with both hip and lumbar spine pathology. METHODS: One hundred percent Medicare inpatient claims data from 2005 to 2015 were used to compare dislocation and revision risks in patients with primary THA with pre-existing lumbar spine fusion vs THA with subsequent lumbar spine fusion within 1, 2, and 5 years after the index THA...
January 14, 2019: Journal of Arthroplasty
Jack M Haglin, Kent R Richter, Naresh P Patel
OBJECTIVEThere is currently a paucity of literature evaluating procedural reimbursements and financial trends in neurosurgery. A comprehensive understanding of the economic trends and financial health of neurosurgery is important to ensure the sustained success and growth of the specialty moving forward. The purpose of this study was to evaluate monetary trends of the 10 most common spinal and cranial neurosurgical procedures in Medicare reimbursement rates from 2000 to 2018.METHODSThe Physician Fee Schedule Look-Up Tool from the Centers for Medicare & Medicaid Services was queried for each of the top 10 most utilized Current Procedural Terminology codes in both spinal and cranial neurosurgery, and comprehensive reimbursement data were extracted...
February 1, 2019: Journal of Neurosurgery
Santiago Zuluaga-Sanchez, Megan Teynor, Christopher Knight, Robin Thompson, Thomas Lundqvist, Mats Ekelund, Annabelle Forsmark, Adrian D Vickers, Andrew Lloyd
BACKGROUND: Spinal muscular atrophy is a rare neuromuscular disorder with a spectrum of severity related to age at onset and the number of SMN2 gene copies. Infantile-onset (≤ 6 months of age) is the most severe spinal muscular atrophy and is the leading monogenetic cause of infant mortality; patients with later-onset (> 6 months of age) spinal muscular atrophy can survive into adulthood. Nusinersen is a new treatment for spinal muscular atrophy. OBJECTIVE: The objective of this study was to evaluate the cost effectiveness of nusinersen for the treatment of patients with infantile-onset spinal muscular atrophy and later-onset spinal muscular atrophy in Sweden...
February 4, 2019: PharmacoEconomics
Wei-Xia Li, Ru-Yi Luo, Chao Chen, Xiang Li, Jing-Sheng Ao, Yue Liu, Yi-Qing Yin
BACKGROUND: Postoperative cognitive dysfunction (POCD) is a serious complication after surgery, especially in elderly patients. The anesthesia technique is a potentially modifiable risk factor for POCD. This study assessed the effects of dexmedetomidine, propofol or midazolam sedation on POCD in elderly patients who underwent hip or knee replacement under spinal anesthesia. METHODS: The present study was a prospective randomized controlled preliminary trial. From July 2013 and December 2014, a total of 164 patients aged 65 years or older who underwent hip or knee arthroplasty at China-Japan Friendship Hospital and 41 non-surgical controls were included in this study...
January 30, 2019: Chinese Medical Journal
Alejandro Suarez-Pierre, Xun Zhou, Jose E Gonzalez, Muhammad Rizwan, Charles D Fraser, Cecillia Lui, Mahmoud B Malas, Christopher J Abularrage, James H Black
OBJECTIVE: Spinal cord ischemia (SCI) is among the most devastating complications of thoracic endovascular aortic repair (TEVAR). Spinal fluid drainage has been proposed as a viable means to reduce SCI, but few data exist to support its routine use. This study investigated the association of preoperative spinal fluid drainage with the risk of SCI after TEVAR. METHODS: The Vascular Quality Initiative TEVAR module was queried for adult patients (≥18 years) undergoing TEVAR (coverage of zones 0-5) between September 2014 and March 2018 (inclusive)...
January 28, 2019: Journal of Vascular Surgery
Anja M Raab, Jörg Krebs, Mirjam Pfister, Claudio Perret, Maria Hopman, Gabi Mueller
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To investigate the effect of training intensity and -volume on improvements in respiratory muscle strength in individuals with spinal cord injury (SCI). SETTING: SCI rehabilitation center in Switzerland. METHODS: Inpatients with SCI, lesion level C4-T12, who had at least 10 individualized inspiratory muscle training sessions with respiratory function measurements before and after the training period...
January 30, 2019: Spinal Cord
P W H Cheung, H K Fong, C S Wong, J P Y Cheung
AIMS: The aim of this study was to determine the influence of developmental spinal stenosis (DSS) on the risk of re-operation at an adjacent level. PATIENTS AND METHODS: This was a retrospective study of 235 consecutive patients who had undergone decompression-only surgery for lumbar spinal stenosis and had a minimum five-year follow-up. There were 106 female patients (45.1%) and 129 male patients (54.9%), with a mean age at surgery of 66.8 years (sd 11.3). We excluded those with adult deformity and spondylolisthesis...
February 2019: Bone & Joint Journal
Laurelie R Wall, Rebecca L Nund, Elizabeth C Ward, Petrea L Cornwell, Delena I Amsters
PURPOSE: Voice and communication changes can occur following cervical spinal cord injury due to dysfunction of the respiratory and phonatory subsystems. Few studies have explored the "lived experience" of communication changes post cervical spinal cord injury. Furthermore, the impacts of these changes on community activity/participation and requirements for psychosocial adjustment have not been well-elucidated. The current study explored the experience of communication changes in non-ventilated individuals following cervical spinal cord injury, using a biopsychosocial framework...
January 29, 2019: Disability and Rehabilitation
Arun-Kumar Kaliya-Perumal, Worawat Limthongkul, Jacob Yoong-Leong Oh
During minimally-invasive long-construct posterior instrumentation, it may be challenging to contour and place the rod as the screw heads are not visualized. To overcome this, we utilized the image data merging (IDM) facility of our spinal navigation system to visualize a coherent whole image of the construct throughout the procedure. Here, we describe this technique that was used for a patient in whom L1–L5 posterior instrumentation was performed. Using an IDM facility, screws are color coded and after placement, the final image is saved...
January 30, 2019: Asian Spine Journal
Stacey Trzcinski, Rebecca E Rosenberg, Dennis Vasquez Montes, Akhila Sure, Peter Zhou, Jared Tishelman, Robert Mansky, Lisa McLeod, Joanna Tracy, Aaron J Buckland, Thomas J Errico
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The objective of this study was to examine associations of gabapentin use with inpatient postoperative daily pain scores and opioid use in children undergoing PSF for AIS. SUMMARY OF BACKGROUND DATA: Gabapentin use in posterior spinal fusion (PSF) postoperative pain management for adolescent idiopathic scoliosis (AIS) is increasingly common in order to decrease opioid use and improve pain control, though there is conflicting data on dosing and effectiveness to support this practice in real world settings...
January 25, 2019: Clinical Spine Surgery
Mona Frey, Alison Poynter, Keisha Younge, Diana De Carvalho
Clinical observations have suggested that limited hamstring flexibility may be associated with sagittal spinal curvatures in spine flexed postures. Thus, limited hamstring flexibility may be related to large amounts of spine flexion in "slumped" sitting postures which could contribute to low back pain and injury. The aim of this study was to determine if hamstring and pelvic flexibility are associated with flexed sitting postures using a backless office chair. Forty-one healthy female adults aged 18-69  years were recruited...
January 9, 2019: Journal of Biomechanics
Daisuke Nakashima, Ken Ishii, Yuji Nishiwaki, Hiromasa Kawana, Masahiro Jinzaki, Morio Matsumoto, Masaya Nakamura, Takeo Nagura
BACKGROUND: To predict conventional test forces (peak torque and pull-out force) and a new test force (implant stability quotient [ISQ] value of a spinal pedicle screw) from computed tomography (CT) parameters, including micro-architectural parameters, using high-resolution micro-CT and clinical multislice CT (MSCT) in human cadaveric vertebrae. METHODS: Micro-CT scans before/after screw insertion (n = 68) and MSCT scans before screw insertion (n = 58) of human cadaveric vertebrae were assessed for conventional test forces and ISQ value...
January 22, 2019: European radiology experimental
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