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Day: July 17, 2018

The concave versus convex approach for minimally invasive lateral lumbar interbody fusion for thoracolumbar degenerative scoliosis.

By wp_zaman
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The concave versus convex approach for minimally invasive lateral lumbar interbody fusion for thoracolumbar degenerative scoliosis.

J Clin Neurosci. 2015 Jul 8;

Authors: Scheer JK, Khanna R, Lopez AJ, Fessler RG, Koski TR, Smith ZA, Dahdaleh NS

Abstract
We retrospectively reviewed patient charts to compare the approach-related (convex versus concave) neurological complications and magnitude of correction in patients undergoing lateral lumbar interbody fusion (LLIF). It is yet to be quantitatively determined if correction of adult degenerative scoliosis from either side of the curve apex using a LLIF results in a reduction in complications and/or improved corrective ability. The inclusion criteria for this study were patients who underwent a LLIF for adult degenerative thoracolumbar scoliosis and had the LLIF prior to any other supplemental procedures. Patients were grouped based on the approach toward the curve apex concavity (CAVE) or the convexity (VEX). Standard coronal and sagittal radiographic measurements were made. Neurological complications and reoperation indications were also recorded. We included 32 patients for review (CAVE: 17; VEX: 15) with a mean age of 65.5 years±a standard deviation of 10.2, and mean follow-up of 17.0months±15.7. There were eight postoperative neurological complications in eight patients (25.0%), and seven reoperations for six patients (18.8%; CAVE: 4/17 [23.5%]; VEX: 2/15 [13.3%]). The CAVE group had 6/17 neurological complications (35.3%; four ipsilateral and two contralateral to approach side) and VEX had 2/15 (13.3%; one ipsilateral and one bilateral to approach side; p>0.05). All patients significantly improved in the mean regional and segmental Cobb angles (p<0.05), except for T11-T12 (p>0.05). There were no significant differences between the groups for any of the radiographic parameters measured (p>0.05). Approaching the curve apex from either the concave or convex side resulted in significant improvements. The concave approach was associated with more postoperative neurological complications.

PMID: 26164479 [PubMed – as supplied by publisher]

Subsidence and malplacement with the Oblique Maverick Lumbar Disc Arthroplasty: technical note.

By wp_zaman

Subsidence and malplacement with the Oblique Maverick Lumbar Disc Arthroplasty: technical note.

Spine J. 2008 Jul-Aug;8(4):650-5

Authors: Marshman LA, Friesem T, Rampersaud YR, Le Huec JC, Krishna M

The A-Mav (Medtronic, Sofamor Danek, Memphis, TN) is a well-established lumbar total disc arthroplasty device. The O-Mav (Medtronic) is a more recent innovation designed to minimize the potential vascular complications associated with A-Mav insertion at L4/5. No study has hitherto studied the relative accuracy or safety of the two techniques.

PMID: 17602886 [PubMed – indexed for MEDLINE]

Urban-Rural Differences in Bone Mineral Density: A Cross Sectional Analysis Based on the Hyderabad Indian Migration Study.

By Kamruz Zaman
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Urban-Rural Differences in Bone Mineral Density: A Cross Sectional Analysis Based on the Hyderabad Indian Migration Study.

PLoS One. 2015;10(10):e0140787

Authors: Viljakainen HT, Ben-Shlomo Y, Kinra S, Ebrahim S, Kuper H, Radhakrishna KV, Kulkarni B, Tobias JH

Abstract
BACKGROUND: Fracture risk is rising in countries undergoing rapid rural to urban migration, but whether this reflects an adverse effect of urbanization on intrinsic bone strength, as reflected by bone mineral density (BMD), is currently unknown.
METHODS: Lumbar spine (LS) and total hip (TH) BMD, and total body fat and lean mass, were obtained from DXA scans performed in the Hyderabad arm of the Indian Migration Study (54% male, mean age 49 years). Sib-pair comparisons were performed between rural-urban migrants (RUM) and rural non-migrated (RNM) siblings (N = 185 sib-pairs).
RESULTS: In analyses adjusted for height, gender, age and occupation, rural to urban migration was associated with higher lumbar and hip BMD and greater predicted hip strength; ΔLS BMD 0.030 (0.005, 0.055) g/cm2, ΔTH BMD 0.044 (0.024; 0.064) g/cm2, Δcross-sectional moment of inertia 0.162 (0.036, 0.289) cm4. These differences were largely attenuated after adjusting for body composition, insulin levels and current lifestyle factors ie. years of smoking, alcohol consumption and moderate to vigorous physical activity. Further analyses suggested that differences in lean mass, and to a lesser extent fat mass, largely explained the BMD differences which we observed.
CONCLUSIONS: Rural to urban migration as an adult is associated with higher BMD and greater predicted hip strength, reflecting associated alterations in body composition. It remains to be seen how differences in BMD between migration groups will translate into fracture risk in becoming years.

PMID: 26484878 [PubMed – indexed for MEDLINE]

[Multisegmental and minimally invasive dorsal stabilization of thoracic and lumbar vertebral column. Operative technique].

By wp_zaman

[Multisegmental and minimally invasive dorsal stabilization of thoracic and lumbar vertebral column. Operative technique].

Unfallchirurg. 2011 Feb;114(2):161-6

Authors: Lendemans S, Hussmann B, Wegner A, Nast-Kolb D, Taeger G

Dorsal stabilization of the thoracic and lumbar vertebral column is still the fundamental technique for acute treatment of unstable vertebral fractures and intervertebral ligament injuries as well as in tumor surgery and the treatment of degenerative and inflammatory diseases. The aim is to achieve the best possible anatomical and axis-correct stabilization of the physical lordosis and kyphosis. This article describes in detail the operational preparation (e.g. necessary imaging, possible positioning of the patient) and procedure (e.g. access, placement of screws and plates, wound closure and postoperative follow-up treatment) and possible complications due to misplaced pedicle screws, the rate of which can possibly be reduced by intraoperative 3D imaging.

PMID: 21327996 [PubMed – indexed for MEDLINE]

Tuberculous retropharyngeal abscess associated with spinal tuberculosis well controlled by fine-needle aspiration and anti-tuberculous chemotherapy.

By wp_zaman

Tuberculous retropharyngeal abscess associated with spinal tuberculosis well controlled by fine-needle aspiration and anti-tuberculous chemotherapy.

Intern Med. 2010;49(12):1155-8

Authors: Mizumura K, Machino T, Sato Y, Ooki T, Hayashi K, Nakagawa Y, Fukunaga M, Sato M, Kiyofuji K, Hayashi S, Kobayashi T, Yoshizawa T, Takahashi N, Hashimoto S

We present a rare case of a tuberculous retropharyngeal abscess (RPA) associated with spinal tuberculosis (TB) (Pott’s disease). A patient presented with RPA and collapse of the second cervical vertebra. Fine needle aspiration was performed through the pharynx, not only for diagnosis but also for reduction of the abscess. Tuberculous RPA was diagnosed by microbiological tests of the aspirated fluid from the abscess, which was likely to be extended from Pott’s disease. Anti-TB chemotherapy after the aspiration proved effective, resulting in the resolution of the abscess. Early diagnosis and treatment are essential in order to prevent life-threatening complications.

PMID: 20558934 [PubMed – indexed for MEDLINE]

Cervical spine involvement as initial manifestation of rheumatoid arthritis: a case report.

By wp_zaman
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Cervical spine involvement as initial manifestation of rheumatoid arthritis: a case report.

Acta Reumatol Port. 2015 Jan-Mar;40(1):64-7

Authors: Araújo F, Silva I, Sepriano A, Reizinho C, Marques L, Nero P, Branco JC

Abstract
Rheumatoid arthritis’ synovitis affects mostly small hand and feet joints, although it may compromise any joint with a synovial lining. Cervical involvement occurs usually in longstanding disease in over half of these patients. We report the case of a 35-year old male patient who was referred to our outpatient clinic for a 2-year severe and disabling inflammatory neck pain, with incomplete response to intramuscular non-steroidal anti-inflammatory drugs and unremarkable cervical imaging studies. He also mentioned self-limited episodes of symmetric polyarthralgia involving hands, wrists, elbows, knees and feet, which started after his cervical complaints. On laboratorial workup, positive rheumatoid factor and anti-citrullinated peptide antibody and negative HLA-B27 were found. Cervical spine magnetic resonance imaging revealed atlantoaxial subluxation and odontoid process inflammatory pannus and erosions. Rheumatoid arthritis with cervical spine involvement as initial manifestation of disease was the definite diagnosis. The patient was started on methotrexate and prednisone and he was referred to neurosurgery outpatient clinic for cervical spine fixation.

PMID: 24861079 [PubMed – indexed for MEDLINE]

Developing a Reliable core Stability Assessment Battery for Patients With non-Specific Low Back Pain.

By wp_zaman

Developing a Reliable core Stability Assessment Battery for Patients With non-Specific Low Back Pain.

Spine (Phila Pa 1976). 2015 Dec 14;

Authors: Kahraman BO, Sengul Y, Kahraman T, Kalemci O

Abstract
STUDY DESIGN: Test-retest design OBJECTIVE.: The objective was to examine the intra-rater (test-retest) reliability of the core stability related tests and to develop a reliable core stability assessment battery.
SUMMARY OF BACKGROUND DATA: Studies suggest that core stability exercises may improve function and decrease pain in patients with non-specific low back pain (LBP). Reliable clinical tests are required to implement adequate rehabilitation and to evaluate results of these interventions.
METHODS: The study had a test-retest design. Thirty-three different tests that might relate to core stability were identified with their mostly used protocols. Five different components of core stability including endurance, flexibility, strength, functional performance, and motor control were assessed in 38 patients with non-specific LBP. The same testing procedure was performed again after 48-72 hours. Intra-class correlation coefficients (ICCs), standard error of measurement, and minimal detectable change were calculated to assess the intra-rater reliability.
RESULTS: The intra-rater reliability of the tests ranged from little to very high (ICC = 0.08-0.98). Partial curl-up (ICC = 0.90), lateral bridge (ICC = 0.95-0.96), trunk flexor endurance (ICC = 0.97), sit-and-reach (ICC = 0.98), single-legged hop (ICC = 0.98-0.97), lateral step-down (ICC = 0.93-0.92), eyes open right and left leg unilateral stance (ICC = 0.97 and 0.91) tests had the highest intra-rater reliability for each core stability component.
CONCLUSIONS: The results indicated that the partial curl-up test (strength), side bridge and trunk flexor tests (endurance), sit-and-reach test (flexibility), single-legged hop, and lateral step-down (functional), unilateral stance test with eyes open (motor control) had very high intra-rater reliability. A core stability assessment battery involving these tests can be used in patients with non-specific LBP to assess all components of core stability.
LEVEL OF EVIDENCE: 3.

PMID: 26679886 [PubMed – as supplied by publisher]