Spine

Percutaneous sacro-iliac screw osteosynthesis is considered to be standard of care for most posterior pelvic ring fractures. However, special situations require alternative strategies for sufficient stabilization. In these cases, stabilization can often be achieved using posterior instrumentation e.g. using SIPS-screws (spina-iliaca-posterior-superior screws). However, this often leads to implant-related aggravation of the sometimes already critical soft tissue conditions after pelvic trauma. S2-Ala-Ilium screws (S2AI screws) are a suitable alternative...

Nature teaches us that form precedes function, yet structure and function are intertwined. Such is the case with synapse structure, function, and plasticity underlying learning, especially in the hippocampus, a crucial brain region for memory formation. As the hippocampus matures, enduring changes in synapse structure produced by long-term potentiation (LTP) shift from synaptogenesis to synapse enlargement that is homeostatically balanced by stalled spine outgrowth and local spine clustering. Production of LTP leads to silent spine outgrowth at P15, and silent synapse enlargement in adult hippocampus at 2hours, but not at 5 or 30min following induction...

We investigated the ability of agmatine to potentiate the antidepressant-like and synaptic effects of ketamine in mice. Agmatine (0.1 and 1 mg/kg, p.o.) and ketamine (1 and 10 mg/kg, i.p.) produced an antidepressant-like effect in the tail suspension test. The combination of agmatine (0.01 mg/kg, p.o.) and ketamine (0.1 mg/kg, i.p.), at subthreshold doses, produced an antidepressant-like effect 1 h, 24 h and 7d after treatment. Western blot analysis from prefrontal cortex tissue showed that the combined treatment, after 1 h, increased p70S6K and GluA1, and reduced synapsin 1 phosphorylation...

BACKGROUND: For the surgical treatment of spinal malignant tumor, spinal reconstruction with bone graft and instrumentation is necessary after tumor resection, but postoperative complications including grafted bone resorption may arise. CASE DESCRIPTION: A 42-year-old Asian woman presented with neck pain, tumorous masses on the neck, and left arm pain. Magnetic resonance imaging (MRI) and computed tomography of the cervical spine showed extensive malignant spinal tumor...

Long-term memory has been associated with morphological changes in the brain, which in turn tightly correlate with changes in synaptic efficacy. Such plasticity is proposed to rely on dendritic spines as a neuronal canvas on which these changes can occur. Given the key role of actin cytoskeleton dynamics in spine morphology, major regulating factors of this process such as Cofilin 1 (Cfl1) and LIM kinase (LIMK), an inhibitor of Cfl1 activity, are prime molecular targets that may regulate dendritic plasticity...

OBJECTIVE: Self-driving technology will bring novelty in vehicle interior design and allow for a wide variety of occupant seating choices. Thus, vehicle safety systems may be challenged to protect occupants over a wider range of potential postures. This study aims to investigate the effects of the seat cushion angle on submarining risk, lumbar spine loads and pelvis excursion for reclined occupants in frontal crashes. METHODS: Frontal crash finite element simulations were performed with two of the simplified Global Human Body Model Consortium (GHBMC) occupant models: the small female and the midsize male...

BACKGROUND: Spinal ligament injury is often a comorbidity in spine fracture. Although the spinal ligament is important to maintain spinal stability, little is done to improve its healing after injury. Platelet-rich plasma (PRP) has been shown effective in treating many tendon and ligament disorders, but its role in spinal ligament injury remains to be evaluated. METHODS: Supraspinous ligament and interspinous ligament were cut in rabbits to simulate spinal ligament injury after spine fracture...

Importance: Magnetic responance imaging (MRI) of the lumbar spine that is not concordant with treatment guidelines for low back pain represents an unnecessary cost for US health plans and may be associated with adverse effects. Use of MRI in the US Department of Veterans Affairs (VA) primary care clinics remains unknown. Objective: To assess the use of MRI scans during the first 6 weeks (early MRI scans) of episodes of nonspecific low back pain in VA primary care sites and to determine if historical concordance can identify clinicians and sites that are the least concordant with guidelines...

Spine implant infections portend poor outcomes as diagnosis is challenging and surgical eradication is at odds with mechanical spinal stability. The purpose of this method is to describe a novel mouse model of spinal implant infection (SII) that was created to provide an inexpensive, rapid, and accurate in vivo tool to test potential therapeutics and treatment strategies for spinal implant infections. In this method, we present a model of posterior-approach spinal surgery in which a stainless-steel k-wire is transfixed into the L4 spinous process of 12-week old C57BL/6J wild-type mice and inoculated with 1 x 103 CFU of a bioluminescent strain of Staphylococcus aureus Xen36 bacteria...

BACKGROUND: Preoperative and/or intraoperative traction have been proposed as adjunctive methods to limit complications associated with growth-friendly instrumentation for early-onset scoliosis (EOS). By gradually correcting the deformity before instrumentation, traction can, theoretically, allow for better overall correction without the complications associated with the immediate intraoperative correction. The purpose of this multicenter study was to investigate the association between preoperative/intraoperative traction and complications following growth-friendly instrumentation for EOS...

INTRODUCTION: One of the primary goals of scoliosis surgery is to balance the head over the pelvis (or avoid creating imbalance). Historically, a normal coronal balance was defined as the C7 plumb line (C7PL) within 2 cm of the central sacral vertical line (CSVL); however, there is limited published information regarding the speed/magnitude and success/failure of balancing, rebalancing, or unbalancing in the postoperative period. The purpose of this study is to classify and quantify coronal plane balance postoperatively in adolescent idiopathic scoliosis when using pedicle screw instrumentation...

BACKGROUND: McGrath MAC videolaryngoscopy is a useful technique for successful intubation in cervical spine-injured patients with manual in-line stabilization of the neck during intubation. We aimed to identify radiographic predictors of difficult McGrath MAC videolaryngoscopy in patient undergoing cervical spine surgery. METHODS: Patients undergoing cervical spine surgery who were intubated with a McGrath MAC videolaryngoscope under manual in-line stabilization of the neck between June 2016 and August 2018 were included in this study...

BACKGROUND: Cervical alignment is vital for maintaining horizontal gaze and sagittal balance. The aims of this study were to summarize previously published descriptions of normative cervical alignment and to analyze a cohort of asymptomatic volunteers in order to identify natural clusters of normal radiographic parameters. METHODS: We performed a systematic review of the literature on radiographic measurements of asymptomatic volunteers through a search of MEDLINE and ScienceDirect databases...

We report the case of a 45-year-old man with thalassemia major referred for a bone scan as a workup for generalized bone pain. Tc-MDP SPECT CT showed multiple elongated soft tissue masses along the inner aspects of ribs and along both sides of dorsal spine with calcification and mild tracer uptake. There was also a large lobulated presacral soft tissue mass displacing the bladder and involving the adjacent pelvic bone. Biopsy of mildly avid tracer uptake in pelvic soft tissue mass was extramedullary hematopoiesis confirmed by biopsy...

OBJECTIVE: In this narrative review, the current literature on therapeutic interventions for low back pain of facet joint etiology is assessed from an economic value perspective. SUMMARY OF BACKGROUND DATA: The efficacy and economics of facet joint interventions in the treatment of lumbar back pain is a controversial topic. Trends show that facet joint interventions are becoming increasingly used, perhaps as physicians become more averse to treating chronic low back pain with opioids...

BACKGROUND: Patients diagnosed with spinal tuberculosis (TB) at a major tertiary hospital in Western Cape Province, South Africa, are required to attend regular follow-up at the hospital's outpatient spine clinic and to remain on TB treatment for at least 9 months. This follow-up and lengthy treatment is intended to allow for specialist monitoring of TB treatment response and early identification of secondary complications, and to reduce the risk of recurrence. However, little is known about adherence to these recommendations...

BACKGROUND: Hanging is a common form of self-harm, and emergency care physicians will not infrequently be called upon to manage a survivor.Despite the relative frequency of the injury, there is a paucity of literature on the topic and the spectrum and incidence of associated injuries are poorly described. OBJECTIVES: To review experience with management of victims of hanging at a major trauma centre in South Africa. METHODS: All patients treated by the Pietermaritzburg Metropolitan Trauma Service following a hanging incident between December 2012 and December 2018 were identified from the Hybrid Electronic Medical Registry...

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Background: Full-endoscopic spine surgery (FESS) necessitates the use of X-ray fluoroscopy for intraoperative guidance and orientation. However, the two-dimensional X-ray fluoroscopic images do not provide real-time guidance. The authors developed a new real-time three-dimensional (3D) navigation technique for FESS that entails the use of intraoperative cone beam computed tomography (CBCT) in a hybrid operating room (OR). Methods: A total of 23 patients undergoing FESS using real-time 3D navigation system were enrolled...

Due to the aging population, patients required spinal surgery for degenerative spondylopathy is increasing. With the advent of surgical instruments and techniques, minimally invasive spine surgery is prevalent worldwide. Besides microscopic techniques, endoscopic spine surgery has gotten attention gradually in this surgical field for the past two decades. There are two essential approaches developed currently, including transforaminal and interlaminar approach. These innovative equipment and skills promote the progression of endoscopic surgery from discectomy to decompression of spinal stenosis...