Aims. Lumbar spinal stenosis (LSS) is a common skeletal system disease that has been partly attributed to genetic variation. However, the correlation between genetic variation and pathological changes in LSS is insufficient, and it is difficult to provide a reference for the early diagnosis and treatment of the disease. Methods. We conducted a transcriptome-wide association study (TWAS) of
This study aimed to determine the relationship between pedicle-lengthening
distance and bulge-canal volume ratio in cases of lumbar spinal
stenosis, to provide a theoretical basis for the extent of lengthening
in pedicle-lengthening osteotomies. Three-dimensional reconstructions of CT images were performed
for 69 patients (33 men and 36 women) (mean age 49.96 years; 24
to 81). Simulated pedicle-lengthening osteotomies and disc bulge
and spinal canal volume calculations were performed using Mimics
software. Aims
Methods
Objectives: To evaluate and compare the imaging of lumbar
In 139 patients with burst fractures of the thoracic, thoracolumbar or lumbar spine, the least sagittal diameter of the spinal canal at the level of injury was measured by computerised tomography. By multiple logistic regression we investigated the joint correlation of the level of the burst fracture and the percentage of
Lumbar disc herniations are quite common pathology in orthopedics. Percutaneous discectomy remains somewhat controvercial. It has limited indications and has not proven to be as effective as conventional or microscopic discectomy. Smith and Foley developed a new minimum invasive procedure for lumbar disc disease, Microendoscopic Discectomy (MED) in 1995. We started MED from October 1998. Besides, we started the clinical application of MED for lumbar
A total number of 428 patients underwent surgical procedure due to different acquired spinal disorders. Conservative approaches were tried where it was indicated. When there was no improvement with conservative treatment then surgical procedures were adopted. It was a prospective study which was done in both Govt. and private hospitals irrespective of age &
sex. Total period was from August 2002 to February, 2008. Age of the patients ranged between from 8–65 years. In this series male was more dominant than female. In this series main causes were traumatic, infective, degenerative &
neoplastic disorders. Prolapsed Lumber Inter-vertibral Disc 202, prolapse cervical disc 15, unstable spinal injuries 86, Pott’s paraplegia 68, degenerative disc disease 18, spondilolisthesis 12 and neoplastic both primary &
secondary were 9 cases. Fenestration &
disectomy done in PLID and decompression and stabilization done in unstable spinal injuries. Instrumentation done as adjuvant to achieve early biological union of bone. In Pott’s disease when conservative treatment failed to improve, decompression and stabilization was done by thoracotomy specially in at thoraco-lumber tuberculosis. Clowards operation done in cervical disc prolapse &
Study design: Retrospective, descriptive study. Objectives: To describe the characteristics and outcomes of patients with
STUDY DESIGN: Retrospective, descriptive study. OBJECTIVES: To describe the characteristics and outcomes of patients with
Aim. Spinal implant-associated infections (SIAI) require combined surgical and antimicrobial treatment and prolonged hospital stay. We evaluated the clinical, laboratory, microbiological and radiological characteristics and treatment approaches in patients with SIAI. Method. Consecutive adult patients with SIAI treated between 2015 and 2017 were prosepctively included. SIAI was defined by: (i) significant microbial growth from intraoperative tissue or sonication fluid, (ii) intraoperative purulence, secondary wound dehiscence or implant on view, (iii) radiographic evidence of infection and fever (>38°C) without other recognized cause, increasing back pain or neurologic impairment, (iv) peri-implant tissue inflammation in histopathology. Results. A total of 60 patients were included, median age was 66 years (range, 28–91 years), 29 (48%) were males. The most common reason for spinal stabilization was
We all aware about overuse syndrome, as compensation of other parts of body. Our famous poet Sa'adi: when part of our body sustains become painful, the other parts can't tolerate and reciprocate. Among our patients who underwent total Knee arthroplasty few of them have pain especially in 1st 3 months (Anterior Knee pain, effusion, ….) but almost 15 – 20 percents are not satisfied enough by this Procedure. In a Cohort historic study on 301 TKA with at least 2 years follow up 47 patients had not enough satisfaction in our clinic we tried to visit them to find out why?. Criteria's we chose, were:. Age. Osteopenia. Sarcopenia. Low back pain.
To assess radiological fusion rates in posterolateral fusions using SiS-CaP. Retrospective, radiological follow-up study. Single surgeon series of 76 consecutive patients were evaluated, in a regional spinal unit. All patients had clinical and radiological (MRI)
Introduction: In this study we report our experience with the clinical outcomes following Dynesys. Our objectives are to revalidate the most suitable indication(s) of Dyne-sys in patients with backpain. Method: A prospective cohort study on 374 consecutive patients who had Dynesys for backpain from September 2000 to-present. Average age of patients was 57 years and male to female ratio were (40%:60%). Preoperative assessment involved ODI, SF36, VAS for leg and backpain and the diagnosis was confirmed with physical examination, x rays, spinal probe and lumbar spine MRI. Regular follow up was arranged at 2 weeks, 3, 6 and 12 months then on annual intervals. In our cohort, clinical indications were:. • Degenerative Disc Disease (DDD). 271 patients. • Spondylolisthesis. 55 patients. • Adjacent segment disease (ASD). 30 patients. •
Posterior approach to the lumbar spine necessarily induces structural damage of paravertebral muscles. In order to avoid these changes, we have started to utilize a microscopic decompression of the spinal canal via an unilateral approach since 1998. The purpose of this study was to evaluate the results of this operative procedure for lumbar
Cervical Cord Neuropraxia (CCN) and incomplete cord injuries such as Central Cord Syndrome (CCS) are more prevalent in patients with congenitally narrow spinal canals. The aim of this study was to identify if racial groups were over represented in patients with incomplete cord injuries, and if there was an ethnic variation in mid sagittal cervical spine diameter in the general population. CT scan was used to measure the mid sagittal diameter of the C3 to C7 cervical vertebrae in a group of 166 sequential trauma patients who had CT scans of the cervical spine at Middlemore Hospital. Patient’s race was that declared by the patient. Four different observers used computer digitisation to measure the mid sagittal diameters and mean sagittal diameter for each level. Measurements were compared between races. Maori cervical spine canals were found to be 1mm smaller than Europeans (P values less than 0.005) whilst Polynesians had on average a 2mm smaller mid sagittal diameter compared to Europeans (all P values less than 0.001). This study has demonstrated that Polynesians were over represented in the group of patients who experienced CCS or Transient Cervical Neuropraxia. CT scan assessment demonstrated that both Maoris and Polynesians had significantly narrower canals than their European counterparts. The implications of this study are that Maori and Polynesians involve in high impact activities such as rugby may be at increased risk of incomplete or complete spinal cord injuries. There is however no reliable screening tool available for congenital
Purpose: There are a wide variety of operative procedures for lumbar
Purpose: The average age of people suffering spinal cord injuries in many countries is shifting toward an older population, with a disproportionate number occurring in the spondylotic cervical spine. These injuries are typically due to low energy impacts, such as a fall from standing height. Since a stenotic spinal canal (a common feature of a spondylotic cervical spine) can cause myelopathy when the spine is flexed or extended, traumatic flexion or extension likely causes the injury during the low energy impact. However, this injury mechanism has not been observed experimentally. Method: To better understand this injury mechanism an in-vitro study, using six whole cervical porcine spines, was conducted. The following techniques were combined to directly observe spinal cord compression in a stenotic spine during physiologic and super-physiologic motion:. A radio-opaque surrogate cord, with material properties matched to in-vivo specimens, replaced the real spinal cord. Sagittal plane X-rays imaged the surrogate cord in the spine during testing. Varying levels of canal stenosis were simulated by a M8 machine cap screw that entered the canal from the anterior by drilling through the C5 vertebral body. Pure moment loading and a compressive follower load were used to replicate physiologic and super-physiologic motion. Results: Initial results show that a stenotic occlusion that removes all extra space in the canal in the neutral posture, without compressing the cord, can lead to spinal cord compression within physiologic ranges of flexion and extension. The spinal cord can also be compressed during slightly super-physiologic flexion and extension with only 25% canal occlusion. Physiologic loads and motions in the same spines did not cause cord compression when canal occlusion was 0%. Conclusion: These results support the hypothesis that cervical
Thoracolumbar junction of the spinal column is the common site of spinal trauma and is often complicated by neurological dysfunction. From 1997 to 2000, there were 12 patients surgically stabilized. 8 of them were victims of major trauma while the rest was after a trivial fall in osteoporotic spine. Lengthen of follow-up ranged from 6 to 42 months. Ages of the patients in the major trauma group were from 22 to 65. Except the one who had anterior approach because of multiple level lesions, all fractures after major trauma were initially relocated and stabilized posteriorly. Subsequent anterior procedures were necessary in three of them because of significant residual
Introduction: Wide laminectomy has been the accepted treatment of choice for stenosis in the lumbar spine. Recently, bilateral laminotomy has been proposed as an alternative decompressive technique for
Summary Statement. Tandem stenosis is a prevalent condition in an Asian population with the narrowest cervical canal diameters and risk factors include advanced age and increased levels of lumbar canal stenosis. Introduction. Tandem spinal stenosis (TSS) is defined as patient with concomitant
Introduction Numerous in-vitro studies demonstrating increased stress at levels adjacent to a lumbar fusion have raised concerns of accelerated degeneration. However, the significance of this increased stress in the in-vivo setting remains unclear, especially with long-term follow-up. The objective of this study was to assess the level of degeneration on MRI in this same cohort of patients at a minimum of 20 years follow-up. Methods Thirty-seven patients undergoing lower lumbar anterior lumbar interbody fusion with a minimum of 20 years follow-up were identified. Only patients with normal pre-operative discograms at the level adjacent to the fusion were considered in this study. MRI scans were performed and evaluated for any evidence of degeneration by an independent radiologist. Advanced degeneration was defined as either: (1) absence of T2 signal intensity in the disk, (2) disk herniation, or (3)
