Pub Date : 2018-11-13DOI: 10.4172/2325-9701.1000306
Sukru Oral, Atilla Yılmaz, A. Küçük, H. Ulutabanca, A. Selçuklu
Objective: In this study, patients with thoracolumbar and lumbar fracture fractures were treated with preservation of the paravertebral muscles, unfused posterior short-segment pedicle instrumentation technique. Methods: Between the years 2009-2015, 24 patients were applied short-segment posterior instrumentation surgery for thoracolumbar and lumbar compression fractures in our clinic included in the study. On radiological evaluation, loss of height in spinal anterior corpus (LHSAC) and local angle of kyphosis (LAK) were used. In the operation, the thoracolumbar fascia opened linearly, fascia was excised laterally and finger-dislocated between the multifidus and longissimus muscles. The transversal processes of vertebrates and manufactured objects were found. The transpedicular screws were placed with the C-arm. Results: The mean local angle of kyphosis measured preoperatively was 11.03 degrees and this angle 7.24 degrees at the end of the first year. Before the operation, loss of height in the spinal anterior corpus (LHSAC) was determined as 27.21% on average. At the end of the 1st year, the mean LHSAC was measured as 22.83%. Mean duration of the operation was 103.75 min and mean blood loss was 123.12 ml. Conclusion: In this surgical procedure, preservation of the paravertebral muscles contributes to vertebral column stabilization in cases of short segment instrumentation. For this reason, short segment instrumentation in thoracic and lumbar locations provides a significant kyphotic improvement in patients with compression fractures.
{"title":"Protection of Paravertebral Muscles and Short Segment Stabilization in Surgical Treatment of Thoracic and Lumbar Compression Fractures","authors":"Sukru Oral, Atilla Yılmaz, A. Küçük, H. Ulutabanca, A. Selçuklu","doi":"10.4172/2325-9701.1000306","DOIUrl":"https://doi.org/10.4172/2325-9701.1000306","url":null,"abstract":"Objective: In this study, patients with thoracolumbar and lumbar fracture fractures were treated with preservation of the paravertebral muscles, unfused posterior short-segment pedicle instrumentation technique. Methods: Between the years 2009-2015, 24 patients were applied short-segment posterior instrumentation surgery for thoracolumbar and lumbar compression fractures in our clinic included in the study. On radiological evaluation, loss of height in spinal anterior corpus (LHSAC) and local angle of kyphosis (LAK) were used. In the operation, the thoracolumbar fascia opened linearly, fascia was excised laterally and finger-dislocated between the multifidus and longissimus muscles. The transversal processes of vertebrates and manufactured objects were found. The transpedicular screws were placed with the C-arm. Results: The mean local angle of kyphosis measured preoperatively was 11.03 degrees and this angle 7.24 degrees at the end of the first year. Before the operation, loss of height in the spinal anterior corpus (LHSAC) was determined as 27.21% on average. At the end of the 1st year, the mean LHSAC was measured as 22.83%. Mean duration of the operation was 103.75 min and mean blood loss was 123.12 ml. Conclusion: In this surgical procedure, preservation of the paravertebral muscles contributes to vertebral column stabilization in cases of short segment instrumentation. For this reason, short segment instrumentation in thoracic and lumbar locations provides a significant kyphotic improvement in patients with compression fractures.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46729499","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 : 2018-08-27DOI: 10.4172/2325-9701.1000301
M. Stephens, A. Sarayusa, Z. Mortensen, L. Nagy, G. Racz
Radiculopathy can occur in a variety of patients ranging from complications of obesity to sports injuries to a combination of repetitive stress movements with post- traumatic disc disorder. In the case of three teenage patients, each of these causes contributed to their pain that led them to present in Emergency Departments, Family Medicine clinics, and eventual referral to Pediatric Neurosurgery. Various approaches were administered to help with the pain of these teenagers that included local steroid injection and chiropractic adjustments that ultimately contributed to no lasting pain relief. Each patient was considered to have chronic lower back pain and deemed a candidate to receive an innovative treatment option to help manage the back pain. The patients were all referred to receive epidural lysis of adhesions (LOA) which provided the lasting relief of the pain that the patients were seeking. LOA is a procedure that includes using a needle, Racz catheter, and injectable contrast guided with fluoroscopy to locate the appropriate spinal level of the radiculopathy and associated scarred entrapment of nerves. LOA utilizes the injection of hyaluronidase dissolved in normal saline to free the entrapped nerve so that a local anesthetic/steroid solution can be injected to block sensory signals and provide pain relief.
{"title":"Innovative Treatment For Chronic Lumbar Back Pain","authors":"M. Stephens, A. Sarayusa, Z. Mortensen, L. Nagy, G. Racz","doi":"10.4172/2325-9701.1000301","DOIUrl":"https://doi.org/10.4172/2325-9701.1000301","url":null,"abstract":"Radiculopathy can occur in a variety of patients ranging from complications of obesity to sports injuries to a combination of repetitive stress movements with post- traumatic disc disorder. In the case of three teenage patients, each of these causes contributed to their pain that led them to present in Emergency Departments, Family Medicine clinics, and eventual referral to Pediatric Neurosurgery. Various approaches were administered to help with the pain of these teenagers that included local steroid injection and chiropractic adjustments that ultimately contributed to no lasting pain relief. Each patient was considered to have chronic lower back pain and deemed a candidate to receive an innovative treatment option to help manage the back pain. The patients were all referred to receive epidural lysis of adhesions (LOA) which provided the lasting relief of the pain that the patients were seeking. LOA is a procedure that includes using a needle, Racz catheter, and injectable contrast guided with fluoroscopy to locate the appropriate spinal level of the radiculopathy and associated scarred entrapment of nerves. LOA utilizes the injection of hyaluronidase dissolved in normal saline to free the entrapped nerve so that a local anesthetic/steroid solution can be injected to block sensory signals and provide pain relief.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47308881","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 : 2018-08-27DOI: 10.4172/2325-9701.1000303
R. G. Jacobson
It is difficult to deny that Adolescent Idiopathic Scoliosis (AIS) has a major impact on the lives of those who are affected by this condition. AIS are defined as the lateral curvature of the spine that occurs in adolescence without an apparent cause. This condition affects the population substantially, as it is evident in as many as four out of one-hundred adolescents, but the majority of cases are minor, so they do not require treatment because the spine straightens itself with growth. Additionally, this condition is more common in females than males, which is why this paper focuses on females. AIS can impact a person in numerous aspects of daily life-ranging from sleep to physical activity-which highlights the importance for attention paid to AIS patients.
{"title":"The Impact of Adolescent Idiopathic Scoliosis on the Emotional Body Image of High School Girls","authors":"R. G. Jacobson","doi":"10.4172/2325-9701.1000303","DOIUrl":"https://doi.org/10.4172/2325-9701.1000303","url":null,"abstract":"It is difficult to deny that Adolescent Idiopathic Scoliosis (AIS) has a major impact on the lives of those who are affected by this condition. AIS are defined as the lateral curvature of the spine that occurs in adolescence without an apparent cause. This condition affects the population substantially, as it is evident in as many as four out of one-hundred adolescents, but the majority of cases are minor, so they do not require treatment because the spine straightens itself with growth. Additionally, this condition is more common in females than males, which is why this paper focuses on females. AIS can impact a person in numerous aspects of daily life-ranging from sleep to physical activity-which highlights the importance for attention paid to AIS patients.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"7 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2018-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49621682","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 : 2018-07-04DOI: 10.4172/2325-9701.1000294
A. Rahimizadeh
Craniocerebral injuries due to relatively sharp and unusual objects are rare. Nearly most of such cases occur within the pediatric population. A majority of these injuries involve the objects entering the cranium via thin orbital roof. Herein the authors describe a 3-year-old child with the retained tip of a ballpoint pen and a broken part of its crystal barrel which had entered the cranium via the right orbital roof. Surgical intervention, with right frontal craniotomy by removal of the corresponding foreign bodies, debridement of the path and dual repair results in full recovery of the patient.
{"title":"Orbitocranial Injury by a Ballpoint Pen in a Child: A Case Report","authors":"A. Rahimizadeh","doi":"10.4172/2325-9701.1000294","DOIUrl":"https://doi.org/10.4172/2325-9701.1000294","url":null,"abstract":"Craniocerebral injuries due to relatively sharp and unusual objects are rare. Nearly most of such cases occur within the pediatric population. A majority of these injuries involve the objects entering the cranium via thin orbital roof. Herein the authors describe a 3-year-old child with the retained tip of a ballpoint pen and a broken part of its crystal barrel which had entered the cranium via the right orbital roof. Surgical intervention, with right frontal craniotomy by removal of the corresponding foreign bodies, debridement of the path and dual repair results in full recovery of the patient.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2018 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42658480","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 : 2018-06-29DOI: 10.4172/2325-9701.1000296
J. Yazdi
CSF leak is one of the most common complications in primary spine surgery. It is even more common in revision surgery. Its causes are multifactorial. It is usually a benign process, but at times it can lead to nerve injury. There have been a number of case reports regarding diagnosis and treatment of spinal nerve injuries due to incidental durotomies. However, they involve either single nerve root or ipsilateral nerves of the cauda equina that were trapped in the durotomy. We present a case of a morbidly obese patient who underwent discectomy for recurrent lumbar disc herniation. During the revision surgery, we encountered a small incidental durotomy through which a significant number of nerve roots exited and as a result were injured. This resulted in bilateral nerve dysfunction, which is a unique aspect of our case presentation. We will discuss the anatomical and pathophysiological bases for this injury. We will also review the literature regarding outcomes after incidental durotomies in regard to spinal nerve injuries.
{"title":"Multiple Nerve Root Injuries after Incidental Durotomy: Case Report with Anatomical Correlation and Review of Literature","authors":"J. Yazdi","doi":"10.4172/2325-9701.1000296","DOIUrl":"https://doi.org/10.4172/2325-9701.1000296","url":null,"abstract":"CSF leak is one of the most common complications in primary spine surgery. It is even more common in revision surgery. Its causes are multifactorial. It is usually a benign process, but at times it can lead to nerve injury. There have been a number of case reports regarding diagnosis and treatment of spinal nerve injuries due to incidental durotomies. However, they involve either single nerve root or ipsilateral nerves of the cauda equina that were trapped in the durotomy. We present a case of a morbidly obese patient who underwent discectomy for recurrent lumbar disc herniation. During the revision surgery, we encountered a small incidental durotomy through which a significant number of nerve roots exited and as a result were injured. This resulted in bilateral nerve dysfunction, which is a unique aspect of our case presentation. We will discuss the anatomical and pathophysiological bases for this injury. We will also review the literature regarding outcomes after incidental durotomies in regard to spinal nerve injuries.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2018 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41352270","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 : 2018-06-29DOI: 10.4172/2325-9701.1000295
J. KennethBurkus
Background: Recently, porous surface polyether-etherketone (PEEK) implants have been developed to interact with adjacent endplates. Our goal was to evaluate the efficacy of novel high-strength, porous PEEK interbody fusion devices for anterior cervical discectomy and fusion (ACDF) in patients with symptomatic single-level and multilevel degenerative cervical disc disease at 1 year. Methods: Fifty consecutive patients (31 women, 19 men; average age, 60 years) with degenerative cervical disc disease underwent ACDF using a porous PEEK interbody implant and plate. There were 11 1-level; 23 2-level, and 16 3-level fusions between C3 and C7. Patients were assessed at 1.5, 3, 6, and 12 months. Standardized outcome measures were used to evaluate the patient’s condition before and after surgery. Plain radiographs were used to assess fusion, bony in-growth, subsidence, and implant migration. Sagittal plane angulation was measured on neutral lateral radiographs and determined by Cobb’s criteria. Intradiscal distraction and subsidence were measured by assessing the vertical distance between the midpoints of the adjacent vertebral endplates. Results: At 12 months after surgery, all patients showed improvement in Oswestry Neck Disability Index and neck and arm pain scores. Similarly, at 12 months, all patients showed radiographic fusion. No patient demonstrated motion across the interspace on flexion-extension lateral radiographs. Sagittal plane angulation improved to an average of -6° (range, -2° to -8°) with no measurable evidence of implant migration or subsidence. Average disc space height increased more than 4 mm. No patient had measurable radiographic evidence of a pseudarthrosis or halo formation around the implant. Conclusion: One-year results in this prospective nonrandomized study show that porous-surface PEEK is a clinically viable alternative for improving osseointegration and fusion rates of interbody implants to treat degenerative cervical disc disease.
{"title":"Early Outcomes of Anterior Cervical Discectomy and Fusion Using a Porous PEEK Interbody Fusion Device","authors":"J. KennethBurkus","doi":"10.4172/2325-9701.1000295","DOIUrl":"https://doi.org/10.4172/2325-9701.1000295","url":null,"abstract":"Background: Recently, porous surface polyether-etherketone (PEEK) implants have been developed to interact with adjacent endplates. Our goal was to evaluate the efficacy of novel high-strength, porous PEEK interbody fusion devices for anterior cervical discectomy and fusion (ACDF) in patients with symptomatic single-level and multilevel degenerative cervical disc disease at 1 year. Methods: Fifty consecutive patients (31 women, 19 men; average age, 60 years) with degenerative cervical disc disease underwent ACDF using a porous PEEK interbody implant and plate. There were 11 1-level; 23 2-level, and 16 3-level fusions between C3 and C7. Patients were assessed at 1.5, 3, 6, and 12 months. Standardized outcome measures were used to evaluate the patient’s condition before and after surgery. Plain radiographs were used to assess fusion, bony in-growth, subsidence, and implant migration. Sagittal plane angulation was measured on neutral lateral radiographs and determined by Cobb’s criteria. Intradiscal distraction and subsidence were measured by assessing the vertical distance between the midpoints of the adjacent vertebral endplates. Results: At 12 months after surgery, all patients showed improvement in Oswestry Neck Disability Index and neck and arm pain scores. Similarly, at 12 months, all patients showed radiographic fusion. No patient demonstrated motion across the interspace on flexion-extension lateral radiographs. Sagittal plane angulation improved to an average of -6° (range, -2° to -8°) with no measurable evidence of implant migration or subsidence. Average disc space height increased more than 4 mm. No patient had measurable radiographic evidence of a pseudarthrosis or halo formation around the implant. Conclusion: One-year results in this prospective nonrandomized study show that porous-surface PEEK is a clinically viable alternative for improving osseointegration and fusion rates of interbody implants to treat degenerative cervical disc disease.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45840448","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 : 2018-06-29DOI: 10.4172/2325-9701.1000297
M. Elsebaey
Lumboperitoneal shunt is one of the CSF diversion devices for the management of many causes, like: idiopathic intracranial hypertension, communicating hypertension, CSF leak, Pseudomeningiocele, growing skull fractures. Idiopathic intracranial hypertension (IIH) that also known as pseudotumour cerebri, is clinical disorder that diagnosed by an establishment of the symptoms and signs of increased intracranial pressure. Augmentation and ensuring of the tight fixing of the anchoring devices to the fascia of the iliac crest is still the available reliable method for avoiding migration complications that usually presenting with occurrence of the signs and symptoms of increased intracerebral fluid.
{"title":"Upward Migration of Lumboperitoneal Shunt in Patient with Idiopathic Intracranial Hypertension: A Case Report","authors":"M. Elsebaey","doi":"10.4172/2325-9701.1000297","DOIUrl":"https://doi.org/10.4172/2325-9701.1000297","url":null,"abstract":"Lumboperitoneal shunt is one of the CSF diversion devices for the management of many causes, like: idiopathic intracranial hypertension, communicating hypertension, CSF leak, Pseudomeningiocele, growing skull fractures. Idiopathic intracranial hypertension (IIH) that also known as pseudotumour cerebri, is clinical disorder that diagnosed by an establishment of the symptoms and signs of increased intracranial pressure. Augmentation and ensuring of the tight fixing of the anchoring devices to the fascia of the iliac crest is still the available reliable method for avoiding migration complications that usually presenting with occurrence of the signs and symptoms of increased intracerebral fluid.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44533084","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 : 2018-05-31DOI: 10.4172/2325-9701.1000298
P. Lin, F. Hsu, Yi Hsing Chen, Furen Xiao
Study Design: Retrospective study Purpose: The aim of this study was to assess the feasibility and safety of stereotactic body radiation therapy (SBRT) followed by surgery for spine metastases. Overview of Literature: SBRT has emerged as an exciting field in the management of patients with spine metastases, including those who first undergo surgery. Similarly, neoadjuvant SBRT, which means planned preoperative SBRT, should also be promising. However, there was no literature supporting this approach. Methods: Ten consecutive patients who received surgical management for spine metastases within 30 days after SBRT were reviewed. For patients with limited spine metastases, SBRT was performed first if there is no severe myelopathy. Surgery for decompression and fixation was then performed. Perioperative events were recorded and analyzed. If available, they were followed up for at least 12 months. Results: The SBRT was delivered in single fraction of 14 to 18 Gy (median: 16 Gy). Surgical decompression with fixation was performed 0 to 24 days (median: 5.5 days) after SBRT. The blood loss ranged from 100 to 1500 mL (median: 775 mL). The patients were discharged or transferred 6 to 36 days (median: 7 days) after surgery. One patient developed transient Brown-Sequard syndrome postoperatively. There was no wound complication. Five patients passed away due to progressive disease 2.3 to 13 months after surgery. There was no local recurrence and no instrument failure. Conclusions: Our experience showed that neoadjuvant SBRT followed by surgery is safe and promising for spinal metastases. The long term benefit over postoperative radiotherapy should be determined by further investigation.
{"title":"Neoadjuvant Stereotactic Body Radiation Therapy for Spine Metastases","authors":"P. Lin, F. Hsu, Yi Hsing Chen, Furen Xiao","doi":"10.4172/2325-9701.1000298","DOIUrl":"https://doi.org/10.4172/2325-9701.1000298","url":null,"abstract":"Study Design: Retrospective study Purpose: The aim of this study was to assess the feasibility and safety of stereotactic body radiation therapy (SBRT) followed by surgery for spine metastases. Overview of Literature: SBRT has emerged as an exciting field in the management of patients with spine metastases, including those who first undergo surgery. Similarly, neoadjuvant SBRT, which means planned preoperative SBRT, should also be promising. However, there was no literature supporting this approach. Methods: Ten consecutive patients who received surgical management for spine metastases within 30 days after SBRT were reviewed. For patients with limited spine metastases, SBRT was performed first if there is no severe myelopathy. Surgery for decompression and fixation was then performed. Perioperative events were recorded and analyzed. If available, they were followed up for at least 12 months. Results: The SBRT was delivered in single fraction of 14 to 18 Gy (median: 16 Gy). Surgical decompression with fixation was performed 0 to 24 days (median: 5.5 days) after SBRT. The blood loss ranged from 100 to 1500 mL (median: 775 mL). The patients were discharged or transferred 6 to 36 days (median: 7 days) after surgery. One patient developed transient Brown-Sequard syndrome postoperatively. There was no wound complication. Five patients passed away due to progressive disease 2.3 to 13 months after surgery. There was no local recurrence and no instrument failure. Conclusions: Our experience showed that neoadjuvant SBRT followed by surgery is safe and promising for spinal metastases. The long term benefit over postoperative radiotherapy should be determined by further investigation.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"7 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43990166","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 : 2018-03-06DOI: 10.4172/2325-9701.1000292
A. Rahimizadeh, Valiolah Hassani, Naser Asgari, Mahdi Hamidifard
The validity of conservative management in certain type of acute cervical disc herniation based on amelioration of brachialgia has been described previously. But, disappearance of radiculopathy secondary to spontaneous resolution of the disc material being demonstrated in control MRI has been sporadically reported as a case report or small series. Herein we will describe 70 carefully selected patients with acute mono-radiculopathy due to cervical soft disc herniation. These cases were enrolled in a prospective study for the possibility of their spontaneous resolution with time. For the possibility spontaneous resolution of the sequestrated disc material, periodic MRI was used. In parallel, pain intensity at the onset and its intensity at the time of its complete resolution were assessed via Visual Analogue Scale (VAS). Mixed-design repeated measures ANOVA and independent sample T-test were carried out to determine the effects of this kind of treatment on pain intensity and ultimate outcome of the patients. Surprisingly, spontaneous resolution of the sequestrated disc material was observed in control MRI, in all 70 recruited patients, in duration with mean of 5.71 ± 1.49 months. Furthermore, despite severity of the pain at the onset, amelioration of radiculopathy occurred with significant decrease in VAS score with initial intensity from mean of 9.30 ± 0.80 to mean of 0.90 ± 0.76, after disappearance of the offending disc material. The details of the current series which is the first prospective one in the literature might offer a strong clue about the validity of conservative management in certain type of acute cervical disc herniation. The current report may advocate the neurosurgeons to allow the nature to resolve its problem with its own alterations in due time in sequestrated cervical disc herniation’s in the absence of neurological deficit.
{"title":"Spontaneous Regression of the Sequestrated Cervical Discs: A Prospective Study of 70 Cases","authors":"A. Rahimizadeh, Valiolah Hassani, Naser Asgari, Mahdi Hamidifard","doi":"10.4172/2325-9701.1000292","DOIUrl":"https://doi.org/10.4172/2325-9701.1000292","url":null,"abstract":"The validity of conservative management in certain type of acute cervical disc herniation based on amelioration of brachialgia has been described previously. But, disappearance of radiculopathy secondary to spontaneous resolution of the disc material being demonstrated in control MRI has been sporadically reported as a case report or small series. \u0000Herein we will describe 70 carefully selected patients with acute mono-radiculopathy due to cervical soft disc herniation. These cases were enrolled in a prospective study for the possibility of their spontaneous resolution with time. For the possibility spontaneous resolution of the sequestrated disc material, periodic MRI was used. In parallel, pain intensity at the onset and its intensity at the time of its complete resolution were assessed via Visual Analogue Scale (VAS). Mixed-design repeated measures ANOVA and independent sample T-test were carried out to determine the effects of this kind of treatment on pain intensity and ultimate outcome of the patients. \u0000Surprisingly, spontaneous resolution of the sequestrated disc material was observed in control MRI, in all 70 recruited patients, in duration with mean of 5.71 ± 1.49 months. Furthermore, despite severity of the pain at the onset, amelioration of radiculopathy occurred with significant decrease in VAS score with initial intensity from mean of 9.30 ± 0.80 to mean of 0.90 ± 0.76, after disappearance of the offending disc material. \u0000The details of the current series which is the first prospective one in the literature might offer a strong clue about the validity of conservative management in certain type of acute cervical disc herniation. The current report may advocate the neurosurgeons to allow the nature to resolve its problem with its own alterations in due time in sequestrated cervical disc herniation’s in the absence of neurological deficit.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2018 1","pages":"1-16"},"PeriodicalIF":0.0,"publicationDate":"2018-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46386988","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 : 2018-03-06DOI: 10.4172/2325-9701.1000291
Ghassan Kerry
Spine surgeons tend to avoid the placement of pedicle screws in fractured vertebrae, even if the pedicles are intact. In this paper, we want to enlighten this surgical behavior by sharing our experience in this field.
{"title":"If the Vertebral Body is Fractured, Why not to Fix the Pedicle of the Injured Vertebra? A Technical Note","authors":"Ghassan Kerry","doi":"10.4172/2325-9701.1000291","DOIUrl":"https://doi.org/10.4172/2325-9701.1000291","url":null,"abstract":"Spine surgeons tend to avoid the placement of pedicle screws in fractured vertebrae, even if the pedicles are intact. In this paper, we want to enlighten this surgical behavior by sharing our experience in this field.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2018 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42425572","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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