Degenerate lumbar disc

By London Spine

I received a lot of information on pre and post procedure. Overall, it was a positive experience considering the inconvenience of going through a surgical procedure. Valeria B.

Autotaxin and lysophosphatidic acid1 receptor-mediated demyelination of dorsal root fibers by sciatic nerve injury and intrathecal lysophosphatidylcholine.

By London Spine

Autotaxin and lysophosphatidic acid1 receptor-mediated demyelination of dorsal root fibers by sciatic nerve injury and intrathecal lysophosphatidylcholine.

Mol Pain. 2010;6:78

Authors: Nagai J, Uchida H, Matsushita Y, Yano R, Ueda M, Niwa M, Aoki J, Chun J, Ueda H

Although neuropathic pain is frequently observed in demyelinating diseases such as Guillain-Barré syndrome and multiple sclerosis, the molecular basis for the relationship between demyelination and neuropathic pain behaviors is poorly understood. Previously, we found that lysophosphatidic acid receptor (LPA1) signaling initiates sciatic nerve injury-induced neuropathic pain and demyelination.

PMID: 21062487 [PubMed – indexed for MEDLINE]

Thyroid gland rupture caused by blunt trauma to the neck.

By London Spine
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Thyroid gland rupture caused by blunt trauma to the neck.

BMC Res Notes. 2016;9(1):114

Authors: Hara H, Hirose Y, Yamashita H

Abstract
BACKGROUND: Thyroid rupture following blunt trauma is extremely rare, and neck pain without swelling may be the only presenting symptom. However, hemorrhage and hematoma subsequently causes severe tracheal compression and respiratory distress.
CASE PRESENTATION: A 71-year-old Japanese woman visited our emergency room with a complaint of increasing right-sided neck pain at the thyroid cartilage level after she tripped and accidentally hit her neck against a pole 3 h back. On admission, her vital signs were stable. There was no swelling or subcutaneous emphysema. Laryngeal endoscopy revealed mild laryngeal edema, although there was no impairment in vocal fold mobility on either side. Contrast-enhanced computed tomography (CT) revealed rupture of the right lobe of the thyroid gland accompanied by a large hematoma extending from the neck to the mediastinum. Under general anesthesia, the right lobe was resected and the hematoma was evacuated.
CONCLUSION: Only a few isolated cases of thyroid rupture caused by blunt neck trauma have been reported in patients with normal thyroid glands and neck pain without swelling may be the only presenting symptom. When suspected, CT should be performed to confirm the diagnosis determine the optimal treatment.

PMID: 26892467 [PubMed – in process]

Expansive open-door laminoplasty secured with titanium miniplates is a good surgical method for multiple-level cervical stenosis.

By London Spine
Related Articles

Expansive open-door laminoplasty secured with titanium miniplates is a good surgical method for multiple-level cervical stenosis.

J Orthop Surg Res. 2014 Aug 21;9(1):49

Authors: Yeh KT, Yu TC, Chen IH, Peng CH, Liu KL, Lee RP, Wu WT

Abstract
BackgroundLaminoplasty is an effective procedure for treating cervical spondylotic myelopathy (CSM). Little information is available regarding the surgical outcomes of expansive open-door laminoplasty (EOLP) when securing with titanium miniplates without bone grafting. This study is aimed to elucidate the efficacy of and problems associated with EOLP secured with titanium miniplates without bone grafting, thereby enhancing future surgical outcomes.MethodsThis is a retrospective study. The study participants comprised 104 patients who underwent cervical EOLP secured with titanium miniplates without bone graft for CSM treatment between August 2005 and March 2011. The clinical results were evaluated based on the Japanese Orthopedic Association (JOA) and Nurick scores. The radiographic outcomes were determined based on plain film and magnetic resonance imaging findings, which were assessed and compared.ResultsLateral cervical spine X-rays exhibited improvement in the Pavlov ratio of the spinal canal at 1 day postoperation, and this ratio did not change at 1 year postoperation. The mean cervical curvature from C2 to C7 decreased 0.21°¿±¿10.09° and the mean cervical range of motion was deteriorated by 35% at 12 months (P¿<¿0.05). The Nurick score improved from 3.19¿±¿1.06 to 0.92¿±¿1.32 (P¿<¿0.05). The mean JOA recovery rate was 75%¿±¿21.1% at 1 year. The mean level of postoperative neck pain at 3 months was 3.09¿±¿2.31, as determined using the visual analogue scale (VAS). Increased age, concomitant thoracolumbar stenosis, depression disorder, and preexisting myelomalacia negatively affected the JOA recovery rate (P¿<¿0.05). A decreased preoperative Nurick score and superior sensory function in the upper extremities were powerful predictors of an enhanced JOA recovery rate. The postoperative complications involved hematoma formation 0.9%, reversible C5 nerve palsy 2.8%, and moderate to severe neck pain (VAS¿¿¿4) 42%. No cases of lamina closure or collapse were observed.ConclusionEOLP secured with titanium miniplates without bone grafting is a safe and effective surgical method for treating most patients with CSM.

PMID: 25142174 [PubMed – as supplied by publisher]