Relief of spinal block during embolization of a vertebral body hemangioma

1976 ◽  
Vol 45 (3) ◽  
pp. 327-330 ◽  
Author(s):  
Cordell E. Gross ◽  
Charles J. Hodge ◽  
Eugene F. Binet ◽  
Irvin I. Kricheff
Keyword(s):  
Vertebral Body ◽  
Spinal Block ◽  
Vertebral Hemangioma ◽  
Percutaneous Embolization ◽  
Content Type ◽  
Subarachnoid Block ◽  
Fine Print

✓ The authors describe a case in which a subarachnoid block caused by a thoracic vertebral hemangioma was relieved during percutaneous embolization of the tumor.

Resection of a vertebral hemangioma after preoperative embolization

1977 ◽  
Vol 47 (2) ◽  
pp. 282-285 ◽  
Author(s):  
David C. Hemmy ◽  
David M. McGee ◽  
Frederick H. Armbrust ◽  
Sanford J. Larson
Keyword(s):  
Vertebral Body ◽  
Spinal Canal ◽  
Arterial Embolization ◽  
Surgical Excision ◽  
Preoperative Embolization ◽  
Vertebral Hemangioma ◽  
Content Type ◽  
Fine Print

✓ Preoperative arterial embolization of a vertebral hemangioma allowed surgical excision of the vertebral body, restoration of normal anatomic continuity of the spinal canal, and improvement in myelopathy.

The use of visible light-curing resin for vertebral body replacement

1991 ◽  
Vol 75 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Ricardo Segal ◽  
Moufid Alsawaf ◽  
Ali Tabatabai ◽  
Reisuke Saito ◽  
Eduardo D. Segal ◽  
...  
Keyword(s):  
Visible Light ◽  
Methyl Methacrylate ◽  
Vertebral Body ◽  
Vertebral Body Replacement ◽  
Halogen Lamp ◽  
Content Type ◽  
Spinal Implant ◽  
Light Curing ◽  
Visible Light Curing ◽  
Fine Print

✓ The technology of visible light-curing resin has recently been developed for use in removable prosthodontics. A quartz halogen lamp producing a 400- to 500-nanometer wave-length spectrum of visible light is used to polymerize high-molecular-weight acrylic resin monomers. While several in vitro and in vivo studies of visible light-curing resin are found in the dental literature, no studies have yet been performed to evaluate it as an intracorporeal implant in surgery. The authors have designed a rat model of microcervical corpectomy to assess vertebral body replacement with visible light-curing resin in comparison to conventional autopolymerizing methyl methacrylate. Spinal cord function tests, spinal-implant stability assessments, and histological evaluations were made in a total of 41 rats at 2, 4, or 6 months postimplant. No animal developed a neurological deficit or radiographic instability, and at sacrifice there was no evidence of implant fracture-extrusion. In addition, there were no signs of adverse reaction in the surrounding tissues. Morphological investigation of the resin/bone interface at 6 months revealed very good implant anchorage. Visible light-curing resin was found to be far superior to methyl methacrylate for construction of spinal implants. Its waxy consistency makes it easy to handle. It remains pliable until light is applied, allowing adjustments in shape for a well-fitted implant without time constraints. Applied in layers, adjustments can be made even after polymerization of a previous layer. This new implantable resin will allow safer, immediate stabilization in patients with neoplastic destruction of the spine, and may also be advantageous for other neurosurgical applications, such as cranioplasty.

Fracture dislocation of the cervical spine with gross displacement

1975 ◽  
Vol 42 (2) ◽  
pp. 209-211 ◽  
Author(s):  
Ian C. Bailey
Keyword(s):  
Cervical Spine ◽  
Vertebral Body ◽  
Cervical Spine Injury ◽  
Fracture Dislocation ◽  
Spine Injury ◽  
Content Type ◽  
Fine Print

✓ A case of cervical spine injury is presented in which complete displacement of one vertebral body was accompanied by only mild quadriparesis.

Clinical recording of pressure on the spinal cord and cauda equina

1982 ◽  
Vol 57 (1) ◽  
pp. 48-56 ◽  
Author(s):  
Bjørn Magnaes
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Arterial Blood Pressure ◽  
Cauda Equina ◽  
Surrounding Tissue ◽  
Spinal Block ◽  
Pressure Curve ◽  
Content Type ◽  
Arterial Blood ◽  
Fine Print

✓ When an intraspinal expanding lesion causes a spinal block, a segment of the spinal cord or cauda equina will be subjected to general pressure from the surrounding tissue. This spinal block pressure, the spinal equivalent to intracranial pressure, was measured by lumbar infusion of fluid and simultaneous recording of the volume-pressure curve caudal to the block. The point of deviation from or breakthrough of the exponential volume-pressure curve indicated the spinal block pressure. Spinal block pressure of about 500 mm H2O and more could be determined by this method, and, when it was combined with Queckenstedt's test, lower pressures could be assessed as well. In the static (thoracic) part of the spine, spinal block pressure up to the level of arterial blood pressure was recorded. In the dynamic part of the spine, however, spinal block pressure could exceed arterial blood pressure due to external compressive forces during extension of the spine. There was a general tendency for more severe neurological deficits in patients with high spinal block pressure; but the duration of the pressure, additional focal pressure, and spinal cord compared with nerve root compression seemed equally important factors. The recording has implications for diagnosis, positioning of patients for myelography and surgery, selection of high-risk patients for the most appropriate surgical procedure, and detection of postoperative hematoma. There were no complications associated with the recordings.

Crossed-screw fixation of the unstable thoracic and lumbar spine

1995 ◽  
Vol 82 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Edward C. Benzel ◽  
Nevan G. Baldwin
Keyword(s):  
Vertebral Body ◽  
Screw Fixation ◽  
Three Dimensional ◽  
Deformity Correction ◽  
Pedicle Screws ◽  
Short Segment ◽  
Content Type ◽  
Thoracic And Lumbar Spine ◽  
Spinal Segments ◽  
Fine Print

✓ An ideal spinal construct should immobilize only the unstable spinal segments, and thus only the segments fused. Pedicle fixation techniques have provided operative stabilization with the instrumentation of a minimal number of spinal segments; however, some failures have been observed with pedicle instrumentation. These failures are primarily related to excessive preload forces and limitations caused by the size and orientation of the pedicles. To circumvent these problems, a new technique, the crossed-screw fixation method, was developed and is described in this report. This technique facilitates short-segment spinal fixation and uses a lateral extracavitary approach, which provides generous exposure for spinal decompression and interbody fusion. The technique employs two large transverse vertebral body screws (6.5 to 8.5 mm in diameter) to bear axial loads, and two unilateral pedicle screws (placed on the side of the exposure) to restrict flexion and extension deformation around the transverse screws and to provide three-dimensional deformity correction. The horizontal vertebral body and the pedicle screws are connected to rods and then to each other via rigid crosslinking. The transverse vertebral body screws are unloaded during insertion by placing the construct in a compression mode after the interbody bone graft is placed, thus optimizing the advantage gained by the significant “toe-in” configuration provided and further decreasing the chance for instrumentation failure. The initial results of this technique are reported in a series of 10 consecutively treated patients, in whom correction of the deformity was facilitated. Follow-up examination (average 10.1 months after surgery) demonstrated negligible angulation. Chronic pain was minimal. The crossed-screw fixation technique is biomechanically sound and offers a rapid and safe form of short-segment three-dimensional deformity correction and solid fixation when utilized in conjunction with the lateral extracavitary approach to the unstable thoracic and lumbar spine. This approach also facilitates the secure placement of an interbody bone graft.

Thoracic idiopathic spinal cord herniation at the vertebral body level: a subgroup with a poor prognosis?

2002 ◽  
Vol 97 (3) ◽  
pp. 369-374 ◽  
Author(s):  
Giuseppe M. V. Barbagallo ◽  
Laurence A. G. Marshman ◽  
Carl Hardwidge ◽  
Richard W. Gullan
Keyword(s):  
Spinal Cord ◽  
Vertebral Body ◽  
Prosthetic Material ◽  
Dural Defect ◽  
Content Type ◽  
Distinct Subgroup ◽  
Surgical Reduction ◽  
Spinal Cord Herniation ◽  
Idiopathic Spinal Cord Herniation ◽  
Fine Print

✓ The authors present two cases of thoracic idiopathic spinal cord herniation (TISCH) occurring at the vertebral body (VB) level in whom adequate surgical reduction failed to reverse symptoms. In the second case, in which TISCH occurred into a VB cavity, presentation was atypical (subacute spinal cord syndrome) and there was persistent postoperative deterioration. In both cases, adequate surgical reduction was achieved via a posterior midthoracic laminectomy, and reduction was maintained by closure of the anterior dural defect by using prosthetic material. Thoracic idiopathic spinal cord herniation occurring at a VB level may be technically well treated by surgical reduction, but the outcome appears less predictable. Herniation that occurs directly into a VB cavity may form a distinct subgroup in which the presentation is atypical and the prognosis worse.

Late vertebral body fracture after lumbar transpedicular fixation

2005 ◽  
Vol 3 (1) ◽  
pp. 57-60 ◽  
Author(s):  
Paolo Missori ◽  
Alessandro Ramieri ◽  
Giuseppe Costanzo ◽  
Simone Peschillo ◽  
Sergio Paolini ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Late Onset ◽  
Traumatic Injury ◽  
Spinal Instrumentation ◽  
Lumbar Pain ◽  
Content Type ◽  
Transpedicular Fixation ◽  
Body Fracture ◽  
Sharing Function ◽  
Fine Print

✓ Late-onset vertebral body (VB) fracture after lumbar transpedicular fixation has not been previously described in the literature. The authors present three cases in which VB fracture occurred several months after posterolateral fixation in patients with degenerative disease or traumatic injury. The authors suggest that postoperative osteopenia, modified load-sharing function, and intravertebral clefts were responsible for the fractures. Two women and one man were evaluated at a mean follow-up interval of 3 months. Two patients suffered recurrent lumbar pain. Radiography and magnetic resonance imaging revealed fracture of some of the instrumentation-treated VBs. These two patients underwent surgical superior or inferior extension of instrumentation. The third, an asymptomatic patient, received conservative management. The two patients who underwent reoperation made complete recoveries, and there was no evidence of further bone collapse in any case. The authors speculate that alterations in the VBs may occur following application of spinal instrumentation. In rare cases, the device can fracture and consequently lead to recurrent lumbar back pain. Recovery can be achieved by extending the instrumentation in the appropriate direction.

Somatosensory evoked potential monitoring in anterior thoracic vertebrectomy

2000 ◽  
Vol 92 (2) ◽  
pp. 155-161 ◽  
Author(s):  
Harel Deutsch ◽  
Marc Arginteanu ◽  
Karen Manhart ◽  
Noel Perin ◽  
Martin Camins ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Vertebral Body ◽  
Evoked Potential ◽  
False Negative ◽  
False Negative Rate ◽  
Neurological Deterioration ◽  
Somatosensory Evoked Potential ◽  
Content Type ◽  
Spinal Cord Function ◽  
Fine Print

Object. Spine surgeons have used intraoperative cortical and subcortical somatosensory evoked potential (SSEP) monitoring to detect changes in spinal cord function when intraoperative procedures can be performed to prevent neurological deterioration. However, the reliability of SSEP monitoring as applied to anterior thoracic vertebral body resections has not been rigorously assessed. Methods. The authors retrospectively reviewed hospital charts and operating room records obtained between August 1993 and December 1998 and found that SSEP monitoring was used in 44 surgical procedures involving an anterior approach for thoracic vertebral body resections. There were no patients in whom SSEP changes did not return to baseline during the surgical procedure. Patients in four cases, despite their stable SSEP recordings throughout the procedure, were noted immediately postoperatively to have experienced significant neurological deterioration. The false-negative rate in SSEP monitoring was 9%. Sensitivity was determined to be 0%. Conclusions. It is important to recognize high false-negative rates and low sensitivity of SSEP monitoring when it is used to record spinal cord function during anterior approaches for thoracic vertebrectomies. The insensitivity of SSEPs for motor deterioration during anterior thoracic vertebrectomies is likely due to the limitation of SSEPs, which monitor only posterior column function whereas motor paths are conveyed in the anterior and anterolateral spinal cord. The authors believe that SSEPs can not be relied on to detect reversible spinal damage during anterior thoracic vertebrectomies.

Spinal tuberculosis: a diagnostic and management challenge

1995 ◽  
Vol 83 (2) ◽  
pp. 243-247 ◽  
Author(s):  
Eric S. Nussbaum ◽  
Gaylan L. Rockswold ◽  
Thomas A. Bergman ◽  
Donald L. Erickson ◽  
Edward L. Seljeskog
Keyword(s):  
Vertebral Body ◽  
Neurological Deficit ◽  
Spinal Tuberculosis ◽  
Bone Destruction ◽  
Disease Recurrence ◽  
Neurological Dysfunction ◽  
Anterior Fusion ◽  
Content Type ◽  
Granulomatous Tissue ◽  
Fine Print

✓ The authors reviewed 29 cases of spinal tuberculosis treated from 1973 to 1993 with an average follow-up time of 7.4 years. Clinical findings included back pain, paraparesis, kyphosis, fever, sensory disturbance, and bowel and bladder dysfunction. Twenty-two patients (76%) presented with neurological deficit; 12 (41%) were initially misdiagnosed. Sixteen patients (55%) had predominant vertebral body involvement; nine had marked bone collapse with neurological compromise. Eleven individuals (39%) had intraspinal granulomatous tissue causing neurological dysfunction in the absence of bone destruction, and two (7%) had intramedullary tuberculomas. All patients received antituberculous medications: 13 were initially treated with bracing alone, eight underwent laminectomy and debridement of extra- or intradural granulomatous tissue, and eight underwent anterior, posterior, or combined fusion procedures. No patient with neurological deficit recovered or stabilized with nonoperative management. Thirteen patients were readmitted with progression of inadequately treated osteomyelitis; 12 (92%) of these required new or more radical fusion procedures. Anterior fusion failure was associated with marked preoperative kyphosis and multilevel disease requiring a graft that spanned more than two disc spaces. Courses of antibiotic medications shorter than 6 months were invariably associated with disease recurrence. It was concluded that 1) patients should receive at least 12 months of appropriate antituberculous therapy; 2) individuals with neurological deficit should undergo surgical decompression; 3) laminectomy and debridement are adequate for intraspinal granulomatous tissue in the absence of significant bone destruction; 4) when vertebral body involvement has produced wedging and kyphosis, aggressive debridement and fusion are indicated to prevent delayed instability and progression of disease.

Vertebral body impactor for posterior lateral decompression of thoracic and lumbar fractures

1989 ◽  
Vol 70 (2) ◽  
pp. 285-286 ◽  
Author(s):  
John Oro ◽  
Clark Watts ◽  
Robert Gaines
Keyword(s):  
Lumbar Spine ◽  
Vertebral Body ◽  
Content Type ◽  
Burst Fractures ◽  
Bone Fragments ◽  
Lumbar Fractures ◽  
Body Bone ◽  
Fine Print

✓ A hand-held impactor is described that allows secure impaction of retropulsed vertebral body bone fragments in burst fractures of the thoracic or lumbar spine.

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