Página 1 dos resultados de 11680 itens digitais encontrados em 0.016 segundos

Percutaneous vertebroplasty for multiple myeloma of the cervical spine

MONT`ALVERNE, Francisco; VALLEE, Jean-Noel; GUILLEVIN, Remy; CORMIER, Evelyne; JEAN, Betty; ROSE, Michelle; CALDAS, Jose Guilherme; CHIRAS, Jacques
Fonte: SPRINGER Publicador: SPRINGER
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
36.75%
Spinal involvement is a common presentation of multiple myeloma (MM); however, the cervical spine is the least common site of myelomatous involvement. Few studies evaluate the results of percutaneous vertebroplasty (PV) in the treatment of MM of the spine. The purpose of this series is to report on the use of PV in the treatment of MM of the cervical spine and to review the literature. From January 1994 to October 2007, four patients (three men and one woman; mean age, 45 years) who underwent five PV for painful MM in the cervical spine were retrospectively reviewed. The pain was estimated by the patient on a verbal analogic scale. Clinical follow-up was available for all patients (mean, 27.5 months; range, 1-96 months). The mean volume of cement injected per vertebral body was 2.3 +/- 0.8 mL (range, 1.0-4.0 mL) with a mean vertebral filling of 55.0 +/- 12.0% (range, 40.0-75.0%). Analgesic efficacy was achieved in all patients. One patient had a spinal instability due to a progression of spinal deformity noted on follow-up radiographs, without clinical symptoms. Cement leakage was detected in three (60%) of the five treated vertebrae. There was no clinical complication. The present series suggests that PV for MM of the cervical spine is safe and effective for pain control; nonetheless...

Desenvolvimento de um sistema para avaliação dos desvios da coluna vertebral em três dimensões- Spine3D; Development of a new three-dimensional system for evaluating spine deformities - Spine3D

Burke, Thomaz Nogueira
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 21/05/2013 PT
Relevância na Pesquisa
36.75%
Introdução: Escoliose é definida como um complexo desalinhamento tridimensional da coluna vertebral na qual há o aparecimento de uma curvatura lateral no plano coronal, normalmente associada com o aplanamento das curvaturas no plano sagital e rotação vertebral em seu eixo longitudinal. O padrão ouro para seu diagnóstico e monitoramento é a medida radiográfica pelo ângulo de Cobb, que possui como principais desvantagens o fato de não avaliar as curvas em três dimensões e expor os pacientes, principalmente os que estão em fase de crescimento, a consideráveis doses de radiação. Objetivo: Esta pesquisa teve como objetivo principal o desenvolvimento de um sistema de avaliação e representação da coluna vertebral em três dimensões, capaz de possibilitar ao usuário a análise quantitativa dos desvios da coluna vertebral nos planos coronal, sagital e transverso. São objetivos secundários estimar a precisão e a exatidão do sistema proposto, e avaliar a sua aplicabilidade a partir de um estudo de caso. Métodos: O Sistema desenvolvido, denominado de Spine 3D, é baseado no uso do controle de videogame Wiimote para rastrear LEDs infravermelhos que compõe um marcador multiplanar em uma cena, e tem como objetivo reconstruir em um ambiente 3D a pose das vértebras torácicas e lombares e...

Influência do nível de lesão torácico no alinhamento cervical no plano sagital = : The influence of the thoracic level of spinal cord injured subjects in the sagittal alignment of the cervical spine; The influence of the thoracic level of spinal cord injured subjects in the sagittal alignment of the cervical spine

Denis Seguchi Sakai
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 29/07/2013 PT
Relevância na Pesquisa
36.81%
Introdução: O trauma raquimedular apresenta maior incidência em indivíduos do sexo masculino entre 15 e 40 anos de idade. A denervação da musculatura segmentar da coluna vertebral abaixo do nível da lesão medular altera a postura do tronco no plano sagital destes indivíduos. Adaptações posturais ocorrem na coluna cervical e podem predispor à degeneração precoce do disco intervertebral e/ou das articulações facetárias, resultando na formação de osteófitos nos corpos vertebrais, diminuição do calibre dos forâmens intervertebrais e do canal vertebral. O envelhecimento da coluna cervical (espondilose cervical) é um processo lento. Sua sintomatologia é imprevisível e ocorre após a 5a década de vida na população geral, podendo decorrer de compressões radiculares ou medulares. As compressões radiculares apresentam-se clinicamente como dores irradiadas nos membros superiores, diminuição da força muscular (paresia) e alterações da sensibilidade (parestesia). Já as compressões medulares (ou mielopatia cervical) levam à incoordenação dos movimentos finos nas mãos, alterações de marcha (claudicação), do equilíbrio e disfunções no controle esfincteriano vesical e anal. Os paraplégicos preservam as funções nos membros superiores e dependem exclusivamente destes para a realização das atividades diárias. As alterações mecânicas no plano sagital na coluna cervical de indivíduos paraplégicos poderiam...

Interobserver agreement for the spine instability neoplastic score varies according to the experience of the evaluator

Teixeira,William Gemio Jacobsen; Coutinho,Pedro Ricardo de Mesquita; Marchese,Luiz Delboni; Narazaki,Douglas Kenji; Cristante,Alexandre Fogaça; Teixeira,Manoel Jacobsen; Barros Filho,Tarcísio Eloy Pessoa de; Camargo,Olavo Pires de
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2013 EN
Relevância na Pesquisa
36.85%
OBJECTIVES: To evaluate the interobserver agreement for the Neoplastic Spine Instability Score (SINS) among spine surgeons with or without experience in vertebral metastasis treatment and physicians in other specialties. METHODS: Case descriptions were produced based on the medical records of 40 patients with vertebral metastases. The descriptions were then published online. Physicians were invited to evaluate the descriptions by answering questions according to the Neoplastic Spine Instability Score (SINS). The agreement among physicians was calculated using the kappa coefficient. RESULTS: Seventeen physicians agreed to participate: three highly experienced spine surgeons, seven less-experienced spine surgeons, three surgeons of other specialties, and four general practitioners (n = 17). The agreement for the final SINS score among all participants was fair, and it varied according to the SINS component. The agreement was substantial for the spine location only. The agreement was higher among experienced surgeons. The agreement was nearly perfect for spinal location among the spine surgeons who were highly experienced in vertebral metastases. CONCLUSIONS: This study demonstrates that the experience of the evaluator has an impact on SINS scale classification. The interobserver agreement was only fair among physicians who were not spine surgeons and among spine surgeons who were not experienced in the treatment of vertebral metastases...

Disuse induced by the spine rectification vest: experimental study

Guirro,Rinaldo Roberto de Jesus; Arruda,Eder João; Silva,Carlos Alberto da
Fonte: Universidade de São Paulo Publicador: Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2014 EN
Relevância na Pesquisa
36.78%
The spine is the main support and movement axis of the locomotor system, and numberless clinical conditions may require that this structure be submitted to functional restriction. Among the non-invasive treatments used in spinal or appendicular skeleton injuries, the immobilization of the spine is used as a rehabilitation strategy. Because of the functional restrictions generated by restraining devices used on the spine, the proposal of this study was to adapt a spinal orthosis on rats, thus mimicking the immobilization of corrective vests and assessing the energetic conditions of thoracic muscles after 12 weeks of application. Wistar rats that were 42 days old were used in this study (post-weaning period), followed-up for 12 weeks in 2 groups called control (C) and rectification vests (R), which were made of PVC to immobilize the spine. The following concentrations were evaluated: glycogen (GLY) of the paravertebral muscle and the thorax; total proteins and DNA (TP/DNA) and interleukin-6 (IL-6). The normality Kolmogorov-Smirnov test was used for statistical analysis, followed by the Tukey test. A 5% level was established for all of the calculations. It was observed that group R presented 12% less body mass and GLY stores 21% lower; the ratio between TP/DNA was in average 6.6% lower; IL-6 concentrations were in average 25% higher. The study shows that the movement restriction in the spine leads to energetic crisis and compromised muscular development. More studies should be conducted with this model to generate physical therapy strategies that could reduce muscle compromise after spine immobilization.

Patient Safety in Spine Surgery: Regarding the Wrong-Site Surgery

Lee, Seung-Hwan; Kim, Ji-Sup; Jeong, Yoo-Chul; Kwak, Dae-Kyung; Chun, Ja-Hae; Lee, Hwan-Mo
Fonte: Korean Society of Spine Surgery Publicador: Korean Society of Spine Surgery
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.78%
Patient safety regarding wrong site surgery has been one of the priority issues in surgical fields including that of spine care. Since the wrong-side surgery in the DM foot patient was reported on a public mass media in 1996, the wrong-site surgery issue has attracted wide public interest as regarding patient safety. Despite the many wrong-site surgery prevention campaigns in spine care such as the operate through your initial program by the Canadian Orthopaedic Association, the sign your site program by the American Academy of Orthopedic Surgeon, the sign, mark and X-ray program by the North American Spine Society, and the Universal Protocol program by the Joint Commission, the incidence of wrong-site surgery has not decreased. To prevent wrong-site surgery in spine surgeries, the spine surgeons must put patient safety first, complying with the hospital policies regarding patient safety. In the operating rooms, the surgeons need to do their best to level the hierarchy, enabling all to speak up if any patient safety concerns are noted. Changing the operating room culture is the essential part of the patient safety concerning spine surgery.

Human Synaptic Plasticity Gene Expression Profile and Dendritic Spine Density Changes in HIV-Infected Human CNS Cells: Role in HIV-Associated Neurocognitive Disorders (HAND)

Alturi, Venakata Subba Rao; Kanthikeel, Sudheesh P.; Reddy, Pichili V.B.; Yndart, Adriana; Nair, Madhavan P.N.
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica Formato: application/pdf
Relevância na Pesquisa
36.75%
HIV-associated neurocognitive disorders (HAND) is characterized by development of cognitive, behavioral and motor abnormalities, and occur in approximately 50% of HIV infected individuals. Our current understanding of HAND emanates mainly from HIV-1 subtype B (clade B), which is prevalent in USA and Western countries. However very little information is available on neuropathogenesis of HIV-1 subtype C (clade C) that exists in Sub-Saharan Africa and Asia. Therefore, studies to identify specific neuropathogenic mechanisms associated with HAND are worth pursuing to dissect the mechanisms underlying this modulation and to prevent HAND particularly in clade B infection. In this study, we have investigated 84 key human synaptic plasticity genes differential expression profile in clade B and clade C infected primary human astrocytes by using RT2 Profile PCR Array human Synaptic Plasticity kit. Among these, 31 and 21 synaptic genes were significantly (≥3 fold) down-regulated and 5 genes were significantly (≥3 fold) up-regulated in clade B and clade C infected cells, respectively compared to the uninfected control astrocytes. In flow-cytometry analysis, down-regulation of postsynaptic density and dendrite spine morphology regulatory proteins (ARC...

Muscular contributions to dynamic dorsoventral lumbar spine stiffness

Keller, T.; Colloca, C.; Harrison, D.; Moore, R.; Gunzburg, R.
Fonte: Springer Publicador: Springer
Tipo: Artigo de Revista Científica
Publicado em //2007 EN
Relevância na Pesquisa
36.75%
Spinal musculature plays a major role in spine stability, but its importance to spinal stiffness is poorly understood. We studied the effects of graded trunk muscle stimulation on the in vivo dynamic dorsoventral (DV) lumbar spine stiffness of 15 adolescent Merino sheep. Constant voltage supramaximal electrical stimulation was administered to the L3–L4 interspinous space of the multifidus muscles using four stimulation frequencies (2.5, 5, 10, and 20 Hz). Dynamic stiffness was quantified at rest and during muscle stimulation using a computer-controlled testing apparatus that applied variable frequency (0.46–19.7 Hz) oscillatory DV forces (13-N preload to 48-N peak) to the L3 spinous process of the prone-lying sheep. Five mechanical excitation trials were randomly performed, including four muscle stimulation trials and an unstimulated or resting trial. The secant stiffness (k y = DV force/L3 displacement, kN/m) and loss angle (phase angle, deg) were determined at 44 discrete mechanical excitation frequencies. Results indicated that the dynamic stiffness varied 3.7-fold over the range of mechanical excitation frequencies examined (minimum resting k y = 3.86 ± 0.38 N/mm at 4.0 Hz; maximum k y = 14.1 ± 9.95 N/mm at 19.7 Hz). Twenty hertz muscle stimulation resulted in a sustained supramaximal contraction that significantly (P < 0.05) increased k y up to twofold compared to rest (mechanical excitation at 3.6 Hz). Compared to rest...

Cervical spine in Treacher Collins Syndrome

Pun, A.; Clark, B.; David, D.; Anderson, P.
Fonte: Lippincott Williams & Wilkins Publicador: Lippincott Williams & Wilkins
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
36.75%
Treacher Collins syndrome is a congenital syndrome with characteristic craniofacial malformations, which are well described in the literature. However, the presence of cervical spine dysmorphology in this syndrome has been minimally described. This study reviews cervical spine radiographs of 40 patients with Treacher Collins syndrome. In this sample, 7 of 40 patients displayed cervical spine anomalies, with 3 of these patients displaying multiple cervical spine anomalies. The patterns of spinal anomalies were variable, suggesting that the underlying genetic mutation has variable expressivity in cervical spine development as it does elsewhere in the craniofacial skeleton.; Amy Hoi-Ying Pun, Bruce Eric Clark, David John David and Peter John Anderson

Challenges in the surgical management of spine trauma in the morbidly obese patient: A case series

Rosenfeld, Hannah Elizabeth; Limb, Rebecca; Chan, Patrick; Fitzgerald, Mark; Bradley, William Pierre Litherland; Rosenfeld, Jeffrey V.
Fonte: American Association of Neurological Surgeons Publicador: American Association of Neurological Surgeons
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
36.75%
Object: The treatment of morbidly obese individuals with spine trauma presents unique challenges to spine surgeons and trauma staff. This study aims to increase awareness of current limitations in the surgical management of spine trauma in morbidly obese individuals, and to illustrate practical solutions. Methods: Six morbidly obese patients were treated surgically for spine trauma over a 2-year period at a single trauma center in Australia. All patients were involved in high-speed motor vehicle accidents and had multisystem injuries. All weighed in excess of 265 pounds (120 kg) with a body mass index ≥ 40 (range 47.8–67.1). Cases were selected according to the considerable challenges they presented in all aspects of their management. Results: Best medical and surgical care may be compromised and outcome adversely affected in morbidly obese patients with spine trauma. The time taken to perform all aspects of care is usually extended, often by many hours. Customized orthotics may be required. Imaging quality is often compromised and patients may not fit into scanners. Surgical challenges include patient positioning, surgical access, confirmation of the anatomical level, and obtaining adequate instrument length. Postoperative nursing care...

Current and future applications for stem cell therapies in spine surgery

Goldschlager, T.; Oehme, D.; Ghosh, P.; Zannettino, A.; Rosenfeld, J.; Jenkin, G.
Fonte: Bentham Science Publishers Ltd. Publicador: Bentham Science Publishers Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
36.78%
Spinal surgery involves the bone-cartilage-neural interface. It is a field of surgery that is rapidly changing and evolving; not only through the development of novel techniques, approaches and devices but also through evidence from large clinical trials assessing indications, efficacy and outcomes. The use of biologics in spine surgery has now become widespread. Biologics in the form of autologous or allogeneic stem cells or progenitor cells are not yet in routine clinical use in spine surgery. However it is likely that they will have a significant role in the future, since increasing numbers of preclinical and clinical studies have demonstrated the safety and efficacy of progenitor cells to treat a variety of spinal conditions. Such studies have paved the way to larger clinical trials. Cell therapies encompass a wide range of stem cell and progenitor cell types. Stem cells subtypes differ in their lineage potential often being described as pluripotent or multipotent, some of which have potential application in therapies to treat diseases of the spine having the ability to differentiate into tissues including bone and cartilage and to secrete factors that promote matrix repair and regeneration. Furthermore, studies have shown that some cells...

Entwicklung einer Messmethode zur berührungslosen Erfassung von Haltungsparametern der Wirbelsäule unter dynamischen Bedingungen; Development of a measurement system to detect spine postures under dynamic conditions

Betsch, Marcel
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
DE_DE
Relevância na Pesquisa
36.75%
Mit der Methode der Rasterstereographie wurde in den 80er Jahren durch Drerup und Hierholzer ein Verfahren entwickelt das mittels einer Oberflächenanalyse des Rückens radiologische und klinische Untersuchungen an der Wirbelsäule bei orthopädischen und orthopädietechnischen Fragestellungen ergänzen kann. Basierend auf dem Prinzip der Triangulation ermöglicht es eine schnelle, berührungslose und großflächige Analyse von Haltungsparametern des Rumpfes. Hierfür werden Veränderungen in Lichtlinien, die durch einen Diaprojektor auf den Rücken des Patienten projiziert werden mit einer Halbleitervideokamera erfasst und dreidimensional rekonstruiert. Durch eine Computersoftware können hieraus Haltungsparameter berechnet werden. Mit dem bisher verwendeten Messgerät können nur Aufnahmen unter statischen Bedingungen durchgeführt werden. Ziel dieser Studie war es daher bestehende Hard- und Softwarekomponenten so weiter zu entwickeln, dass dynamische Bewegungsabläufe erfasst werden können. Zur Evaluierung der Messgenauigkeit des neuen Messsystems, unter dynamischen Bedingungen, wurden auf einer Holzplatte angebrachte Marker vermessen. Bewegt wurde die Holzplatte dabei durch einen computergesteuerten Roboterarm. Insgesamt wurde so die Position der Marker während sieben unterschiedlichen Bewegungsmustern bestimmt. Dabei konnte die sog. "Rumpflänge" bei insgesamt 1090 Einzelmessungen...

Wirbelsäulenbefall bei Multiplem Myelom - Zusammenhang zwischen Art und Größe der Osteolysen, sowie dem Frakturrisiko; Multiple Myeloma and its spine involvement - Correlation between character and size of the osteolysis, as well as the risk of pathological fracture

Lostritto, Nicola
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
DE_DE
Relevância na Pesquisa
36.87%
Das Multiple Myelom ist eine hämatologische, maligne Erkrankung, die zur Gruppe der Non-Hodgkin-Lymphone der B-Zell-Reihe gezählt wird. Typisch ist die klonale Vermehrung der B-Lymphozyten und die Infiltration des Knochenmarks, sowie die Produktion von Paraproteinen, die zur Zerstörung des Knochens führen. Dabei ist die Pathogenese noch nicht vollständig geklärt, wobei verschiedene genetische Mutationen eine Schlüsselrolle zu spielen scheinen. Im Verlauf der Erkrankung zeigen etwa 70-80% der Patienten Osteolysen und/oder pathologische Frakturen. In diesen Fällen kann es unter anderem zu massiven Schmerzen und Wirbelsäuleninstabilität kommen. In dieser Arbeit wurden nun die Eigenschaften der Osteolysen und der Wirbelsäule auf ihren Zusammenhang mit den entstehenden pathologischen Frakturen und der daraus resultierenden möglichen Wirbelsäuleninstabilität untersucht. Insgesamt wurden 50 Patienten (27 Frauen und 23 Männer) mit gesichertem Multiplen Myelom und Wirbelsäulenbefall retrospektiv untersucht. Die Datenerhebung fand anhand von CT-Aufnahmen der Wirbelsäule der einzelnen Patienten statt. Von jedem Betroffenen wurden CT-Aufnahmen von drei verschiedenen Zeitpunkten ausgewertet. Dabei betrug das Zeitintervall im Idealfall etwa zwei Jahre. Um nun einen Zusammenhang zu finden und dadurch eventuell die Vorhersage pathologischer Frakturen zu ermöglichen...

Use your legs, not your back: An investigation into the links between lower body work and spine angles and moments during paramedic related lifting tasks

Makhoul, PAUL
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
EN; EN
Relevância na Pesquisa
36.75%
Background: Paramedics commonly suffer back injuries as a result of lifting. Improving lifting technique is often cited as an injury prevention approach; however traditional postural-based technique classifications have yet to identify an optimal technique. Instead, this thesis explored the hypothesis that an increased contribution of work done by the lower body relative to the trunk will be associated with lower peak sagittal plane trunk angles and moments experienced by paramedics while performing common paramedic lifting – a spine sparing strategy. Additionally this thesis explored whether higher peak lower body power capacity (calculated using vertical jump scores) was associated with reduced trunk angles and moments during lifting. Methods: Thirty-three healthy paramedics performed three lifting tasks and completed a vertical jump test. A 3D linked-segment model computed sagittal plane trunk moments and angles, as well as joint power and the corresponding work done by the ankle, knee, hip, and trunk during lifting. Peak lower body power capacity was computed using vertical jump height. A correlational analysis determined the associations between lower body work contribution, lower body power capacity (calculated from the vertical jump score)...

Biomechanically Constrained Ultrasound to Computed Tomography Registration of the Lumbar Spine

Gill, Sean
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado Formato: 5825962 bytes; application/pdf
EN; EN
Relevância na Pesquisa
36.78%
Spinal injections for back-pain management are frequently carried out in hospitals and radiological clinics. Currently, these procedures are performed under fluoroscopy or CT guidance in specialized interventional radiology facilities, and thus incur a major financial burden on the healthcare system. Additionally, the current practice exposes patients and surgeons to X-ray radiation. The use of US for image guided navigation of the spine would greatly reduce the exposure of both the patient and the physician to ionizing radiation and allow the procedure to be performed outside of a specialized facility. However, US as the sole guidance modality has its own challenges. In particular, due to the significant level of occlusion in spinal US images, it can be difficult to accurately identify the appropriate injection site. Here, a groupwise US to CT registration algorithm for guiding percutaneous spinal interventions is presented. In our registration methodology, each vertebra in CT is treated as a sub-volume and transformed individually. A biomechanical model is used to constrain the displacement of the vertebrae relative to one another. The sub-volumes are then reconstructed into a single volume. In each iteration of registration...

Ultrasound to CT Registration of the Lumbar Spine: a Clinical Feasibility Study

Nagpal, Simrin
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
EN; EN
Relevância na Pesquisa
36.78%
Spine needle injections are widely applied to alleviate pain and to remove nerve sensation through anesthesia. Current treatment is performed either blindly having no image guidance or using fluoroscopy or computed tomography (CT). Both CT and fluoroscopy guidance expose patients to ionizing radiation. Alternatively, ultrasound (US) guidance for spine needle procedures is becoming more prevalent since US is a non-ionizing and more accessible image modality. An inherent challenge to US imaging of the spine is the acoustic shadows created by the bony structures of the vertebra limiting visibility. It is challenging to use US as the sole imaging modality for intraoperative guidance of spine needle injections. However, it is possible to enhance the anatomical information through a preoperative diagnostic CT. To achieve this, image registration between the CT and the US images is proposed in this thesis. Image registration integrates the anatomical information from the CT with the US images. The aligned CT augments anatomical visualization for the clinician during spinal interventions. To align the preoperative CT and intraoperative US, a novel registration pipeline is presented that involves automatic global and multi-vertebrae registration. The registration pipeline is composed of two distinct phases: preoperative and intraoperative. Preoperatively...

Is Complex Regional Pain Syndrome a Cause of Post-Operative Syndrome in the Lumbar Spine? - A Case Report -

Chae, Soo Uk; Kim, Tae Kyun; Shim, Dae Moo; Kim, Yeung Jin; Choi, Deok Hwa
Fonte: Korean Society of Spine Surgery Publicador: Korean Society of Spine Surgery
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.81%
Complex regional pain syndrome (CRPS) along with post-operative syndrome in the lumbar spine shows confusing and duplicated symptoms, and this makes it difficult to make a clear differential diagnosis. Therefore, the patient with post-operative syndrome in the lumbar spine suffers losses of time and money, and the surgeon who diagnoses and treats post-operative syndrome in the lumbar spine also agonize from the patient's losses. It is necessary to provide these patients with a multidisciplinary approach to their disease and symptoms. We diagnosed herniation of an intervertebral disc of the lumbar spine (L4/5) and we performed discetomy twice in different hospitals. However, the symptoms did not improve, so we re-operated and performed discetomy along with monosegmental fixation using pedicular screws and interbody cages. There was improvement of pre-operation symptoms, but neurogenic symptoms occurred and then progressed after the surgery. Therefore, we report here on the case of CRPS that was diagnosed with the exclusion of the causes of post-operative syndrome in the lumbar spine, and the patient was finally effectively treated with spinal cord stimulation. Although differentiating post-operative syndrome in the lumbar spine from CRPS is difficult...

Interobserver agreement for the spine instability neoplastic score varies according to the experience of the evaluator

Teixeira, William Gemio Jacobsen; Coutinho, Pedro Ricardo de Mesquita; Marchese, Luiz Delboni; Narazaki, Douglas Kenji; Cristante, Alexandre Fogaça; Teixeira, Manoel Jacobsen; Barros Filho, Tarcísio Eloy Pessoa de; Camargo, Olavo Pires de
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; Formato: application/pdf
Publicado em 01/01/2013 ENG
Relevância na Pesquisa
36.85%
OBJECTIVES: To evaluate the interobserver agreement for the Neoplastic Spine Instability Score (SINS) among spine surgeons with or without experience in vertebral metastasis treatment and physicians in other specialties. METHODS: Case descriptions were produced based on the medical records of 40 patients with vertebral metastases. The descriptions were then published online. Physicians were invited to evaluate the descriptions by answering questions according to the Neoplastic Spine Instability Score (SINS). The agreement among physicians was calculated using the kappa coefficient. RESULTS: Seventeen physicians agreed to participate: three highly experienced spine surgeons, seven less-experienced spine surgeons, three surgeons of other specialties, and four general practitioners (n = 17). The agreement for the final SINS score among all participants was fair, and it varied according to the SINS component. The agreement was substantial for the spine location only. The agreement was higher among experienced surgeons. The agreement was nearly perfect for spinal location among the spine surgeons who were highly experienced in vertebral metastases. CONCLUSIONS: This study demonstrates that the experience of the evaluator has an impact on SINS scale classification. The interobserver agreement was only fair among physicians who were not spine surgeons and among spine surgeons who were not experienced in the treatment of vertebral metastases...

Biomechanics of Coupled Motion in the Cervical Spine During Simulated Whiplash in Patients with Pre-existing Cervical or Lumbar Spinal Fusion: A Finite Element Study

Huang, Haoming
Fonte: Universidade Duke Publicador: Universidade Duke
Tipo: Tese de Doutorado
Publicado em //2014
Relevância na Pesquisa
36.78%

It is well understood that loss of motion following spinal fusion increases strain in the adjacent motion segments. However, it is unclear if to date, studies on cervical spine biomechanics can be affected by the role of coupled motions in the lumbar spine. Accordingly, we investigated the biomechanics of the cervical spine following cervical fusion and lumbar fusion during simulated whiplash.

A validated whole-human finite element model was used to investigate whiplash injury. The cervical spine before and after spinal fusion was subjected to simulated whiplash exposure in accordance with Euro NCAP testing guidelines, and the strains in the anterior longitudinal ligaments of the adjacent motion segments were computed.

In the models of cervical arthrodesis, peak ALL strains were higher in the motion segments adjacent to the level of fusion, and strains directly increased with longer fusions. The mean strain increase in the motion segment immediately adjacent to the site of fusion from C2-C3 through C5-C6 was 26.1% and 50.8% following single- and two-level cervical fusion (p=0.03). On average, peak strains experienced in a lumbar-fused spine were 1.0% less than those seen in a healthy spine (p=0.61). The C3-C4 motion segment had disproportionately high increases in strain following cervical fusion. The C6-C7 motion segment experienced high absolute strain under all tested conditions but the increase in strain following fusion was very small. This study provides support for both the hypothesis that adjacent segment disease is associated with post-arthrodesis biomechanical influences and the hypothesis that adjacent segment disease is a result of natural history...

Spine preparation: factors affecting optimum linkage of paper and adhesive in adhesive bookbinding

Adams, Richard
Fonte: Rochester Instituto de Tecnologia Publicador: Rochester Instituto de Tecnologia
Tipo: Tese de Doutorado
EN_US
Relevância na Pesquisa
36.78%
Adhesive bookbinding, a method of holding trimmed pages together in a book using hotmelt glue, offers rapid binding and curing time, but has the disadvantage of poor glue penetration into the paper edges. A weak binding will result unless good linkage can be made between paper and glue, which is the objective of spine-roughening treatments. Eight spine-roughening treatments from three manufacturers were compared on an uncoated and a coated paper stock, against a control treatment of trimmed paper. Treatments were studied by light- and scanning electron microscopic examination of paper edges and by measurement of the mean page-pull values based on samples of 30 or more page-pulls. The results were compared with four hypotheses concerning bookbinding strength. First, when 95 percent confidence intervals were compared, different spine-roughening treatments were found to produce different bookbinding strengths, as measured by mean page-pull value. Specifically, almost all of the treatments produced higher page-pull values than the control, showing that these roughening treatments increased book strength. Some treatments produced significantly higher page-pull values than others, indicating that some roughening treatments were better than others for binding the two papers studied. The results of these tests are summarized in the table at the top of the next page. Secondly...