Pub Date : 2007-07-01DOI: 10.1097/BCO.0B013E3281FBD418
Aaron M. Freilich, A. Chhabra
Purpose of review Carpal tunnel syndrome is the most commonly reported compression neuropathy. Awareness of the syndrome has increased the frequency of diagnosis. Yet controversy remains regarding the exact mechanism of nerve compression and the existence of a true gold standard for the diagnosis of carpal tunnel syndrome. We examine recent literature regarding pathophysiology and diagnostic criteria. Recent findings Our understanding of changes in the carpal tunnel and median nerve as seen with magnetic resonance imaging and ultrasound continues to improve. These show promise, both as screening tests and to enable understanding of the causes of carpal tunnel syndrome. A clinical diagnostic standard has been proposed, and may allow better comparison among studies. Obesity and age are independent risk factors. Findings and symptoms differ depending on the population examined, with more severe findings in the elderly for given symptoms. Summary Carpal tunnel syndrome is a clinical diagnosis. Electrodiagnostic studies are frequently useful in further evaluation of cases. Alternate imaging methodologies may become useful as screening tools in the future. Causes are related to mechanical strain and increased carpal canal pressures. Noninvasive imaging is assisting in defining the anatomy and dynamic nature of the carpal tunnel with movement.
{"title":"Diagnosis and pathophysiology of carpal tunnel syndrome","authors":"Aaron M. Freilich, A. Chhabra","doi":"10.1097/BCO.0B013E3281FBD418","DOIUrl":"https://doi.org/10.1097/BCO.0B013E3281FBD418","url":null,"abstract":"Purpose of review Carpal tunnel syndrome is the most commonly reported compression neuropathy. Awareness of the syndrome has increased the frequency of diagnosis. Yet controversy remains regarding the exact mechanism of nerve compression and the existence of a true gold standard for the diagnosis of carpal tunnel syndrome. We examine recent literature regarding pathophysiology and diagnostic criteria. Recent findings Our understanding of changes in the carpal tunnel and median nerve as seen with magnetic resonance imaging and ultrasound continues to improve. These show promise, both as screening tests and to enable understanding of the causes of carpal tunnel syndrome. A clinical diagnostic standard has been proposed, and may allow better comparison among studies. Obesity and age are independent risk factors. Findings and symptoms differ depending on the population examined, with more severe findings in the elderly for given symptoms. Summary Carpal tunnel syndrome is a clinical diagnosis. Electrodiagnostic studies are frequently useful in further evaluation of cases. Alternate imaging methodologies may become useful as screening tools in the future. Causes are related to mechanical strain and increased carpal canal pressures. Noninvasive imaging is assisting in defining the anatomy and dynamic nature of the carpal tunnel with movement.","PeriodicalId":81061,"journal":{"name":"Current opinion in orthopaedics","volume":"18 1","pages":"347-351"},"PeriodicalIF":0.0,"publicationDate":"2007-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BCO.0B013E3281FBD418","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62100133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-07-01DOI: 10.1097/BCO.0B013E32816AA3CF
John‐Erik Bell, C. Ahmad
{"title":"Current concepts in arthroscopic rotator cuff repair: single vs. double row repair","authors":"John‐Erik Bell, C. Ahmad","doi":"10.1097/BCO.0B013E32816AA3CF","DOIUrl":"https://doi.org/10.1097/BCO.0B013E32816AA3CF","url":null,"abstract":"","PeriodicalId":81061,"journal":{"name":"Current opinion in orthopaedics","volume":"18 1","pages":"363-368"},"PeriodicalIF":0.0,"publicationDate":"2007-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BCO.0B013E32816AA3CF","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62099282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-07-01DOI: 10.1097/BCO.0B013E3281C8F25A
Steve K. Lee, A. Dubey
{"title":"Flexor tendon injury: advances in repair and biology","authors":"Steve K. Lee, A. Dubey","doi":"10.1097/BCO.0B013E3281C8F25A","DOIUrl":"https://doi.org/10.1097/BCO.0B013E3281C8F25A","url":null,"abstract":"","PeriodicalId":81061,"journal":{"name":"Current opinion in orthopaedics","volume":"18 1","pages":"339-346"},"PeriodicalIF":0.0,"publicationDate":"2007-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BCO.0B013E3281C8F25A","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62099852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-05-01DOI: 10.1097/BCO.0B013E3280D64709
Terrence T. Kim, S. Ludwig, D. Gelb, K. Poelstra
{"title":"Diagnosis and management of postoperative wound infections of the cervical spine","authors":"Terrence T. Kim, S. Ludwig, D. Gelb, K. Poelstra","doi":"10.1097/BCO.0B013E3280D64709","DOIUrl":"https://doi.org/10.1097/BCO.0B013E3280D64709","url":null,"abstract":"","PeriodicalId":81061,"journal":{"name":"Current opinion in orthopaedics","volume":"18 1","pages":"276-281"},"PeriodicalIF":0.0,"publicationDate":"2007-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BCO.0B013E3280D64709","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62098710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-05-01DOI: 10.1097/BCO.0B013E3280964DDA
Daniel R. Fassett, D. Csaszar, T. Albert
{"title":"Anterior cervical plating update","authors":"Daniel R. Fassett, D. Csaszar, T. Albert","doi":"10.1097/BCO.0B013E3280964DDA","DOIUrl":"https://doi.org/10.1097/BCO.0B013E3280964DDA","url":null,"abstract":"","PeriodicalId":81061,"journal":{"name":"Current opinion in orthopaedics","volume":"18 1","pages":"282-288"},"PeriodicalIF":0.0,"publicationDate":"2007-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BCO.0B013E3280964DDA","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62098657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-05-01DOI: 10.1097/BCO.0B013E32810F2DC0
R. Molinari
Purpose of reviewThis is a review of the recent literature involving dynamic posterior stabilization in the lumbar spine.Recent findingsAs an alternative to fusion, a mobile, dynamic stabilization restricting segmental motion would be advantageous in various indications, allowing greater physiologic
{"title":"Dynamic stabilization of the lumbar spine","authors":"R. Molinari","doi":"10.1097/BCO.0B013E32810F2DC0","DOIUrl":"https://doi.org/10.1097/BCO.0B013E32810F2DC0","url":null,"abstract":"Purpose of reviewThis is a review of the recent literature involving dynamic posterior stabilization in the lumbar spine.Recent findingsAs an alternative to fusion, a mobile, dynamic stabilization restricting segmental motion would be advantageous in various indications, allowing greater physiologic","PeriodicalId":81061,"journal":{"name":"Current opinion in orthopaedics","volume":"18 1","pages":"215-220"},"PeriodicalIF":0.0,"publicationDate":"2007-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BCO.0B013E32810F2DC0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62098809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-05-01DOI: 10.1097/BCO.0B013E32813AEAFD
A. Mohit, R. D. Orr
{"title":"Percutaneous vertebral augmentation in osteoporotic fractures","authors":"A. Mohit, R. D. Orr","doi":"10.1097/BCO.0B013E32813AEAFD","DOIUrl":"https://doi.org/10.1097/BCO.0B013E32813AEAFD","url":null,"abstract":"","PeriodicalId":81061,"journal":{"name":"Current opinion in orthopaedics","volume":"18 1","pages":"221-225"},"PeriodicalIF":0.0,"publicationDate":"2007-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BCO.0B013E32813AEAFD","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62098373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-05-01DOI: 10.1097/BCO.0B013E32810C00F6
Richard S. Lee, Andrew P. White, J. Grauer
{"title":"The safety and utility of bone morphogenetic protein in anterior and posterior cervical-spine fusions","authors":"Richard S. Lee, Andrew P. White, J. Grauer","doi":"10.1097/BCO.0B013E32810C00F6","DOIUrl":"https://doi.org/10.1097/BCO.0B013E32810C00F6","url":null,"abstract":"","PeriodicalId":81061,"journal":{"name":"Current opinion in orthopaedics","volume":"18 1","pages":"270-275"},"PeriodicalIF":0.0,"publicationDate":"2007-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BCO.0B013E32810C00F6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62098644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-05-01DOI: 10.1097/BCO.0B013E3280D942FC
M. Bilsky, Syed S. Azeem
Purpose of review The question of whether to irradiate or operate may have significant consequences for successful palliation in terms of pain relief, neurologic function, and quality of life. This article reviews the relevant issues of decision making using a framework, NOMS, applied to the cervical spine. Recent findings At Memorial Sloan-Kettering Cancer Center, a decision framework is used to assess four fundamental considerations in decision making, NOMS: neurologic (N), oncologic (O), mechanical instability (M) and systemic disease and medical comorbidities (S). This framework provides a method to dissect complicated tumor issues into simple components and allows for the integration of new technologies. Currently, patients who have high-grade spinal cord compression (N) from radioresistant tumors (O) or demonstrate mechanical instability (M) are offered surgery followed by radiation. Patients with minimal or no spinal cord compression (N) and who are stable (M) are treated with radiation therapy. The evolution of surgical techniques has made decompression and instrumentation safer and more reliable. Summary The decision framework NOMS can be applied to issues relevant to decision making for the atlanto-axial and subaxial cervical spine in which they are distinct in terms of definitions of instability and indications for operation or radiation.
{"title":"The Noms framework for decision making in metastatic cervical spine tumors","authors":"M. Bilsky, Syed S. Azeem","doi":"10.1097/BCO.0B013E3280D942FC","DOIUrl":"https://doi.org/10.1097/BCO.0B013E3280D942FC","url":null,"abstract":"Purpose of review The question of whether to irradiate or operate may have significant consequences for successful palliation in terms of pain relief, neurologic function, and quality of life. This article reviews the relevant issues of decision making using a framework, NOMS, applied to the cervical spine. Recent findings At Memorial Sloan-Kettering Cancer Center, a decision framework is used to assess four fundamental considerations in decision making, NOMS: neurologic (N), oncologic (O), mechanical instability (M) and systemic disease and medical comorbidities (S). This framework provides a method to dissect complicated tumor issues into simple components and allows for the integration of new technologies. Currently, patients who have high-grade spinal cord compression (N) from radioresistant tumors (O) or demonstrate mechanical instability (M) are offered surgery followed by radiation. Patients with minimal or no spinal cord compression (N) and who are stable (M) are treated with radiation therapy. The evolution of surgical techniques has made decompression and instrumentation safer and more reliable. Summary The decision framework NOMS can be applied to issues relevant to decision making for the atlanto-axial and subaxial cervical spine in which they are distinct in terms of definitions of instability and indications for operation or radiation.","PeriodicalId":81061,"journal":{"name":"Current opinion in orthopaedics","volume":"18 1","pages":"263-269"},"PeriodicalIF":0.0,"publicationDate":"2007-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BCO.0B013E3280D942FC","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62098773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-05-01DOI: 10.1097/BCO.0B013E32810498D0
Daniel R. Fassett, Roman Politi, Archit Patel, Zoe Brown, A. Vaccaro
{"title":"Classification systems for acute thoracolumbar trauma","authors":"Daniel R. Fassett, Roman Politi, Archit Patel, Zoe Brown, A. Vaccaro","doi":"10.1097/BCO.0B013E32810498D0","DOIUrl":"https://doi.org/10.1097/BCO.0B013E32810498D0","url":null,"abstract":"","PeriodicalId":81061,"journal":{"name":"Current opinion in orthopaedics","volume":"18 1","pages":"253-258"},"PeriodicalIF":0.0,"publicationDate":"2007-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BCO.0B013E32810498D0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62098339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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