MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Seminars in Spine Surgery' source. Mon, 30 Jan 2012 01:20:38 +0100 http://www.medworm.com/index.php?rid=5443555&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000694%2Fabstract%3Frss%3Dyes Several nonoperative therapies have been shown to be beneficial in the treatment of chronic low-back pain, including different forms of exercise and spinal manipulative therapy. The efficacy of less time-consuming and less costly self-care interventions remains inconclusive. Bronfort et al performed an observer-blinded mixed-method randomized clinical trial to assess the relative efficacy of supervised exercise, spinal manipulation, and home exercise for the treatment of chronic low-back pain. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5443555 Fri, 25 Nov 2011 16:58:48 +0100 5443555 http://www.medworm.com/index.php?rid=5443544&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS104073831100075X%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5443544 Fri, 25 Nov 2011 16:58:48 +0100 5443544 http://www.medworm.com/index.php?rid=5443543&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000748%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5443543 Fri, 25 Nov 2011 16:58:48 +0100 5443543 http://www.medworm.com/index.php?rid=5443542&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000724%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5443542 Fri, 25 Nov 2011 16:58:48 +0100 5443542 http://www.medworm.com/index.php?rid=5443541&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000712%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5443541 Fri, 25 Nov 2011 16:58:48 +0100 5443541 http://www.medworm.com/index.php?rid=5443553&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000530%2Fabstract%3Frss%3Dyes The objectives are to comprehensively define adjacent segment disease; highlight advances in the approach to spinal disorders, present the identified risk factors; examine outcomes; and summarize current recommendations. The literature supports previous degeneration and altered biomechanics of the spine as causes of adjacent segment disease. Excessive facet degeneration is a risk factor. Clinical outcome scores show improvement irrespective of procedure type. The number of spinal segments fused, fusion level, and age yield conflicting reports regarding their contribution to adjacent segment disease. Arthroplasty, dynamic stabilization, and interspinous process implants are effective in decreasing incidence. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5443553 Mon, 03 Oct 2011 04:00:00 +0100 5443553 http://www.medworm.com/index.php?rid=5443552&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000529%2Fabstract%3Frss%3Dyes The management of infections or tumors affecting the lumbar spine presents a unique challenge. Indications for surgery and the appropriate timing for interventions are not always clear. Moreover, depending on the location and the extent of the disease as well as the underlying medical condition of the patient, surgical approaches and goals can vary significantly. With improved understanding of the pathologic process and the advent of new surgical techniques, our overall treatment strategies continue to evolve, leading to better outcomes and reduced morbidity. The available literature on the role of lumbar fusions in the treatment of infection and tumor will be presented. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5443552 Mon, 03 Oct 2011 04:00:00 +0100 5443552 http://www.medworm.com/index.php?rid=5443548&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000487%2Fabstract%3Frss%3Dyes Chronic low back is one of the most common reasons that patients seek medical attention. There is little agreement on how to treat pain that persists despite an adequate trial of conservative care. When the pain generator can be determined, a logical and targeted treatment plan can be implemented. Diskography can be used to identify an abnormal, painful disk, although the value and safety of this diagnostic tool have been debated. Lumbar fusion for chronic low back pain remains a contentious issue that has been widely debated; however, many studies have inherent flaws that weaken their conclusions. Procedures that do not include interbody fusion ignore the role of the painful disk and might be associated with poorer results. With proper attention to selecting the correct patient, identifyi... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5443548 Mon, 03 Oct 2011 04:00:00 +0100 5443548 http://www.medworm.com/index.php?rid=5148874&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000566%2Fabstract%3Frss%3Dyes It is well-known that vertebral compression fractures are associated with increased mortality risk. However, the association between surgical treatment and survivorship is unclear. Recent prospective randomized trials have failed to demonstrate a clear benefit of cement injection techniques for management of vertebral compression fractures. Edidin et al evaluated the mortality risk for vertebral compression fractures in patients undergoing conservative treatment as well as kyphoplasty or vertebroplasty. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5148874 Wed, 24 Aug 2011 19:58:28 +0100 5148874 http://www.medworm.com/index.php?rid=5148864&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000621%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5148864 Wed, 24 Aug 2011 19:58:12 +0100 5148864 http://www.medworm.com/index.php?rid=5148863&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS104073831100061X%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5148863 Wed, 24 Aug 2011 19:58:12 +0100 5148863 http://www.medworm.com/index.php?rid=5148862&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000591%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5148862 Wed, 24 Aug 2011 19:58:11 +0100 5148862 http://www.medworm.com/index.php?rid=5148861&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS104073831100058X%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5148861 Wed, 24 Aug 2011 19:58:11 +0100 5148861 http://www.medworm.com/index.php?rid=5443554&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000542%2Fabstract%3Frss%3Dyes Lumbar pseudoarthrosis is one of the most common complications of spine surgery. The prevalence of lumbar pseudarthrosis following instrumented lumbar fusion in adults is highly variable across studies with lower back pain being the most common complaint. Some researches believe that spinal instability is directly responsible for the painful symptoms sometimes associated with pseudarthoses. However, this point has also been debated.Diagnostic work-up of these cases include flexion and extension radiographs and CT scans. MRI can also be helpful to identify any residual or new areas of nerve compression. The most definitive test to identify a pseudoarthosis is an exploration of the fusion. This is performed when there is sufficient clinical and radiographic data to suggest the presence of a ... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5443554 Mon, 11 Jul 2011 04:00:00 +0100 5443554 http://www.medworm.com/index.php?rid=5443551&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000517%2Fabstract%3Frss%3Dyes Many surgeons acknowledge that anatomical and biomechanical characteristics specific to the lower lumbar (L3-L5) spine influence management after injury. In this review, the literature was evaluated to determine the surgical indications and optimal operative approach for lower lumbar burst fractures, fracture-dislocations, and flexion-distraction injuries. Low-quality studies (eg, retrospective case series, etc) suggest nonoperative and operative management of neurologically intact lower lumbar burst fractures achieve comparable functional results, with greater complication rates noted in surgical cohorts. Although surgical stabilization of injuries with neurological deficits is determined by sound pathophysiological rationale and allows earlier rehabilitation, it remains unclear whether t... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5443551 Mon, 11 Jul 2011 04:00:00 +0100 5443551 http://www.medworm.com/index.php?rid=5443550&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000554%2Fabstract%3Frss%3Dyes For patients with symptomatic recurrent disk herniations that have failed nonoperative treatment, surgical treatment can be considered. Although simple repeat diskectomy can be an effective treatment for first time recurrences, many surgeons would consider the addition of fusion, particularly for second or third recurrences. With a lack of high-level evidence, decision making concerning when and how to fuse for a recurrent lumbar disk herniation remains largely surgeon-dependent because a variety of options are available. Although there are limited data, both posterolateral and interbody fusion can be effective. Future study is needed to better define the indications and ideal method of fusion for recurrent disk herniations. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5443550 Mon, 11 Jul 2011 04:00:00 +0100 5443550 http://www.medworm.com/index.php?rid=5443549&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000499%2Fabstract%3Frss%3Dyes This article reviews the current literature concerning MIS lumbar fusion and examines the evidence supporting these proposed advantages along with the limitations of these technically challenging techniques. From the available data, some perioperative advantages might be supported, although the evidence is not robust. In addition, concerns have been raised regarding the potential for increased complications as well as the lack of long-term results with MIS lumbar fusion. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5443549 Mon, 11 Jul 2011 04:00:00 +0100 5443549 http://www.medworm.com/index.php?rid=5443547&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000475%2Fabstract%3Frss%3Dyes Adult degenerative deformities of the lumbar spine can present with a myriad of radiographic and clinical characteristics. Growing evidence suggests that the pain and disability emanating from the musculoskeletal degeneration of the spine and the resulting neural compression (ie, stenosis) can be successfully treated with surgery in properly selected patients. In addition to the often difficult decision to proceed with surgical treatment, the surgical instrumentation and fusion of adult lumbar deformities involve complex decision making and surgical planning. Important and potentially controversial decisions include the selection of fusion levels as well as the selection of surgical approaches, correction techniques, and the use of osteotomies. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5443547 Mon, 11 Jul 2011 04:00:00 +0100 5443547 http://www.medworm.com/index.php?rid=5443546&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000505%2Fabstract%3Frss%3Dyes The U.S. population is living longer and staying increasingly more active. Symptoms of degenerative lumbar spinal stenosis are being seen with increasing frequency in older age groups. Many of the more symptomatic patients do not respond to nonoperative care and seek potential surgical solutions. The current article offers an evidence-based review of the literature for surgical treatment of degenerative lumbar spinal stenosis with a focus on the role of lumbar fusion. The author evaluates the evidence for surgical treatment of this condition so that appropriate, patient-centered care can be provided in the safest and most cost-effective manner possible. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5443546 Mon, 11 Jul 2011 04:00:00 +0100 5443546 http://www.medworm.com/index.php?rid=5443545&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000463%2Fabstract%3Frss%3Dyes During the past few years, lumbar fusion has been examined with exacting scrutiny by medical professionals as well as the federal government, private insurance payers, and the lay press. Perhaps the root of the onslaught of these inquiries has been the general perception of unreliable outcomes of fusion for low back pain coupled with the rising cost and complexity of such surgeries. Although this indication has deservedly come under fire from nearly all angles, both within and outside spine surgical groups, it has vortexed the appropriateness of lumbar fusion for nearly all other indications into a sea of uncertainty. In a 2006 Medicare Coverage Advisory Committee (MCAC) meeting, what began as a review of fusion for discogenic low back pain quickly morphed into a reappraisal of fusion for ... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5443545 Mon, 11 Jul 2011 04:00:00 +0100 5443545 http://www.medworm.com/index.php?rid=5148867&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000372%2Fabstract%3Frss%3Dyes Degenerative disease in the cervical spine is a common source of axial neck pain and neurologic disturbances. In addition to pain, upper extremity radiculopathy and myelopathy, advanced cervical degenerative disease can result in altered biomechanics, most commonly manifested as a kyphotic deformity. As the disk spaces narrow, the weight-bearing axis of the spine is translated anteriorly, placing the posterior structures under an abnormal tensile load. This in turn leads to attenuation of the posterior ligamentous structures, allowing further progression of the deformity.Treatment of cervical kyphotic deformities is generally multimodal, often beginning with conservative measures. In cases in which conservative measures have failed or in cases of incapacitating pain or progressive neurolog... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5148867 Sun, 10 Jul 2011 23:00:00 +0100 5148867 http://www.medworm.com/index.php?rid=5148866&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000402%2Fabstract%3Frss%3Dyes This article will review each of the unique anatomical regions of the cervical spine and describe the normal axial, coronal, and sagittal plane alignment and kinematics. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5148866 Sun, 10 Jul 2011 23:00:00 +0100 5148866 http://www.medworm.com/index.php?rid=5148868&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000360%2Fabstract%3Frss%3Dyes Alignment plays a critical role in cervical spine function. In the thoracic and lumbar spines, degenerative disease often manifests as complex deformities involving coronal and sagittal plane decompensation, but in the cervical spine, degenerative disease often presents with isolated sagittal plane deformity. Multiple etiologies of cervical kyphosis have been described including traumatic, iatrogenic, inflammatory, and neoplastic processes; all share a common pathway of anterior column shortening, failure of the posterior tension band, or, most commonly, both. The focus of this article will be on the degenerative etiology of cervical kyphosis. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5148868 Wed, 29 Jun 2011 23:00:00 +0100 5148868 http://www.medworm.com/index.php?rid=5148873&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000359%2Fabstract%3Frss%3Dyes Neurologic and myopathic deformities of the cervical spine present a unique management challenge to spine surgeons. The clinical presentations of these deformities can be quite similar; however, the spectrum of etiologies ranges from common systemic conditions with reversible symptoms to localized and progressive conditions without effective treatment. Given the success of systemic treatments for certain known etiologies, it is essential to screen symptomatic patients early for common causes to either stop or reverse progression of the deformity. Unfortunately, such evaluations can be challenging and the generalizability of treatment strategies is difficult. However, when reversible causes cannot be identified, management of these patients should focus upon symptomatic control with medicat... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5148873 Sun, 12 Jun 2011 23:00:00 +0100 5148873 http://www.medworm.com/index.php?rid=5148870&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000384%2Fabstract%3Frss%3Dyes Rheumatoid arthritis leads to progressive synovial inflammation and joint destruction, with the cervical spine being the third most commonly affected area. Atlantoaxial instability is the most common presenting diagnosis, followed by subaxial instability and atlantoaxial impaction. Patients present with a range of symptoms from axial neck pain to frank myelopathy. Treatment begins with medical management in the early stages, which has shown promise in preventing or delaying atlantoaxial instability. Surgical treatment has shown good results but is reserved for patients with severe pain, instability, and progressive neurologic deficits and should adequately decompress the neural elements and fuse the unstable segments. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5148870 Sun, 12 Jun 2011 23:00:00 +0100 5148870 http://www.medworm.com/index.php?rid=5148869&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000426%2Fabstract%3Frss%3Dyes Iatrogenic deformities of the cervical spine are not uncommon and may be associated with either anterior or posterior operations. To minimize the “footprints” left behind from surgical interventions on the cervical spine, it is imperative not only to treat the present disorder but also avoid sowing the seeds of future problems, or at least create a milieu in which they can be easily addressed should they occur. Doing so requires attention to either correcting or preventing cervical deformities whenever possible during the index operation because the optimal method of treating iatrogenic cervical deformity remains its prevention. In treating established deformities, surgical decision making hinges on whether the deformity is rigid, flexible, or fused. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5148869 Sun, 12 Jun 2011 23:00:00 +0100 5148869 http://www.medworm.com/index.php?rid=5148865&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000414%2Fabstract%3Frss%3Dyes Deformities of the cervical spine have received less attention in the literature than those involving the thoracic and lumbar spines. However, surgeons treating cervical pathology not infrequently encounter such deformities in the course of daily practice. Cervical deformities may range from the obvious—such as a chin on chest deformity with loss of horizontal gaze—to the subtle but more common—such as myelopathy in the setting of kyphosis seen only on x-ray without a visible external deformity. As in the thoracolumbar spine, most cervical deformities involve the sagittal plane. In this issue of Seminars in Spine Surgery, we present a series of papers devoted to the discussion of this extremely important but infrequently addressed topic. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5148865 Sun, 12 Jun 2011 23:00:00 +0100 5148865 http://www.medworm.com/index.php?rid=5148872&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000396%2Fabstract%3Frss%3Dyes Understanding the complexities of congenital deformities of the cervical spine and their sequelae is greatly enhanced by knowledge of the development of the cervical spine. Although many of these deformities are asymptomatic, when encountered, it is important for the physician to identify potential problem patterns and to be aware of any associated systemic manifestations. In this article, we discuss Klippel-Feil syndrome, torticollis, os odontoideum, and congenital absent cervical pedicle in detail but also other disorders that commonly involve the cervical spine. The presentation, investigation, and management of congenital cervical spine anomalies will also be discussed. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5148872 Thu, 09 Jun 2011 23:00:00 +0100 5148872 http://www.medworm.com/index.php?rid=5148871&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000438%2Fabstract%3Frss%3Dyes Ankylosing spondylitis is an inflammatory disorder that can produce disabling musculoskeletal conditions. Spinal deformity is among the most common manifestations. Cervical kyphosis can be particularly debilitating to the patient because of interference with forward gaze and activities of daily living. In addition, cervical deformity can lead to both neurologic and respiratory deterioration. For many patients, the only treatment option is surgery. Both the Smith-Petersen osteotomy and the pedicle subtraction osteotomy have been used successfully to manage cervical deformity in patients with ankylosing spondylitis. These procedures are technically difficult and carry significant risk but can produce excellent and safe outcomes. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=5148871 Thu, 09 Jun 2011 23:00:00 +0100 5148871 http://www.medworm.com/index.php?rid=4856882&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS104073831100027X%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4856882 Wed, 25 May 2011 16:56:15 +0100 4856882 http://www.medworm.com/index.php?rid=4856881&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000268%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4856881 Wed, 25 May 2011 16:56:15 +0100 4856881 http://www.medworm.com/index.php?rid=4856880&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000244%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4856880 Wed, 25 May 2011 16:56:15 +0100 4856880 http://www.medworm.com/index.php?rid=4856879&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000232%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4856879 Wed, 25 May 2011 16:56:15 +0100 4856879 http://www.medworm.com/index.php?rid=4856891&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000207%2Fabstract%3Frss%3Dyes Lumbar vertebral bone marrow changes are commonly observed on magnetic resonance imaging scans. The correlation of these marrow changes with low back pain is unclear. The authors performed a prospective cohort study to examine the relationship between low back pain after diskectomy for disk herniation and type 1 Modic changes in the bone marrow. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4856891 Tue, 19 Apr 2011 23:00:00 +0100 4856891 http://www.medworm.com/index.php?rid=4856888&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001218%2Fabstract%3Frss%3Dyes Motion-sparing technology has gained popularity in recent years. However, the benefits remain theoretic and unproven. Long-term, level I investigations are underway to explore the efficacy and usefulness of such procedures for the prevention of adjacent segment disease. As with any new treatment, appropriate attention must be given to strict surgical indications and proper patient selection. A clear understanding of the various implants and tools available and their associated complications is an essential component of sound spine surgical care. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4856888 Sun, 03 Apr 2011 23:00:00 +0100 4856888 http://www.medworm.com/index.php?rid=4585033&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001243%2Fabstract%3Frss%3Dyes Relatively few reports have examined surgical outcomes in adult scoliosis patients. Zimmerman et al performed a prospective study to evaluate the complications, clinical outcomes, and self-reported quality of life in a homogenous group of adult scoliosis patients. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4585033 Tue, 01 Mar 2011 00:00:00 +0100 4585033 http://www.medworm.com/index.php?rid=4585032&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001140%2Fabstract%3Frss%3Dyes Minimally invasive surgery (MIS) has been extensively used for the treatment of adult spinal disorders, including degenerative, trauma, and deformity. More recently, MIS techniques have been applied for the treatment of pediatric spine deformity. Several features of the pediatric spine allow for the natural application of MIS techniques. These include its greater inherent flexibility and tendency to form robust fusion. MIS techniques have been used at the top of long constructs to minimize junctional kyphosis, in treatment of adolescent idiopathic scoliosis, and for growing rods to minimize spine auto fusion. As in adult patients, these patients sustain less blood loss and shorter hospital stays. However, the surgical procedures are longer with extensive fluoroscopy, particularly in the ea... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4585032 Tue, 01 Mar 2011 00:00:00 +0100 4585032 http://www.medworm.com/index.php?rid=4585030&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001127%2Fabstract%3Frss%3Dyes Minimally invasive surgical stabilization of thoracolumbar spine injuries has the potential to reduce surgical morbidity, improve postoperative care and rehabilitation, and even serve as a lifesaving measure in the treatment of patients with multiple traumatic injuries. The advantages of minimally invasive surgery in the treatment of thoracolumbar trauma have been investigated. Although it seems to offer considerable advantages over conventional open surgery, more outcome data are needed to prove its true advantages. The role of minimally invasive surgery in treating spine trauma will likely increase significantly as the field progresses and as techniques are enhanced and more widely learned. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4585030 Tue, 01 Mar 2011 00:00:00 +0100 4585030 http://www.medworm.com/index.php?rid=4585028&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001103%2Fabstract%3Frss%3Dyes This article describes both the mini-open and the minimally invasive tranforaminal lumbar interbody fusion (TLIF) techniques. The mini-open TLIF technique uses an expandable tubular retractor through a Wiltse approach and provides an alternative to the standard open surgical technique for TLIF. Alternatively, a nonexpandable tubular retractor can be combined with percutaneous screw fixation for a more minimally invasive approach. Patient selection, as in open procedures, is important in achieving desirable outcomes. Minimally invasive approaches to TLIF provide an elegant approach to treating various lumbar spinal pathologies. Minimally invasive TLIF requires an excellent working knowledge of anatomy. Minimally invasive approaches for TLIF reduce blood loss and shorten hospital stay when c... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4585028 Tue, 01 Mar 2011 00:00:00 +0100 4585028 http://www.medworm.com/index.php?rid=4585027&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001073%2Fabstract%3Frss%3Dyes More than 700,000 osteoporotic vertebral compression fractures occur annually and can have an impact on the health and life of a patient similar to that of a hip fracture. Percutaneous vertebral augmentation with vertebroplasty and kyphoplasty can be performed to treat painful compression fractures refractory to nonoperative care. Both procedures have been reported to result in pain reduction and functional improvement for patients with compression fractures. Cement extrusion with neurologic compromise and subsequent fracture can complicate treatment. Although evidence is currently mixed, vertebral augmentation should be considered for patients with severe pain and functional impairment caused by a compression fracture. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4585027 Tue, 01 Mar 2011 00:00:00 +0100 4585027 http://www.medworm.com/index.php?rid=4585025&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001085%2Fabstract%3Frss%3Dyes This article offers an overview of indications and effectiveness of interspinous spacers, particularly regarding LSS/neurogenic intermittent claudication. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4585025 Tue, 01 Mar 2011 00:00:00 +0100 4585025 http://www.medworm.com/index.php?rid=4585024&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001061%2Fabstract%3Frss%3Dyes At our institution decompression through tubular retractors has become the preferred approach for the treatment of a variety of degenerative spinal disorders, including lumbar stenosis, disk herniations, foraminal narrowing, and facet joint cysts in up to 2 levels. More complex procedures, such as spinal fusions and deformity corrections, also are routinely performed. Spinal surgery through tubular retractors offers particular advantages in these conditions and is especially suited for surgery in high-risk patients, such as obese and the elderly patients. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4585024 Tue, 01 Mar 2011 00:00:00 +0100 4585024 http://www.medworm.com/index.php?rid=4585021&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001048%2Fabstract%3Frss%3Dyes Minimally invasive surgery of the spine (MISS) has become an increasingly popular buzz word in the spine community. What truly constitutes MISS is not entirely clear. We propose that MISS procedures be judged on the basis of the degree to which they spare additional anatomical structures compared with the existing standard as long as the safety and efficacy of the procedure are preserved. In this work we explore this structure-sparing perspective and the anticipated benefits on patient outcomes, against the notion that small incisions or technology dictate MISS. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4585021 Tue, 01 Mar 2011 00:00:00 +0100 4585021 http://www.medworm.com/index.php?rid=4585019&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000128%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4585019 Tue, 01 Mar 2011 00:00:00 +0100 4585019 http://www.medworm.com/index.php?rid=4585018&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000104%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4585018 Tue, 01 Mar 2011 00:00:00 +0100 4585018 http://www.medworm.com/index.php?rid=4585017&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000074%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4585017 Tue, 01 Mar 2011 00:00:00 +0100 4585017 http://www.medworm.com/index.php?rid=4585016&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738311000050%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4585016 Tue, 01 Mar 2011 00:00:00 +0100 4585016 http://www.medworm.com/index.php?rid=4856889&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS104073831000122X%2Fabstract%3Frss%3Dyes Sagittal plane deformity describes the loss of normal lumbar lordosis. This deformity is usually iatrogenic and often follows lumbar fusion, thoracolumbar fusion, and (in some cases) lumbar decompressive procedures. Nonsurgical causes include ankylosing spondylitis, degenerative changes, or adult presentation of adolescent idiopathic scoliosis. The deformity may lead to neurogenic radicular symptoms secondary to stenosis, paraspinal muscular fatigue, and low back pain. Nonoperative treatment options fail for most patients. Surgical interventions are aimed at restoring lumbar lordosis, which is typically accomplished with revision decompression, fusion, and various osteotomies. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4856889 Mon, 14 Feb 2011 00:00:00 +0100 4856889 http://www.medworm.com/index.php?rid=4856887&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001206%2Fabstract%3Frss%3Dyes Compared with open procedures, minimally invasive spine surgery allows spinal abnormalities to be addressed through smaller incisions with less soft-tissue damage and postoperative pain, which may lead to shorter hospitalizations and earlier mobility for the patient. However, minimally invasive spine procedures require advanced techniques, mandate specialized equipment, provide decreased visualization, and are associated with a steep learning curve. Although studies have shown similar complication rates for the 2 approaches, minimally invasive surgery may be associated with decreased fusion rates, increased dural injury rates, and inadequate decompression compared with conventional surgical techniques. This review addresses the complications associated with minimally invasive spine procedu... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4856887 Mon, 14 Feb 2011 00:00:00 +0100 4856887 http://www.medworm.com/index.php?rid=4856885&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001188%2Fabstract%3Frss%3Dyes Anterior and lateral approaches to the spine have an increasing role in addressing deformity, tumor, and degenerative conditions of the spine. When conducted by an experienced team and supportive care system, anterior and lateral approaches to the spine can be performed safely, with few complications and good to excellent patient outcomes and satisfaction. A thorough knowledge of vascular, neural, and visceral anatomy is essential in minimizing approach-related complications. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4856885 Mon, 14 Feb 2011 00:00:00 +0100 4856885 http://www.medworm.com/index.php?rid=4856890&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001231%2Fabstract%3Frss%3Dyes Infection after lumbar spine surgery can be a challenging and devastating complication. Numerous risk factors have been identified, and algorithms for reducing the risk of such infections have been described. New concepts in prevention continue to evolve as lumbar spinal surgeries become more complex. Antibiotic prophylaxis, antimicrobial irrigation, placement of drains, antibiotic-loaded allograft, and gentamicin microspheres all reduce the risk of infection. However, despite these measures, postoperative infections still occur and demand clinician diligence for their detection and treatment. Treatment options include antibiotics, operative irrigation and debridement, and vacuum-assisted closure or muscle flaps for more complex wounds. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4856890 Wed, 09 Feb 2011 00:00:00 +0100 4856890 http://www.medworm.com/index.php?rid=4856886&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS104073831000119X%2Fabstract%3Frss%3Dyes Complications associated with posterior lumbar surgeries include pseudarthrosis, loss of fixation, instrumentation malposition, and cerebrospinal fluid leakage. An understanding of the associated risk factors and their incidences can help to reduce the likelihood of complications. Adhering to meticulous operative technique is also essential. Once complications occur, establishing the diagnosis and tailoring treatment to each individual patient can help to reduce the risk for progression of symptoms and can limit additional complications. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4856886 Wed, 09 Feb 2011 00:00:00 +0100 4856886 http://www.medworm.com/index.php?rid=4856884&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001176%2Fabstract%3Frss%3Dyes Balancing the risks and benefits of spine surgery is important to securing a successful outcome. The goals of perioperative medical risk assessment are to optimize the patient's medical condition preoperatively and minimize the potential for postoperative morbidity and mortality. Common sources of morbidity and mortality in spine surgery that benefit from perioperative optimization include cardiac, respiratory, and renal conditions. Patients with diabetes, malnutrition, and obesity warrant special consideration. An informed dialogue establishing realistic expectations, potential pitfalls, and alternatives is equally important. The elements of successful perioperative management of the patient who is being considered for spine surgery are reviewed here. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4856884 Fri, 04 Feb 2011 00:00:00 +0100 4856884 http://www.medworm.com/index.php?rid=4856883&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001164%2Fabstract%3Frss%3Dyes The goal of any surgical procedure is to improve a patient's outcome relative to the natural history of the underlying disease process while avoiding intraoperative and perioperative complications. The initial management of the great majority of patients with lumbar spine disorders is nonoperative. Surgery is typically considered for patients for whom maximal nonoperative management for degenerative disorders has failed and for patients with spinal neoplasms, trauma, infection, and deformity. The decision to proceed with spinal surgery is a serious one, one that includes the informed consent process where the risks, benefits, and alternatives to surgery are discussed with the patient and, often, their families. Although both surgeons and patients are aware that any surgery can result in in... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4856883 Mon, 24 Jan 2011 00:00:00 +0100 4856883 http://www.medworm.com/index.php?rid=4585029&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001115%2Fabstract%3Frss%3Dyes Minimally invasive access techniques are increasingly applied to patients with spine tumors, eliminating the morbidity of more invasive open procedures in appropriate patients. Minimally invasive treatments include various percutaneous image-guided approaches with radiofrequency ablation, drilling, or intralesional injections of cement, embolic agents, or medications that promote sclerosis or ossification. Intraoperative ablation methods include direct lesional injection of cement and devascularizing options with injection of embolic agents and cryocoagulation. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4585029 Tue, 18 Jan 2011 00:00:00 +0100 4585029 http://www.medworm.com/index.php?rid=4585023&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001152%2Fabstract%3Frss%3Dyes Posterior cervical foraminotomy and discectomy has been used to treat disk pathology and foraminal stenosis since the 1940s. In properly selected patients, the outcomes were quite successful in relieving radicular symptoms. The associated postoperative pain and potential instability led many surgeons to abandon the technique in favor of the anterior approach to the cervical spine. In the late 1990s, the refinement of minimally invasive techniques revived the posterior approach because patients could be offered a procedure that resulted in less postoperative pain and less disruption of the posterior elements. The advent of the minimally invasive technologies allowed surgeons to have direct access to the pathology with minimal destruction of surrounding tissues. Today, the microendoscopic fo... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4585023 Tue, 18 Jan 2011 00:00:00 +0100 4585023 http://www.medworm.com/index.php?rid=4585022&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS104073831000105X%2Fabstract%3Frss%3Dyes Minimally invasive spine surgery has evolved dramatically during the past 15 years. Technological advances have enabled the spine surgeon to perform a wide range of spinal procedures effectively while reducing approach-related morbidity and improving patient outcomes. For these reasons, minimally invasive spine surgery is becoming increasingly popular not only among spine surgeons but also with their patients. The time and effort involved in incorporating a new technique into one's practice depends on several factors. This “learning curve” will be the focus of this article. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4585022 Tue, 18 Jan 2011 00:00:00 +0100 4585022 http://www.medworm.com/index.php?rid=4585020&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001036%2Fabstract%3Frss%3Dyes In the past decade, there has been an explosion in the growth and adaptation of minimally invasive spinal (MIS) surgery techniques. Advances in retractor design, spinal instrumentation, and imaging have helped facilitate this, but surgeon champions have really defined what is possible. In the beginning, MIS surgeries were limited to the treatment of spinal disk herniations, stenosis, and single-level lumbar fusions. This has now evolved to include complex spinal problems such as scoliosis, tumors, trauma, and pediatric spinal disorders. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4585020 Tue, 18 Jan 2011 00:00:00 +0100 4585020 http://www.medworm.com/index.php?rid=4585031&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001139%2Fabstract%3Frss%3Dyes We describe the surgical technique used for the minimally invasive correction and fusion of adult scoliosis and review outcomes. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4585031 Fri, 14 Jan 2011 00:00:00 +0100 4585031 http://www.medworm.com/index.php?rid=4585026&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310001097%2Fabstract%3Frss%3Dyes The past decade has witnessed a renaissance in minimally invasive spinal (MIS) surgery. Currently, percutaneous techniques are available for segment fixation of the cervical, thoracic, and lumbar spine. The MIS approach has become popularized as a result of its reduction in soft tissue destruction, blood loss, and postoperative pain when compared with open spinal surgery. This review outlines contemporary methods for percutaneous spinal fixation. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4585026 Fri, 14 Jan 2011 00:00:00 +0100 4585026 http://www.medworm.com/index.php?rid=4160959&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000857%2Fabstract%3Frss%3Dyes Chronic low back pain with degenerative lumbar osteoarthritis is widespread in the adult population. Although glucosamine is increasingly used by patients with chronic low back pain, little is known about its effect in this setting. The authors set out to investigate the effect of glucosamine in patients with chronic low back pain and degenerative lumbar osteoarthritis. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4160959 Sat, 13 Nov 2010 08:49:06 +0100 4160959 http://www.medworm.com/index.php?rid=4160953&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000699%2Fabstract%3Frss%3Dyes Cervical spine injuries in the athlete range from a simple stinger to cervical cord neuropraxia and in some cases complete spinal cord injuries. These injuries can be a result of a herniated disk or fracture dislocation of the spine. Treatment is tailored to the degree of neurological injury and location of neural compression as well as the desire to return to sports. Radiographic criteria of ligamentous instability and characteristics of fractures that are known to progress to instability are critical for treatment decision-making. The mainstay of surgical treatment is decompression and fusion with many patients allowed to return to contact sports after a healed single level fusion. Although the results of cervical disk replacements are promising in the general population, in athletes who... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4160953 Sat, 13 Nov 2010 08:49:06 +0100 4160953 http://www.medworm.com/index.php?rid=4160947&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000900%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4160947 Sat, 13 Nov 2010 08:49:05 +0100 4160947 http://www.medworm.com/index.php?rid=4160946&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000894%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4160946 Sat, 13 Nov 2010 08:49:05 +0100 4160946 http://www.medworm.com/index.php?rid=4160945&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000882%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4160945 Sat, 13 Nov 2010 08:49:05 +0100 4160945 http://www.medworm.com/index.php?rid=4160944&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000870%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4160944 Sat, 13 Nov 2010 08:49:05 +0100 4160944 http://www.medworm.com/index.php?rid=4160957&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000705%2Fabstract%3Frss%3Dyes This article concentrates on sports-related back pain seen in the second two groups.Back pain is pervasive, but usually benign and self-limited. In older athletes, transient back problems occur in the context of nearly universal, radiographic evidence of lumbar degeneration. These radiographic findings, and the increased likelihood of “dangerous” conditions such as cord compression, osteoporosis, metastatic disease and atherosclerosis, complicate the clinical evaluation in this patient group.The epidemiology of back pain and both known and suspected risk factors for back pain are examined. For example, the controversial relationship of sports participation in youth is addressed. The pathophysiology of back pain in this age group is related with a strategy for clinical and radiographic ... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4160957 Thu, 21 Oct 2010 00:00:00 +0100 4160957 http://www.medworm.com/index.php?rid=4160951&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000717%2Fabstract%3Frss%3Dyes In North America, approximately 10% of acute traumatic spinal cord injury cases result from sport-related events. These injuries lead to significant human disability and societal costs, and despite extensive research to attenuate secondary injury, methylprednisolone remains the only drug in clinical practice. However, several new agents, including minocycline, riluzole, ATI-355, Cethrin, and cell-replacement therapy, currently show great promise in ongoing clinical trials. We have also recognized the importance of supportive care—avoiding hypoxia and supporting the blood pressure. Hypothermia is a long-explored intervention, but it is not currently recommended for clinical use because of the lack of supporting evidence. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4160951 Thu, 21 Oct 2010 00:00:00 +0100 4160951 http://www.medworm.com/index.php?rid=4160958&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS104073831000064X%2Fabstract%3Frss%3Dyes The evaluation and management of concussion (ie, mild traumatic brain injury) in athletes is typically the responsibility of team or school physicians. The great majority of these physicians are orthopedists, family physicians, internists, pediatricians, or sports medicine specialists who have not had specialty training in neurology or neurosurgery. The evaluation and management of mild traumatic brain injury is primarily guided by a neurological clinical evaluation of the patient. The purpose of this article is to review relevant aspects of the neurological history and examination as well as the neurological approach to the concussed athlete. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4160958 Mon, 04 Oct 2010 00:00:00 +0100 4160958 http://www.medworm.com/index.php?rid=4160956&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000675%2Fabstract%3Frss%3Dyes Patients with congenital or developmental anomalies of the cervical spine are encouraged to be active and participate in sports for their overall health. This population has unique anatomic considerations that preclude standard participation guidelines from being relevant. A conscientious evaluation of these patients coupled with an understanding of consensus recommendations for participation in sporting activities should allow for their injury-free participation in sporting activities. After appropriate evaluation a subset of patients with Os odontoideum, Klippel–Feil syndrome, and Down syndrome can safely participate in sporting activities. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4160956 Mon, 04 Oct 2010 00:00:00 +0100 4160956 http://www.medworm.com/index.php?rid=4160955&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000729%2Fabstract%3Frss%3Dyes Spondylolysis and spondylolisthesis remain 2 of the most commonly encountered clinical entities in athletes complaining of low back pain. There has been particular attention devoted to these diagnoses in adolescent athletes; however, they pervade all levels of competition. Bone scan with single-photon emission computed tomography imaging and magnetic resonance imaging remain the diagnostic modalities of choice. Conservative care remains the mainstay of treatment with very selective indications for surgery. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4160955 Mon, 04 Oct 2010 00:00:00 +0100 4160955 http://www.medworm.com/index.php?rid=4160954&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000651%2Fabstract%3Frss%3Dyes This work reviews the epidemiology, evaluation, treatment, and return-to-play guidelines for athletes with degenerative disk disease and herniated nucleus pulposus. Although most athletes with degenerative disk disease and herniated nucleus pulposus improve with conservative treatment, athletes with persistent symptoms may benefit from lumbar discectomy surgery. Lumbar interbody spinal fusion or disk-replacement surgery should only be considered after all other treatment options have been exhausted. Although some general consensus exists, return-to-play guidelines for the athlete with lumbar degenerative disk disease or disk herniation are not well-defined and require further investigation. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4160954 Mon, 04 Oct 2010 00:00:00 +0100 4160954 http://www.medworm.com/index.php?rid=4160952&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000663%2Fabstract%3Frss%3Dyes Burner syndrome and cervical cord neuropraxia are 2 transient neurologic conditions that can occur in athletes participating in contact sports. Burner syndrome is most often characterized by a temporary episode of unilateral upper-extremity dysesthesia with accompanying weakness. More than 50% of athletes who participate in contact sports report at least one such episode. Athletes experiencing a burner can return to play once the symptoms have resolved. Although recurrent burners have not been associated with an increased risk of a more serious neck injury, athletes who have sustained more than 2 burners are placed into the moderate-risk category because they may be at some risk of permanent weakness with further recurrences. Cervical cord neuropraxia refers to a temporary cessation of spi... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4160952 Mon, 04 Oct 2010 00:00:00 +0100 4160952 http://www.medworm.com/index.php?rid=4160950&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000730%2Fabstract%3Frss%3Dyes A wide range of cervical spine injury patterns are related to sports activities. The clinical presentation of the injuries, a pertinent focused physical examination, and proper on-field management are paramount in the successful treatment of an injured athlete. Preexisting conditions (both acquired and congenital) affecting the spine must be determined. All these factors contribute to the challenges faced by health-care professionals in making accurate diagnoses, developing treatment plans, and deciding whether and when the athletes can return to play. A thorough understanding of the injury patterns assists in early recognition and subsequent management. In addition, clinical guidelines are available to assist health-care professionals in stratifying athletes into risk categories and subse... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4160950 Mon, 04 Oct 2010 00:00:00 +0100 4160950 http://www.medworm.com/index.php?rid=4160949&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000687%2Fabstract%3Frss%3Dyes This article reviews the available epidemiologic data concerning these sports and the catastrophic spinal cord injuries associated with them. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4160949 Mon, 04 Oct 2010 00:00:00 +0100 4160949 http://www.medworm.com/index.php?rid=4160948&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000638%2Fabstract%3Frss%3Dyes I was very honored to be asked to serve as Guest Editor for this issue of Seminars in Spine Surgery. The focus of this issue is on spine injuries in athletes. During the last 7 years I have served as the spine surgical consultant to the New York Jets, New York Islanders, New York Dragons, Hofstra, and Molloy College. During this time I have seen the genuine confusion—on the part of the physicians (orthopedic surgeons, neurosurgeons, sports medicine physicians), families, therapists, and trainers—regarding the spine issues that befall athletes of all ability levels. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=4160948 Mon, 04 Oct 2010 00:00:00 +0100 4160948 http://www.medworm.com/index.php?rid=3905674&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000626%2Fabstract%3Frss%3Dyes Postoperative management after lumbar fusion commonly focuses on pain control and activities of daily living. Exercise therapy is often implemented; however, no randomized controlled trial has investigated the impact of early rehabilitation techniques. Abbott et al performed an open-label randomized controlled trial to investigate the effectiveness of a psychomotor therapy that focused on cognition, behavior, and motor relearning compared with exercise therapy applied during the first 3 months after lumbar fusion. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3905674 Fri, 27 Aug 2010 07:16:40 +0100 3905674 http://www.medworm.com/index.php?rid=3905673&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000420%2Fabstract%3Frss%3Dyes Adult congenital scoliosis is more common that congenital kyphosis or lordosis. It is usually present at birth and may remain untreated until adulthood, at which point treatment may be needed for neuro, profession, pulmonary dysfunction, or loss of function. Treatment methods include posterior fusion and instrumentation with or without osteotomies, anterior/posterior fusion with or without osteotomies, or resection and posterior vertebral column resection. The surgical procedures are complex and of high risk with significant morbidity. Current segmental instrumentation systems afford a three dimensional correction of deformity with acceptable complication rates and good outcomes in the properly selected patient. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3905673 Fri, 27 Aug 2010 07:16:40 +0100 3905673 http://www.medworm.com/index.php?rid=3905663&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000572%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3905663 Fri, 27 Aug 2010 07:16:39 +0100 3905663 http://www.medworm.com/index.php?rid=3905662&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000560%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3905662 Fri, 27 Aug 2010 07:16:39 +0100 3905662 http://www.medworm.com/index.php?rid=3905661&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000559%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3905661 Fri, 27 Aug 2010 07:16:39 +0100 3905661 http://www.medworm.com/index.php?rid=3905660&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000547%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3905660 Fri, 27 Aug 2010 07:16:39 +0100 3905660 http://www.medworm.com/index.php?rid=3905667&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000286%2Fabstract%3Frss%3Dyes This article is a brief overview of the evolution of nonoperative and operative treatment methods for patients with congenital spinal deformities. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3905667 Thu, 10 Jun 2010 23:00:00 +0100 3905667 http://www.medworm.com/index.php?rid=3905664&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000237%2Fabstract%3Frss%3Dyes The past decade, if not the past 50 years, has seen great advancements in the evaluation and treatment of congenital spinal deformities. Every year, new research is published on the etiology of congenital malformations of the spine. Although the definitive cause still eludes us, the list of agents and insults that are capable of causing such a problem continually is lengthened. Dr. Fran Farley and colleagues add to that list with their basic science work on carbon monoxide exposure in mice. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3905664 Thu, 10 Jun 2010 23:00:00 +0100 3905664 http://www.medworm.com/index.php?rid=3905670&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000274%2Fabstract%3Frss%3Dyes This article discusses the preoperative evaluation and operative techniques in the treatment of congenital deformities of the cervicothoracic and cervical regions. We also review operative techniques in the treatment of congenital deformities in the cervicothoracic and cervical regions. The goal of early surgery in children with congenital cervicothoracic and cervical spinal deformities to prevent the development of severe local deformities, secondary structural curves, and to allow for normal growth in the unaffected spinal regions. This surgery requires consideration of the anomalies of osseous anatomy, brachial plexus, and vascular anatomy. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3905670 Wed, 09 Jun 2010 23:00:00 +0100 3905670 http://www.medworm.com/index.php?rid=3905668&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000249%2Fabstract%3Frss%3Dyes By nature, congenital spinal deformity is always early in onset. Left untreated, many patients with progressive deformities of the spine and chest wall experience life-threatening complications. The goal of treatment is to improve the deformities and to allow the maximum potential growth of the spine and chest to occur. Therefore, non-fusion distraction-based procedures, such as growing rod (GR) or vertical expandable prosthetic titanium rib (VEPTR) are appealing. The GR procedure may be beneficial in the absence of multiple rib fusions, when the congenital anomaly involves a vertebral segment too long for resection, or with compensatory curve with structural pattern concomitant to the congenital deformity. There has been increasing interest in the use of GR techniques in congenital spine ... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3905668 Wed, 09 Jun 2010 23:00:00 +0100 3905668 http://www.medworm.com/index.php?rid=3905666&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000262%2Fabstract%3Frss%3Dyes This article will emphasize the overall evaluation of a patient with a congenital spinal deformity and the associated organ system defects that the physician should examine. It will also highlight the subsequent tests that should be ordered to aid in the decision-making process of treatment. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3905666 Wed, 09 Jun 2010 23:00:00 +0100 3905666 http://www.medworm.com/index.php?rid=3905672&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000225%2Fabstract%3Frss%3Dyes Hemivertebrae may be progressive and result in significant spinal deformity and truncal imbalance. The development of the deformity is dependent upon the nature of the deformity, the site of the deformity, the age of the patient, and potential for future growth. Addressing the deformity early is essential to prevent serious structural deformity and prevent the development of compensatory curvature. Hemivertebrectomy of the lumbar spine is an accepted technique in the treatment of congenital spinal deformity. It is technically demanding, and the technique affords excellent and immediate correction of the deformity with restoration of proper spinal balance. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3905672 Sun, 06 Jun 2010 23:00:00 +0100 3905672 http://www.medworm.com/index.php?rid=3616787&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000298%2Fabstract%3Frss%3Dyes Recently, a clinical predictive rule has been developed and validated that identifies patients with low back pain who are likely to respond rapidly and dramatically to thrust manipulation. Cleland et al performed a randomized clinical trial to examine the generalizability of 3 different manual therapy techniques in a patient population with low back pain. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3616787 Mon, 31 May 2010 23:00:00 +0100 3616787 http://www.medworm.com/index.php?rid=3616782&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309001026%2Fabstract%3Frss%3Dyes The combination of percutaneus vertebral augmentation with posterior instrumentation may be an attractive treatment option for certain high energy burst fractures. Biomaterials such as calcium phosphate cement are biocompatible, share similar biomechanical properties to bone, and are gradually replaced by host bone tissue. Early biomechanical and clinical results indicate that the anterior column may be restored without the need of a traditional anterior surgical approach. Further clinical studies are needed to confirm that this less invasive approach improves patient outcome. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3616782 Mon, 31 May 2010 23:00:00 +0100 3616782 http://www.medworm.com/index.php?rid=3616779&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000365%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3616779 Mon, 31 May 2010 23:00:00 +0100 3616779 http://www.medworm.com/index.php?rid=3616778&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000353%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3616778 Mon, 31 May 2010 23:00:00 +0100 3616778 http://www.medworm.com/index.php?rid=3616777&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000341%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3616777 Mon, 31 May 2010 23:00:00 +0100 3616777 http://www.medworm.com/index.php?rid=3616776&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS104073831000033X%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3616776 Mon, 31 May 2010 23:00:00 +0100 3616776 http://www.medworm.com/index.php?rid=3905671&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000213%2Fabstract%3Frss%3Dyes The objective of this review is to discuss the indications, surgical technique, and potential complications of thoracic hemivertebra excision in the pediatric population. Thoracic hemivertebra produce a congenital scoliosis or kyphoscoliosis that may progress and require surgical intervention. Patients may require either separate anterior and posterior approaches for hemivertebra excision, or more recently, a posterior-only approach has been developed, which is our preferred method. A posterior-only approach is accomplished with a unilateral costotransversectomy, which allows complete hemivertebra excision as well as reconstruction of the anterior as well as posterior column. Preoperative preparation, intraoperative pearls, and pitfalls and postoperative care will be discussed for this sur... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3905671 Sun, 09 May 2010 23:00:00 +0100 3905671 http://www.medworm.com/index.php?rid=3905669&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000250%2Fabstract%3Frss%3Dyes Growth imbalance of the vertebrae leads to three dimensional deformities of the spinal column in congenital spinal deformities. Deformities are often rigid and create serious challenge for reconstructive surgery. In-situ fusions were popular before use of instrumentation in congenital spinal deformities. Combined anterior-posterior fusions of the vertebral column were performed to stop the progression of the curves. Unique problems in congenital spinal deformity like shorter spinal/trunk length and thoracic insufficiency syndrome are worsened due to shortening of the spine in time after conventional fusion treatments. Spine is stiff in congenital spinal deformities and all surgical interventions increase rigidity by reducing the amount of mobile segments. Spinal canal compromises observed ... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3905669 Sun, 09 May 2010 23:00:00 +0100 3905669 http://www.medworm.com/index.php?rid=3905665&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000201%2Fabstract%3Frss%3Dyes Congenital scoliosis may have an environmental or genetic etiology. Environmental etiologies have focused on maternal carbon monoxide exposure in mice early in gestation. Genetic studies have focused on skeletal patterning genes in the human and the mouse. Genetic mutations have been isolated in the related Jarcho-Levin syndrome. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3905665 Sun, 09 May 2010 23:00:00 +0100 3905665 http://www.medworm.com/index.php?rid=3616784&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000999%2Fabstract%3Frss%3Dyes Minimally invasive surgical techniques hold promise as a valuable tool for the treatment of patients with thoracolumbar fractures. Percutaneous pedicle–based fixation provides secure fracture stabilization and theoretically may minimize associated morbidity while allowing for early mobilization. This holds particular benefit in the management of critically ill patients who may not tolerate conventional open procedures. Furthermore, in select cases the ability to stabilize spinal fractures without fusion may reduce the risk of fusion disease by allowing for late implant removal after fracture healing and subsequent motion preservation. Although early results are promising, prospective trials are necessary for understanding long-term results. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3616784 Wed, 07 Apr 2010 23:00:00 +0100 3616784 http://www.medworm.com/index.php?rid=3616781&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309001002%2Fabstract%3Frss%3Dyes Approximately 2 million people sustain an osteoporotic fracture in the United States each year; 25% of those are vertebral compression fractures. Most fractures can be treated nonoperatively, using a combination of bracing, physical therapy, and pain medications. Surgical treatment may be considered for patients with severe pain or who have failed nonoperative options. Surgical treatment options include vertebroplasty and kyphoplasty, which involve the injection of bone cement (polymethylmethacrylate) to augment vertebral bone strength; kyphoplasty adds the inflation of a balloon tamp to help reduce the fracture and create a space for the cement. The risk of cement extravasation is relatively high, especially during vertebroplasty; however, the incidence of symptomatic leaks is relatively ... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3616781 Wed, 07 Apr 2010 23:00:00 +0100 3616781 http://www.medworm.com/index.php?rid=3616786&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000987%2Fabstract%3Frss%3Dyes Spinal trauma is relatively common, and each year approximately 10,000 to 17,000 people in the United States will sustain a spinal cord injury, and approximately 150,000 to 160,000 will fracture their spinal column. Posttraumatic spinal deformity is a common potential complication of spinal injury and poses as the greatest challenge in spinal surgery. Successful treatment of posttraumatic spinal deformity is dependent on careful patient selection and appropriate surgical intervention. Surgery should be considered in the presence of significant or increasing deformity, increasing back and/or leg pain, “breakdown” at levels above or below the deformity, pseudarthrosis or malunion, and increasing neurological deficit. The goals of surgery should be to decompress the neural elements if neu... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3616786 Sun, 04 Apr 2010 23:00:00 +0100 3616786 http://www.medworm.com/index.php?rid=3616785&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS104073830900104X%2Fabstract%3Frss%3Dyes Because of its complex anatomy, the thoracolumbar spine remains one of the most common sites for spinal column injuries and pathologies. Current surgical management to address thoracolumbar lesions remains challenging as traditional surgical procedures—anterior, posterior, and either combined or staged anterior-posterior approaches—are frequently associated with complications and morbidity. By remaining extrapleural and/or extraperitoneal, the extracavitary approach avoids many of these potential complications by using a single incision to provide direct access to anterior, middle, and posterior column, while offering direct visualization of the common dural sac and neural elements. Recent improvements in surgical technique combined with advancements in spinal instrumentation have redu... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3616785 Sun, 04 Apr 2010 23:00:00 +0100 3616785 http://www.medworm.com/index.php?rid=3616783&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309001014%2Fabstract%3Frss%3Dyes Gunshot wounds to the spine are a common cause of spinal cord injury. The thoracolumbar area is the second most commonly injured region of the spine by gunshot wounds and is the focus of this article. In this article, the authors discuss the fundamentals of ballistics and tissue injury, involved in both low- and high-velocity gunshot wounds to the thoracolumbar spine. A discussion of the diagnostic and therapeutic tools involved in the management of these injuries is undertaken. Furthermore, the approach to the patient with a thoracolumbar gunshot wound is presented. Management must start with maintenance of airway, breathing, and circulation, and proceed with physical examination, laboratory, diagnostic imaging, and medical and surgical interventions. Tetanus prophylaxis and antibiotic ad... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3616783 Sun, 28 Mar 2010 23:00:00 +0100 3616783 http://www.medworm.com/index.php?rid=3616780&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309001038%2Fabstract%3Frss%3Dyes As guest editors, we are excited to present the second half of the issue on Thoracolumbar Spine Injuries. In this edition we start by covering the use of cement augmentation for the management of osteoporotic senile fractures. Recently, as we gain experience with these techniques, indications have expanded to include the management of traumatic lesions, which previously was thought to be a relative contraindication. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3616780 Sun, 28 Mar 2010 23:00:00 +0100 3616780 http://www.medworm.com/index.php?rid=3274512&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS104073831000002X%2Fabstract%3Frss%3Dyes Headaches are frequently reported in patients who have radiculopathy or myelopathy with cervical spondylosis. Modalities of treatment are as varied as their speculated causes. Riina et al performed a study to determine whether anterior cervical reconstructive surgery consisting of cervical arthrodesis or disk arthroplasty also helps to alleviate associated headaches. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3274512 Tue, 16 Feb 2010 15:05:04 +0100 3274512 http://www.medworm.com/index.php?rid=3274511&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000835%2Fabstract%3Frss%3Dyes This article will summarize a common sense way of evaluation and treatment of them. The premise is to stress principles and a methodical approach to analyze these injuries and then to apply a practical, effective, and efficient treatment modalities to manage them. There has been no attempt to address each and every possible injury type. Rather, the goal here was to provide a more general framework through which a physician managing such injuries can maneuver. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3274511 Tue, 16 Feb 2010 15:05:04 +0100 3274511 http://www.medworm.com/index.php?rid=3274509&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000793%2Fabstract%3Frss%3Dyes Fractures of the low lumbar spine are relatively uncommon and have various injury patterns. Treatment must be individualized and should take into account the fracture type, ligamentous injury pattern, neurological injury, the limitations of surgical implants, and the anatomical approaches available. Nonoperative management of burst fractures for patients without neurological deficits has generally been reported to have acceptable outcomes. For low lumbar burst fractures or fracture dislocations of the lumbosacral segment where neurological injury has occurred, surgery is indicated. This surgery should include decompression (posterior or anterior), spinal realignment with maintenance of lumbar lordosis, and instrumentation over minimal segments. Conservatively managed patients require conti... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3274509 Tue, 16 Feb 2010 15:05:04 +0100 3274509 http://www.medworm.com/index.php?rid=3274506&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000781%2Fabstract%3Frss%3Dyes The spinal thoracolumbar junction is uniquely predisposed to injury caused by forces transmitted through the region and the anatomy of transition from the thoracic to lumbar regions. Management of thoracolumbar injuries requires an understanding of the anatomy and biomechanics of this region. Classification systems need to be reproducible and should assist with treatment decisions. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3274506 Tue, 16 Feb 2010 15:05:04 +0100 3274506 http://www.medworm.com/index.php?rid=3274504&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000092%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3274504 Tue, 16 Feb 2010 15:05:04 +0100 3274504 http://www.medworm.com/index.php?rid=3274503&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000080%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3274503 Tue, 16 Feb 2010 15:05:04 +0100 3274503 http://www.medworm.com/index.php?rid=3274502&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000079%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3274502 Tue, 16 Feb 2010 15:05:04 +0100 3274502 http://www.medworm.com/index.php?rid=3274500&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738310000055%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3274500 Tue, 16 Feb 2010 15:05:04 +0100 3274500 http://www.medworm.com/index.php?rid=3274510&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000823%2Fabstract%3Frss%3Dyes High energy injuries to the thoracolumbar (TL) region are commonly encountered and have been described since the time of Hippocrates. Despite this long history and mountains of manuscripts generated on the topic, the optimal care of TL burst fractures remains controversial. There is such great heterogeneity in study designs, inclusion criteria, and interventions used that traditional treatment guidelines require a critical re-evaluation. Many outcome studies have failed to correlate radiographic indicators such a kyphosis, loss of vertebral body height, and canal compromise to long-term clinical outcomes. Furthermore, 3 large prospective, randomized trials have demonstrated outcome equivalency of operative and nonoperative treatment for TL burst fractures without neurological compromise. S... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3274510 Mon, 04 Jan 2010 00:00:00 +0100 3274510 http://www.medworm.com/index.php?rid=3274508&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000811%2Fabstract%3Frss%3Dyes Series of cases from our own practice as a means of reviewing the basic principles for the treatment of thoracolumbar fractures are presented in this article. Although there are no widely accepted evidence-based standards to guide surgeons in choosing treatment approaches, several basic and logical principles may be applied to each case to first decide whether a patient is best managed nonoperatively or with surgical treatment. If operative management is indicated, the surgeon must decide whether decompression and/or stabilization is indicated, whether surgery should be done from an anterior and/or posterior approach, the timing of surgery, the surgical technique, and how extensive the instrumentation should be. Through a series of case example, the authors emphasize the principles of shor... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3274508 Mon, 04 Jan 2010 00:00:00 +0100 3274508 http://www.medworm.com/index.php?rid=3274507&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS104073830900080X%2Fabstract%3Frss%3Dyes Fractures of the thoracic and lumbar spine are common in patients who have sustained high energy spinal trauma, and are associated with injury to the spinal cord in up to 50% of cases. Accurate early assessment is essential because delay in diagnosis may result in the development of neurologic complications. Clinical assessment of these patients is often challenging, and as a result, diagnostic imaging usually plays a central role in their management. The purpose of this chapter is to explore this role by answering the following questions: What are the imaging options? Who should be imaged? How should they be imaged? and What are the imaging findings for the most common types of thoracolumbar fractures? (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3274507 Mon, 04 Jan 2010 00:00:00 +0100 3274507 http://www.medworm.com/index.php?rid=3274505&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000847%2Fabstract%3Frss%3Dyes We are excited and honored for the opportunity to serve as guest editors for this issue of Seminars in Spine Surgery. You will notice that the focus of this issue is on thoracolumbar spine injuries. It was a conscious decision on our part not to title it as Thoracolumbar Fractures. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3274505 Mon, 04 Jan 2010 00:00:00 +0100 3274505 http://www.medworm.com/index.php?rid=3037980&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000756%2Fabstract%3Frss%3Dyes The management of degenerative spondylolisthesis when associated with spinal stenosis remains controversial. Questions remain regarding the long-term effects of surgical treatment compared with those of nonoperative treatment. Weinstein et al performed a prospective randomized multicenter clinical trial to assess the stability of pain and functional outcomes at 4 years for patients with degenerative spondylolisthesis and spinal stenosis treated surgically or nonoperatively. Surgical candidates from 13 centers, with symptoms of at least 12-week duration as well as confirmatory imaging showing degenerative spondylolisthesis with spinal stenosis were offered enrollment into a randomized cohort or observational cohort. Treatment consisted of standard decompressive laminectomy (with or without ... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3037980 Mon, 30 Nov 2009 15:07:54 +0100 3037980 http://www.medworm.com/index.php?rid=3037979&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000744%2Fabstract%3Frss%3Dyes Spine care has become increasingly evidence-based. The investigators who have generated this evidence have learned important lessons that should help guide future trials: 1. Patients will agree to enroll in studies and to be randomized; 2. Patients will crossover between treatment arms if it is an option; 3. Observational studies can provide the best answers to some questions; 4. High quality clinical research is extremely expensive and work-intensive; 5. High quality spine research is needed now more than ever. This paper reviews these issues as they have arisen in recent clinical studies. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3037979 Mon, 30 Nov 2009 15:07:54 +0100 3037979 http://www.medworm.com/index.php?rid=3037978&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000732%2Fabstract%3Frss%3Dyes Evidence suggests that effective conservative treatment is available for chronic low back pain (LBP). The effectiveness of conservative treatment has received attention following publication of several randomized controlled trials that reported similar improvements in outcomes from cognitive intervention with exercise as from spinal fusion surgery. This paper explores the conservative treatment arms of these randomized controlled trials with the goal of educating the reader about the principles of cognitive intervention with exercise. These principles can be incorporated into the care of chronic LBP patients both as primary treatment and as a means of augmenting surgical outcomes. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3037978 Mon, 30 Nov 2009 15:07:54 +0100 3037978 http://www.medworm.com/index.php?rid=3037977&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000720%2Fabstract%3Frss%3Dyes The objective of this review was to examine the randomized controlled trials evaluating fusion surgery for discogenic axial back pain without associated leg pain, spondylolisthesis, or stenosis. Six studies were reviewed: 4 that considered spinal fusion in comparison with nonoperative treatment, and 2 that considered fusion in comparison with artificial disc replacement. We found that methodological difficulties limit the ability to draw definitive conclusions, but that fusion appears superior to unstructured nonoperative treatment, similar to structured nonoperative treatment, and similar to short-term results of artificial disc replacement. Further long term, well-constructed randomized controlled trials are warranted. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3037977 Mon, 30 Nov 2009 15:07:54 +0100 3037977 http://www.medworm.com/index.php?rid=3037976&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000719%2Fabstract%3Frss%3Dyes The objective of this paper is to review the most important literature to address these controversies. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3037976 Mon, 30 Nov 2009 15:07:54 +0100 3037976 http://www.medworm.com/index.php?rid=3037975&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000707%2Fabstract%3Frss%3Dyes This article briefly reviews the evidence regarding diagnosis and nonoperative management, as well as the best outcome measurement tools to evaluate this disorder. It then reviews several of the best evidence studies regarding the utility of surgical and nonsurgical treatment for lumbar spinal stenosis. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3037975 Mon, 30 Nov 2009 15:07:54 +0100 3037975 http://www.medworm.com/index.php?rid=3037974&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000690%2Fabstract%3Frss%3Dyes Several randomized controlled trials (RCTs) and prospective observational cohort studies have compared surgical to conservative treatment for patients with sciatica caused by lumbar disc herniation. Whereas no RCT has been able to compare surgery with nonoperative treatment without substantial crossover between treatment groups, multiple RCTs and observational studies have suggested that surgery resulted in faster improvement and a greater degree of improvement compared with nonoperative treatment. However, many patients in these studies also experienced improvement with nonoperative care without adverse sequelae. This paper critically reviews the literature comparing surgery with nonoperative treatment for lumbar disc herniation. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3037974 Mon, 30 Nov 2009 15:07:54 +0100 3037974 http://www.medworm.com/index.php?rid=3037973&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000689%2Fabstract%3Frss%3Dyes Healthcare decision making can be complex, often requiring decision makers to weigh serious trade-offs, consider patients' values, and incorporate evidence in the face of uncertainty. Medical decisions are made implicitly by clinicians and other decision-makers daily. Decisions based largely on personal experience are subject to many biases. Decision analysis and cost-effectiveness analysis are systematic approaches used to support decision-making under conditions of uncertainty that involve important trade-offs. These mathematical tools can provide patients, physicians, and policy makers with a useful approach to complex medical decision making. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3037973 Mon, 30 Nov 2009 15:07:53 +0100 3037973 http://www.medworm.com/index.php?rid=3037972&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000677%2Fabstract%3Frss%3Dyes The use of biostatistics is ubiquitous in the spine literature, however, many clinicians have not been trained in basic statistical principles and do not understand their application. The goal of statistics is to estimate the underlying distribution of a variable in the population based on the observations from a sample. Statistics allow investigators to determine the likelihood that specific groups of patients are different. Such comparisons are obviously important when attempting to determine the utility of a given treatment. The goal of this review is to cover the basic principles of biostatistics with a focus on spine-related examples. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3037972 Mon, 30 Nov 2009 15:07:53 +0100 3037972 http://www.medworm.com/index.php?rid=3037971&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000665%2Fabstract%3Frss%3Dyes This article reviews these concepts, using examples from the spine literature. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3037971 Mon, 30 Nov 2009 15:07:53 +0100 3037971 http://www.medworm.com/index.php?rid=3037969&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000902%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3037969 Mon, 30 Nov 2009 15:07:53 +0100 3037969 http://www.medworm.com/index.php?rid=3037968&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000896%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3037968 Mon, 30 Nov 2009 15:07:53 +0100 3037968 http://www.medworm.com/index.php?rid=3037967&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000884%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3037967 Mon, 30 Nov 2009 15:07:53 +0100 3037967 http://www.medworm.com/index.php?rid=3037966&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000872%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3037966 Mon, 30 Nov 2009 15:07:53 +0100 3037966 http://www.medworm.com/index.php?rid=3037970&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000653%2Fabstract%3Frss%3Dyes This issue of Seminars in Spine Surgery is unique. Although prior issues have focused on specific pathology or treatment techniques, the articles that follow in the current issue focus on the much broader topic of “Evidence-Based Medicine for the Spine.” The first 3 articles review the general concepts of study design, biostatistics, and decision and cost-effectiveness analysis. Although these articles do not focus on spine-specific topics, we felt that interested members of the spine community would benefit from review articles focusing on these subjects that are central to understanding the published data on spine. Most practicing spine surgeons did not have specific training in these fields despite these concepts being at the core of interpreting clinical research. Given that spine ... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=3037970 Thu, 15 Oct 2009 00:00:00 +0100 3037970 http://www.medworm.com/index.php?rid=2755340&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000483%2Fabstract%3Frss%3Dyes Lumbar spinal stenosis is quite common among the elderly population. There are insufficient data concerning the effectiveness of nonoperative treatments. Koc and coworkers performed a randomized single-blinded controlled trial to compare the effects of epidural steroid injections and physical therapy on pain and function in patients with lumbar spinal stenosis. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2755340 Mon, 31 Aug 2009 23:00:00 +0100 2755340 http://www.medworm.com/index.php?rid=2755339&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000471%2Fabstract%3Frss%3Dyes Anterior cervical discectomy and fusion (ACDF) has long been the gold standard for the treatment of cervical pathology. ACDF, when performed successfully, has shown good disease-free survival of up to 89% at 5 years for patients. However, the potential for complications has prompted clinicians to search for alternatives to cervical discectomy and fusion. Recent efforts have focused on total disc arthroplasty and interest in its application to the cervical spine. If performed successfully, total disc arthroplasty would preclude the need for graft harvest for fusion, attempt to maintain more physiological kinematics of the cervical spine and prevent/delay adjacent segment disease. Currently, at least 2 devices for cervical disc arthroplasty have been approved by the US Food and Drug Administ... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2755339 Mon, 31 Aug 2009 23:00:00 +0100 2755339 http://www.medworm.com/index.php?rid=2755338&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS104073830900046X%2Fabstract%3Frss%3Dyes The past several decades have seen tremendous progress in the technology and techniques used in cervical spine surgery. Regardless of the technique, anatomical approach, or implants used, the long-term goals of spine surgery, including neurologic decompression and vertebral column stability, remain unchanged. Furthermore, achievement of these outcomes with minimal complications is of utmost importance. By critically evaluating the various techniques available and their respective long-term outcomes and complications, surgeons can provide their patients with more optimized surgical solutions. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2755338 Mon, 31 Aug 2009 23:00:00 +0100 2755338 http://www.medworm.com/index.php?rid=2755337&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000458%2Fabstract%3Frss%3Dyes Occipitocervical fixation (OCF) is indicated for OC instability, or atlantoaxial instability where the patient is not a candidate for atlantoaxial arthrodesis or has failed prior C1-C2 fusion. Most commonly, OC instability is caused by trauma, rheumatoid arthritis (RA), and tumors/tumor excision, and can be associated with significant vertical migration of the odontoid and cranial settling (eg, RA). In this review, we discuss complications that can occur during stabilization of the craniovertebral junction (CVJ), providing the reader some pearls on how to avoid them and how to manage them should they occur. Complications discussed include those related to fixation and/or pseudarthrosis, neurologic injuries, craniocervical alignment, screw placement, and vascular injuries. We reference the ... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2755337 Mon, 31 Aug 2009 23:00:00 +0100 2755337 http://www.medworm.com/index.php?rid=2755336&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000446%2Fabstract%3Frss%3Dyes Cerebrospinal fluid leaks are among the most commonly reported complications in spinal surgery. The prevalence of cervical dural tears is 0.5%-3%. Although the gold standard for management of cervical dural leaks is direct suture repair, most cervical dural tears can be managed by observation alone. Large dural defects or tenuous repairs may warrant the placement of a lumbar cerebrospinal fluid shunt. The diagnosis of an occult or a chronic dural leak can be made from clinical information with patients classically complaining of a spinal headache. Properly managed cervical dural tears heal without adverse effects and without long-term neurologic sequelae. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2755336 Mon, 31 Aug 2009 23:00:00 +0100 2755336 http://www.medworm.com/index.php?rid=2755335&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000434%2Fabstract%3Frss%3Dyes Intraoperative complications during posterior spinal surgery are best avoided by awareness of which complications are possible during each portion of the surgery. Neurologic injury, vascular injury, and mechanical instability are the major complications that occur during the posterior cervical surgery. The relevance of positioning, tissue resection, instrumentation, and wound closure to each complication is considered. Preoperative planning, understanding each patient's anatomy, optimization in surgical positioning, and use of appropriate surgical tools form the basis for avoiding these complications. Early recognition intraoperatively, using neurologic monitoring and awareness of changes to the anatomical structures, is essential in salvaging the best chance for a successful outcome. (Sou... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2755335 Mon, 31 Aug 2009 23:00:00 +0100 2755335 http://www.medworm.com/index.php?rid=2755332&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000550%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2755332 Mon, 31 Aug 2009 23:00:00 +0100 2755332 http://www.medworm.com/index.php?rid=2755331&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000549%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2755331 Mon, 31 Aug 2009 23:00:00 +0100 2755331 http://www.medworm.com/index.php?rid=2755330&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000525%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2755330 Mon, 31 Aug 2009 23:00:00 +0100 2755330 http://www.medworm.com/index.php?rid=2755329&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000513%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2755329 Mon, 31 Aug 2009 23:00:00 +0100 2755329 http://www.medworm.com/index.php?rid=2755334&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000422%2Fabstract%3Frss%3Dyes This article reviews the published data on complications of the anterior approach to the cervical spine, focusing on etiology, diagnosis, and management of these complications. Raising the surgeons' awareness on complications that are possible during the procedure is essential in minimizing the incidence of adverse events, and allows for early detection and appropriate management of complications when they do occur. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2755334 Mon, 20 Jul 2009 23:00:00 +0100 2755334 http://www.medworm.com/index.php?rid=2755333&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000410%2Fabstract%3Frss%3Dyes The surgeon's desire to improve patient function is always tempered by a risk of potential adverse effects from the surgical endeavor itself. Possibly, more than any other surgical discipline, complications after cervical spine surgery can have a profound effect on patient function and outcomes. Our efforts toward preventing these complications need to be aggressive and proactive. This issue of Seminars in Spine Surgery is part of that effort. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2755333 Thu, 09 Jul 2009 23:00:00 +0100 2755333 http://www.medworm.com/index.php?rid=2481533&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000173%2Fabstract%3Frss%3Dyes Osteogenic protein 1 (OP-1) Putty is a commercially available recombinant BMP preparation that is already approved for limited use in humans. Previous clinical studies involving patients with degenerative spondylolisthesis have reported the efficacy and safety of OP-1 Putty was comparable to that of autogenous bone graft at 2-year follow-up. Vaccaro and coworkers performed a review to evaluate the intermediate term efficacy and safety of OP-1 Putty as an alternative to autogenous bone. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2481533 Mon, 01 Jun 2009 04:00:00 +0100 2481533 http://www.medworm.com/index.php?rid=2481532&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000136%2Fabstract%3Frss%3Dyes Hypofractionated stereotactic radiosurgery allows the treatment of metastatic and primary spinal tumors with highly conformal dosing while sparing the adjacent neural structures. This enables the physician to treat tumors which are recurrent after standard external beam radiation, are radioresistant in doses normally tolerated by the spinal cord or are in patients with primary tumors who are not candidates for surgical resection. Initial results have shown satisfactory achievement of treatment goals with minimal occurrence of complications. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2481532 Mon, 01 Jun 2009 04:00:00 +0100 2481532 http://www.medworm.com/index.php?rid=2481531&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000148%2Fabstract%3Frss%3Dyes Primary and metastatic spinal tumors as a group represent a heterogeneous mixture of benign and malignant processes. In general, primary tumors of the spine remain relatively uncommon, and the majority of spinal tumors that are treated annually represent systemic spread of extraosseous primary malignancy. The management of spinal tumors requires meticulous yet expedient attention as the consequences of failed or inappropriate treatment can be devastating. Radiotherapy has proven beneficial in many tumors of the spine, particularly metastatic lesions, Ewing's sarcoma, and myeloid malignancies. A review of the use of radiotherapy for the more common primary spinal malignancies and metastasis is presented. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2481531 Mon, 01 Jun 2009 04:00:00 +0100 2481531 http://www.medworm.com/index.php?rid=2481530&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000161%2Fabstract%3Frss%3Dyes In an effort to reduce the burden of harm that our treatments cause to our patients, there has been a trend toward the minimalization of spine surgery. We review the minimally invasive procedures used in the treatment of spinal tumors, including minimally invasive diagnostic techniques, vertebral augmentation, radiofrequency ablation, endoscopic/thoracoscopic spine surgery, and minimal access open spine surgery. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2481530 Mon, 01 Jun 2009 04:00:00 +0100 2481530 http://www.medworm.com/index.php?rid=2481529&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000185%2Fabstract%3Frss%3Dyes Tumors affecting the spinal column include primary and metastatic tumors. Primary tumors of the spine comprise less than 11% of all primary musculoskeletal tumors, and only 4.2% of all spine tumors and include aneurysmal bone cysts (ABCs) and giant cell tumors (GCTs). The radiographic and histologic features of these tumors may appear similar, as both create osteolysis and cystic patterns in the vertebra, and both may contain giant cells and hemosiderin on histology. However, the biological behavior and clinical course of these tumors differ significantly and an effective approach to treatment is distinct in these conditions. The purpose of this article is to describe ABCs as a primary benign tumor of the spine and to differentiate this entity from GCTs of the spine, which have the capacit... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2481529 Mon, 01 Jun 2009 04:00:00 +0100 2481529 http://www.medworm.com/index.php?rid=2481528&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000197%2Fabstract%3Frss%3Dyes This article presents techniques for sacral resection and subsequent spinopelvic reconstruction. Biomechanical studies are summarized on construct stability, and recommendations are made as to when reconstruction is required. The expected bowel and bladder functional outcomes are summarized, based on the level of sacral resection. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2481528 Mon, 01 Jun 2009 04:00:00 +0100 2481528 http://www.medworm.com/index.php?rid=2481527&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS104073830900015X%2Fabstract%3Frss%3Dyes This report details this technique along with a discussion of the reconstruction and associated potential complications. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2481527 Mon, 01 Jun 2009 04:00:00 +0100 2481527 http://www.medworm.com/index.php?rid=2481525&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000112%2Fabstract%3Frss%3Dyes En bloc resection is a surgical procedure attempting to remove the whole tumor in a single piece, intact, encased by a continuous cuff of healthy (tumor-free) tissue. This cuff is called the “margin”: its quality and thickness defines the oncologic feature of the procedure. When en bloc resection is planned in the treatment of bone tumors of the spine, obtaining a tumor-free margin can be extremely difficult and is a much more frequent problem in the axial spine than in limb tumors. Structures, such as the spinal cord and the vital vascular anatomy in and around the spine, present challenges that make achieving tumor-free margins impossible or difficult at best. The authors' experience is based on the treatment of 1072 bone tumors of the spine (515 primary tumors)—145 of them treated... Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2481525 Mon, 01 Jun 2009 04:00:00 +0100 2481525