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. Sat, 20 Mar 2010 14:56:35 +0100 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 http://www.medworm.com/index.php?rid=2481524&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000215%2Fabstract%3Frss%3Dyes A major advance has been made in the diagnosis, classification and treatment of neoplasms of the spine. The biopsy represents a final step in the diagnosis of such lesions. Although technically it may be a minor procedure, it is well established that poorly conceived or executed biopsy may result in adverse outcome. In this article, we discuss issues related to preoperative work-up, optimal planning, and executing of the vertebral and paraspinous biopsy. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2481524 Mon, 01 Jun 2009 04:00:00 +0100 2481524 http://www.medworm.com/index.php?rid=2481522&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000288%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2481522 Mon, 01 Jun 2009 04:00:00 +0100 2481522 http://www.medworm.com/index.php?rid=2481521&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000276%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2481521 Mon, 01 Jun 2009 04:00:00 +0100 2481521 http://www.medworm.com/index.php?rid=2481520&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000264%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2481520 Mon, 01 Jun 2009 04:00:00 +0100 2481520 http://www.medworm.com/index.php?rid=2481519&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000240%2Fabstract%3Frss%3Dyes (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2481519 Mon, 01 Jun 2009 04:00:00 +0100 2481519 http://www.medworm.com/index.php?rid=2481526&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000124%2Fabstract%3Frss%3Dyes Metastatic disease of the spine is a common and troublesome complication in many cancer patients. Metastases may cause debilitating pain and neurologic dysfunction, significantly limiting functional ability and quality of life. With advances in chemotherapy, radiation therapy, and surgical techniques, the treatment of metastatic spine disease has facilitated improved quality of life for many patients. Surgical advances have allowed more aggressive surgical decompression, debulking, and stabilization for vertebral metastases. With an aging population and as more patients survive longer with their burden of disease, surgical management of metastatic spine disease will become more prevalent. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2481526 Mon, 27 Apr 2009 04:00:00 +0100 2481526 http://www.medworm.com/index.php?rid=2481523&cid=s_38666_31_f&fid=38666&url=http%3A%2F%2Fwww.semspinesurg.com%2Farticle%2FPIIS1040738309000203%2Fabstract%3Frss%3Dyes Spinal tumors include a wide range of entities, all of which can have a major impact on the quality, if not the length, of an individual's life. Cancer is the second leading cause of death in the United States, and between 30% and 70% of patients who die of cancer have spinal metastases at autopsy. Up to 14% have clinically symptomatic disease, and with an aging population and improved survival, more patients will likely require treatment for spinal metastases in the future. Advances in surgical and radiotherapy techniques over the past several decades have caused a pendulum swing in the management strategy preferred at the time. The 2 options are now considered complementary, and exciting new combined treatment paradigms are emerging. (Source: Seminars in Spine Surgery) Seminars in Spine Surgery journals http://www.medworm.com/rss/comments.php?id=2481523 Mon, 27 Apr 2009 04:00:00 +0100 2481523