Journal of spine最新文献

{"title":"Suggestions for a Practical and Progressive Approach to Endoscopic Spine Surgery Training and Privileges","authors":"A. Yeung, A. Roberts, P. Shin, Evan Rivers, A. Paterson","doi":"10.4172/2165-7939.1000414","DOIUrl":"https://doi.org/10.4172/2165-7939.1000414","url":null,"abstract":"Progress within the various surgical fields has been facilitated by the use of minimally invasive procedures to achieve the same clinical outcomes as traditional techniques. Spine surgery is no different, and endoscopic spine surgery continues to demonstrate extensive applications while minimizing collateral tissue damage. Endoscopic spine surgery blends skill sets, technology, and clinical applications from both surgical spine and interventional spine. Clinicians from these fields have adopted endoscopic spine surgery. This has created a dilemma: there are now physicians providing surgical care who have not had formal spine surgical training. Some interventional spine practitioners are able to offer safe and effective endoscopic spine surgery, but training standards and practice standards are necessary for the field to progress. This article provides suggestions for a pragmatic approach to endoscopic spine surgery training and credentialing for physicians who practice interventional spine.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"7 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000414","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70770157","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":"Computer Navigated Percutaneous Sacroiliac Joint Screws Assisted by Caudal Epidural Contrast Injection","authors":"S. Moniz, Samuel J Duff, S. Punwar, D. Fick, Max P. Majedi, K. Jarvi","doi":"10.4172/2165-7939.1000427","DOIUrl":"https://doi.org/10.4172/2165-7939.1000427","url":null,"abstract":"This article describes an innovative technique for effective analgesia and enhanced accuracy in placement of percutaneous sacroiliac screws in patients with unstable, posterior pelvic ring injuries. Our approach involves introducing radio-opaque contrast through an indwelling caudal epidural catheter to enhance existing computer navigation systems. This delineates the lumbosacral nerve roots to promote the safe and accurate placement of sacroiliac screws and concurrently provides effective analgesia. We describe the technique and our first cases. It can be used to supplement your current technique in placing sacroiliac joint screws and provide effective analgesia for our patients.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"07 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000427","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70771345","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":"Endoscopic Spine Surgery: Navigating the Learning Curve","authors":"Sohrab Gollogly, A. Yeung","doi":"10.4172/2165-7939.S7-010","DOIUrl":"https://doi.org/10.4172/2165-7939.S7-010","url":null,"abstract":"Endoscopic spine has been routinely performed worldwide for nearly 30 years and there is an extensive body of peer reviewed literature that demonstrates clinical effectiveness [1-8]. The progression of surgical techniques for the treatment of spinal disease towards more effective, less invasive, and less costly care is influenced by academic, regulatory, financial, and consumer driven factors [9-11]. Inertia created by the current CPT based system for reimbursement for surgical services has delayed the development of endoscopic procedures for spinal surgery in the United States. This area of spine surgery has historically not seen the same investments in instrumentation, training, and techniques as other surgical subspecialties such as arthroscopic and laparoscopic surgery. The recent introduction of a CPT code for the reimbursement of endoscopic treatment of herniated discs and symptomatic spinal stenosis in the lumbar spine has resulted in an increased interest in this area of minimally invasive spine surgery. The appropriate standards for teaching endoscopic techniques in surgical training programs or adopting the same techniques into an established surgical practice have not been formally defined [12,13].","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.S7-010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70776133","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":"A Retrospective Study on Dual Growing Rod at the End of Treatment","authors":"P. Zarantonello, G. Tedesco, E. Maredi, K. Martikos, F. Vommaro, A. Scarale, T. Greggi","doi":"10.4172/2165-7939.1000423","DOIUrl":"https://doi.org/10.4172/2165-7939.1000423","url":null,"abstract":"Study design: Retrospective review of patients affected by Early Onset Scoliosis (EOS), treated with dual growing rod (GR) and reached final posterior arthrodesis. Objective: To evaluate the trend of main thoracic and kyphotic curves during treatment with GR until final fusion. Background context: Previous studies analysed the effect of GR implantation and lengthening during treatment of patients affected by EOS. The sagittal balance has not been previously evaluated. Methods: 52 patients affected by EOS, treated with growing implants from 2007 to 2017 at our Institution were reviewed. We considered 10 consecutive patients treated with dual mechanical GR and reached final arthrodesis. The lengthening are made every 10-12 months. The minimum follow-up was 2 years and the minimum number of lengthening was 2. Every patients were monitored with periodic anteroposterior and lateral X-Ray. Measurements of the main thoracic curve and of kyphosis were performed according to Cobb method at different stages of treatment. Results: Both main thoracic and kyphotic curves had similar trends during treatment. The main thoracic curve improved from a mean pre-op value of 63,8° Cobb to a mean value of 39° Cobb after placement of GR. During lengthening, there was a loss of correction. After final arthrodesis, the average angle of main thoracic curve was 47,6° Cobb. The kyphosis changed from a mean pre-op angle of 62°, to a mean angle of 40,2° after the treatment with GR. The measure at the end of lengthenings was 49,9° and after the final arthrodesis the average angle of the kyphosis was 49,6° Cobb. Conclusion: Both main thoracic and kyphotic curves show a fluctuating trend. The first implant represents the most corrective system, instead lengthening shows a partial loss of correction. The final correction obtained by definitive arthrodesis is comparable to the first correction. The main reason for this trend could be the progressive autofusion of the spine during treatment, which causes a progressive stiffness of the spine. *Corresponding author: Paola Zarantonello, Department of Spine Deformity, IRCCS Orthopaedics and Traumatology, Rizzoli Orthopedic Institute – Via Giulio Cesare Pupilli, 1, 40136-Bologna BO, Italy, Tel: +393478379071; E-mail: paola.zarantonello@ior.it, p.zarantonello1@gmail.com Received November 06, 2018; Accepted November 19, 2018; Published November 21, 2018 Citation: Zarantonello P, Tedesco G, Maredi E, Martikos K, Vommaro F, et al. (2018) A Retrospective Study on Dual Growing Rod at the End of Treatment. J Spine 7: 423. doi: 10.4172/2165-7939.1000423 Copyright: © 2018 Zarantonello P, 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":"07 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000423","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70770440","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":"Role of Fluorodeoxyglucose - Positron Emission Tomography Scan in Detection of Residual Pus Pocket Post-Operatively in Tuberculosis of Spine and Juxta Articular Tuberculosis","authors":"K. Rcs","doi":"10.4172/2165-7939.1000424","DOIUrl":"https://doi.org/10.4172/2165-7939.1000424","url":null,"abstract":"The aim of this article is to review the main applications and advantages of Fluorodeoxyglucose PET in imaging of tuberculosis (TB) of spine post-operatively. In TB, granulomas typically demonstrate increased Fluorodeoxyglucose uptake, and areas of active TB can be differentiated from old or inactive disease by dual time point imaging. However, standardized uptake value measurements are high in both TB and malignant lesions, with significant overlap that limits their usefulness. In spinal TB, Fluorodeoxyglucose PET detects more tuberculous lesions than CT, is of value in assessing response to tuberculostatic treatment. Fluorodeoxyglucose PET can also be considered a marker of disease status in patients with HIV and TB co-infection. Overall, evaluation of treatment response is potentially the most important clinical application of Fluorodeoxyglucose PET in TB, owing to its ability to distinguish active from inactive disease. Fluorodeoxyglucose PET and PET/CT may assist early diagnosis and facilitate differentiation between malignancies and TB, identification of extra pulmonary TB, staging of TB, and assessment of treatment response. The diagnosis and prognosis of residual disease is a bit of problem in spinal TB owing to artifacts produced by implants. PET scan proves to be important in this scenario. It also helps in measuring the effectiveness of treatment. It also recognizes the new lesions that may arise because of resistance to anti-tubercular drugs. *Corresponding author: Khandelwal RCS, Department of Orthopaedics, King Edward Memorial Hospital, Mumbai, India, Tel: +9892499162; E-mail: dhakejagdish9@gmail.com Received October 24, 2018; Accepted November 16, 2018; Published November 21, 2018 Citation: Khandelwal RCS, Nathan S, Deo T, Dhake JM, Shetty NS (2018) Role of Fluorodeoxyglucose Positron Emission Tomography Scan in Detection of Residual Pus Pocket Post-Operatively in Tuberculosis of Spine and Juxta Articular Tuberculosis. J Spine 7: 424. doi: 10.4172/2165-7939.1000424 Copyright: © 2018 Khandelwal RCS, 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":"07 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000424","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70770626","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":"Preface to Special Issue Minimally Invasive Surgery Spine-II","authors":"J. Yue","doi":"10.4172/2165-7939.1000E129","DOIUrl":"https://doi.org/10.4172/2165-7939.1000E129","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/10.4172/2165-7939.1000E129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70772685","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":"Surgical Procedure of Balloon Kyphoplasty and Cement Injection in Osteoporotic Vertebral Body Fractures","authors":"Mohsen Ghiassi","doi":"10.4172/2165-7939.s7-014","DOIUrl":"https://doi.org/10.4172/2165-7939.s7-014","url":null,"abstract":"Figure 2: Filling the balloon with contrast agent. great importance. Operative stabilization using a minimally invasive procedure called balloon kyphoplasty has been one of the established methods for years. Balloon kyphoplasty provides a good and efficient pain relief with faster mobilization of patients and thus avoiding a need for care mit fast return the patients home. The surgery lasts between 30 to 60 minutes under general anesthesia. In some cases it is also possible in local anesthesia (Figures 1-8).","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.s7-014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70776257","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":"Endoscopic Spinal Decompression from an Interventional Spine Physician's Perspective","authors":"Bernard Lee","doi":"10.4172/2165-7939.S7-012","DOIUrl":"https://doi.org/10.4172/2165-7939.S7-012","url":null,"abstract":"Mechanical low back pain conditions have been traditionally treated with open surgical spinal decompression. The approach to the spine has evolved towards using minimally invasive techniques, previously microdiscectomy and now endoscopic spine surgery (ESS). ESS has bridged the gap between the frustrations of conservative measures with opioid medications to open surgery with inherent surgical and anaesthetic risks. ESS offers a direct aware state means of localizing and treating neuro-claudicant back pain, referred pain and weakness associated with stenosis that fail to respond to rehabilitation, pain management or surgery. In this letter to the editor, I discuss the endoscopic spinal decompression from an interventional spine in view of a physician’s perspective.","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.S7-012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70776331","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":"Discogenic Pain Relief by Re-Establishing Fluid Exchange between Disc and Circulation","authors":"J. Yeung, Jin-hui Shi, Huilin Yang, Hansen A. Yuan, Simon Turner, H. Seim, A. Yeung","doi":"10.4172/2165-7939.1000421","DOIUrl":"https://doi.org/10.4172/2165-7939.1000421","url":null,"abstract":"Background: Discs are avascular oxygen and nutrients are diffused from capillaries in endplates into thick discs. Calcified layers begin to fortify the cartilaginous endplates around age 16, (1) Blocking many capillaries, (2) Reducing diffusion depths, (3) Causing starvation and hypoxia in the mid-disc layer. Starvation triggers enzymatic degradation of proteoglycans in mid-disc layer, leading to desiccation and voids in nucleus, and fissure in annulus. Hypoxia triggers production inflammatory cytokines and lactic acid, leading to pH 5.5-6.5 in mid-disc layer, 5-50X acidity of blood plasma. Lactic acid leaks through the annulus fissure to cause discogenic pain from lactic acid burn, as shown in figure. Conversely, disc matrixes near superior and inferior endplates are in the diffusion zones of bicarbonate (pH buffer), oxygen and nutrients from body circulation, and have neutral pH 7.2. Proposed intervention: Percutaneous Disc Scaffold (PDS) is a multi-spiral fluid absorbing filament, a braided nylon #3 suture, for bridging between diffusion zones near superior and inferior endplates to re-establish interstitial fluid exchange between the mid-disc and body circulation. Bicarbonate in blood plasma neutralizes the lactic acid. Oxygen inhibits hypoxic inflammation and is essential to biosynthesize the most water-retaining chondroitin sulfate in proteoglycans. Constant supply of nutrients relieves starvation. Methods: In-vitro and in-vivo studies are used to verify the intended use, safety and efficacy of the PDS. (1) Fluid transport through the #3 braided nylon sutures is verified by capillary action of drawing pork blood. (2) Lactic acid neutralization is verified by titration with fresh pork blood. (3) Safety is verified in sheep discs by histology on tissue response at euthanized time point 1, 3, 12 and 30 months. (4) Efficacy is verified in a pilot clinical study after confirming discogenic pain. PDS is implanted through the discography needle. Visual Analog Pain Score (VAS) and Oswestry Disability Index (ODI) are used to evaluate therapeutic efficacy of PDS at 1-week, 3-12 and 24-months. Results: (1) Fluid transport through the #3 braided nylon sutures as PDS is demonstrated by capillary action of drawing pork blood 10.3 ± 1.2 cm against gravity. (2) Approximately 0.51-1.51 cc of pork blood is required to neutralize 1 cc of 2-6 mM lactic-acid, common concentration in painful disc. (3) PDS is inert, elicited no immune response in sheep discs euthanized at 1, 3, 12 and 30-months. (4) Baseline or pre-PDS VAS was 6.1 ± 1.6, and 2-Year VAS after PDS is 1.2 ± 0.7. Baseline ODI was 37.9 ± 15.1%, and 2-Year ODI is 9.8 ± 5.1%. Conclusion: Acid-base neutralization is instantaneous, which may be the reason for rapid reduction of discogenic pain from lactic acid burn. *Corresponding author: Jeff Yeung, MS, Aleeva Medical Inc, San Jose, CA, USA, Tel: 408-464-7431; E-mail: aleevamed@gmail.com Huilin Yang, MD, PhD, Professor and Chairman, Department of Orthope","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/10.4172/2165-7939.1000421","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70770473","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":"Consequences and Outcome of Spinal Cord injury Occurred by Bull Attack: A 10 Years Observation from Bangladesh","authors":"Ahmed Ms","doi":"10.4172/2165-7939.1000419","DOIUrl":"https://doi.org/10.4172/2165-7939.1000419","url":null,"abstract":"Background: Spinal Cord Injury (SCI) a sudden devastating and debilitating neurological condition that suffers a patient’s lot. SCI have a consequence upon physical, psychological, domestic and social context and the incidence diverse upon socio-economic and cultural perspective. In developing countries with the profound agriculture-based economy like Bangladesh, bull attack is one of the causes of SCI and the consequence and outcome in this cultural scaffold yet to be explored. Aim: The aim of this study was to elicit the consequence, clinical characteristics and outcome of the patient with SCI caused by bull attack. Methods: The study design was retrospective study design and conducted at Centre for the rehabilitation of the paralyzed (CRP), Dhaka-1343 in Bangladesh from January 2008 to December 2017. 72 persons with bull attack-induced spinal cord injury (BASCI) were found from the medical records. The data were recorded, compared and analyzed by Statistical package of social science (SPSS) 16 versions and Microsoft excel software 2007 version. Results: Among 72 respondents, 30.5% of the respondents were aged between 41-50 years, 93.1% male, 43.05% illiterate, 93.1% had traumatic tetraplegia and 58.33% were farmer living in the village. The neurological level was C1-C8 in more than half of the respondents thought the attack was in lower back and extremities. During admission, ASIA-A was 43.1% and during discharge, ASIA-A was 36.1% and an average length of rehabilitation was 3 months. Conclusion: SCI causes lifelong impairments for an individual and there is a strong association with farming, animal husbandry, literacy, and awareness. The findings can contribute to developing awareness among stakeholders in a developing country like Bangladesh. *Corresponding author: Hossain KMA, Clinical Physiotherapist, Department of Physiotherapy, Centre for the Rehabilitation of the Paralysed, Bangladesh, Tel: +8801735661492; E-mail: amranphysio@gmail.com Received September 26, 2018; Accepted October 06, 2018; Published October 09, 2018 Citation: Ahmed MS, Hossain KMA, Rahman A, Kamrunnaher, Arafat SMY, et al. (2018) Consequences and Outcome of Spinal Cord injury Occurred by Bull Attack: A 10 Years Observation from Bangladesh. J Spine 7: 419. doi: 10.4172/21657939.1000419 Copyright: © 2018 Ahmed MS, 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":"07 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000419","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70769958","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}