Journal of spine & neurosurgery最新文献

{"title":"Split-Cord Malformation of the Cervical Spinal Cord Following Dorsal Root Entry Zone Lesioning Surgery","authors":"Solomon Ondoma, John K. Park, Amgad S. Hanna","doi":"10.4172/2325-9701.1000314","DOIUrl":"https://doi.org/10.4172/2325-9701.1000314","url":null,"abstract":"The authors report a rare case of a 54-year-old man who developed an asymptomatic cleft within the cervical spinal cord at C7-T1 following Dorsal Root Entry Zone (DREZ) lesioning surgery. The patient presented to the authors’ institution with neuropathic pain from a left brachial plexopathy resulting from a lower trunk avulsion. The initial MRI at 6 months post-injury confirmed preganglionic avulsions of the left C7, C8 and T1 nerve roots. Of note, there was a prominent anterior median fissure at the C7-T1 spinal level. He underwent a DREZ lesion 8 months after the injury. Subsequent MRI studies showed a progressive near complete split within the cervical cord at C7- T1. The patient did not develop any new neurological deficits. It remains unclear whether this observation was a sequela of the root avulsion or the DREZ surgery.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45887716","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":"Percutaneous Transpedicular Fixation with Cemented Screws – A Surgical Hypothesis for Kummel’s Disease","authors":"Frederico Paiva, Carla Martins, J. Moreno, Miguel Varzielas, L. Guerra, Eduardo Mendes","doi":"10.4172/2325-9701.1000311","DOIUrl":"https://doi.org/10.4172/2325-9701.1000311","url":null,"abstract":"Introduction: The majority of compression fractures is stable and treated without major complications. One of the possible late consequences after trauma is the so called vertebral body avascular necrosis, also known as Kummel’s disease. This entity is clinically characterized by a progressively painful kyphosis within months after a minor trauma. The incidence of this finding is difficult to accurately precise because many designations have been used to describe it and it has been over diagnosed in many patients who don´t follow all the inclusion criteria. Clinical case: This paper presents the case of a 63-year-old female, with a background of Psoriatic Arthritis under biological treatment. She confirmed having a minor dorsolumbar trauma in the beginning of 2011, at the time without any complaints or new onset of pain. Five years after the trauma she came to the Emergency Room with back pain limiting her daily life. X-rays and a Computerized Tomography (CT) were taken and showed classical signs compatible with Kummel’s disease. It was suggested surgical treatment, accepted by the patient and in February 17th 2016 she was submitted to a percutaneous transpedicular fixation from D10 to L4, with cemented screws. She had a favorable outcome with clinical and radiological signs of bone consolidation Conclusion: Kummel’s disease is an exclusion diagnosis. There are clinical and imagiological criteria to help define this disease. Treatment consists of surgical fixation with anterior, posterior and both anterior/posterior approaches still being discussed on which of these gives the best results.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42740035","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":"Anterior Bone Loss in an Anterior Cervical Disectomy and Fusion","authors":"Kieser Dc, Mazas S, Roscop C, C. D., Boissiere L, Obeid I, Pointillart V, Vital Jm, Gille O","doi":"10.4172/2325-9701.1000316","DOIUrl":"https://doi.org/10.4172/2325-9701.1000316","url":null,"abstract":"","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70254702","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":"The Clinical Outcomes Of Patients With L1-L2 Disc Herniation Treated By Microsurgical Trans Facet Approach","authors":"G. Sharifi, A. Rahimzadeh, N. Fereydonyan, A. Divanbeigi, H. Kasbkar, K. Ebrahimzadeh, S. Amiri, Omidvar Rezaei","doi":"10.4172/2325-9701.1000302","DOIUrl":"https://doi.org/10.4172/2325-9701.1000302","url":null,"abstract":"Background: In comparison to lower lumbar disc herniation, L1-L2 disc herniation has unique characteristics, which cause controversy in selection of surgical approach. The goal of this study was to evaluate the clinical outcomes for treatment of L1-L2 disc herniation by microsurgical transforaminal lumbar interbody fusion (TLIF) technique. Therefore, 37 symptomatic patients of L1-L2 disc herniation who were treated by TLIF, from 2008 to 2016, in three academic hospitals were reviewed retrospectively. Follow-up of these patients should significant clinical improvement following TLIF surgery (p-value <0.001) and acceptable bony union with respect to the results, we concluded that TLIF can be an effective, reproducible and safe technique for surgical treatment of L1-L2 disc herniation.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2018 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2018-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48065267","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":"Preliminary Clinical Outcomes From The Polyetheretherketone On Ceramic Simplify™ Disc FDA IDE Trial","authors":"G. Maislin, D. Maislin, B. Keenan, A. Mr.","doi":"10.4172/2325-9701.1000304","DOIUrl":"https://doi.org/10.4172/2325-9701.1000304","url":null,"abstract":"Background: This study was performed to evaluate the preliminary clinical results for the Simplify™ Cervical Artificial Disc. Methods: We compared outcomes for the first 61 subjects to reach Month 12 follow-up in a prospective, multicenter, FDA IDE clinical trial with 61 propensity score matched historical control subjects who received conventional anterior cervical discectomy and fusion (ACDF) for single-level cervical degenerative disc disease. The outcome measures included the change from preoperative baseline to Month 12 in Neck Disability Index (NDI) and visual analog scales (VAS) for neck and arm pain with missing follow-up determined by last observation carried forward. Results: The null hypothesis that the Simplify 1-disc is inferior to ACDF (non-inferiority margin=8.4) was rejected at a 1-sided p<0.0001. The upper bound of the 1-sided 95% non-inferiority confidence interval was -7.44 which is much smaller than the non-inferiority margin of 8.4. Superiority was demonstrated with a 2-sided p=0.0004. The upper bound of the 2-sided 95% confidence interval was -6.26 which is much less than zero. Sensitivity analyses on the assumptions about missing data and the matching included completer’s analyses and analyses that were restricted to the 55 of 61 first stage matches that could be achieved without expanding of the calipers used to identify potential matches. The p-values for non-inferiority in all analyses are <0.0001. Similarly, the p-values for superiority are all ≤ 0.0030. Conclusion: Therefore, we conclude that the Simplify Disc is superior to ACDF control in terms of improvement in NDI and VAS from baseline to Month 12.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2018 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2018-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46753734","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":"Bilateral Sequential Central Retinal Artery Occlusion due to Giant Cell Arteritis","authors":"A. Schaefer, John Behnke, H. Peters, S. Sen, Sunitha Paudyal, R. Pokharna","doi":"10.4172/2325-9701.1000307","DOIUrl":"https://doi.org/10.4172/2325-9701.1000307","url":null,"abstract":"A patient presented with acute, painless loss of vision in each eye occurring successively over a few days. He was diagnosed with bilateral central retinal artery occlusions (CRAO) and immediately underwent treatment for possible giant cell arteritis (GCA) while the etiology of CRAO was being determined. Further workup initially proved ambiguous in many respects for GCA verses other types of vasculitis. Definitive diagnosis of GCA was achieved with temporal artery biopsy, though this too demonstrated characteristics of other vasculitides. While awaiting pathology results, empiric treatment for GCA should continue uninterrupted to prevent progression or relapse, as GCA carries a significant risk of vision loss and visual recovery is exceedingly rare. Ultimately, the diagnosis relies heavily on clinical correlation.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48816401","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":"How I Fix Spinopelvic Abnormalities With Hyperlordotic Cages","authors":"J. Yazdi, Thomas K. Lee","doi":"10.4172/2325-9701.1000300","DOIUrl":"https://doi.org/10.4172/2325-9701.1000300","url":null,"abstract":"In recent years, normalization of spinopelvic parameters has become a significant focus in the treatment of adult spinal deformity (ASD). Numerous studies have shown that by correcting those parameters, the patient-reported outcomes have statistically improved significantly. However, very little is published about the actual technique used to accomplish this task. In this article, we present the case of a patient with significant spinopelvic parameter abnormalities. We will discuss step-by-step how the case was analyzed preoperatively and the steps taken during surgery to achieve our goals. We will also discuss some pitfalls and how to avoid them. Short-term post-operative films are used to demonstrate the effectiveness of our technique and decision making process.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2018 1","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2018-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46890876","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":"True Recurrent Lumbar Disc Herniation And Arterial Hypertension: Is There Any Relation?","authors":"H. Reihani-Kermani, S. Saidi, F. Zolala, A. Reihani, M. Mehrabian","doi":"10.4172/2325-9701.1000299","DOIUrl":"https://doi.org/10.4172/2325-9701.1000299","url":null,"abstract":"Cardiovascular risk factors and atherosclerosis are associated with lumbar disc herniation. However, studies fail to identify a consistent risk factor for the recurrence. To investigate the association between cardiovascular risk factors and true recurrent of lumbar disc herniation, 186 patients who underwent unilateral microdiscectomy for intractable radiculopathy due to lumbar disc herniation were enrolled in this cross-sectional study. One surgeon performed all operations, and all patients were treated with the same procedure. The follow-up period was between 6 months to 5 years. The association between some cardiovascular risk factors e.g. hypertension, diabetes, hyperlipidemia, smoking and true recurrent lumbar disc herniation investigated using logistic regression analysis. Sixty-nine patients with true recurrence of lumbar disc herniation (RLDH group) were compared to 117 patients who were surgically treated with no recurrence of lumbar disc herniation (LDH group). The differences of age, gender, diabetes, morphine addiction, hyperlipidemia and smoking between two groups were not statistically significant. The prevalence of hypertension in RLDH and LDH was 61.5% and 38.5% respectively. The difference was significant (p<0.001). The logistic regression analysis showed the recurrence rate was significantly higher in hypertensive patients (OR: 1.74-7.55, CI: 95%, P = 0.001). Furthermore, there was no correlation between confounding factor of medications, diabetes, history of cardiovascular disease, hyperlipidemia, duration of the symptom-free interval, gender and the true recurrence. The results of this preliminary study showed that there might be a possible relation between arterial hypertension and true recurrence of lumbar disc herniation, so it would be advisable to pay more attention to hypertensive patients who have been operated.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2018 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43420400","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 Excision of Large Sacral Chordoma with Lumbopelvic Fixation","authors":"Ramadan Shamseldien","doi":"10.4172/2325-9701.1000308","DOIUrl":"https://doi.org/10.4172/2325-9701.1000308","url":null,"abstract":"Background: Chordoma is slowly growing locally malignant destructive tumor originated as a remnant of notochord. It occur less than 5% of all bone tumors. It has a preferentiality to attack sacrum up to 50%, followed by base of the skull up to 40% and to less extent other vertebral regions up to 15%. Local pain, radiculopathy, and urinary incontinence are the usual presenting symptoms in case of Sacral Chordoma. Contrast enhanced MRI and CT are recommended studies to evaluate extent of both soft tissue invasion and displacement and bone destruction and calcification. This lesion is resistant to chemotherapy and weak response to radiotherapy make the surgical excision first line of treatment. Aggressive surgical excision and stabilization of lumbosacral spin and pelvis improve the local control in spite of risk of associated morbidity. Sacral Chordoma is reported to be poor prognosis. The optimal method for management of this lesion is debatable due to its rarity. \u0000Aim: To present a case of Sacral Chordoma with very large local extension and sacral destruction. \u0000Study design: Case report. \u0000Methods: our 60 years old male patient presented with lower lumbar and sacral swelling, bilateral gluteal pain, and obstructive uropathy. Slowly progressive within the last nine months prior to presentation; contrast enhanced MRI and CT lumbosacral spine, show a large sacral destructive heterogeneous mass lesion destructing the sacrum and intraspinal structures apart from first sacral segment. By CT guided biopsy at oncology institute diagnosed as Sacral Chordoma. He was subjected to gross surgical total excision, and posterior lumbosacral transpedicular screw fixation concomitant with iliac screw for sacral augmentation, then adjuvant radiation therapy. \u0000Results: After tumor excision and lumbopelvic fixation, the patient still incontinent, full motor power of both lower limbs. Complete course of adjuvant radiation. And after one year follow up the patient died due to bad general condition. \u0000Conclusion: Sacral Chordoma is infrequent lesion that affect male more than females. Gross surgical excision is the first line of treatment. Lumbopelvic stabilization is mandatory when extensive sacral destruction exist. Sacral Chordoma reported to be poor prognosis.","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":"2018 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70254686","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":"The Primary Interosseous Meningeoma: A Rare but Fascinating Entity","authors":"S. Ganapathy, R. Nair, G. Menon","doi":"10.4172/2325-9701.1000305","DOIUrl":"https://doi.org/10.4172/2325-9701.1000305","url":null,"abstract":"Primary interosseous meningeomas are rare. They account for less than 1% of the total number of meningeomas seen today. We present a case of a swelling on the scalp as a result of recurrent trauma, which was ignored but gradually increased to a size of 5 cms. Imaging showed an interosseous lesion extending ontothe convexity dura of the right frontal lobe but not invading the underlying brain. The tumor was completely excised with a wide margin and a bone cement cranioplasty was done to cover the defect. Follow up after 6 weeks showed no recurrence of the tumor. Histopathology revealed that the lesion was a grade 1 meningioma. A review of relevant literature along with a discussion of possible differential diagnoses is provided as well","PeriodicalId":90240,"journal":{"name":"Journal of spine & neurosurgery","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43613984","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}