Pub Date : 2016-12-26DOI: 10.4172/2325-9701.1000241
H. Chau, B. Krueger, S. Vadivelu
With interest, we read the article by Vadivelu and in this article, the authors performed a novel retrospective study of the relationship between time delay to presentation for medical treatment following non-accidental head trauma (NAHT) in pediatric patients with patient outcomes at discharge [1]. Categorizing time delay as 12 hours (severe delay), it was concluded that patients who presented to pediatric emergency departments after a moderate delay following NAHT were associated with the worst outcomes.
{"title":"Does Presentation Time Matter in Abusive Head Trauma","authors":"H. Chau, B. Krueger, S. Vadivelu","doi":"10.4172/2325-9701.1000241","DOIUrl":"https://doi.org/10.4172/2325-9701.1000241","url":null,"abstract":"With interest, we read the article by Vadivelu and in this article, \u0000the authors performed a novel retrospective study of the relationship \u0000between time delay to presentation for medical treatment following \u0000non-accidental head trauma (NAHT) in pediatric patients with \u0000patient outcomes at discharge [1]. Categorizing time delay as 12 hours \u0000(severe delay), it was concluded that patients who presented to \u0000pediatric emergency departments after a moderate delay following \u0000NAHT were associated with the worst outcomes.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2016 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2016-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70254311","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 : 2016-12-26DOI: 10.4172/2325-9701.1000251
F. Zhang, J. Xie, G. Wang, Y. Yang, H. Yang, W. Jiang
Nonunion of flexion-distraction thoracolumbar fractures has few been described previously. The case report discussed a case of nonunion of traumatic lumbar fracture. A 30-year-old man suffered a traumatic L1-2 flexion-distraction fracture and no paraplegia. After complete bed rest 2 months, then hyperextension thoracolumbar cast 3 months, he still felt back pain when out-of-bed activity. X-ray images demonstrated the fracture was not united. At last, the patient underwent open reduction of the fracture nonunion and L1-2 posterior fusion using short segmental pedicle screw instrumentation with autogenous iliac crest graft. The patient gained an excellent functional restoration at 5 months after operation. This suggests that the disease entity may require surgical treatment as early as possible. Spinal fusion combined instrumentation fixation and bone graft may be the best treatment.
{"title":"Nonunion of Traumatic Lumbar Fracture: Case Report","authors":"F. Zhang, J. Xie, G. Wang, Y. Yang, H. Yang, W. Jiang","doi":"10.4172/2325-9701.1000251","DOIUrl":"https://doi.org/10.4172/2325-9701.1000251","url":null,"abstract":"Nonunion of flexion-distraction thoracolumbar fractures has few \u0000been described previously. The case report discussed a case of \u0000nonunion of traumatic lumbar fracture. A 30-year-old man suffered \u0000a traumatic L1-2 flexion-distraction fracture and no paraplegia. After \u0000complete bed rest 2 months, then hyperextension thoracolumbar \u0000cast 3 months, he still felt back pain when out-of-bed activity. \u0000X-ray images demonstrated the fracture was not united. At last, \u0000the patient underwent open reduction of the fracture nonunion \u0000and L1-2 posterior fusion using short segmental pedicle screw \u0000instrumentation with autogenous iliac crest graft. The patient gained \u0000an excellent functional restoration at 5 months after operation. This \u0000suggests that the disease entity may require surgical treatment as \u0000early as possible. Spinal fusion combined instrumentation fixation \u0000and bone graft may be the best treatment.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"51 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70254799","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 : 2016-12-26DOI: 10.4172/2325-9701.1000244
Sit Kh, A. Zolal, G. Schackert, T. Juratli
Background: Spinal epidural abscess (SEA) is a rare but severe infection requiring prompt diagnosis and therapy. Its incidence yet doubled in the past decade probably due to aging population with risk factors and increasing number of spinal interventions. Objective: The optimal risk stratified management of the SEA patient remains a matter of debate. We present a comprehensive review of literature of the past 15 years and focus o management and outcome. Methods: A broad MeSH search for the terms “spinal” “epidural” “abscess” was performed, and papers were evaluated for demographic data, comorbidities, treatment, surgical technique and outcome. Results: The pooled results from studies showed a total of 1928 patients with SEA. The most common comorbidity was diabetes mellitus (27.02%) followed by i.v. substance abuse (19.55%), whereas 12.02% (n 129/1073) had a previous spinal surgery. Staphylococcus aureus (74.74%) is still the most common pathogen, including Methicillin-resistant staphylococcus aureus (MRSA) in 18.78% of the cases, reflecting a shift toward more virulent species. The surgical evacuation yielded a better outcome than medical treatment only (p
{"title":"Spinal Epidural Abscess: A comprehensive Review and an Update Focusing on Outcomeand Management","authors":"Sit Kh, A. Zolal, G. Schackert, T. Juratli","doi":"10.4172/2325-9701.1000244","DOIUrl":"https://doi.org/10.4172/2325-9701.1000244","url":null,"abstract":"Background: Spinal epidural abscess (SEA) is a rare but severe \u0000infection requiring prompt diagnosis and therapy. Its incidence yet \u0000doubled in the past decade probably due to aging population with \u0000risk factors and increasing number of spinal interventions. \u0000Objective: The optimal risk stratified management of the SEA \u0000patient remains a matter of debate. We present a comprehensive \u0000review of literature of the past 15 years and focus o management \u0000and outcome. \u0000Methods: A broad MeSH search for the terms “spinal” “epidural” \u0000“abscess” was performed, and papers were evaluated for \u0000demographic data, comorbidities, treatment, surgical technique \u0000and outcome. \u0000Results: The pooled results from studies showed a total of \u00001928 patients with SEA. The most common comorbidity was \u0000diabetes mellitus (27.02%) followed by i.v. substance abuse \u0000(19.55%), whereas 12.02% (n 129/1073) had a previous spinal \u0000surgery. Staphylococcus aureus (74.74%) is still the most \u0000common pathogen, including Methicillin-resistant staphylococcus \u0000aureus (MRSA) in 18.78% of the cases, reflecting a shift toward \u0000more virulent species. The surgical evacuation yielded a better \u0000outcome than medical treatment only (p","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2016 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2016-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70254927","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 : 2016-12-26DOI: 10.4172/2325-9701.1000243
de Ruiter Gcw, D. Holl, er Phc
Ulnar nerve injury is a rare complication following fracture of the distal radius. Dislocation of the nerve due to additional disruption of the distal radio-ulnar joint (DRUJ) occurs even less frequently with only a number of cases reported in the literature. In this article we present a unique case of dislocation of the ulnar nerve following distal radius fracture with dislocation of the ulnar nerve through the DRUJ and rotation around the ulna. Surgical repositioning of the ulnar nerve in this case resulted in nearly complete recovery of nerve function. In addition to its rareness, this case shows the importance of careful neurologic examination in distal radius fractures and the need for early explorative surgery or advanced imaging in cases with combined DRUJ dislocation and suspected ulnar nerve injury.
{"title":"Ulnar Nerve Palsy with Dislocation of the Nerve around the Ulna Following a Fracture of the Distal Radius","authors":"de Ruiter Gcw, D. Holl, er Phc","doi":"10.4172/2325-9701.1000243","DOIUrl":"https://doi.org/10.4172/2325-9701.1000243","url":null,"abstract":"Ulnar nerve injury is a rare complication following fracture of the \u0000distal radius. Dislocation of the nerve due to additional disruption of \u0000the distal radio-ulnar joint (DRUJ) occurs even less frequently with \u0000only a number of cases reported in the literature. \u0000In this article we present a unique case of dislocation of the ulnar \u0000nerve following distal radius fracture with dislocation of the ulnar \u0000nerve through the DRUJ and rotation around the ulna. Surgical \u0000repositioning of the ulnar nerve in this case resulted in nearly \u0000complete recovery of nerve function. \u0000In addition to its rareness, this case shows the importance of \u0000careful neurologic examination in distal radius fractures and the \u0000need for early explorative surgery or advanced imaging in cases \u0000with combined DRUJ dislocation and suspected ulnar nerve injury.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2016 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70254917","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 : 2016-12-26DOI: 10.4172/2325-9701.1000245
M. A. Sonmez, Y. Alpay, M. Karademir, O. Eser
A 29-year-old female presented with a brain abscess with subdural empyema in the left parafalcine region caused by Finegoldia magna. There was a partial clinical response to surgery and antibiotic therapy. An acute enfarctus developed after abscess drainage surgery in occipital lobe. We think that infarction developed due to transtentorial herniation and with the mass effect of brain abscess. F magna may be detected in many cases like soft tissue infections, septic arthritis, osteomyelitis, endocarditis and necrotizing pneumonia. Actually this is the first report of brain abscess in which F magna was found upon bacterial culture.
{"title":"Finegoldia magna Causing Brain Abscess with Subdural Empyema: Case Report","authors":"M. A. Sonmez, Y. Alpay, M. Karademir, O. Eser","doi":"10.4172/2325-9701.1000245","DOIUrl":"https://doi.org/10.4172/2325-9701.1000245","url":null,"abstract":"A 29-year-old female presented with a brain abscess with \u0000subdural empyema in the left parafalcine region caused by \u0000Finegoldia magna. There was a partial clinical response to \u0000surgery and antibiotic therapy. An acute enfarctus developed \u0000after abscess drainage surgery in occipital lobe. We think that \u0000infarction developed due to transtentorial herniation and with \u0000the mass effect of brain abscess. F magna may be detected in \u0000many cases like soft tissue infections, septic arthritis, \u0000osteomyelitis, endocarditis and necrotizing pneumonia. Actually \u0000this is the first report of brain abscess in which F magna was \u0000found upon bacterial culture.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"69 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2016-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70254988","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 : 2016-12-26DOI: 10.4172/2325-9701.1000248
Chen My, T. Fuji, B. Cheung, Graf Mr, Holt Se, Clark Aj, A. Chidambaram, J. Lin, R. IaL, Broaddus Wc
Object: Glioblastomas are difficult tumors to eradicate because of resistance to apoptosis and other mechanisms of programmed cell death such as autophagy. We hypothesized that DNA damage, regardless of etiology, would cause autophagy. To test our hypothesis, we examined the ability of two DNA damaging agents, 1, 3-Bis (2-chloroethyl)-1-nitrosourea (BCNU) and cisplatin, to induce autophagy. Materials and methods: DNA damage was assessed by western blot for γ-H2AX and immunofluorescence for phospho-53BP1. Autophagy was measured by microtubule-associated protein 1 light chain (LC3) and beclin 1 western blots, acridine orange staining, response to the 3-MA inhibitor, and autophagosome detection using electron microscopy. To study apoptosis, we examined levels of BAX and BAK, TUNEL staining, inhibition with ZVAD.fmk and caspase 3/7 activation. Results: The levels of the DNA damage indicators γ-H2AX and 53BP1 increased with both BCNU and cisplatin. While LC3-II autophagy proteins were highly expressed in BCNU samples, LC3-II levels were below the limits of detection in cells treated with cisplatin. Caspase 3/7 activation only slightly increased with BCNU, but markedly increased with cisplatin. Surprisingly, BAX and BAK levels did not change in response to either chemotherapeutic compound. Significant TUNEL staining was evident in cisplatin, but not BCNU-treated cells, and the pancaspase inhibitor, ZVAD.fmk, did not diminish cell death after BCNU treatment. Conclusion: Although both drugs caused DNA damage, we concluded not all DNA damage results in a specific type of cell death, as BCNU-related cell death in glioblastomas occurs through autophagy and cisplatin predominantly induces apoptosis. The specific molecular mechanisms underlying the activation of autophagy remain obscure.
目的:胶质母细胞瘤对细胞凋亡及细胞自噬等程序性死亡机制具有抵抗性，是一种难以根治的肿瘤。我们假设DNA损伤，无论病因如何，都会引起自噬。为了验证我们的假设，我们检测了两种DNA损伤剂1,3 -双(2-氯乙基)-1-亚硝基脲(BCNU)和顺铂诱导自噬的能力。材料和方法:采用western blot法检测γ-H2AX和免疫荧光法检测phospho-53BP1的DNA损伤。通过微管相关蛋白1轻链(LC3)和beclin 1 western blots、吖啶橙染色、对3-MA抑制剂的反应和电镜检测自噬体来检测自噬。为了研究细胞凋亡，我们检测了BAX和BAK的水平、TUNEL染色和ZVAD的抑制作用。FMK和caspase 3/7活化。结果:BCNU和顺铂组DNA损伤指标γ-H2AX、53BP1水平均升高。虽然LC3-II自噬蛋白在BCNU样品中高表达，但在顺铂处理的细胞中LC3-II水平低于检测限。Caspase 3/7激活在BCNU组仅轻微增加，而在顺铂组明显增加。令人惊讶的是，BAX和BAK水平在两种化疗药物的作用下都没有改变。明显的TUNEL染色在顺铂中很明显，但在bcnu处理的细胞和pancaspase抑制剂ZVAD中没有。fmk并没有减少BCNU治疗后的细胞死亡。结论:虽然这两种药物都引起DNA损伤，但我们得出结论，并非所有DNA损伤都导致特定类型的细胞死亡，因为胶质母细胞瘤中bcnu相关的细胞死亡是通过自噬发生的，而顺铂主要诱导细胞凋亡。自噬激活的具体分子机制尚不清楚。
{"title":"Differential Cell Death Effects in Glioblastoma after Drug- Induced DNA DamageLaboratory Investigation","authors":"Chen My, T. Fuji, B. Cheung, Graf Mr, Holt Se, Clark Aj, A. Chidambaram, J. Lin, R. IaL, Broaddus Wc","doi":"10.4172/2325-9701.1000248","DOIUrl":"https://doi.org/10.4172/2325-9701.1000248","url":null,"abstract":"Object: Glioblastomas are difficult tumors to eradicate because \u0000of resistance to apoptosis and other mechanisms of programmed \u0000cell death such as autophagy. We hypothesized that DNA damage, \u0000regardless of etiology, would cause autophagy. To test our \u0000hypothesis, we examined the ability of two DNA damaging agents, \u00001, 3-Bis (2-chloroethyl)-1-nitrosourea (BCNU) and cisplatin, to \u0000induce autophagy. \u0000Materials and methods: DNA damage was assessed by western \u0000blot for γ-H2AX and immunofluorescence for phospho-53BP1. \u0000Autophagy was measured by microtubule-associated protein 1 light \u0000chain (LC3) and beclin 1 western blots, acridine orange staining, \u0000response to the 3-MA inhibitor, and autophagosome detection \u0000using electron microscopy. To study apoptosis, we examined levels \u0000of BAX and BAK, TUNEL staining, inhibition with ZVAD.fmk and \u0000caspase 3/7 activation. \u0000Results: The levels of the DNA damage indicators γ-H2AX and \u000053BP1 increased with both BCNU and cisplatin. While LC3-II \u0000autophagy proteins were highly expressed in BCNU samples, \u0000LC3-II levels were below the limits of detection in cells treated \u0000with cisplatin. Caspase 3/7 activation only slightly increased \u0000with BCNU, but markedly increased with cisplatin. Surprisingly, \u0000BAX and BAK levels did not change in response to either \u0000chemotherapeutic compound. Significant TUNEL staining was \u0000evident in cisplatin, but not BCNU-treated cells, and the pancaspase \u0000inhibitor, ZVAD.fmk, did not diminish cell death after \u0000BCNU treatment. \u0000Conclusion: Although both drugs caused DNA damage, we \u0000concluded not all DNA damage results in a specific type of cell \u0000death, as BCNU-related cell death in glioblastomas occurs \u0000through autophagy and cisplatin predominantly induces apoptosis. \u0000The specific molecular mechanisms underlying the activation of \u0000autophagy remain obscure.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2016 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2016-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70255069","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 : 2016-12-08DOI: 10.4172/2325-9701.1000232
I. Lotfinia, Payman Vahedi, M. Shakeri, A. Mahdkhah
Background: Osteochondroma, known as exostosis, are the most common benign tumors of the bone that usually occur in the long bones. It is a rarity in the spine. When present in the spine, however, they have a predilection for the cervical region. They occur in two forms as solitary and hereditary multiple forms. Case Description: The authors describe a case of spinal cord compression due to a solitary osteochondroma arising from the T-8 vertebral facet. This 52-year-old female presented with spastic paraparesis. We also review the literature and discuss thoracic spine reported solitary osteochondroma. Conclusion: Thoracic spine osteochondromas can cause neurological symptom. Based on the presented case and literature review, the authors concludethat osteochondromas of the thoracic spine that cause myelopathy usually arise from the vertebral body and pedicle. Prompt and systematic radiological investigations are important in planning surgical management. Surgical excision usually yields good results. Keywords Osteochondroma; Spinal cord compression; Thoracic spine
{"title":"Thoracic Solitary Osteochondroma with Spinal Cord Compression: Reportof a Case and Review of the Literature","authors":"I. Lotfinia, Payman Vahedi, M. Shakeri, A. Mahdkhah","doi":"10.4172/2325-9701.1000232","DOIUrl":"https://doi.org/10.4172/2325-9701.1000232","url":null,"abstract":"Background: Osteochondroma, known as exostosis, are the most common benign tumors of the bone that usually occur in the long bones. It is a rarity in the spine. When present in the spine, however, they have a predilection for the cervical region. They occur in two forms as solitary and hereditary multiple forms. Case Description: The authors describe a case of spinal cord compression due to a solitary osteochondroma arising from the T-8 vertebral facet. This 52-year-old female presented with spastic paraparesis. We also review the literature and discuss thoracic spine reported solitary osteochondroma. Conclusion: Thoracic spine osteochondromas can cause neurological symptom. Based on the presented case and literature review, the authors concludethat osteochondromas of the thoracic spine that cause myelopathy usually arise from the vertebral body and pedicle. Prompt and systematic radiological investigations are important in planning surgical management. Surgical excision usually yields good results. Keywords Osteochondroma; Spinal cord compression; Thoracic spine","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2016 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2016-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70254449","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 : 2016-12-08DOI: 10.4172/2325-9701.1000234
M. Sassi, Lavanga, A. Spada, Pascale, P. Boria, W. Pascale
Objectives: To assess the no inferiority of K2M Mesa Small Stature versus K2M Mesa System for degenerative lumbar spondylolisthesis (DS). To assess pros and cons of K2M Mesa Small Stature System vs K2M Mesa System to treat degenerative lumbar spondylolisthesis. To assess evolutions of symptoms after surgery using a lower profile screws and rods system for lumbar arthrodesis generally adopted in pediatric patients. Methods: Seventy-one (71) patients were evaluated during a 24 months follow-up period. Oswestry Disability Index (ODI) plus Economic and Functional PROLO grades and VAS scores were obtained using a webbased questionnaire. We investigated ODI plus Economic and Functional PROLO grades and VAS scores on a series of patients treated surgically for degenerative lumbar spondylolisthesis with a 24 months follow-up. 40 patients were treated with K2M Mesa Small Stature System and 31 patients with K2M Mesa System. All surgical operation were performed by the same surgeon (SM) using CT based computer assisted surgical navigation. No statistical difference was noticed among the two groups. K2M Mesa Small Stature System is lower in profile and size than standard Mesa system. Nevertheless it provided comparable follow-up results to K2M Mesa. Results: Variables studied at 6, 12 and 24 months were similar among two groups (p>0,05). Conclusions: Lower profile, lower invasivity Mesa Small Stature System demonstrated safe and reliable for degenerative lumbar spine disease
{"title":"K2M Mesa versus Small Stature Systems in Degenerative Lumbar Spondylolisthesis: A Noninferiority, Two Years Followup Trial","authors":"M. Sassi, Lavanga, A. Spada, Pascale, P. Boria, W. Pascale","doi":"10.4172/2325-9701.1000234","DOIUrl":"https://doi.org/10.4172/2325-9701.1000234","url":null,"abstract":"Objectives: To assess the no inferiority of K2M Mesa Small Stature versus K2M Mesa System for degenerative lumbar spondylolisthesis (DS). To assess pros and cons of K2M Mesa Small Stature System vs K2M Mesa System to treat degenerative lumbar spondylolisthesis. To assess evolutions of symptoms after surgery using a lower profile screws and rods system for lumbar arthrodesis generally adopted in pediatric patients. Methods: Seventy-one (71) patients were evaluated during a 24 months follow-up period. Oswestry Disability Index (ODI) plus Economic and Functional PROLO grades and VAS scores were obtained using a webbased questionnaire. We investigated ODI plus Economic and Functional PROLO grades and VAS scores on a series of patients treated surgically for degenerative lumbar spondylolisthesis with a 24 months follow-up. 40 patients were treated with K2M Mesa Small Stature System and 31 patients with K2M Mesa System. All surgical operation were performed by the same surgeon (SM) using CT based computer assisted surgical navigation. No statistical difference was noticed among the two groups. K2M Mesa Small Stature System is lower in profile and size than standard Mesa system. Nevertheless it provided comparable follow-up results to K2M Mesa. Results: Variables studied at 6, 12 and 24 months were similar among two groups (p>0,05). Conclusions: Lower profile, lower invasivity Mesa Small Stature System demonstrated safe and reliable for degenerative lumbar spine disease","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2016 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70254497","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 : 2016-12-08DOI: 10.4172/2325-9701.1000228
D. Dixon, Lewis Me, A. Caputo, B. Darden
Background: Adjacent segment degeneration (ASD) occurs after anterior cervical discectomy and fusion (ACDF) at a rate of 2.9% per level per year. Cervical disc arthroplasty was developed to theoretically reduce the transfer of forces onto adjacent levels while allowing motion at adjacent sites. We present a review of the biomechanics of cervical disc arthroplasty. Methods: A systematic review of the literature was performed by three junior authors regarding the biomechanics and/or the alteration of the biomechanics following a cervical disc arthroplasty. PubMed and Medline databases were used. Keywords for search results utilized included; cervical disc arthroplasty, adjacent segment disease, cervical disc biomechanics, cervical arthroplasty biomechanics. Level IV evidence or higher was utilized for the purposes of this review. Both articles of historical interest on the subject and articles of recent publication were included in the analysis. Articles included in the analysis were published from 1965 to present. 70% of the 50 articles were chosen for inclusion in the analysis. The reviewers consisted of one experienced fellowship trained orthopedic spine surgeon, one junior fellowship trained orthopedic spine surgeon, one current spine surgery fellow, and one current orthopedic surgery resident. Exclusions were left at the discretion of the senior author. Results: Biomechanics studies suggest that cervical disc arthroplasty more accurately mimics normal range of motion (ROM) and kinematics at the native vertebral functional unit. Some studies suggest that this will delay adjacent segment disease but this has not yet been proven in long term followup. In terms of patient outcomes, early results of cervical disc arthroplasty are at minimum non inferior to ACDF. Emerging evidence suggest higher patient reported outcome scores with CDA. Conclusions: The literature reviewed in this review suggests that cervical disc arthroplasty more accurately mimics native kinematics and ROM at the functional spine unit. CDA is at least non inferior to anterior cervical discectomy and fusion and may in fact be superior to ACDF in recent patient centered outcome studies. Long term studies are ongoing and will help elucidate whether CDA reduces adjacent segment disease and results in lower rates of revision surgeries.
{"title":"A Review of Cervical Disc Arthroplasty Biomechanics","authors":"D. Dixon, Lewis Me, A. Caputo, B. Darden","doi":"10.4172/2325-9701.1000228","DOIUrl":"https://doi.org/10.4172/2325-9701.1000228","url":null,"abstract":"Background: Adjacent segment degeneration (ASD) occurs after anterior cervical discectomy and fusion (ACDF) at a rate of 2.9% per level per year. Cervical disc arthroplasty was developed to theoretically reduce the transfer of forces onto adjacent levels while allowing motion at adjacent sites. We present a review of the biomechanics of cervical disc arthroplasty. Methods: A systematic review of the literature was performed by three junior authors regarding the biomechanics and/or the alteration of the biomechanics following a cervical disc arthroplasty. PubMed and Medline databases were used. Keywords for search results utilized included; cervical disc arthroplasty, adjacent segment disease, cervical disc biomechanics, cervical arthroplasty biomechanics. Level IV evidence or higher was utilized for the purposes of this review. Both articles of historical interest on the subject and articles of recent publication were included in the analysis. Articles included in the analysis were published from 1965 to present. 70% of the 50 articles were chosen for inclusion in the analysis. The reviewers consisted of one experienced fellowship trained orthopedic spine surgeon, one junior fellowship trained orthopedic spine surgeon, one current spine surgery fellow, and one current orthopedic surgery resident. Exclusions were left at the discretion of the senior author. Results: Biomechanics studies suggest that cervical disc arthroplasty more accurately mimics normal range of motion (ROM) and kinematics at the native vertebral functional unit. Some studies suggest that this will delay adjacent segment disease but this has not yet been proven in long term followup. In terms of patient outcomes, early results of cervical disc arthroplasty are at minimum non inferior to ACDF. Emerging evidence suggest higher patient reported outcome scores with CDA. Conclusions: The literature reviewed in this review suggests that cervical disc arthroplasty more accurately mimics native kinematics and ROM at the functional spine unit. CDA is at least non inferior to anterior cervical discectomy and fusion and may in fact be superior to ACDF in recent patient centered outcome studies. Long term studies are ongoing and will help elucidate whether CDA reduces adjacent segment disease and results in lower rates of revision surgeries.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2016 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2016-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70254412","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 : 2016-12-08DOI: 10.4172/2325-9701.1000231
M. Bruder, S. Theuss, Seifert, G. Marquardt
We present the case of a 57-year-old female with sciatica, paresis and paresthesia of the left leg. MRI obviously revealed an enlarged L3 nerve root with circumjacent gadolinium enhancement. Due to these findings a schwannoma was suspected. Operation was performed using a lateral approach. However, no nerve sheath tumor was encountered intraoperatively but a far lateral disc herniation exerting considerable pressure on the nerve root. Histopathological examination confirmed this diagnosis, and surgical resection resulted in complete relief. According to these findings, far lateral disc herniation should be considered as a differential diagnosis in case of an enlarged nerve root with marginal gadolinium enhancement.
{"title":"Far Lateral Disc Herniation Imitating Nerve Sheath Tumor: Case Report","authors":"M. Bruder, S. Theuss, Seifert, G. Marquardt","doi":"10.4172/2325-9701.1000231","DOIUrl":"https://doi.org/10.4172/2325-9701.1000231","url":null,"abstract":"We present the case of a 57-year-old female with sciatica, paresis and paresthesia of the left leg. MRI obviously revealed an enlarged L3 nerve root with circumjacent gadolinium enhancement. Due to these findings a schwannoma was suspected. Operation was performed using a lateral approach. However, no nerve sheath tumor was encountered intraoperatively but a far lateral disc herniation exerting considerable pressure on the nerve root. Histopathological examination confirmed this diagnosis, and surgical resection resulted in complete relief. According to these findings, far lateral disc herniation should be considered as a differential diagnosis in case of an enlarged nerve root with marginal gadolinium enhancement.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2016 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2016-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70254441","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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