Short segment fixation aims to restore spinal stability and alignment in thoracolumbar spine injuries while preserving spinal motion by decreasing the levels of spine involved in fixation. In its simplest form it applies to fixation one level above and one level below the fractured vertebra. It has proven effective with good clinical, functional and radiological results in well selected cases. However not insignificant rates of sagittal collapse and recurrence of kyphosis with or without clinical implications have also been reported. Most of the failures were attributed to lack of anterior column integrity and relatively inferior robustness of earlier posterior short segment constructs. With better understanding of fracture biomechanics, better implant designs and evolution of strategies to increase the biomechanical strengths of posterior constructs, the rates of kyphosis recurrence and implant failure have been significantly reduced. Although there is lack of robust evidence to guide a surgeon to the best approach for a particular fracture, adhering to basic biomechanical principals increases the efficacy and reliability of short segment fixation. This narrative review highlights the status of short segment fixation in dorsolumbar spine injuries with emphasis on patient selection and strategies to increase effectiveness and reduce failures of short segment fixation.
Lumbar degenerative spinal ailments are the most important causes for chronic low **** pain. Modic changes (**) are vertebral bone marrow signal intensity changes seen on MRI, commonly in association with degenerative disc disease (DDD). Despite being widely studied, majority of issues concerning ** are still controversial. The current narrative, evidence-based review comprehensively discusses the various aspects related to **.

An elaborate search was made using keywords "Modic changes", "lumbar Modic changes", "Modic changes in lumbar spine", and "vertebral Endplate Spinal Changes", on pubmed and google (scholar.google.com) databases on the 3rd of March 2020. We identified crucial questions regarding Modic changes and included relevant articles pertaining to these topics for this narrative review.

The initial search using the keywords "Modic changes", "lumbar Modic changes", "Modic changes in lumbar spine", and "vertebral Endplate Spinal Changes" on pubmed yielded a total of 568, 412, 394 and 216 articbesity, spinal deformities, higher occupational loads and DDD are known risk factors. There is no conclusive evidence on the causative role of ** in chronic low **** pain (LBP) or any influence on the long term outcome in patients with LBP or lumbar disc herniations (LDH). Patients with ** have been reported to have less satisfactory outcome following conservative treatment or discectomy, although the evidence is still unclear.With clinical innovation and technological advancement, the paradigm of surgical procedures on the spine and spinal cord along with the perioperative management are rapidly evolving. https://www.selleckchem.com/products/Mubritinib-TAK-165.html Irrespective of different modes the anesthetic management of spine surgery is challenging in view of significant blood loss, prolong procedure, position-related complications, and complex pain management. The enhanced recovery after surgery (ERAS) for this kind of surgery is yet to be finalized. The aim of this article is to highlight the current evidence-based major perioperative considerations for patients undergoing spine surgery.Spinal injuries constitute about 3% of all injury cases and most of these injuries affect the thoracolumbar region, but thoracolumbar fracture-dislocations are **** rarer. Dislocations (AO Type C injuries) of the thoracic and lumbar vertebrae, with or without associated fractures, happen due to very high energy trauma involving simultaneous, multidirectional, distractive and compressive forces across various spinal elements, which results in translational and rotational instability of the spinal column. Various reduction maneuvers have been described for thoracolumbar fracture-dislocations in the literature aiming to provide standardization in surgery for this situation. The aim of this review article is to systematically review the literature till date and describe various reduction maneuvers which help to achieve adequate sagittal and coronal balance as well as vertebral alignment with minimal soft tissue trauma. We searched the PubMed, the Cochrane Library (the most recent issue), Scopus, Cochrane Bone, Joideration based on inclusion criteria, after excluding unrelated papers manually. We have summarised the published literature on the surgical management of thoraco-lumbar fracture dislocations and described the reduction maneuvers used in detail.
Lower **** pain is the fifth most common reason for visiting a physician in the United States. Degenerative disc disease, degenerative spondylolisthesis, arthritis, and facet arthrosis are leading causes for lumbar spinal stenosis. The previous gold standard involved open laminectomy combined with medial facetectomy and foraminotomy. The advent of minimally invasive surgery (MIS) and endoscopic technologies has led to less invasive and targeted interventions. In this study, the authors aim to show a five-year experience using a three-blade retractor for lumbar decompression and microdiscectomy.

A database review of a single spine surgeon over the last 5 years with a total of 306 patients undergoing single-level lumbar decompression with and without microdiscectomy.

The average age was 47±12 years and the average BMI was 29.7±5.7kg/m2 with a total of 52% male patients. Operative levels included L3-4, L4-L5, and L5-S1, with 65% of procedures at the L5-S1 level and follow-up was for two years. Overall mean VAS **** scores decreased from 7.9±1.6 to 2.5±1.1at two-year follow-up, p=0.001. Preoperative ODI scores improved from 32.1±5.1 to 17.9±4.3at two-year follow-up, p=0.002. The mean EBL and surgeon time was 21±15ml and 35±17min, respectively.

This less exposure surgery technique can be performed to allow lumbar decompression, with or without microdiscectomy. This is an anatomy preserving technique with improved outcomes.
This less exposure surgery technique can be performed to allow lumbar decompression, with or without microdiscectomy. This is an anatomy preserving technique with improved outcomes.
Short segment fixation aims to restore spinal stability and alignment in thoracolumbar spine injuries while preserving spinal motion by decreasing the levels of spine involved in fixation. In its simplest form it applies to fixation one level above and one level below the fractured vertebra. It has proven effective with good clinical, functional and radiological results in well selected cases. However not insignificant rates of sagittal collapse and recurrence of kyphosis with or without clinical implications have also been reported. Most of the failures were attributed to lack of anterior column integrity and relatively inferior robustness of earlier posterior short segment constructs. With better understanding of fracture biomechanics, better implant designs and evolution of strategies to increase the biomechanical strengths of posterior constructs, the rates of kyphosis recurrence and implant failure have been significantly reduced. Although there is lack of robust evidence to guide a surgeon to the best approach for a particular fracture, adhering to basic biomechanical principals increases the efficacy and reliability of short segment fixation. This narrative review highlights the status of short segment fixation in dorsolumbar spine injuries with emphasis on patient selection and strategies to increase effectiveness and reduce failures of short segment fixation. Lumbar degenerative spinal ailments are the most important causes for chronic low back pain. Modic changes (MC) are vertebral bone marrow signal intensity changes seen on MRI, commonly in association with degenerative disc disease (DDD). Despite being widely studied, majority of issues concerning MC are still controversial. The current narrative, evidence-based review comprehensively discusses the various aspects related to MC. An elaborate search was made using keywords "Modic changes", "lumbar Modic changes", "Modic changes in lumbar spine", and "vertebral Endplate Spinal Changes", on pubmed and google (scholar.google.com) databases on the 3rd of March 2020. We identified crucial questions regarding Modic changes and included relevant articles pertaining to these topics for this narrative review. The initial search using the keywords "Modic changes", "lumbar Modic changes", "Modic changes in lumbar spine", and "vertebral Endplate Spinal Changes" on pubmed yielded a total of 568, 412, 394 and 216 articbesity, spinal deformities, higher occupational loads and DDD are known risk factors. There is no conclusive evidence on the causative role of MC in chronic low back pain (LBP) or any influence on the long term outcome in patients with LBP or lumbar disc herniations (LDH). Patients with MC have been reported to have less satisfactory outcome following conservative treatment or discectomy, although the evidence is still unclear.With clinical innovation and technological advancement, the paradigm of surgical procedures on the spine and spinal cord along with the perioperative management are rapidly evolving. https://www.selleckchem.com/products/Mubritinib-TAK-165.html Irrespective of different modes the anesthetic management of spine surgery is challenging in view of significant blood loss, prolong procedure, position-related complications, and complex pain management. The enhanced recovery after surgery (ERAS) for this kind of surgery is yet to be finalized. The aim of this article is to highlight the current evidence-based major perioperative considerations for patients undergoing spine surgery.Spinal injuries constitute about 3% of all injury cases and most of these injuries affect the thoracolumbar region, but thoracolumbar fracture-dislocations are much rarer. Dislocations (AO Type C injuries) of the thoracic and lumbar vertebrae, with or without associated fractures, happen due to very high energy trauma involving simultaneous, multidirectional, distractive and compressive forces across various spinal elements, which results in translational and rotational instability of the spinal column. Various reduction maneuvers have been described for thoracolumbar fracture-dislocations in the literature aiming to provide standardization in surgery for this situation. The aim of this review article is to systematically review the literature till date and describe various reduction maneuvers which help to achieve adequate sagittal and coronal balance as well as vertebral alignment with minimal soft tissue trauma. We searched the PubMed, the Cochrane Library (the most recent issue), Scopus, Cochrane Bone, Joideration based on inclusion criteria, after excluding unrelated papers manually. We have summarised the published literature on the surgical management of thoraco-lumbar fracture dislocations and described the reduction maneuvers used in detail. Lower back pain is the fifth most common reason for visiting a physician in the United States. Degenerative disc disease, degenerative spondylolisthesis, arthritis, and facet arthrosis are leading causes for lumbar spinal stenosis. The previous gold standard involved open laminectomy combined with medial facetectomy and foraminotomy. The advent of minimally invasive surgery (MIS) and endoscopic technologies has led to less invasive and targeted interventions. In this study, the authors aim to show a five-year experience using a three-blade retractor for lumbar decompression and microdiscectomy. A database review of a single spine surgeon over the last 5 years with a total of 306 patients undergoing single-level lumbar decompression with and without microdiscectomy. The average age was 47±12 years and the average BMI was 29.7±5.7kg/m2 with a total of 52% male patients. Operative levels included L3-4, L4-L5, and L5-S1, with 65% of procedures at the L5-S1 level and follow-up was for two years. Overall mean VAS back scores decreased from 7.9±1.6 to 2.5±1.1at two-year follow-up, p=0.001. Preoperative ODI scores improved from 32.1±5.1 to 17.9±4.3at two-year follow-up, p=0.002. The mean EBL and surgeon time was 21±15ml and 35±17min, respectively. This less exposure surgery technique can be performed to allow lumbar decompression, with or without microdiscectomy. This is an anatomy preserving technique with improved outcomes. This less exposure surgery technique can be performed to allow lumbar decompression, with or without microdiscectomy. This is an anatomy preserving technique with improved outcomes.
0 Commentarios 0 Acciones 7 Views 0 Vista previa
Patrocinados