Pub Date : 2018-01-06DOI: 10.4172/2165-7939.1000405
P. Fransen, D. Noriega, A. Chatzisotiriou, Pointillart
Introduction: Although cervical arthroplasties have been widely used with some success over the last decade, long terms results are missing, particularly for the latest designed implants such as semi constrained prostheses. Material and methods: 89 patients were enrolled in an observational study evaluating long term safety and potential complications related to the use of the cervical prosthesis Baguera® C. All patients had been treated at one or two levels between June 2009 and June 2011. At the 5 years FU visit, the patients were evaluated clinically and neurologically, and with self-assessment questionnaires (NDI, SF12). Radiological examination was performed by lateral X-rays in neutral, flexion and extension positions. Results: There were no reoperations at the arthroplasty level, no fracture of system components, no loss of fixation, and no migration nor subsidence. 17 patients had signs of adjacent level(s) degeneration. The performance related to Baguera®C usage, was evaluated at 5+ Y. PO by three parameters: Range of Motion (ROM), NDI and SF-12 scores. ROM at the treated level was 8.6° ± 5.0°. 87.7% of the treated levels showed preserved motion. NDI score was 19.5% ± 14.1%. 92% of the subjects reported NDI scores over 50%, and 74.2% of the subjects reported NDI scores under 30% and 45% of the subjects reported NDI scores under 10%. The QOL Index and Patient Satisfaction (SF-12 scores) reached 48.5 ± 8.6 for the PCS physical score and 48.0 ± 10.5 for the MCS Mental score. Both SF-12 components, physical and mental, were close to a normal health status (50%). Conclusion: Cervical disc replacement with the Baguera®C prosthesis shows excellent safety, clinical results and long-term motion preservation. There was no index or adjacent level reoperation after 5 years. Radiological progression of adjacent level degeneration was seen in a significant minority of cases, but without clinical expression.
{"title":"One- or Two- Levels Treatment by Arthroplasty of Cervical Degenerative Disease. Preliminary Results after 5 Years Postoperative Controls","authors":"P. Fransen, D. Noriega, A. Chatzisotiriou, Pointillart","doi":"10.4172/2165-7939.1000405","DOIUrl":"https://doi.org/10.4172/2165-7939.1000405","url":null,"abstract":"Introduction: Although cervical arthroplasties have been widely used with some success over the last decade, long terms results are missing, particularly for the latest designed implants such as semi constrained prostheses. \u0000Material and methods: 89 patients were enrolled in an observational study evaluating long term safety and potential complications related to the use of the cervical prosthesis Baguera® C. All patients had been treated at one or two levels between June 2009 and June 2011. \u0000At the 5 years FU visit, the patients were evaluated clinically and neurologically, and with self-assessment questionnaires (NDI, SF12). Radiological examination was performed by lateral X-rays in neutral, flexion and extension positions. \u0000Results: There were no reoperations at the arthroplasty level, no fracture of system components, no loss of fixation, and no migration nor subsidence. 17 patients had signs of adjacent level(s) degeneration. \u0000The performance related to Baguera®C usage, was evaluated at 5+ Y. PO by three parameters: Range of Motion (ROM), NDI and SF-12 scores. ROM at the treated level was 8.6° ± 5.0°. 87.7% of the treated levels showed preserved motion. \u0000NDI score was 19.5% ± 14.1%. 92% of the subjects reported NDI scores over 50%, and 74.2% of the subjects reported NDI scores under 30% and 45% of the subjects reported NDI scores under 10%. \u0000The QOL Index and Patient Satisfaction (SF-12 scores) reached 48.5 ± 8.6 for the PCS physical score and 48.0 ± 10.5 for the MCS Mental score. Both SF-12 components, physical and mental, were close to a normal health status (50%). \u0000Conclusion: Cervical disc replacement with the Baguera®C prosthesis shows excellent safety, clinical results and long-term motion preservation. There was no index or adjacent level reoperation after 5 years. Radiological progression of adjacent level degeneration was seen in a significant minority of cases, but without clinical expression.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"7 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000405","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43165996","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 : 2018-01-01DOI: 10.4172/2165-7939.1000409
K. Lewandrowski
Fusion of the anterior column with placement of interbody fusion cages is commonly employed in the treatment of instability-related degenerative disc disease that has been proven refractory in non-operative treatment. Interbody fusion cages aid in the containment of bone graft, promotion of more reliable fusion, and restoration of neuroforaminal height. The VariLift® Interbody Fusion System (VariLift® system) has been developed as a standalone solution to address subsidence and migration problems seen with traditional lumbar interbody fusion cages that require posterior supplemental transpedicular screw fixation for improved stability. This series of 24 consecutive patients describes patient selection criteria and the technical aspects of this novel endoscopic transforaminal lumbar interbody fusion technique in a step-by-step fashion. The transforaminal endoscopically assisted interbody fusion with the standalone expandable VariLift® system represents a simplified alternative to other pedicle screw-based spinal fusion.
{"title":"Surgical Technique of Endoscopic Transforaminal Decompression and Fusion with a Threaded Expandable Interbody Fusion Cage and A Report of 24 Cases","authors":"K. Lewandrowski","doi":"10.4172/2165-7939.1000409","DOIUrl":"https://doi.org/10.4172/2165-7939.1000409","url":null,"abstract":"Fusion of the anterior column with placement of interbody fusion cages is commonly employed in the treatment of instability-related degenerative disc disease that has been proven refractory in non-operative treatment. Interbody fusion cages aid in the containment of bone graft, promotion of more reliable fusion, and restoration of neuroforaminal height. The VariLift® Interbody Fusion System (VariLift® system) has been developed as a standalone solution to address subsidence and migration problems seen with traditional lumbar interbody fusion cages that require posterior supplemental transpedicular screw fixation for improved stability. This series of 24 consecutive patients describes patient selection criteria and the technical aspects of this novel endoscopic transforaminal lumbar interbody fusion technique in a step-by-step fashion. The transforaminal endoscopically assisted interbody fusion with the standalone expandable VariLift® system represents a simplified alternative to other pedicle screw-based spinal fusion.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"7 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000409","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70770098","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 : 2018-01-01DOI: 10.4172/2165-7939.s7-017
Ping Yen Yeo, Aravind Kumar
Objective: Dynamic radiographs are widely used to assess radiological spinal instability. The authors aim to compare the sensitivity of dynamic radiographs versus spontaneous reduction seen on magnetic resonance imaging when compared to a standing lateral radiograph in diagnosing instability. Materials and Methods: This study is a retrospective review of 75 patients from a single center with suspected clinical lumbar spinal instability presenting with back and/or leg pain and had undergone a magnetic resonance imaging of their lumbosacral spine as well as a lumbar radiograph series. The authors compared the criterion sensitivity (in accordance to Posner criteria) of dynamic radiographs versus magnetic resonance imaging. Pearson's chi-square test was used to determine statistical significance. Results: The Posner criteria was satisfied in 45/75 patients (60%) using dynamic radiographs as compared to 32/75 patients (42.6%) when using spontaneous reduction seen on magnetic resonance imaging. This was statistically significant (p<0.01). However, we noted that 29/45 (64.4%) patients with instability diagnosed on dynamic radiographs also had it diagnosed on spontaneous reduction. Conclusion: Posner criteria when applied to spontaneous reduction seen on magnetic resonance imaging has a specificity of 90% and positive predictive value of 90.63%, assuming that satisfaction of Posner criteria on dynamic radiographs indicates true instability. The authors advocate the use of Posner criteria applied to spontaneous reduction to assess for spinal instability. Failure to satisfy the Posner criteria on spontaneous reduction should then prompt the use of a more sensitive modality such as dynamic radiographs.
{"title":"Dynamic Radiographs Not Always Essential in Diagnosis of Lumbar Spinal Instability","authors":"Ping Yen Yeo, Aravind Kumar","doi":"10.4172/2165-7939.s7-017","DOIUrl":"https://doi.org/10.4172/2165-7939.s7-017","url":null,"abstract":"Objective: Dynamic radiographs are widely used to assess radiological spinal instability. The authors aim to compare the sensitivity of dynamic radiographs versus spontaneous reduction seen on magnetic resonance imaging when compared to a standing lateral radiograph in diagnosing instability. Materials and Methods: This study is a retrospective review of 75 patients from a single center with suspected clinical lumbar spinal instability presenting with back and/or leg pain and had undergone a magnetic resonance imaging of their lumbosacral spine as well as a lumbar radiograph series. The authors compared the criterion sensitivity (in accordance to Posner criteria) of dynamic radiographs versus magnetic resonance imaging. Pearson's chi-square test was used to determine statistical significance. Results: The Posner criteria was satisfied in 45/75 patients (60%) using dynamic radiographs as compared to 32/75 patients (42.6%) when using spontaneous reduction seen on magnetic resonance imaging. This was statistically significant (p<0.01). However, we noted that 29/45 (64.4%) patients with instability diagnosed on dynamic radiographs also had it diagnosed on spontaneous reduction. Conclusion: Posner criteria when applied to spontaneous reduction seen on magnetic resonance imaging has a specificity of 90% and positive predictive value of 90.63%, assuming that satisfaction of Posner criteria on dynamic radiographs indicates true instability. The authors advocate the use of Posner criteria applied to spontaneous reduction to assess for spinal instability. Failure to satisfy the Posner criteria on spontaneous reduction should then prompt the use of a more sensitive modality such as dynamic radiographs.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"01 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.s7-017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70775930","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 : 2018-01-01DOI: 10.4172/2165-7939.1000415
M. Siala, Daniel N’dele, F. Accadbled, J. S. Gauzy
The aim of surgical treatment of adolescent idiopathic scoliosis (AIS) is to achieve a balanced spine. Distal addingon is a postoperative phenomenon in AIS, which is characterized by a progressive correction loss. A 13-Year-old girl with AIS who underwent posterior arthrodesis showed aggravation of the disequilibrium under the last instrumented vertebra (LIV) 30 months post operatively and an increase of the lumbar curvature with no evident cause. Extension surgery was made and per operatively we noticed that the distal end of the arthrodesis was disengaged and that the left rod was conflicting with the upper left articular process of L2. Among the causes of adding-on we report in this article a particular etiology that consists in a conflict with the instrumentation material. This conflict has to be looked for postoperatively if an adding-on phenomenon is suspected in addition to a distally protruding rod, and could motivate a CT scan imaging for diagnosis.
{"title":"Post-Operative Adding-On in Adolescent Idiopathic Scoliosis, A Particular Etiology: Conflict Between the Upper Articular Process and the Instrumentation Material : A Case Report","authors":"M. Siala, Daniel N’dele, F. Accadbled, J. S. Gauzy","doi":"10.4172/2165-7939.1000415","DOIUrl":"https://doi.org/10.4172/2165-7939.1000415","url":null,"abstract":"The aim of surgical treatment of adolescent idiopathic scoliosis (AIS) is to achieve a balanced spine. Distal addingon is a postoperative phenomenon in AIS, which is characterized by a progressive correction loss. A 13-Year-old girl with AIS who underwent posterior arthrodesis showed aggravation of the disequilibrium under the last instrumented vertebra (LIV) 30 months post operatively and an increase of the lumbar curvature with no evident cause. Extension surgery was made and per operatively we noticed that the distal end of the arthrodesis was disengaged and that the left rod was conflicting with the upper left articular process of L2. Among the causes of adding-on we report in this article a particular etiology that consists in a conflict with the instrumentation material. This conflict has to be looked for postoperatively if an adding-on phenomenon is suspected in addition to a distally protruding rod, and could motivate a CT scan imaging for diagnosis.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"7 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000415","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70770184","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 : 2018-01-01DOI: 10.4172/2165-7939.1000416
F. Niknam, Nahid Davoodian, Dhuha Ali, Reza Vazifehmand, Tina Saber
Disequilibrium between bone resorption and bone formation may cause osteoporosis that reduces bone integrity and physiological function of skeletal system. Osteoblast and osteoclast genesis are two major of biological events that act in bone turnover and dynamic rate of bone remodeling. Ample evidences have been revealed that RANK-L/ OPG, Wnt and BMP Pathways are crucial pathways involved in osteoporosis. Treatment of osteoporosis is becoming important task in post menopause women and old people. Current treatment strategies with osteoporosis drugs are mainly by inhibiting the bone-resorbtion. However, these synthetic medicines have limitless side effects. Several studies have established the important of a group of small non-coding RNAs (MiRNAs) which involve in pathogenesis osteoporosis, bone remodeling, osteoblast differentiation and osteoclast formation and has consider as a gold biomarker for osteoporosis treatment. The pathogenicity factors of osteoporosis, pathways involved in the disease and potential replacement treatment have been emphasized in this paper.
{"title":"MicroRNA Based Therapy and Osteoporosis: A Review of a Novel Therapeutic Agent from Diagnosis to Treatment","authors":"F. Niknam, Nahid Davoodian, Dhuha Ali, Reza Vazifehmand, Tina Saber","doi":"10.4172/2165-7939.1000416","DOIUrl":"https://doi.org/10.4172/2165-7939.1000416","url":null,"abstract":"Disequilibrium between bone resorption and bone formation may cause osteoporosis that reduces bone integrity and physiological function of skeletal system. Osteoblast and osteoclast genesis are two major of biological events that act in bone turnover and dynamic rate of bone remodeling. Ample evidences have been revealed that RANK-L/ OPG, Wnt and BMP Pathways are crucial pathways involved in osteoporosis. Treatment of osteoporosis is becoming important task in post menopause women and old people. Current treatment strategies with osteoporosis drugs are mainly by inhibiting the bone-resorbtion. However, these synthetic medicines have limitless side effects. Several studies have established the important of a group of small non-coding RNAs (MiRNAs) which involve in pathogenesis osteoporosis, bone remodeling, osteoblast differentiation and osteoclast formation and has consider as a gold biomarker for osteoporosis treatment. The pathogenicity factors of osteoporosis, pathways involved in the disease and potential replacement treatment have been emphasized in this paper.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"7 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000416","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70770239","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 : 2018-01-01DOI: 10.4172/2165-7939.1000429
S. Jc, Hope Jmv, D. Souleymane, Kassé An, Diouf Jd, Ni An, B. Thiam, M. Diallo, Camara Ehs, M. HabibSy
Background: Spinal trauma is a well‑documented problem in developed countries but literature has been mute on this problem in developing counties. The purpose of this study was to elucidate epidemiological characteristics of spine trauma in our center over a 15-year period. Methods: All consecutive patients with acute spinal trauma who were admitted in our center from March 2003 to March 2018 were included. The analysis was focused on patient-related demographic characteristics, cause and mechanism of injury, level and type of injury, neurological deficit, associated injuries, management and outcome. All of the statistical calculations were performed using the Statistical Package for Social Sciences (SPSS). Statistical analyses were conducted using the Student t-test and nonparametric tests (Mann-Whitney U-test, Kruskal-Wallis test). Values for p<0.05 were regarded as statistically significant and all confidence intervals were expressed at 95%. Results: A total of 1,092 patients with acute traumatic spinal injuries were managed in our trauma center. There were 74.3% males and 25.7% females with mean age 34.5 years. Young adults (age group: 18-39 years) were more affected with 58.9%. The leading mechanism of injury was compression with 39.2%. The most common cause of accident was motor vehicle collision accident (58.5%) followed by high-energy falls (32.6%). Six hundred eighty-seven patients (62.8%) had spinal cord injury, with 14.4% complete tetraplegia and 7.7% complete paraplegia. Overall, the use of operative treatment (64.8%) exceeded that of conservative treatment (35.2%). Conclusion: This study’s unique feature of delineating variables with statistical significance trending toward better management provides useful data to guide future researches, benchmarking, public health policy, and efficient resource allocation for the management of spine trauma.
{"title":"Epidemiology of Traumatic Spinal Injury: A 15-Year Retrospective Study of 1092 Cases","authors":"S. Jc, Hope Jmv, D. Souleymane, Kassé An, Diouf Jd, Ni An, B. Thiam, M. Diallo, Camara Ehs, M. HabibSy","doi":"10.4172/2165-7939.1000429","DOIUrl":"https://doi.org/10.4172/2165-7939.1000429","url":null,"abstract":"Background: Spinal trauma is a well‑documented problem in developed countries but literature has been mute on this problem in developing counties. The purpose of this study was to elucidate epidemiological characteristics of spine trauma in our center over a 15-year period. Methods: All consecutive patients with acute spinal trauma who were admitted in our center from March 2003 to March 2018 were included. The analysis was focused on patient-related demographic characteristics, cause and mechanism of injury, level and type of injury, neurological deficit, associated injuries, management and outcome. All of the statistical calculations were performed using the Statistical Package for Social Sciences (SPSS). Statistical analyses were conducted using the Student t-test and nonparametric tests (Mann-Whitney U-test, Kruskal-Wallis test). Values for p<0.05 were regarded as statistically significant and all confidence intervals were expressed at 95%. Results: A total of 1,092 patients with acute traumatic spinal injuries were managed in our trauma center. There were 74.3% males and 25.7% females with mean age 34.5 years. Young adults (age group: 18-39 years) were more affected with 58.9%. The leading mechanism of injury was compression with 39.2%. The most common cause of accident was motor vehicle collision accident (58.5%) followed by high-energy falls (32.6%). Six hundred eighty-seven patients (62.8%) had spinal cord injury, with 14.4% complete tetraplegia and 7.7% complete paraplegia. Overall, the use of operative treatment (64.8%) exceeded that of conservative treatment (35.2%). Conclusion: This study’s unique feature of delineating variables with statistical significance trending toward better management provides useful data to guide future researches, benchmarking, public health policy, and efficient resource allocation for the management of spine trauma.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"07 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000429","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70771246","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 : 2018-01-01DOI: 10.4172/2165-7939.s7-011
Jian Shen
Traditional open and tubular approaches for treatment of central and lateral recess spinal stenosis involve laminotomy or laminectomy with removal of overgrown ligamentum flavum and a portion of the medial facet joints in order to decompress the central canal and lateral recess. Fully-endoscopic posterior lumbar laminectomy follows similar principle but is a more minimally invasive approach with unique advantages. This case presentation describes a step-by-step technique for fully-endoscopic lumbar laminectomy and its unique advantages to achieve bilateral decompression with unilateral approach and en bloc excision of a large dorsal ligmentum flavum cyst.
{"title":"Fully Endoscopic Lumbar Laminectomy for Treatment of Large Dorsal Ligamentum Flavum Cyst and Severe Spinal Stenosis: A Technical note on a Case Report","authors":"Jian Shen","doi":"10.4172/2165-7939.s7-011","DOIUrl":"https://doi.org/10.4172/2165-7939.s7-011","url":null,"abstract":"Traditional open and tubular approaches for treatment of central and lateral recess spinal stenosis involve laminotomy or laminectomy with removal of overgrown ligamentum flavum and a portion of the medial facet joints in order to decompress the central canal and lateral recess. Fully-endoscopic posterior lumbar laminectomy follows similar principle but is a more minimally invasive approach with unique advantages. This case presentation describes a step-by-step technique for fully-endoscopic lumbar laminectomy and its unique advantages to achieve bilateral decompression with unilateral approach and en bloc excision of a large dorsal ligmentum flavum cyst.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"01 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.s7-011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70776200","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 : 2018-01-01DOI: 10.4172/2165-7939.S7-015
Y. Hirano, K. Watanabe, S. Pawar, R. Bansil
Objective: Microsurgical discectomy is the gold standard treatment for the herniated nucleus pulposus (HNP) of the lumbar spine. On the other hand, less invasive procedures have been developed and accepted rapidly. Percutaneous endoscopic lumbar discectomy (PELD) was developed as one of the minimally invasive techniques for HNP of the lumbar spine, and satisfactory outcomes have been reported. For the contained type HNP or discogenic pain, however, surgical indication of PELD is sometimes controversial. We describe our experiences of surgical treatment with DiscFX, focusing on advantages of endoscopic observation. Patients and Methods: A total of 10 patients with contained type HNP were treated with Disc-FX system. DiscFX was carried out percutaneously under local anesthesia using a cannula of 3.4 mm diameter, with a trajectory compatible with the transforaminal approach of the PELD. Endoscope was introduced intermittently in 5 patients to observe the results of each procedure. Results: Sufficient pain relief was achieved in all patients, and Japanese Orthopedic Association score improved from 7-16 (mean 13.0) to 22-29 (mean 25.9), and visual analogue scale improved from 6-10 (mean 8.0) to 0-3 (mean 1.2). Endoscopic observation enabled the procedure almost equivalent to targeted fragmentectomy, and contributed in better surgical outcome. Conclusion: Disc-FX is a promising procedure in the armamentarium of minimally invasive surgery for the selected conditions of patients, and endoscopic observation is considered to be beneficial in more accurate and adequate decompression. Citation: Hirano Y, Pawar S, Bansil R, Watanabe K (2018) Advantages of Endoscope-Assisted Disc-FX in Surgical Management of Lumbar Disc Herniation: A Report of 10 Cases. J Spine 7: 015. doi: 10.0142/2165-7939.1000015
{"title":"Advantages of Endoscope-Assisted Disc-FX in Surgical Management of Lumbar Disc Herniation: A Report of 10 Cases","authors":"Y. Hirano, K. Watanabe, S. Pawar, R. Bansil","doi":"10.4172/2165-7939.S7-015","DOIUrl":"https://doi.org/10.4172/2165-7939.S7-015","url":null,"abstract":"Objective: Microsurgical discectomy is the gold standard treatment for the herniated nucleus pulposus (HNP) of the lumbar spine. On the other hand, less invasive procedures have been developed and accepted rapidly. Percutaneous endoscopic lumbar discectomy (PELD) was developed as one of the minimally invasive techniques for HNP of the lumbar spine, and satisfactory outcomes have been reported. For the contained type HNP or discogenic pain, however, surgical indication of PELD is sometimes controversial. We describe our experiences of surgical treatment with DiscFX, focusing on advantages of endoscopic observation. Patients and Methods: A total of 10 patients with contained type HNP were treated with Disc-FX system. DiscFX was carried out percutaneously under local anesthesia using a cannula of 3.4 mm diameter, with a trajectory compatible with the transforaminal approach of the PELD. Endoscope was introduced intermittently in 5 patients to observe the results of each procedure. Results: Sufficient pain relief was achieved in all patients, and Japanese Orthopedic Association score improved from 7-16 (mean 13.0) to 22-29 (mean 25.9), and visual analogue scale improved from 6-10 (mean 8.0) to 0-3 (mean 1.2). Endoscopic observation enabled the procedure almost equivalent to targeted fragmentectomy, and contributed in better surgical outcome. Conclusion: Disc-FX is a promising procedure in the armamentarium of minimally invasive surgery for the selected conditions of patients, and endoscopic observation is considered to be beneficial in more accurate and adequate decompression. Citation: Hirano Y, Pawar S, Bansil R, Watanabe K (2018) Advantages of Endoscope-Assisted Disc-FX in Surgical Management of Lumbar Disc Herniation: A Report of 10 Cases. J Spine 7: 015. doi: 10.0142/2165-7939.1000015","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"01 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.S7-015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70776278","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 : 2018-01-01DOI: 10.4172/2165-7939.s7-016
V. Yadav, Ravinder Yadav, James Wong
{"title":"The Effect of Spinal Arte Care (™) Manipulation Techniques in a Case of Adult Idiopathic Scoliosis","authors":"V. Yadav, Ravinder Yadav, James Wong","doi":"10.4172/2165-7939.s7-016","DOIUrl":"https://doi.org/10.4172/2165-7939.s7-016","url":null,"abstract":"","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"01 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.s7-016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70776314","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 : 2018-01-01DOI: 10.4172/2165-7939.1000408
A. Yeung
Endoscopic spine surgery is receiving intense interest as minimally invasive techniques, robotics and biologics are the latest focus in spine care that is embraced by a myriad of providers, all touting their area of expertise as the answer to treating painful conditions of the spine. All stakeholders agree that if non-surgical methods of treatment are effective, the natural adaptation of painful degenerative conditions will eventually be mitigated or resolved with some modification of work or activities of daily living that avoids aggravating the clinical condition or delays a rapid advancement to a painful condition. Each stakeholder in the treatment spectrum is touting, and marketing their areas of expertise, but few stakeholders work together in a truly multidisciplinary and cooperative agenda. Procedural or surgical interventions are easiest to market and to measure its efficacy and cost effectiveness. The cumulative cost of spinal care is, however, becoming less affordable as spinal care does not follow the economics of a free market since increased consumption and availability does not result in decreased cost as an economic model. There is a need for cooperation and a focus on the diagnosis and treatment of common painful conditions of an aging spine, starting with common back pain that affects tens of millions of patients. Back pain is one of the most costly and debilitating conditions universally affecting work productivity. In the United States and in industrialized countries, new procedures for back pain tend to “follow the money” aided by industry. In Asian and OUS countries, there is more acceptance of traditional non-surgical treatment from thousands of years of medical treatment history. New and non-traditional treatments based on evolving science, are being made readily available in the information highway by Open Access Journals where researchers can publish their Level V evidenced based concepts for interested parties and other scientists. Anthony T. Yeung’s work focuses on the surgical treatment of the pain generator in the lumbar spine. Patient selection is aided by using diagnostic and therapeutic injections, to identify the likelihood of surgical success when the pain source is targeted. This article focuses on the details of Yeung’s 27 years’ experience on identifying and treating the pain generators in the lumbar spine by an endoscope and combined with an endoscopic system that he has trademarked the Yeung Endoscopic Spine System (YESSTM).
内窥镜脊柱手术正受到人们的强烈兴趣，因为微创技术、机器人技术和生物制剂是脊柱护理的最新焦点，受到无数供应商的欢迎，他们都在兜售自己的专业领域，作为治疗脊柱疼痛状况的答案。所有利益相关者都同意，如果非手术治疗方法有效，疼痛的退行性疾病的自然适应最终将得到缓解或解决，通过对日常生活的工作或活动进行一些修改，避免加重临床病情或延缓迅速发展到疼痛状态。治疗领域的每个利益相关者都在吹捧和推销自己的专业领域，但很少有利益相关者在真正的多学科合作议程中共同努力。程序或外科干预是最容易市场化和衡量其疗效和成本效益。然而，脊柱护理的累积成本变得越来越难以负担，因为脊柱护理不遵循自由市场的经济学，因为作为一种经济模式，增加的消费和可用性并不会导致成本下降。有必要进行合作，并把重点放在诊断和治疗脊柱老化的常见疼痛上，从影响数千万患者的常见背痛开始。背痛是影响工作效率的最昂贵和最虚弱的疾病之一。在美国和工业化国家，治疗背痛的新方法往往是在工业的帮助下“跟着钱走”。在亚洲和美国，从几千年的医疗历史来看，传统的非手术治疗方式越来越被接受。基于不断发展的科学的新的和非传统的治疗方法，正在通过开放获取期刊在信息高速公路上随时可用，研究人员可以向感兴趣的各方和其他科学家发表他们的基于第五级证据的概念。Anthony T. Yeung的工作重点是腰椎疼痛源的手术治疗。通过使用诊断性和治疗性注射来辅助患者选择，以确定手术成功的可能性。本文重点介绍了杨氏27年来通过内窥镜识别和治疗腰椎疼痛源的经验，并结合了他已注册为Yeung内窥镜脊柱系统(YESSTM)的内窥镜系统。
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