Latest journal articles about spine from European Spine Journal, Scoliosis, The Bone & Joint Journal, Journal of Bone and Joint Surgery, Clinical Orthopaedics and Related Research, Acta Orthopaedica, Orthopedic Clinics of North, America, Journal of Orthopaedic Surgery and Research, Orthopedics
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By Editor-in-Chief Before moving the patient, the EMS team must immobilize the individual in a cervical (neck) collar and backboard. The trauma team will perform a complete and thorough evaluation in the hospital emergency room.
The emergency room doctor will conduct a thorough evaluation, beginning with a head-to-toe physical examination of the patient. This will include an inspection of the head, chest, abdomen, pelvis, limbs, and spine.
Neurological tests. The doctor will also evaluate the patient's neurological status. This includes testing his or her ability to move, feel, and sense the position of all the limbs. In addition, the doctor will test the patient's reflexes to help determine whether there has been an injury to the spinal cord or individual nerves.
Pregnancy has a profound effect on the human body, particularly the musculoskeletal system. Hormonal changes cause ligamentous joint laxity, weight gain, and a shift in the center of gravity that leads to lumbar spine hyperlordosis and anterior tilting of the pelvis. In addition, vascular changes may lead to compromised metabolic supply in the low back. The most common musculoskeletal complaints in pregnancy are low back pain and/or pelvic girdle pain. They can be diagnosed and differentiated from each other by history taking, clinical examination, provocative test maneuvers, and imaging. Management ranges from conservative and pharmacologic measures to surgical treatment. Depending on the situation, and given the unique challenges pregnancy places on the human body and the special consideration that must be given to the fetus, an orthopaedic surgeon and the obstetrician may have to develop a plan of care together regarding labor and delivery or when surgical interventions are indicated.
197 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:
These pubmed results were generated on 2013/11/30
155 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:
These pubmed results were generated on 2013/09/22
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Do intervertebral discs degenerate before they herniate, or after?
Bone Joint J. 2013 Aug 1;95-B(8):1127-1133
Authors: Lama P, Le Maitre CL, Dolan P, Tarlton JF, Harding IJ, Adams MA
Abstract
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Implant survival after deep infection of an instrumented spinal fusion.
Bone Joint J. 2013 Aug 1;95-B(8):1121-1126
Authors: Núñez-Pereira S, Pellisé F, Rodríguez-Pardo D, Pigrau C, Bagó J, Villanueva C, Cáceres E
Abstract
This study evaluates the long-term survival of spinal implants after surgical site infection (SSI) and the risk factors associated with treatment failure. A Kaplan-Meier survival analysis was carried out on 43 patients who had undergone a posterior spinal fusion with instrumentation between January 2006 and December 2008, and who consecutively developed an acute deep surgical site infection. All were appropriately treated by surgical debridement with a tailored antibiotic program based on culture results for a minimum of eight weeks. A 'terminal event' or failure of treatment was defined as implant removal or death related to the SSI. The mean follow-up was 26 months (1.03 to 50.9). A total of ten patients (23.3%) had a terminal event. The rate of survival after the first debridement was 90.7% (95% confidence interval (CI) 82.95 to 98.24) at six months, 85.4% (95% CI 74.64 to 96.18) at one year, and 73.2% (95% CI 58.70 to 87.78) at two, three and four years. Four of nine patients required re-instrumentation after implant removal, and two of the four had a recurrent infection at the surgical site. There was one recurrence after implant removal without re-instrumentation. Multivariate analysis revealed a
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Cervical dermal sinus complicated with intramedullary abscess in a child: case report and review of literature.
Eur Spine J. 2013 Aug 3;
Authors: Nicola Z, Antonio C, De Tommasi A
Abstract
BACKGROUND: Dermal sinus tract (DST) is an uncommon spinal dysraphism presenting in childhood along the midline neuroaxis. Cervical DST less frequent is in association with intramedullary abscess.
METHODS: A 9-month-old baby was admitted to our unit suffering from right hemiparesis. Physical examination showed a cervical midline cutaneous fistula dripping a yellowish thick liquid. Cervical MRI showed at C5 level a sinus tract in continuity with a C3-C6 intramedullary lesion. Total removal of the fistula and the intramedullary lesion was performed. Histopathological examination confirmed the diagnosis of dermal sinus and abscess.
RESULTS: Post-operative cervical MRI showed a complete removal of the spinal dysraphism, fistula, and intramedullary abscess. The baby showed a progressive clinical improvement and was discharged on day 10 post-surgery.
CONCLUSION: Literature review confirms that an early diagnosis followed by prompt surgical spinal cord decompression gives a functional neurological recovery.
PMID: 23907309 [PubMed - as supplied by publisher]
Read more... http://www.ncbi.nlm.nih.gov/pubmed/23907309?dopt=Abstract
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Mini-open lateral retroperitoneal lumbar spine approach using psoas muscle retraction technique. Technical report and initial results on six patients.
Eur Spine J. 2013 Aug 1;
Authors: Aghayev K, Vrionis FD
Abstract
PURPOSE: The main aim of this paper was to report reproducible method of lumbar spine access via a lateral retroperitoneal route.
METHODS: The authors conducted a retrospective analysis of the technical aspects and clinical outcomes of six patients who underwent lateral multilevel retroperitoneal interbody fusion with psoas muscle retraction technique. The main goal was to develop a simple and reproducible technique to avoid injury to the lumbar plexus.
RESULTS: Six patients were operated at 15 levels using psoas muscle retraction technique. All patients reported improvement in back pain and radiculopathy after the surgery. The only procedure-related transient complication was weakness and pain on hip flexion that resolved by the first follow-up visit.
CONCLUSIONS: Psoas retraction technique is a reliable technique for lateral access to the lumbar spine and may avoid some of the complications related to traditional minimally invasive transpsoas approach.
PMID: 23904000 [PubMed - as supplied by publisher]
Read more... http://www.ncbi.nlm.nih.gov/pubmed/23904000?dopt=Abstract
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Electromyographic characteristics of gait impairment in cervical spondylotic myelopathy.
Eur Spine J. 2013 Aug 2;
Authors: Malone A, Meldrum D, Gleeson J, Bolger C
Abstract
AIM: Gait impairment in cervical spondylotic myelopathy (CSM) is characterised by a number of kinematic and kinetic abnormalities. Surface electromyography (EMG) can evaluate the contributions of individual muscles to a movement pattern and provide insight into the underlying impairments that characterise an abnormal gait. This study aimed to analyse EMG signals from major lower limb muscles in people with CSM and healthy controls during gait.
METHODS: Sixteen people with radiologically confirmed CSM and 16 matched healthy controls participated in gait analysis. Surface EMG was recorded during walking from four lower limb muscles bilaterally. The timing of muscle activation, relative amplitudes of each burst of activity and baseline activation during gait, and the muscles' responses to lengthening as a measure of spasticity were compared using previously validated methods of EMG analysis.
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