Low Pain Catastrophization and Disability Predict Successful Outcome to Radiofrequency Neurotomy in Individuals with Chronic Whiplash.

By London Spine
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Low Pain Catastrophization and Disability Predict Successful Outcome to Radiofrequency Neurotomy in Individuals with Chronic Whiplash.

Pain Pract. 2015 Jan 9;

Authors: Smith AD, Jull GA, Schneider GM, Frizzell B, Hooper RA, Sterling MM

Abstract
OBJECTIVES: Physical and psychological symptoms of individuals with chronic whiplash-associated disorders (WAD) are modulated by successful treatment with cervical radiofrequency neurotomy (cRFN). However, not all individuals respond to cRFN, and it is unknown which clinical features predict successful response to cRFN.
METHODS: This prospective cohort study investigated 53 individuals with chronic WAD (36 female, 17 male; mean age = 44.7 ± 10.9 (SD) years) who underwent cRFN. Predictor variables measured at baseline (prior to RFN) included self-reported pain (VAS), disability (NDI), post-traumatic stress symptoms (PDS), pain catastrophizing (PCS), and measures of sensory hypersensitivity (pressure and cold pain thresholds). The outcome measure was perceived Global Rating of Change (where scores ≥ 4 were classified as a successful response) 3 months post-cRFN.
RESULTS: Univariate logistic regression demonstrated that lower levels of disability and pain catastrophizing were associated with successful response of cRFN (both P < 0.05). Multivariable logistic regression demonstrated that low levels of pain catastrophizing and disability remained significant predictors of a successful response to cRFN (both P < 0.05).
CONCLUSIONS: Low levels of pain catastrophizing and disability independently predicted a successful response to cRFN in patients with chronic WAD.

PMID: 25594839 [PubMed – as supplied by publisher]

[In Process Citation].

By London Spine

Related Articles [In Process Citation]. Rofo. 2012 Apr;184(4):377; author reply 377-8 Authors: Reuther G, RÃ?¶hner U PMID: 22426871 [PubMed – indexed for MEDLINE]

Spinal gas accumulation causing lumbar discogenic disease: a case report.

By London Spine

Spinal gas accumulation causing lumbar discogenic disease: a case report.

Acta Orthop Traumatol Turc. 2015;49(1):103-105

Authors: Ayberk G, Özveren MF, Yıldırım T

Abstract
Vacuum disc phenomenon is seen frequently with degenerative disc disease and is characterized by the collection of gas in the disc space. Although the accumulation of gas within the disc space does not have clinical significance, symptoms may develop when occurring within the spinal canal. We present a 60-year-old female patient with low back and left leg pain occurring for 3 months before admission to our clinic. Straight leg raise test was 50 degrees in the left leg. Magnetic resonance imaging showed a narrowing of the L5-S1 disc space with vacuum disc phenomenon and hypointense cystic mass in T1 and T2-weighted images. The decision for surgery was made and left L5-S1 hemilaminectomy and foraminotomy was performed. The cyst wall was adherent to the root and dura mater and was partially excised. The patient was pain-free on the first postoperative day. In cases of gas accumulation in the spinal canal, discogenic pain may occur. Surgical therapy is still an acceptable method for the treatment of vacuum disc phenomenon and accumulation of gas within the spinal canal.

PMID: 25803262 [PubMed – as supplied by publisher]

Vertebral destruction due to abdominal aortic aneurysm.

By London Spine
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Vertebral destruction due to abdominal aortic aneurysm.

Int J Surg Case Rep. 2014 Dec 10;6C:296-299

Authors: Jiménez Viseu Pinheiro JF, Blanco Blanco JF, Pescador Hernández D, García García FJ

Abstract
INTRODUCTION: Low back pain is a common cause of medical consultation, and usually supposes a non-malignant prognostic.
PRESENTATION OF CASE: We report an atypical appearance of low back pain associated to shock and pulsatile abdominal mass that made us diagnose an abdominal aortic aneurysm as reason of vertebral lysis and pain.
DISCUSION: Surgical repair of contained AAA should be directed to secondary re-rupture prevention, with an approximate survival near to 100% at selected patients for elective surgery. Consequently, orthopedic surgery for back spine stabilization has to be elective in those cases when vertebral destruction is above 30% and clinic is directly related to spine instability.
CONCLUSION: We should consider AAA as other cause of low back pain and routinely examine the abdomen and seek complementary imaging proves when risk factors for AAA are present.

PMID: 25569196 [PubMed – as supplied by publisher]

Hidradenoma of the external auditory canal: clinical presentation and surgical treatment.

By London Spine
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Hidradenoma of the external auditory canal: clinical presentation and surgical treatment.

Coll Antropol. 2012 Nov;36 Suppl 2:159-61

Authors: Drvis P, Ries M, Zurak K, Trotić R, Ajduk J, Stevanović S

Abstract
The aim of this article is to present clinical features, diagnostic procedures and surgical treatment of a rare ear tumor. We report a case of 78 year old female with hidradenoma of the external auditory canal. Patient had a sensation of pain and fullness with permanent ottorhea from the right ear for one year Temporal bone computed tomography showed a tumor of the external ear, 6 centimeters in diameter, without bone, temporomandibular joint or intracranial invasion; the tumor was limited medially by the tympanic membrane. Biopsy was performed and pathohistology finding was: hydradenoma nodulare atypicum. Surgical intervention and wide tumor removal in general endotracheal anesthesia was performed. One year after the surgery there was no sign of tumor recurrence. Hidradenoma is rare ear tumor arising from the epithelial cells of sweat glands of the external auditory canal. Radiological evaluation and pathohistology confirmation of hidradenoma is necessary and wide excision of the tumor is the treatment of choice.

PMID: 23397777 [PubMed – indexed for MEDLINE]

Simultaneous Translation in 2 Rods to treat Adolescent Idiopathic Scoliosis : Radiographic results in coronal, sagittal and transverse plane of a series of 62 patients with a minimum follow-up of 2 years.

By London Spine

Simultaneous Translation in 2 Rods to treat Adolescent Idiopathic Scoliosis : Radiographic results in coronal, sagittal and transverse plane of a series of 62 patients with a minimum follow-up of 2 years.

Spine (Phila Pa 1976). 2011 Feb 17;

Authors: Clement JL, Chau E, Geoffray A, Vallade MJ

STRUCTURED ABSTRACT: Study Design: Retrospective analysis of a consecutive cohort of 62 Adolescent patients treated by Posterior Spinal Fusion (PSF), with a minimum follow-up of 2 years.Objective: to present sagittal and coronal results of a specific method of reduction: Simultaneous translation on 2 rods (ST2R).Summary of background data: The long-term outcome of surgically treated scoliosis is dependent not only on the coronal correction but also on restoration of sagittal curves. Recent publications confirm the moderate correction of thoracic hypokyphosis by posterior instrumentation with hooks or pedicle screws.Methods: Radiographic parameters were measured preoperatively, and at 6 weeks, 1 year and at last follow-up (between 2 to 7.4 years) in a consecutive cohort of 62 patients with Adolescent Idiopathic Scoliosis (AIS) treated by PSF. All operative procedures were performed by the same surgeon using stable anchorages such as screws or self-stabilizing claws. The screws and claws included a polyaxial threaded extension, which was fixed to the rod with connecting clamps. Reduction of the deformity was obtained by gradual and alternate tightening of the nuts on all threaded extensions on both rods, which allowed the vertebrae to gradually approach the rods while performing the translation maneuver.Results: In the coronal plane, the average main curve was reduced from 51° to 16° and maintained 70% of correction at last follow-up.In the sagittal plane, for patients with hypokyphosis (27 cases<20°), the average kyphosis angle was significantly improved from 9° to 29° and maintained during follow-up (32°) with a mean gain of 23° (p<0.0001). Only one patient reported hypokyphosis (18°) at last follow-up. For patients with normal kyphosis, the average gain was 8°.Conclusion: In a large consecutive cohort, reduction of scoliosis by ST2R is a simple method that allows 70% of correction in the coronal plane, equivalent to screw instrumentations, and a restoration of normal thoracic kyphosis.

PMID: 21336234 [PubMed – as supplied by publisher]

Three-stage surgery in the management of severe rigid angular kyphosis.

By London Spine

Three-stage surgery in the management of severe rigid angular kyphosis.

Eur Spine J. 2002 Apr;11(2):107-14

Authors: Sar C, Eralp L

There are conflicting data regarding the management of rigid kyphosis. None of the currently known techniques can completely correct severe kyphosis without resulting in residual deformity. Seven patients with local kyphosis exceeding 60 degrees were operated on to achieve complete correction of the deformity. The surgery consisted of total spondylectomy of the deformed vertebra and simultaneous application of compression-distraction forces to this area. The operation included three stages: The initial stage includes resection of posterior spinal elements and temporary fixation. In the second stage, an anterior corpectomy is performed to conclude the resection, and simultaneous antero-posterior correction is obtained. The final stage includes another posterior procedure to achieve a precise correction and to correct any compensatory curves. All patients were operated on using this technique in a single session. The mean preoperative and postoperative kyphosis angles were 76.1 degrees (range, 65 degrees -92 degrees) and 6 degrees (range, 0 degrees -13 degrees), respectively. Complete bony fusion was achieved after a mean follow-up period of 38 months (range, 26-52 months) without any neurological sequelae or significant loss of correction.

PMID: 11956915 [PubMed – indexed for MEDLINE]