Pub Date : 2017-12-14DOI: 10.4172/2325-9701.1000266
A. Yeung
Background: Endoscopic Spine Surgery has evolved rapidly in the past 5 years, and is getting less pushback by traditional spine surgeons who have no exposure or training in endoscopic spine surgery in their training. The author has dedicated his last 25 years to transforaminal endoscopic surgery. He has previously reported on his 12 years’ experience in 2007 in IJAS Surgery, but 13 years later, continued evolution of the transforaminal approach aided by new endoscopes and endoscopic instrumentation has allowed the author and experienced endoscopic surgeons adopting this approach, with the ability to treat 90 percent of painful degenerative conditions of the lumbar spine after the learning curve is conquered. Methods: Three different methods have evolved. Yeung’s “insideout” philosophy and technique, Hoogland’s “outside in” philosophy technique, and a hybrid targeted technique combining inside out and outside in, that depends on targeting the patho-anatomy. This paper reviews Yeung’s philosophy and technique backed by over10,000 procedures in the past 25 years Results: After a learning curve for each pathology targeted, an overall 90% good to excellent success rate measured by VAS, Oswestry, patient satisfaction, and minimal minor complications of less than 3 percent can be achieved. A detailed review of Yeung’s experience supplements his 12 year report in the International Journal of Spine Surgery in 2007. Conclusion: The transforaminal endoscopic technique has evolved to be the least invasive, most effective method to surgically address the pain generators in the lumbar spine. The technique allows for earlier treatment of painful conditions that fail nonsurgical treatment. This monograph can be used as a guide for new surgeons who want to treat patients with “surgical pain management” that incorporates pain management with surgical treatment that will help decrease the escalating cost of spine care all over the world.
{"title":"Transforaminal Endoscopic Decompression for Painful Degenerative Conditions of The Lumbar Spine: A review of One Surgeon’s Experience with Over 10,000 Cases Since 1991","authors":"A. Yeung","doi":"10.4172/2325-9701.1000266","DOIUrl":"https://doi.org/10.4172/2325-9701.1000266","url":null,"abstract":"Background: Endoscopic Spine Surgery has evolved rapidly in the past 5 years, and is getting less pushback by traditional spine surgeons who have no exposure or training in endoscopic spine surgery in their training. The author has dedicated his last 25 years to transforaminal endoscopic surgery. He has previously reported on his 12 years’ experience in 2007 in IJAS Surgery, but 13 years later, continued evolution of the transforaminal approach aided by new endoscopes and endoscopic instrumentation has allowed the author and experienced endoscopic surgeons adopting this approach, with the ability to treat 90 percent of painful degenerative conditions of the lumbar spine after the learning curve is conquered. \u0000Methods: Three different methods have evolved. Yeung’s “insideout” philosophy and technique, Hoogland’s “outside in” philosophy technique, and a hybrid targeted technique combining inside out and outside in, that depends on targeting the patho-anatomy. This paper reviews Yeung’s philosophy and technique backed by over10,000 procedures in the past 25 years \u0000Results: After a learning curve for each pathology targeted, an overall 90% good to excellent success rate measured by VAS, Oswestry, patient satisfaction, and minimal minor complications of less than 3 percent can be achieved. A detailed review of Yeung’s experience supplements his 12 year report in the International Journal of Spine Surgery in 2007. \u0000Conclusion: The transforaminal endoscopic technique has evolved to be the least invasive, most effective method to surgically address the pain generators in the lumbar spine. The technique allows for earlier treatment of painful conditions that fail nonsurgical treatment. This monograph can be used as a guide for new surgeons who want to treat patients with “surgical pain management” that incorporates pain management with surgical treatment that will help decrease the escalating cost of spine care all over the world.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2017 1","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2017-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42160944","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 : 2017-12-14DOI: 10.4172/2325-9701.1000270
Y. Imajo
Background: There are currently few reports on the etiology and the prognosis of C5 palsy using electrophysiological examination. The aim of this study was to discuss the etiology and prognosis of C5 palsy after anterior decompression with spinal fusion (ASF) using radiological findings and electrophysiological examination. Methods: 219 patients underwent ASF for cervical degenerative disease. We assessed the cervical sagittal alignment, the local angle at the fused level, and the height of the fused vertebral body on lateral radiographs in a neutral position preoperatively and at final follow-up. We performed intraoperative motor evoked potentials (MEPs) from deltoid and biceps, and measured compound muscle action potentials (CMAPs) in deltoid and central motor conduction time (CMCT) preoperatively and approximately 1 month after onset of the C5 palsy. C5 palsy was defined as a paresis of the deltoid (manual muscle testing (MMT) score of 1 or 2) with involvement of the biceps brachii muscle and supination. To compare the radiological and neurological findings of patients with C5 palsy and those without C5 palsy, 40 patients (designated as group C) were randomly selected from 209 patients without C5 palsy. Results: The incidence of C5 palsy was 4.6% (10 patients). We calculated the CMCT pre- and postoperatively in 8 patients. Compared with preoperatively, the CMCT shortened in 7 patients (87.5%) postoperatively, except for case 6. Intraoperatively, there were no patients with a decrease in MEPs from deltoid and biceps. Patients had a CMAP amplitude that exceeded 1.5 mV for the deltoid on the C5 palsy side recovered deltoid function. There were no significance differences in radiological findings between the group with C5 palsy and group C. Conclusions: We considered the prognosis to be good in patients with a CMAP amplitude of the deltoid muscle on the C5 palsy side that exceeded 1.5 mV.
{"title":"The Etiology And Prognosis Of C5 Palsy After Anterior Decompression With Spinal Fusion","authors":"Y. Imajo","doi":"10.4172/2325-9701.1000270","DOIUrl":"https://doi.org/10.4172/2325-9701.1000270","url":null,"abstract":"Background: There are currently few reports on the etiology and the prognosis of C5 palsy using electrophysiological examination. The aim of this study was to discuss the etiology and prognosis of C5 palsy after anterior decompression with spinal fusion (ASF) using radiological findings and electrophysiological examination. \u0000Methods: 219 patients underwent ASF for cervical degenerative disease. We assessed the cervical sagittal alignment, the local angle at the fused level, and the height of the fused vertebral body on lateral radiographs in a neutral position preoperatively and at final follow-up. We performed intraoperative motor evoked potentials (MEPs) from deltoid and biceps, and measured compound muscle action potentials (CMAPs) in deltoid and central motor conduction time (CMCT) preoperatively and approximately 1 month after onset of the C5 palsy. C5 palsy was defined as a paresis of the deltoid (manual muscle testing (MMT) score of 1 or 2) with involvement of the biceps brachii muscle and supination. To compare the radiological and neurological findings of patients with C5 palsy and those without C5 palsy, 40 patients (designated as group C) were randomly selected from 209 patients without C5 palsy. \u0000Results: The incidence of C5 palsy was 4.6% (10 patients). We calculated the CMCT pre- and postoperatively in 8 patients. Compared with preoperatively, the CMCT shortened in 7 patients (87.5%) postoperatively, except for case 6. Intraoperatively, there were no patients with a decrease in MEPs from deltoid and biceps. Patients had a CMAP amplitude that exceeded 1.5 mV for the deltoid on the C5 palsy side recovered deltoid function. There were no significance differences in radiological findings between the group with C5 palsy and group C. \u0000Conclusions: We considered the prognosis to be good in patients with a CMAP amplitude of the deltoid muscle on the C5 palsy side that exceeded 1.5 mV.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46610791","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 : 2017-12-14DOI: 10.4172/2325-9701.1000268
Luc M. Fortier
Background: Fibergraft material is a synthetic bone graft substitute that has been proven in animal models to reveal 100% fusion in posterolateral spine fusion at 26 weeks. The purpose of this study is to analyze post-op CT scans to evaluate the fusion effectiveness of Fibergraft BG Morsels when combined with bone marrow aspirate (BMA) in one-, two-, three-, and four-level anterior cervical discectomy and fusion (ACDF). Methods: In this retrospective, single-center medical record review, post-op cervical CT scans at approximately six months were evaluated in 27 patients by one senior orthopedic spine surgeon. The surgeon was blinded to the clinical outcomes, patient demographics and past medical history. Fusion results were given a grade of either I, II, III or IV based on the presence of trabecular bridging bone across both graft-vertebral body interfaces. Results: A total of 52 levels were grafted in the 27 subjects who underwent the Smith-Robinson anterior cervical discectomy and fusion. 88.5% of the levels were classified as Grade I complete fusion, 5.8% of the levels classified as Grade II, 3.8% classified as Grade III, and 1.9% classified as Grade IV. Conclusions: Fibergraft BG Morsels mixed with bone marrow aspirate (BA) is an effective bone graft option in one-, two-, three-, and four-level ACDF procedures. This synthetic bioactive glass bone graft substitute combined with BMA achieves high rates of fusion comparable to the biological performance of autologous bone graft.
{"title":"Use Of FIBERGRAFT BG Morsels Mixed With BMA In Anterior Cervical Discectomy And Fusion At 1, 2, 3 And 4 Levels: A Retrospective Analysis Of Fusion Results","authors":"Luc M. Fortier","doi":"10.4172/2325-9701.1000268","DOIUrl":"https://doi.org/10.4172/2325-9701.1000268","url":null,"abstract":"Background: Fibergraft material is a synthetic bone graft substitute that has been proven in animal models to reveal 100% fusion in posterolateral spine fusion at 26 weeks. The purpose of this study is to analyze post-op CT scans to evaluate the fusion effectiveness of Fibergraft BG Morsels when combined with bone marrow aspirate (BMA) in one-, two-, three-, and four-level anterior cervical discectomy and fusion (ACDF). \u0000 Methods: In this retrospective, single-center medical record review, post-op cervical CT scans at approximately six months were evaluated in 27 patients by one senior orthopedic spine surgeon. The surgeon was blinded to the clinical outcomes, patient demographics and past medical history. Fusion results were given a grade of either I, II, III or IV based on the presence of trabecular bridging bone across both graft-vertebral body interfaces. \u0000 Results: A total of 52 levels were grafted in the 27 subjects who underwent the Smith-Robinson anterior cervical discectomy and fusion. 88.5% of the levels were classified as Grade I complete fusion, 5.8% of the levels classified as Grade II, 3.8% classified as Grade III, and 1.9% classified as Grade IV. \u0000Conclusions: Fibergraft BG Morsels mixed with bone marrow aspirate (BA) is an effective bone graft option in one-, two-, three-, and four-level ACDF procedures. This synthetic bioactive glass bone graft substitute combined with BMA achieves high rates of fusion comparable to the biological performance of autologous bone graft.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42352275","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 : 2017-12-14DOI: 10.4172/2325-9701.1000269
S. Hilmani
Background: Chordomas are malignant tumors arising from notochordal remnants and are typically locally aggressive tumors with a high propensity for local recurrence. Method: We report an extremely rare case of cervical spine chordoma presenting with neurological deficit and retropharyngeal extension in order to assess the clinical presentation and treatment. Results: We describe a case of 82-year-old man treated simultaneously by a precarotid approach for a retropharyngeal extension of cervical chordoma. He was referred to our institution with cervical pain, and weakness of the four limbs for 3 months, without dysphagia or dysphonia. The preoperative magnetic resonance imaging (MRI) showed a lesion of C5-C6- with epidural space and retropharyngeal involvement. After total resection, the cervical spine was stabilized with an anterior reconstruction and plating, with good improvement. Conclusion: Among primary malignant tumors of bone, chordomas account for 3-4% of all cases. Chordoma is typically a locally aggressive tumor with a high propensity for local recurrence. Its management involves surgery, radiotherapy, or both. Increased awareness of this neoplasm may lead to earlier diagnosis and better treatment.
{"title":"Cervical Spine Chordoma With Retropharyngeal Extension: Cases Report","authors":"S. Hilmani","doi":"10.4172/2325-9701.1000269","DOIUrl":"https://doi.org/10.4172/2325-9701.1000269","url":null,"abstract":"Background: Chordomas are malignant tumors arising from notochordal remnants and are typically locally aggressive tumors with a high propensity for local recurrence. Method: We report an extremely rare case of cervical spine chordoma presenting with neurological deficit and retropharyngeal extension in order to assess the clinical presentation and treatment. Results: We describe a case of 82-year-old man treated simultaneously by a precarotid approach for a retropharyngeal extension of cervical chordoma. He was referred to our institution with cervical pain, and weakness of the four limbs for 3 months, without dysphagia or dysphonia. The preoperative magnetic resonance imaging (MRI) showed a lesion of C5-C6- with epidural space and retropharyngeal involvement. After total resection, the cervical spine was stabilized with an anterior reconstruction and plating, with good improvement. Conclusion: Among primary malignant tumors of bone, chordomas account for 3-4% of all cases. Chordoma is typically a locally aggressive tumor with a high propensity for local recurrence. Its management involves surgery, radiotherapy, or both. Increased awareness of this neoplasm may lead to earlier diagnosis and better treatment.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42933265","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 : 2017-12-14DOI: 10.4172/2325-9701.1000267
Khalid H. Kurtom
An 83-year-old man with a large sacral chordoma not amenable to surgical resection presented with severe lower back and lower extremity pain refractory to opioid medications. Trial with a temporary external spinal cord stimulator (SCS) elicited a >50% relief of symptoms and a permanent SCS was subsequently placed. The patient continued to report adequate pain relief from the SCS 12 months after placement, despite continued progression of his disease.
{"title":"Spinal Cord Stimulation for Pain Relief of Unresectable Sacral Chordoma: Case Report","authors":"Khalid H. Kurtom","doi":"10.4172/2325-9701.1000267","DOIUrl":"https://doi.org/10.4172/2325-9701.1000267","url":null,"abstract":"An 83-year-old man with a large sacral chordoma not amenable to surgical resection presented with severe lower back and lower extremity pain refractory to opioid medications. Trial with a temporary external spinal cord stimulator (SCS) elicited a >50% relief of symptoms and a permanent SCS was subsequently placed. The patient continued to report adequate pain relief from the SCS 12 months after placement, despite continued progression of his disease.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"13 5","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41301405","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 : 2017-12-14DOI: 10.4172/2325-9701.1000271
S. Miyachi
Spinal epidural arteriovenous fistula (SEDAVF) is a novel clinical entity that is distinct from spinal dural arterovenous fistula, although both diseases manifest as venous congestive myelopathy. We reviewed nine cases of SEDAVF to elucidate its pathogenesis and radioanatomic features and to optimize treatment strategy. All cases exhibited similar angioarchitecture, with a single shunt at the epidural venous plexus that drains into the intradural perimedullary vein and connects to the ventral spinal vein. Interestingly, all lesions were located on the ventral side of the lower lumber and sacral region, and shunts were located ventrally in association with the epidural pouch suspected to be isolated as extradural venous lake. This may be the result of the specificity of the feeding artery and a congenital shift in the distribution of the venous drainage system at the terminal film and conus. We explored two options for the treatment for SEADF: endovascular transarterial embolization and surgical shunt interruption. Among our patients, three were treated using the endovascular approach and six were treated with surgery. While both treatments were effective at improving symptoms, the delay between disease onset and diagnosis precluded a complete cure. Early diagnosis and adequate treatment based on precise knowledge of the angioarchitecture and pathogensis of SEDAVF is essential for improved outcomes.
{"title":"Distinct Radioanatomic Features and Treatments for Spinal Epidural Arteriovenous Fistulae","authors":"S. Miyachi","doi":"10.4172/2325-9701.1000271","DOIUrl":"https://doi.org/10.4172/2325-9701.1000271","url":null,"abstract":"Spinal epidural arteriovenous fistula (SEDAVF) is a novel clinical entity that is distinct from spinal dural arterovenous fistula, although both diseases manifest as venous congestive myelopathy. We reviewed nine cases of SEDAVF to elucidate its pathogenesis and radioanatomic features and to optimize treatment strategy. All cases exhibited similar angioarchitecture, with a single shunt at the epidural venous plexus that drains into the intradural perimedullary vein and connects to the ventral spinal vein. Interestingly, all lesions were located on the ventral side of the lower lumber and sacral region, and shunts were located ventrally in association with the epidural pouch suspected to be isolated as extradural venous lake. This may be the result of the specificity of the feeding artery and a congenital shift in the distribution of the venous drainage system at the terminal film and conus. We explored two options for the treatment for SEADF: endovascular transarterial embolization and surgical shunt interruption. Among our patients, three were treated using the endovascular approach and six were treated with surgery. While both treatments were effective at improving symptoms, the delay between disease onset and diagnosis precluded a complete cure. Early diagnosis and adequate treatment based on precise knowledge of the angioarchitecture and pathogensis of SEDAVF is essential for improved outcomes.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49584723","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 : 2017-12-07DOI: 10.4172/2325-9701.1000285
I. Frid, Rebecca Lewis, Maria T. Marsans, Farrokh R. Farrokhi
Propionibacterium acnes (P. acnes) infection in Deep Brain Stimulation (DBS) patients has distinct characteristics that distinguish it from the most commonly associated bacteria in postoperative wound infections, Staphylococcus aureus (S. aureus). Whereas S. aureus is typically cultured from patients presenting with early fever and elevated inflammatory markers, P. acnes infections in DBS have been found to present with later clinical onset and unremarkable inflammatory markers. The purpose of this report is to highlight the unique characteristics of P. acnes infections in DBS patients. We review the literature in conjunction with a series of three P. acnes DBS infections at our institution. All three cases resulted in the development of abscess surrounding the lead, requiring complete hardware removal. All explanted lead cultures yielded P. acnes. The unifying feature amongst the cases was the presentation of neurological symptoms in the absence of fever or elevated inflammatory markers. Given the context of late complications and need for revision surgery, P. acnes infections must be taken into consideration in DBS patients in order to avoid additional harm.
{"title":"Propionibacterium acnes Infection with Intracerebral Abscess in Deep Brain Stimulation","authors":"I. Frid, Rebecca Lewis, Maria T. Marsans, Farrokh R. Farrokhi","doi":"10.4172/2325-9701.1000285","DOIUrl":"https://doi.org/10.4172/2325-9701.1000285","url":null,"abstract":"Propionibacterium acnes (P. acnes) infection in Deep Brain Stimulation (DBS) patients has distinct characteristics that distinguish it from the most commonly associated bacteria in postoperative wound infections, Staphylococcus aureus (S. aureus). Whereas S. aureus is typically cultured from patients presenting with early fever and elevated inflammatory markers, P. acnes infections in DBS have been found to present with later clinical onset and unremarkable inflammatory markers. The purpose of this report is to highlight the unique characteristics of P. acnes infections in DBS patients. We review the literature in conjunction with a series of three P. acnes DBS infections at our institution. All three cases resulted in the development of abscess surrounding the lead, requiring complete hardware removal. All explanted lead cultures yielded P. acnes. The unifying feature amongst the cases was the presentation of neurological symptoms in the absence of fever or elevated inflammatory markers. Given the context of late complications and need for revision surgery, P. acnes infections must be taken into consideration in DBS patients in order to avoid additional harm.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49133756","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 : 2017-12-06DOI: 10.4172/2325-9701.1000286
Zeki Serdar Ataizi, Hasan Emre Aydın
Objective: Low back pain in adults is the most commonly reported cause of the pain. After the surgery, some patients may have low back pain that is different from that seen before the surgery. The aim of the present study was to demonstrate that this post-fusion pain is originated from the sacroiliac joint. Methods: This study was carried out on 93 patients previously underwent lumbar or lumbosacral fusion surgery and admitted to our outpatient clinic between July 2011 and September 2014 with postoperative persistent chronic pain (for more than 3 months) which is different from the preoperative pain. Results: The VAS scores in patients having fusion ending at L5 and S1, respectively. Mean pre-procedural VAS scores of the patients from S1 and L5 groups suggest that patients having fusion ending at S1 have admitted to our clinic with a more severe pain. Conclusion: The percutaneous tripolar electrode RF device designed as a safe, easily applied and encouraging method will eliminate the unnecessary and in accurate surgical interventions and revision surgeries. This will also increase the success of the surgeon.
{"title":"Radiofrequency Denervation Treatment And The Outcomes In Patients With Lumbar And Lumbosacral Fusion And Diagnosed With Sacroiliac Joint Pain","authors":"Zeki Serdar Ataizi, Hasan Emre Aydın","doi":"10.4172/2325-9701.1000286","DOIUrl":"https://doi.org/10.4172/2325-9701.1000286","url":null,"abstract":"Objective: Low back pain in adults is the most commonly reported cause of the pain. After the surgery, some patients may have low back pain that is different from that seen before the surgery. \u0000The aim of the present study was to demonstrate that this post-fusion pain is originated from the sacroiliac joint. \u0000Methods: This study was carried out on 93 patients previously underwent lumbar or lumbosacral fusion surgery and admitted to our outpatient clinic between July 2011 and September 2014 with postoperative persistent chronic pain (for more than 3 months) which is different from the preoperative pain. \u0000Results: The VAS scores in patients having fusion ending at L5 and S1, respectively. Mean pre-procedural VAS scores of the patients from S1 and L5 groups suggest that patients having fusion ending at S1 have admitted to our clinic with a more severe pain. \u0000Conclusion: The percutaneous tripolar electrode RF device designed as a safe, easily applied and encouraging method will eliminate the unnecessary and in accurate surgical interventions and revision surgeries. This will also increase the success of the surgeon.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2017 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70255025","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 : 2017-11-13DOI: 10.4172/2325-9701.1000283
A. Rahimizadeh, H. Soufiani, Mahan Amirzadeh, Shaghayegh Rahimizadeh
Ossification of the ligamentum flavum or OLF is a disease with heterotopic ossification in this spinal ligament. The key of OLF pathogenesis is the differentiation of fibroblasts into osteoblasts. The majority of cases of ossification of the yellow ligament occur at the lower third of the thoracic or the thoracolumbar spine. However, the literature contains only few reports of patients with OLF of the lumbar spine. The clinical presentation of lumbar OLF is radiculopathy or intermittent neurogenic claudication, although some might remain asymptomatic. Herein, we present 8 Caucasians with symptomatic lumbar OLf. The age and gender as well as the clinical picture, characteristic radiological features, the number of the affected levels will be described. The tips and tricks for achievement of a successful decompressive laminectomy, as the treatment of choice, done at one level in three and at two levels in five cases will be described. Furthermore, the degree of adherence of the lesions to dura and ultimate outcome will be discussed.
{"title":"Ossification Of The Ligamentum Flavum Of The Lumbar Spine In Caucasians: Case Series","authors":"A. Rahimizadeh, H. Soufiani, Mahan Amirzadeh, Shaghayegh Rahimizadeh","doi":"10.4172/2325-9701.1000283","DOIUrl":"https://doi.org/10.4172/2325-9701.1000283","url":null,"abstract":"Ossification of the ligamentum flavum or OLF is a disease with heterotopic ossification in this spinal ligament. The key of OLF pathogenesis is the differentiation of fibroblasts into osteoblasts. The majority of cases of ossification of the yellow ligament occur at the lower third of the thoracic or the thoracolumbar spine. However, the literature contains only few reports of patients with OLF of the lumbar spine. The clinical presentation of lumbar OLF is radiculopathy or intermittent neurogenic claudication, although some might remain asymptomatic. Herein, we present 8 Caucasians with symptomatic lumbar OLf. The age and gender as well as the clinical picture, characteristic radiological features, the number of the affected levels will be described. The tips and tricks for achievement of a successful decompressive laminectomy, as the treatment of choice, done at one level in three and at two levels in five cases will be described. Furthermore, the degree of adherence of the lesions to dura and ultimate outcome will be discussed.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45342024","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 : 2017-11-09DOI: 10.4172/2325-9701.1000278
H. Goischke
The application of intravenous gadolinium-based contrast agents (GBCA) is a great relief in the diagnosis and characterization of pathologic processes and course control, especially in multiple sclerosis (MS), where they play a large role in the detection of disease activity.
{"title":"Gadolinium Deposition in all Human Tissues after Repeat MRI with GBCA Administration-In the Radiological and Neurological Community Accepted or Further Ignored","authors":"H. Goischke","doi":"10.4172/2325-9701.1000278","DOIUrl":"https://doi.org/10.4172/2325-9701.1000278","url":null,"abstract":"The application of intravenous gadolinium-based contrast agents (GBCA) is a great relief in the diagnosis and characterization of pathologic processes and course control, especially in multiple sclerosis (MS), where they play a large role in the detection of disease activity.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48597464","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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