scholarly journals Technical Aspects on the Use of Ultrasonic Bone Shaver in Spine Surgery: Experience in 307 Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Derya Burcu Hazer ◽  
Barış Yaşar ◽  
Hans-Eric Rosberg ◽  
Aytaç Akbaş
Keyword(s):  
Spine Surgery ◽  
Neck Disability Index ◽  
Surgical Techniques ◽  
Foramen Magnum ◽  
Spinal Diseases ◽  
One Year ◽  
The One ◽  
Neck Disability ◽  
Dural Tears ◽  
Lumbar Spinal

Aim. We discuss technical points, the safety, and efficacy of ultrasonic bone shaver in various spinal surgeries within our own series.Methods. Between June 2010 and January 2014, 307 patients with various spinal diseases were operated on with the use of an ultrasonic bone curette with microhook shaver (UBShaver). Patients’ data were recorded and analyzed retrospectively. The technique for the use of the device is described for each spine surgery procedure.Results. Among the 307 patients, 33 (10.7%) cases had cervical disorder, 17 (5.5%) thoracic disorder, 3 (0.9%) foramen magnum disorder, and 254 (82.7%) lumbar disorders. Various surgical techniques were performed either assisted or alone by UBShaver. The duration of the operations and the need for blood replacement were relatively low. The one-year follow-up with Neck Disability Index (NDI) and Oswestry Disability Index (ODI) scores were improved. We had 5 cases of dural tears (1.6%) in patients with lumbar spinal disease. No neurological deficit was found in any patients.Conclusion. We recommend this device as an assistant tool in various spine surgeries and as a primary tool in foraminotomies. It is a safe device in spine surgery with very low complication rate.

scholarly journals Anterior Controllable Antedisplacement and Fusion (ACAF) technique for the treatment of multilevel cervical spondylotic myelopathy with spinal stenosis (MCSMSS): a retrospective study of 45 cases

2019 ◽  
Author(s):  
Xi Luo ◽  
Kaiqiang Sun ◽  
Jingchuan Sun ◽  
Shunmin Wang ◽  
Yuan Wang ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Cervical Spondylotic Myelopathy ◽  
Japanese Orthopaedic Association ◽  
Neck Disability Index ◽  
Operation Time ◽  
Significant Difference ◽  
Csf Leakage ◽  
One Year ◽  
Neck Disability ◽  
Multilevel Cervical Spondylotic Myelopathy

Abstract Background To investigate the clinical effect of anterior controllable antedisplacement and fusion (ACAF) technique for the treatment of multilevel cervical spondylotic myelopathy with spinal stenosis (MCSMSS), and compare ACAF with hybrid decompression fixation (HDF). Methods A retrospective analysis of 85 cases with MCSMSS was carried out. 45 patients were treated with ACAF, while 40 patients were treated with HDF. The operation time, intraoperative bleeding volume, postoperative complications, Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI) score, Computed Tomography (CT) transverse measurement, cervical curvature and Kang's grade were compared between two groups. Results The patients were followed up for 12 to 17 months. Compared with HDF, ACAF group achieved better decompression according to CT measurement and Kang’s grade (P < 0.05), and recovered to a greater cervical Cobb’s angle (P < 0.05). However, JOA score and NDI index showed no significant difference one year after surgery (P＞0.05). Additionally, ACAF presented longer operation time and greater intraoperative blood loss (P < 0.05). As to complications, ACAF developed less incidences of cerebrospinal fluid examination (CSF) leakage, neurologic deterioration, epidural hematoma and C5 palsy by comparing with HDF. Conclusions ACAF is an effective method for the treatment of MCSMSS. Compared with HDF, ACAF has the advantages of significant decompression, increasing cervical curvature, and reducing the incidences of complications.

scholarly journals The Qualification of Outcome after Cervical Spine Surgery by Patients Compared to the Neck Disability Index

PLoS ONE ◽  
2016 ◽  
Vol 11 (8) ◽  
pp. e0161593 ◽  
Author(s):  
Roland Donk ◽  
Andre Verbeek ◽  
Wim Verhagen ◽  
Hans Groenewoud ◽  
Allard Hosman ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Neck Disability Index ◽  
Cervical Spine Surgery ◽  
Neck Disability

Use of a sternocleidomastoid rotational and cervical-fascial advancement flap for closure of a persistent mastoid cutaneous fistula

2020 ◽  
Vol 134 (10) ◽  
pp. 936-938
Author(s):  
Y Tsitsiou ◽  
A Mantelakis ◽  
A Joshi
Keyword(s):  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Surgical Techniques ◽  
Advancement Flap ◽  
Suppurative Otitis Media ◽  
Limited Applicability ◽  
A New Technique ◽  
One Year ◽  
The One ◽  
Surgical Treatments

AbstractBackgroundPost-auricular mastoid fistula is a rare occurrence. It typically appears following repeated soft tissue injury, and is commonly caused by chronic suppurative otitis media and repeated surgical treatments. Management is challenging, with few reported successful surgical techniques, which often have limited applicability.Case reportThis paper presents the case of a 58-year-old male with a persistent right-sided post-auricular cutaneous mastoid fistula resulting from two previous mastoidectomies. Although the patient underwent two simple primary closures, the fistula recurred. This was successfully treated with a new technique utilising a sternocleidomastoid rotational and cervical-fascial advancement flap, which was completely healed at the one-year follow up without a recurrence of the fistula.ConclusionThis novel technique provided definitive obliteration of a persistent cutaneous mastoid fistula. Utilising a double-layered flap and a facelift incision results in excellent functional and cosmetic outcomes.

scholarly journals Unique Bone Suture Anchor Repair of Complex Lumbar Cerebrospinal Fluid Fistulas

2020 ◽  
Vol 11 ◽  
pp. 153
Author(s):  
Marc Agulnick ◽  
Benjamin R. Cohen ◽  
Nancy E. Epstein
Keyword(s):  
Cerebrospinal Fluid ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Suture Anchor ◽  
Hand Surgery ◽  
Lumbar Spine Surgery ◽  
Lumbar Spinal Surgery ◽  
Lumbar Cerebrospinal Fluid ◽  
Dural Tears ◽  
Lumbar Spinal

Background: Spine surgeons encounter occasional complex cerebrospinal fluid fistulas/dural tears (CSF/DT) during lumbar spinal surgery. In some cases, these leaks are found during the index procedure, but others may appear postoperatively, or in the course of successive procedures. Here we asked, whether these complex CSF fistulas/DT could be more readily repaired utilizing a “bone suture anchor” technique, particularly where there is no residual dural margin/remnant. Methods: With the combined expertise of the orthopedist and neurosurgeon, mini/micro bone suture anchors, largely developed for hand surgery, facilitated repair of complex DT occurring during lumbar spine surgery. This technique was utilized to suture in place fascia, periosteal, or muscle grafts, and was followed by the application of microfibrillar collagen, and a fibrin sealant. Results: This mini/micro suture anchor technique has now been utilized to repair multiple significant intraoperative and/or postoperative recurrent DT, largely avoiding the need to place lumbar drains and/or lumbo- peritoneal shunts. Conclusions: Here, we reviewed how to directly suture dural grafts utilizing a mini/micro bone suture anchor technique to repair complex intraoperative primary/recurrent DT occurring during lumbar spine surgery. The major advantages of this technique, in addition to obtaining definitive occlusion of the DT, largely avoids the need to place lumbar drains and/or lumbo-peritoneal shunts with their attendant risks and complications.

Using PROMIS-29 to predict Neck Disability Index (NDI) scores using a national sample of cervical spine surgery patients

2020 ◽  
Vol 20 (8) ◽  
pp. 1305-1315
Author(s):  
Jacquelyn S. Pennings ◽  
Inamullah Khan ◽  
Claudia A. Davidson ◽  
Robert Freitag ◽  
Mohamad Bydon ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Neck Disability Index ◽  
National Sample ◽  
Cervical Spine Surgery ◽  
Neck Disability

scholarly journals Surgical treatment of senile spinal diseases

2021 ◽  
Vol 64 (3) ◽  
pp. 191-199
Author(s):  
Dal-Sung Ryu ◽  
Seung-Hwan Yoon
Keyword(s):  
Spine Surgery ◽  
Surgical Outcomes ◽  
Thoracolumbar Spine ◽  
Age Groups ◽  
Surgical Techniques ◽  
The Elderly ◽  
Advanced Age ◽  
Spinal Diseases ◽  
Minimally Invasive Surgical ◽  
Surgery In The Elderly

Advanced age is a well-known risk factor for spinal surgery-related complications. Decisions on spine surgery in the elderly are difficult due to higher morbidity and mortality than in younger age groups. In addition, spine surgery is a kind of ‘functional surgery’ which does not directly affect the survival of patients. In recent years, individualized risk stratification has gained ground over simple chronological age-based assessment. In the elderly, frailty is one of the strongest factors which affect surgical outcomes for both cervical and thoracolumbar spine surgery, regardless of the surgical technique used. Spine surgery in the elderly have worse surgical outcomes in terms of duration of hospital stay, degree of functional recovery, and complication, readmission, and mortality rates. However, the benefit of spine surgery even in the very-elderly is substantial. In conclusion, surgical decisions should be made based on both personalized risk assessment and benefits of surgery. Recent advanced surgical techniques such as minimally invasive surgical techniques and robotics assistance are likely to be helpful in minimizing surgical complications. Therefore, advanced age in itself should not be considered as a contraindication for spine surgery.

scholarly journals Follow-up of a new titanium-coated polyetheretherketone cage for the cervical spine

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Ricardo Arregui ◽  
José Aso Escario ◽  
José-Vicente Martínez Quiñones ◽  
Cristina Sebastián ◽  
Fabián Consolini ◽  
...  
Keyword(s):  
Modulus Of Elasticity ◽  
Neck Disability Index ◽  
Clinical Results ◽  
Poly Ether Ether Ketone ◽  
Clinical And Radiological Outcome ◽  
The One ◽  
Neck Disability ◽  
Polyetheretherketone Cage ◽  
Anterior Cervical Discectomy Fusion

Poly-ether-ether-ketone (PEEK) cages have lower modulus of elasticity when compared with Titanium (TTN) cages. This suggests that PEEK-cages could show a lower rate of subsidence after anterior cervical discectomy-fusion (ACDF) and might lead to a lower loss of correction. We investigated the one to five year-results of standalone PEEK-TTN-porous coated cages in a patient cohort from 2014 to 2017. The patients underwent single-level ACDF for disc herniation and degenerative discopathy. Clinical and radiological outcome were assessed in 50 eligible patients after a mean of 27 months. Results: Solid arthrodesis was found in 84%. Neck disability index (NDI), and visual analogue scale (VAS) of neck and arm show comparable results to the literature. Conclusions: Clinical and radiological outcomes of ACDF with PEEK-body-cages with a porous coated surface show good bony integration. The modulus of elasticity, design, shape, size, cage surface architecture, as well as bone density, endplate preparation, radical microdiscectomy and distraction during surgery should be considered as important factors influencing the clinical results. One main advantage, over titanium cages, is the absence of MRI artifacts, allowing an excellent postoperative follow-up.

scholarly journals Anterior Dural Tear in Thoracic and Lumbar Spinal Fractures: Single-Center Experience with Coating Technique and Literature Review of the Available Strategies

Life ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 875
Author(s):  
Giorgio Lofrese ◽  
Jacopo Visani ◽  
Francesco Cultrera ◽  
Pasquale De Bonis ◽  
Luigino Tosatto ◽  
...  
Keyword(s):  
Literature Review ◽  
Surgical Techniques ◽  
Spinal Fractures ◽  
Fat Graft ◽  
Dural Tear ◽  
Coating Technique ◽  
Single Center Experience ◽  
Dural Tears ◽  
Lumbar Spinal ◽  
Repair Techniques

Differently from the posterior, the anterior dural tears associated with spinal fractures are rarely reported and debated. We document our experience with a coating technique for repairing ventral dural lacerations, providing an associated literature review on the available strategies to seal off such dural defects. A PubMed search on watertight repair techniques of anterior dural lacerations focused on their association with spinal fractures was performed. Studies on animal or cadaveric models, on cervical spine, or based on seal/gelfoam or “not suturing” strategies were excluded. 10 studies were finally selected and our experience of three patients with thoracic/lumbar spinal fractures with associated ventral dural tear was integrated into the analysis of the surgical techniques. Among the described repair techniques for ventral dural lacerations a preference for primary suturing, mostly trans-dural, was noted (n = 6/10 papers). Other documented strategies were the plugging of the dural opening with a fat graft sutured to its margins, or stitched to the dura adjacent to the defect, and the closure of the dural tear with two patches, both trans-dural and epidural. Our coating techniques of the whole dural sac with the heterologous patch were revealed as safe and effective alternatives strategies, even when patch flaps wrapping nerve roots have to be cut and a fat graft has to be stitched in the patch respectively for sealing off antero-lateral and wide anterior dural tears. Compared to all the documented strategies for obtaining a watertight closure of an anterior dural laceration, the coating techniques revealed advantages of preserving neural structures, being adaptable to anterior and antero-lateral dural tears of any size.

Resources: Internet Resources for the Independent Medical Evaluator – 2007

2007 ◽  
Vol 12 (4) ◽  
pp. 4-7
Author(s):  
Christopher R. Brigham ◽  
Jenny Walker
Keyword(s):  
Head Trauma ◽  
Clonic Seizure ◽  
Acute Subdural Hematoma ◽  
Orbital Fracture ◽  
Orbital Wall ◽  
First Occurrence ◽  
One Year ◽  
The One ◽  
Neurological Injuries ◽  
Medial Orbital Wall

Abstract Rating patients with head trauma and multiple neurological injuries can be challenging. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, Section 13.2, Criteria for Rating Impairment Due to Central Nervous System Disorders, outlines the process to rate impairment due to head trauma. This article summarizes the case of a 57-year-old male security guard who presents with headache, decreased sensation on the left cheek, loss of sense of smell, and problems with memory, among other symptoms. One year ago the patient was assaulted while on the job: his Glasgow Coma Score was 14; he had left periorbital ecchymosis and a 2.5 cm laceration over the left eyelid; a small right temporoparietal acute subdural hematoma; left inferior and medial orbital wall fractures; and, four hours after admission to the hospital, he experienced a generalized tonic-clonic seizure. This patient's impairment must include the following components: single seizure, orbital fracture, infraorbital neuropathy, anosmia, headache, and memory complaints. The article shows how the ratable impairments are combined using the Combining Impairment Ratings section. Because this patient has not experienced any seizures since the first occurrence, according to the AMA Guides he is not experiencing the “episodic neurological impairments” required for disability. Complex cases such as the one presented here highlight the need to use the criteria and estimates that are located in several sections of the AMA Guides.

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