Journal of spine最新文献

{"title":"A Modification to the Gill Technique of Removal of the Rattler Fragment in Isthmic Spondylolisthesis","authors":"Daniel D Lee, Amit Parekh Do","doi":"10.4172/2165-7939.1000418","DOIUrl":"https://doi.org/10.4172/2165-7939.1000418","url":null,"abstract":"Adult isthmic spondylolisthesis treated with en-bloc laminectomy has long been a standard practice. The technique of removing the rattler fragment can have associated complications including durotomy and damage to exiting nerve roots. We describe a technique of en-bloc laminectomy by mobilizing the fragment through the pars defect and resecting the ligamentum flavum with the aid of an interspinous distraction device. *Corresponding author: Daniel D Lee, Desert Orthopedic Center, 2800 East Desert Inn Road, Suite 100, Las Vegas, Nevada-89121, USA, Tel: +7027314088; E-mail: ddleee@hotmail.com Received July 22, 2018; Accepted September 25, 2018; Published October 09, 2018 Citation: Lee DD, Amit Parekh DO (2018) A Modification to the Gill Technique of Removal of the Rattler Fragment in Isthmic Spondylolisthesis. J Spine 7: 418. doi: 10.4172/2165-7939.1000418 Copyright: © 2018 Lee DD, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000418","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70770299","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}

{"title":"Uniportal Endoscopic Transforaminal Discectomy Associated with Cylindrical Percutaneous Interspinous Spacer","authors":"Cantu-Leal R, Cantu-Longoria R","doi":"10.4172/2165-7939.1000420","DOIUrl":"https://doi.org/10.4172/2165-7939.1000420","url":null,"abstract":"Background: The benefits from endoscopic spine surgery are well documented in literature. The use of interspinous spacers remains controversial, but the results reported in the studies just compare open decompression versus indirect decompression with interspinous spacers. Percutaneous cylindrical interspinous spacer portal is recommended at 16 cm from midline and endoscopic transforaminal discectomy from 10-12 cm. The risk of using an extreme lateral portal is greater. The literature recommends general anesthesia for interspinous instrumentation. We hypothesized that patients could benefit from a minimal invasive endoscopic decompression and an indirect decompression using the same portal for endoscopic transforaminal discectomy and the interspinous spacer instrumentation changing the introduction angle. This will reduce the recovery time, reoperation rate, soft tissue damage, anesthetic risk, and the possibility of damage to abdominal and retroperitoneal organs. Methods: We collected data from 152 consecutive patients from January 2008 to June 2016. All patients were candidates for endoscopic transforaminal discectomy and/or foraminoplasty and had surgical indications for interspinous spacer instrumentation. Mild sedation and local anesthesia was used during the endoscopic procedure. The interspinous spacer instrumentation was performed with local or epidural anesthesia. Results: Of the 152 patients that had the minimum 2 years follow up, we lost 10 patients at the end. Another 7 had another surgery. Average age was 49 years old, 80 males and 72 females. A total of 214 lumbar interspinous spacers were used. 84 patients referred their primary problem was axial pain (facets/discs) and 68 radicular pain (with central and/or foraminal stenosis). VAS lumbar pain dropped from 7.2 to 0.8 at 2 years, radicular pain from 6.1 to 0.4. The preoperatory ODI was 54.8 and went down to 12.4 at 24 months. More than 90% of the patients reported excellent or good results. Conclusion: No complications associated with the combination of both procedures. In proper selected cases, the uses of interspinous spacers and endoscopic transforaminal decompression have good results. Minimally invasive procedures can help patients to prevent or retard a greater surgery like fusion or laminectomy. Citation: Cantu-Leal R, Cantu-Longoria R (2018) Uniportal Endoscopic Transforaminal Discectomy Associated with Cylindrical Percutaneous Interspinous Spacer. J Spine 7: 420. doi: 10.0142/2165-7939.1000420","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"07 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000420","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70770026","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}

{"title":"SEP as A Sensory Pathway Integrity Check in Patients Undergoing Lumbar Endoscopic Spine Surgery Using the Yeung Endoscopic Spine System","authors":"A. Yeung, J. Porter","doi":"10.4172/2165-7939.1000422","DOIUrl":"https://doi.org/10.4172/2165-7939.1000422","url":null,"abstract":"","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"07 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000422","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70770656","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}

{"title":"Whole Body Vibration Exercises on Physiological and Hemodynamic Parameters of Spinal Cord Injury Individuals: A Systematic Review","authors":"L. P. Domingos, D. Sá-Caputo, E. Guedes-Aguiar, E. Moreira-Marconi, M. Moura-Fernandes, A. S. Reis, P. Marín, C. Stark, M. Bernardo-Filho","doi":"10.4172/2165-7939.1000426","DOIUrl":"https://doi.org/10.4172/2165-7939.1000426","url":null,"abstract":"","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"07 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000426","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70770845","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}

{"title":"Cost Effectiveness Analysis-Cryopreserved Amniotic Membrane?s (cAM) Use in Lumbar Micro Discectomy-A Modeling of the Costs and Outcomes from a Randomized Controlled Trial","authors":"Jeffrey D. Voigt, D. Anderson","doi":"10.4172/2165-7939.1000430","DOIUrl":"https://doi.org/10.4172/2165-7939.1000430","url":null,"abstract":"Objective: Few studies have evaluated the cost effectiveness associated with lumbar microdiscectomy. The outcome data used in this analysis was from a prior randomized controlled trial (RCT) demonstrating that the use of a cryopreserved amniotic membrane (cAM) reduced the incidence of repeat procedures and improved outcomes vs. the standard of care (SOC). The purpose of this analysis was to cost out the procedural data associated with the outcomes from this RCT for cAM and then to evaluate the cost effectiveness of this alternative compared to every day practice. Methods: The direct costs of care for patients undergoing lumbar microdiscectomy were modeled using Medicare 2017 national average reimbursement. TreeAge Pro 2018 software was used for the decision tree analysis over a 2 year period. The assumed cost of cAM was $500 US. The probabilities of events were derived from the published literature, including repeat surgery from recurrent disc herniation. The effectiveness outcome evaluated was the Ostwestry Disability Index, as evaluated in the RCT and from published literature. One-way sensitivity analysis was conducted along with Monte Carlo simulation. Results: The use of cAM was the least costly alternative over 2 years by $343 vs. SOC ($12,417 vs. $12,760). One-way sensitivity analyses found the following variables had the greatest effect on the decision to use SOC vs. cAM (based on costs alone): incidence of revision surgery due to recurrent disc herniation for cAM (>6.8%) and SOC ( $843); cost of an inpatient repeat procedure of <$8,408. In Monte Carlo simulation, cAM dominated 53% of the time. Conclusion: Based on a lower incidence of repeat procedures and an improved ODI, cAM can be a cost effective alternative when compared to SOC. In today’s environment of US value based reimbursement, the use of cAM may hold promise.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"07 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000430","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70771326","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}

{"title":"Thoracic Fracture-Dislocations without Neurologic Injury: 2 Cases Report and their Literature Review","authors":"H. Ribeiro, R. Teixeira, P. Fernandes, A. Nunes, J. Sousa, R. Almeida","doi":"10.4172/2165-7939.1000425","DOIUrl":"https://doi.org/10.4172/2165-7939.1000425","url":null,"abstract":"","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"07 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000425","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70770901","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}

{"title":"Fully Endoscopic Bilateral Cervical Laminotomy with Unilateral Approach for Cervical Spinal Stenosis and Myelopathy: A Case Series","authors":"Jian Shen","doi":"10.4172/2165-7939.s7-009","DOIUrl":"https://doi.org/10.4172/2165-7939.s7-009","url":null,"abstract":"Surgical decompression via an anterior or posterior approach is the treatment of choice for patients with cervical spinal stenosis/cord compression and cervical myelopathy. Traditional open and tubular approaches for treatment of central and lateral recess spinal stenosis involve laminotomy or laminectomy with removal of overgrown ligamentum flavum and a portion of the medial facet joints in order to decompress the central canal and lateral recess. Posterior minimally invasive compression techniques allow preservation of motion segment and neural decompression without fusion. Microendoscopic laminotomy (MED) patients have significantly less postoperative axial pain and improved subaxial cervical lordosis when compared with traditional laminoplasty patients [1].","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"01 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.s7-009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70776123","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}

{"title":"Fully Endoscopic Transforaminal Discectomy under Local Anesthesia for Thoracic Disc Herniations: A Case Series","authors":"Jian Shen","doi":"10.4172/2165-7939.S7-013","DOIUrl":"https://doi.org/10.4172/2165-7939.S7-013","url":null,"abstract":"Background: Symptomatic thoracic disc herniation is a relatively rare yet challenging-to-treat condition. Minimally invasive approaches potentially offer less complications and quick recovery. Purpose: Here we describe a step-by-step technique for fully-endoscopic foraminoplasty with high-speed drill under direct visualization through transforaminal/retropleural approach, followed by discectomy to treat thoracic disc herniations under local anesthesia, and report the primary results of a case series. Results: Between January 2012 and December, 2017, 16 patients with symptomatic thoracic disc herniation were treated with fully endoscopic transforaminal foraminoplasty and discectomy under local anesthesia. Intraoperative data and clinical outcomes were analyzed and reported. One patient with a chronic calcified giant central disc herniation and significant myelopathy had complaints of worsening symptoms postoperatively; she subsequently underwent open multi-level laminectomy fusion surgery elsewhere. For the remaining 15 patients, at the final follow up (mean: 21 months; range: 7–60 months), the mean VAS was improved from 7.9 to 2.1. No other complications were observed or reported during and after the surgery. Conclusion: Results from this case series shows that fully-endoscopic transforaminal/retropleural foraminoplasty and discectomy under local anesthesia is a safe and effective treatment for symptomatic soft and calcified thoracic disc herniations. *Corresponding author: Jian Shen, Department of Spine Surgery, Mohawk Valley Orthopedics, Center for Spine Regeneration Surgery, 215 East 77th Street, New York-10075, USA, Tel: + 518842-2663, E-mail: james2173@yahoo.com Received August 24, 2018; Accepted September 03, 2018; Published September 06, 2018 Citation: Shen J (2018) Fully Endoscopic Transforaminal Discectomy under Local Anesthesia for Thoracic Disc Herniations: A Case Series. J Spine S7: 013. doi: 10.0132/2165-7939.S7-013 Copyright: © 2018 Shen J. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"01 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.S7-013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70776349","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}

{"title":"Prediction of Treatment Resistance in Conservative Treatment of Osteoporotic Vertebral Fractures Using Lateral Plain Dynamic Loading Radiographs","authors":"T. Funayama, T. Tsukanishi, T. Abe, H. Kumagai, Shigeo Izawa, H. Noguchi, Kengo Fujii, Y. Shibao, M. Koda, M. Yamazaki","doi":"10.4172/2165-7939.1000404","DOIUrl":"https://doi.org/10.4172/2165-7939.1000404","url":null,"abstract":"Purpose: To elucidate the association between computed tomography (CT)/magnetic resonance imaging (MRI) and radiographic findings of fractured vertebral body instability in patients with osteoporotic vertebral fractures and to clarify whether resistance to conservative treatment can be evaluated on the basis of dynamic loading radiography.Methods: Seventy-eight patients aged ≥ 65 years who underwent conservative treatment for osteoporotic single vertebral fractures of the thoracolumbar junction were divided into the conservative treatment-resistant group (18 patients) and control group (60 patients). We evaluated the accuracy of the prediction of resistance to conservative treatment on the basis of the CT/MRI findings and the difference in compression rates between standing and supine positions at the time of the first visit. The differences in compression rates (%) were compared between the two groups. In addition, a receiver operating characteristics (ROC) curve was drawn to evaluate the accuracy of the prediction of resistance to conservative treatment.Results: In patients without (47 cases) and with CT findings (31 cases), the mean differences in compression rates (%) was 8.9% and 19.1%, respectively (p=0.0029). The mean differences in compression rates (%) of patients without (60 cases) and with MRI findings (18 cases) was 9.7% and 24.0%, respectively (p=0.0043). The mean differences in compression rates (%) in the conservative treatment-resistant group was 26.3%, while that in the control group was 9.0 (p=0.0066). In addition, according to the ROC curve of the difference in compression rate was 0.93 (95% confidence interval: 0.87–1), and when a 20% difference in compression rate was considered as the threshold value.Conclusion: Dynamic loading radiography is useful for the evaluation of resistance to conservative treatment in patients with osteoporotic vertebral fractures, and that a compression rate difference of ≥ 20% predicts resistance to conservative treatment.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000404","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48561155","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}

{"title":"Can Cervical Arthroplasty Impact Alignment? A Comparison of the Synergy Disc with Cervical Fusion","authors":"K. Yücesoy, K. Yüksel, Idiris Altun, Murvet Yuksel, O. Kalemci","doi":"10.4172/2165-7939.1000400","DOIUrl":"https://doi.org/10.4172/2165-7939.1000400","url":null,"abstract":"Background context: Synergy disc is a new cervical disc prosthesis that incorporates alignment restoration while providing full intervertebral disc kinematics.Purpose: This follow-up study with 40 Synergy Disc patients with 24-month follow-up compared cervical alignment changes with a retrospective cohort of 30 single level anterior cervical discectomy and fusion (ACDF) patients.Study design/setting: The pilot trial was a multi-center, prospective, consecutive patient enrollment study using the Synergy Disc for the treatment of single and two-level degenerative disc disease of the cervical spine.Patient sample: The procedure was performed on 43 patients (45 implants) with follow-up on 40 patients (42 implants). For the historical cohort ACDF arm, 30 patients with similar follow-up with single level anterior discectomy, fusion and plating were used for segmental lordosis measurements.Outcome measures: For the Synergy Disc group, the kinematic parameters included: range of motion (ROM), shell angle (SA), disc height (DH), sagittal plane translation and center of rotation (COR) in the X and Y direction. Standard assessments of clinical outcomes were also measured (Neck Disability Index, Visual Analog Scale). For the fusion arm, only functional spinal unit (FSU) angle was recorded using a single pre-operative and post-operative standing lateral cervical radiograph.Methods: In the Synergy Disc group, static and dynamic radiological assessments were performed in 43 consecutive patients prior to the placement of the Synergy Disc. Forty patients were studied for the course of the study protocol (3 patients lost to follow-up). For the Synergy Disc group, all kinematic parameters were examined at a minimum of 24 months follow-up. Neck Disability Index and Visual Analog Scale for arm and neck pain were collected and analyzed. For the fusion group, standing lateral radiographs were reviewed.Results: At a mean of 28 months with all patients having a minimum of 24-month follow-up (40 patients, 42 implants), the average SA of the Synergy Disc was maintained at 6 ± 2.7˚ of lordosis. There was significant improvement in all clinical outcome measures. In the fusion group, with a similar follow-up period, there was a 4˚ increase in lordosis of the FSU.Conclusion: The Synergy Disc had an endplate angle of 6 ± 2.7˚ at 2 years following surgery. This was comparable to the lordotic correction provided by an anterior cervical discectomy with interbody fusion and plating.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"6 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41729386","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}