Subjects -> MEDICAL SCIENCES (Total: 8679 journals)
    - ALLERGOLOGY AND IMMUNOLOGY (219 journals)
    - ANAESTHESIOLOGY (120 journals)
    - CARDIOVASCULAR DISEASES (338 journals)
    - CHIROPRACTIC, HOMEOPATHY, OSTEOPATHY (21 journals)
    - COMMUNICABLE DISEASES, EPIDEMIOLOGY (235 journals)
    - DENTISTRY (294 journals)
    - DERMATOLOGY AND VENEREOLOGY (163 journals)
    - EMERGENCY AND INTENSIVE CRITICAL CARE (124 journals)
    - ENDOCRINOLOGY (151 journals)
    - FORENSIC SCIENCES (42 journals)
    - GASTROENTEROLOGY AND HEPATOLOGY (189 journals)
    - GERONTOLOGY AND GERIATRICS (138 journals)
    - HEMATOLOGY (157 journals)
    - HYPNOSIS (4 journals)
    - INTERNAL MEDICINE (177 journals)
    - LABORATORY AND EXPERIMENTAL MEDICINE (99 journals)
    - MEDICAL GENETICS (58 journals)
    - MEDICAL SCIENCES (2410 journals)
    - NURSES AND NURSING (369 journals)
    - OBSTETRICS AND GYNECOLOGY (207 journals)
    - ONCOLOGY (386 journals)
    - OPHTHALMOLOGY AND OPTOMETRY (141 journals)
    - ORTHOPEDICS AND TRAUMATOLOGY (170 journals)
    - OTORHINOLARYNGOLOGY (83 journals)
    - PATHOLOGY (100 journals)
    - PEDIATRICS (275 journals)
    - PHYSICAL MEDICINE AND REHABILITATION (158 journals)
    - PSYCHIATRY AND NEUROLOGY (833 journals)
    - RADIOLOGY AND NUCLEAR MEDICINE (192 journals)
    - RESPIRATORY DISEASES (105 journals)
    - RHEUMATOLOGY (79 journals)
    - SPORTS MEDICINE (81 journals)
    - SURGERY (406 journals)
    - UROLOGY, NEPHROLOGY AND ANDROLOGY (155 journals)

ORTHOPEDICS AND TRAUMATOLOGY (170 journals)                     

Showing 1 - 170 of 170 Journals sorted alphabetically
Acta Orthopaedica     Open Access   (Followers: 36)
Acta Orthopaedica et Traumatologica Turcica     Open Access   (Followers: 1)
Acta Ortopédica Brasileira     Open Access   (Followers: 1)
Advances in Orthopedics     Open Access   (Followers: 9)
American Journal of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6)
Archives of Orthopaedic and Trauma Surgery     Hybrid Journal   (Followers: 10)
Archives of Osteoporosis     Hybrid Journal   (Followers: 2)
Arthritis und Rheuma     Hybrid Journal  
Arthroplasty Today     Open Access   (Followers: 1)
Athletic Training & Sports Health Care     Full-text available via subscription   (Followers: 23)
Australasian Musculoskeletal Medicine     Full-text available via subscription   (Followers: 4)
BMC Musculoskeletal Disorders     Open Access   (Followers: 27)
Bone & Joint 360     Full-text available via subscription   (Followers: 21)
Bone Research     Hybrid Journal   (Followers: 3)
Burns & Trauma     Open Access   (Followers: 13)
Cartilage     Hybrid Journal   (Followers: 5)
Case Reports in Orthopedic Research     Open Access  
Case Reports in Orthopedics     Open Access   (Followers: 6)
Chinese Journal of Traumatology (English Edition)     Open Access  
Cleft Palate-Craniofacial Journal     Hybrid Journal   (Followers: 8)
Clinical Medicine Insights : Arthritis and Musculoskeletal Disorders     Open Access   (Followers: 3)
Clinical Orthopaedics and Related Research     Hybrid Journal   (Followers: 98)
Clinical Trials in Orthopedic Disorders     Open Access   (Followers: 2)
Concussion     Open Access  
Craniomaxillofacial Trauma & Reconstruction Open     Open Access  
Craniomaxillofacial Trauma and Reconstruction     Hybrid Journal   (Followers: 2)
Current Orthopaedic Practice     Hybrid Journal   (Followers: 13)
Current Orthopaedics     Full-text available via subscription   (Followers: 12)
Current Reviews in Musculoskeletal Medicine     Open Access   (Followers: 13)
Der Orthopäde     Hybrid Journal   (Followers: 7)
Die Wirbelsäule     Hybrid Journal  
East African Orthopaedic Journal     Full-text available via subscription   (Followers: 1)
EFORT Open Reviews     Open Access  
Egyptian Orthopaedic Journal     Open Access   (Followers: 2)
EMC - Técnicas Quirúrgicas - Ortopedia y Traumatología     Full-text available via subscription  
EMC - Tecniche Chirurgiche - Chirurgia Ortopedica     Full-text available via subscription  
Ergonomics     Hybrid Journal   (Followers: 24)
European Journal of Orthopaedic Surgery & Traumatology     Hybrid Journal   (Followers: 11)
European Journal of Podiatry / Revista Europea de Podología     Open Access   (Followers: 2)
European Orthopaedics and Traumatology     Hybrid Journal   (Followers: 8)
European Spine Journal     Hybrid Journal   (Followers: 23)
Evidence Based Spine Care Journal     Hybrid Journal   (Followers: 11)
Foot & Ankle International     Hybrid Journal   (Followers: 11)
Foot & Ankle Orthopaedics     Open Access   (Followers: 4)
Formosan Journal of Musculoskeletal Disorders     Partially Free   (Followers: 2)
Gait & Posture     Hybrid Journal   (Followers: 18)
Geriatric Orthopaedic Surgery Rehabilitation     Open Access   (Followers: 4)
Global Spine Journal     Open Access   (Followers: 10)
Hip International     Hybrid Journal   (Followers: 3)
Indian Journal of Orthopaedics     Open Access   (Followers: 8)
Informationen aus Orthodontie & Kieferorthopädie     Hybrid Journal  
Injury     Hybrid Journal   (Followers: 21)
International Journal of Orthopaedic and Trauma Nursing     Hybrid Journal   (Followers: 11)
International Journal of Orthopaedics     Open Access   (Followers: 2)
International Journal of Research in Orthopaedics     Open Access  
International Musculoskeletal Medicine     Hybrid Journal   (Followers: 7)
International Orthopaedics     Hybrid Journal   (Followers: 17)
JAAOS : Global Research & Reviews     Open Access   (Followers: 2)
JBJS Journal of Orthopaedics for Physician Assistants     Hybrid Journal  
JBJS Reviews     Full-text available via subscription   (Followers: 12)
Joints     Open Access   (Followers: 1)
JOR Spine     Open Access   (Followers: 1)
Journal de Traumatologie du Sport     Full-text available via subscription   (Followers: 3)
Journal für Mineralstoffwechsel & Muskuloskelettale Erkrankungen     Hybrid Journal  
Journal of Bone and Joint Infection     Open Access  
Journal of Brachial Plexus and Peripheral Nerve Injury     Open Access   (Followers: 6)
Journal of Cachexia, Sarcopenia and Muscle     Open Access   (Followers: 3)
Journal of Children's Orthopaedics     Open Access   (Followers: 10)
Journal of Clinical Orthopaedics and Trauma     Full-text available via subscription   (Followers: 7)
Journal of Experimental Orthopaedics     Open Access   (Followers: 8)
Journal of Hand Surgery (European Volume)     Hybrid Journal   (Followers: 44)
Journal of Head Trauma Rehabilitation     Hybrid Journal   (Followers: 16)
Journal of Hip Surgery     Hybrid Journal   (Followers: 1)
Journal of Knee Surgery Reports     Open Access   (Followers: 5)
Journal of Musculoskeletal Research     Hybrid Journal   (Followers: 9)
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie     Hybrid Journal  
Journal of Orthodontic Science     Open Access   (Followers: 2)
Journal of Orthopaedic & Sports Physical Therapy     Full-text available via subscription   (Followers: 63)
Journal of Orthopaedic Research     Hybrid Journal   (Followers: 28)
Journal of Orthopaedic Science     Hybrid Journal   (Followers: 4)
Journal of Orthopaedic Surgery     Open Access   (Followers: 2)
Journal of Orthopaedic Surgery and Research     Open Access   (Followers: 8)
Journal of Orthopaedic Translation     Open Access  
Journal of Orthopaedic Trauma     Hybrid Journal   (Followers: 19)
Journal of Orthopaedics     Full-text available via subscription   (Followers: 2)
Journal of Orthopaedics and Allied Sciences     Open Access   (Followers: 8)
Journal of Orthopaedics and Spine     Open Access   (Followers: 2)
Journal of Orthopaedics and Traumatology     Open Access   (Followers: 17)
Journal of Orthopaedics, Trauma and Rehabilitation     Open Access   (Followers: 5)
Journal of Orthopedics & Rheumatology     Open Access   (Followers: 3)
Journal of Orthopedics, Traumatology and Rehabilitation     Open Access   (Followers: 7)
Journal of Pediatric Orthopaedics     Hybrid Journal   (Followers: 14)
Journal of Prosthetics and Orthotics     Hybrid Journal   (Followers: 13)
Journal of Rheumatology and Orthopedics     Open Access   (Followers: 2)
Journal of Scleroderma and Related Disorders     Hybrid Journal  
Journal of the American Academy of Orthopaedic Surgeons     Hybrid Journal   (Followers: 11)
Journal of the American Podiatric Medical Association     Full-text available via subscription   (Followers: 7)
Journal of Traumatic Stress     Hybrid Journal   (Followers: 25)
Knee Surgery, Sports Traumatology, Arthroscopy     Hybrid Journal   (Followers: 28)
La Lettre de Médecine Physique et de Réadaptation     Hybrid Journal   (Followers: 1)
Manual Therapy     Hybrid Journal   (Followers: 28)
Multiple Sclerosis and Related Disorders     Hybrid Journal   (Followers: 6)
Musculoskeletal Care     Hybrid Journal   (Followers: 19)
Musculoskeletal Regeneration     Open Access   (Followers: 4)
Musculoskeletal Science and Practice     Hybrid Journal   (Followers: 3)
Nederlands tijdschrift voor traumatologie     Hybrid Journal   (Followers: 5)
Nepal Orthopaedic Association Journal     Open Access   (Followers: 1)
Nigerian Journal of Orthopaedics and Trauma     Open Access  
OA Orthopaedics     Open Access   (Followers: 7)
Obere Extremität     Hybrid Journal  
Open Journal of Orthopedics     Open Access   (Followers: 3)
Open Journal of Orthopedics and Rheumatology     Open Access   (Followers: 2)
Open Journal of Trauma     Open Access   (Followers: 2)
Open Orthopaedics Journal     Open Access  
Operative Orthopädie und Traumatologie     Hybrid Journal   (Followers: 1)
Operative Techniques in Orthopaedics     Full-text available via subscription   (Followers: 7)
Orthopädie & Rheuma     Full-text available via subscription   (Followers: 2)
Orthopädie und Unfallchirurgie - Mitteilungen und Nachrichten     Hybrid Journal  
Orthopädie und Unfallchirurgie up2date     Hybrid Journal  
Orthopaedic Genius     Open Access  
Orthopaedic Journal of Sports Medicine     Open Access   (Followers: 13)
Orthopaedic Nursing     Hybrid Journal   (Followers: 11)
Orthopaedic Proceedings     Partially Free   (Followers: 1)
Orthopaedic Surgery     Open Access   (Followers: 1)
Orthopaedics & Traumatology: Surgery & Research     Full-text available via subscription   (Followers: 7)
Orthopaedics and Trauma     Full-text available via subscription   (Followers: 30)
Orthopedic Clinics of North America     Full-text available via subscription   (Followers: 7)
Orthopedic Research and Reviews     Open Access   (Followers: 6)
Orthopedic Reviews     Open Access   (Followers: 7)
Orthopedics     Full-text available via subscription   (Followers: 6)
Orthopedics and Traumatology     Hybrid Journal   (Followers: 3)
Osteoarthritis and Cartilage     Full-text available via subscription   (Followers: 19)
Osteologie     Hybrid Journal  
Osteoporosis and Sarcopenia     Open Access   (Followers: 2)
OTA International     Open Access  
Paediatric Orthopaedics and Related Sciences     Open Access   (Followers: 3)
Pain Management in General Practice     Full-text available via subscription   (Followers: 12)
Podiatry Today     Free   (Followers: 2)
Prosthetics and Orthotics International     Hybrid Journal   (Followers: 9)
Revista Brasileira de Ortopedia     Hybrid Journal  
Revista Brasileira de Ortopedia     Open Access  
Revista Brasileira de Ortopedia (English Edition)     Open Access  
Revista Chilena de Ortopedia y Traumatología / Chilean Journal of Orthopaedics and Traumatology     Open Access   (Followers: 1)
Revista Colombiana de Ortopedia y Traumatología     Full-text available via subscription   (Followers: 2)
Revista Cubana de Ortopedia y Traumatologí­a     Open Access  
Revista de la Asociación Argentina de Ortopedia y Traumatología     Open Access   (Followers: 2)
Revista del Pie y Tobillo     Open Access  
Revista Española de Artroscopia y Cirugía Articular     Open Access  
Revista Española de Cirugía Ortopédica y Traumatología     Full-text available via subscription   (Followers: 1)
Revista Española de Cirugía Ortopédica y Traumatología (English Edition)     Full-text available via subscription   (Followers: 1)
Revista Internacional de Ciencias Podológicas     Open Access  
Revista Portuguesa de Ortopedia e Traumatologia     Open Access  
Revue de Chirurgie Orthopédique et Traumatologique     Full-text available via subscription   (Followers: 4)
Romanian Journal of Orthopaedic Surgery and Traumatology     Open Access  
SA Orthopaedic Journal     Open Access   (Followers: 2)
Scientific Journal of the Foot & Ankle     Open Access   (Followers: 1)
Shafa Orthopedic Journal     Open Access  
SICOT-J     Open Access   (Followers: 1)
Spine     Hybrid Journal   (Followers: 75)
Sport-Orthopädie - Sport-Traumatologie - Sports Orthopaedics and Traumatology     Full-text available via subscription   (Followers: 3)
Strategies in Trauma and Limb Reconstruction     Open Access   (Followers: 3)
Techniques in Orthopaedics     Hybrid Journal   (Followers: 7)
The Spine Journal     Hybrid Journal   (Followers: 23)
Therapeutic Advances in Musculoskeletal Disease     Hybrid Journal   (Followers: 6)
Trauma     Hybrid Journal   (Followers: 6)
Trauma (Travma)     Open Access   (Followers: 2)
Trauma und Berufskrankheit     Hybrid Journal  
Traumatology     Full-text available via subscription   (Followers: 1)
Zeitschrift für Orthopädie und Unfallchirurgie     Hybrid Journal   (Followers: 3)
Ортопедия, травматология и протезирование     Open Access   (Followers: 1)

           

Similar Journals
Journal Cover
Evidence Based Spine Care Journal
Number of Followers: 11  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1663-7976 - ISSN (Online) 1869-4136
Published by Thieme Publishing Group Homepage  [242 journals]
  • How to Prove the Value Proposition of Spine Surgery
    • Evidence-Based Spine-Care Journal 2014; 05: 073-073
      DOI: 10.1055/s-0034-1390026



      Georg Thieme Verlag KG Stuttgart · New York

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     Volltext

      Evidence-Based Spine-Care Journal 2014; 05: 073-0732014-09-24T15:27:01+01:00
      Issue No: Vol. 05, No. 02 (2014)
       
  • Administrative Database Studies: Goldmine or Goose Chase'
    • Evidence-Based Spine-Care Journal 2014; 05: 074-076
      DOI: 10.1055/s-0034-1390027



      Georg Thieme Verlag KG Stuttgart · New York

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     Volltext

      Evidence-Based Spine-Care Journal 2014; 05: 074-0762014-09-24T15:27:10+01:00
      Issue No: Vol. 05, No. 02 (2014)
       
  • Microdiscectomy for the Treatment of Lumbar Disc Herniation: An Evaluation
           of Reoperations and Long-Term Outcomes
    • Authors: Aichmair; Alexander, Du, Jerry Y., Shue, Jennifer, Evangelisti, Gisberto, Sama, Andrew A., Hughes, Alexander P., Lebl, Darren R., Burket, Jayme C., Cammisa, Frank P., Girardi, Federico P.
      Pages: 077 - 086
      Abstract: Design Retrospective case series. Objective The objective of this study was to assess the reoperation rate after microdiscectomy for the treatment of lumbar disc herniation (LDH) in patients with ≥ 5-year follow-up and identify demographic, perioperative, and outcome-related differences between patients with and without a reoperation. Methods The medical records, operative reports, and office notes of patients who had undergone microdiscectomy at a single institution between March 1994 and December 2007 were reviewed and long-term follow-up was assessed via a telephone questionnaire. Results Forty patients (M:24, F:16) with an average age at surgery of 39.9 ± 12.5 years (range: 18–80) underwent microdiscectomy at the levels L5–S1 (n = 28, 70%), L4-L5 (n = 9, 22.5%), L3–L4 (n = 2, 5.0%), and L1–L2 (n = 1, 2.5%). After an average of 40.4 ± 40.1 months (range: 1–128), 25% of patients (10/40) required further spine surgery related to the initial microdiscectomy. At an average postoperative follow-up of 11.1 ± 4.0 years (range: 5–19), additional symptoms apart from back and leg pain were reported more frequently by patients who underwent a reoperation (p = 0.005). Patient satisfaction was significantly higher in patients who did not undergo a reoperation (p = 0.041). For the Oswestry disability index, pain intensity (p = 0.036), and pain-related sleep disturbances (p = 0.006) were reported to be more severe in the reoperation group. Conclusions Microdiscectomy for the treatment of LDH results in a favorable long-term outcome in the majority of cases. The reoperation rate was higher in our series than reported in previous investigations with shorter follow-up. Although there were no statistically significant pre-/perioperative differences between patients with and without reoperation, our findings suggest a difference in self-reported long-term outcome measures.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 077-086
      PubDate: 2014-09-24T15:27:07+01:00
      DOI: 10.1055/s-0034-1386750
      Issue No: Vol. 05, No. 02 (2014)
       
  • Electrical Stimulation to Enhance Spinal Fusion: A Systematic Review
    • Authors: Park; Paul, Lau, Darryl, Brodt, Erika D., Dettori, Joseph R.
      Pages: 087 - 094
      Abstract: Study Design Systematic review. Clinical Questions Compared with no stimulation, does electrical stimulation promote bone fusion after lumbar spinal fusion procedures' Does the effect differ based on the type of electrical stimulation used' Methods Electronic databases and reference lists of key articles were searched up to October 15, 2013, to identify randomized controlled trials (RCTs) comparing the effect of electrical stimulation to no electrical stimulation on fusion rates after lumbar spinal fusion for the treatment of degenerative disease. Two independent reviewers assessed the strength of evidence using the Grades of Recommendation Assessment, Development and Evaluation (GRADE) criteria. Results Six RCTs met the inclusion criteria. The following types of electrical stimulation were investigated: direct current (three studies), pulsed electromagnetic field (three studies), and capacitive coupling (one study). The control groups consisted of no stimulation (two studies) or placebo (four studies). Marked heterogeneity in study populations, characteristics, and design prevented a meta-analysis. Regardless of the type of electrical stimulation used, cumulative incidences of fusion varied widely across the RCTs, ranging from 35.4 to 90.6% in the intervention groups and from 33.3 to 81.9% in the control groups across 9 to 24 months of follow-up. Similarly, when stratified by the type of electrical stimulation used, fusion outcomes from individual studies varied, leading to inconsistent and conflicting results. Conclusion Given the inconsistency in study results, possibly due to heterogeneity in study populations/characteristics and quality, we are unable to conclude that electrical stimulation results in better fusion outcomes compared with no stimulation. The overall strength of evidence for the conclusions is low.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 087-094
      PubDate: 2014-09-24T15:27:09+01:00
      DOI: 10.1055/s-0034-1386752
      Issue No: Vol. 05, No. 02 (2014)
       
  • Incidental Findings on Magnetic Resonance Imaging of the Spine in the
           Asymptomatic Pediatric Population: A Systematic Review
    • Authors: Ramadorai; Uma, Hire, Justin, DeVine, John G., Brodt, Erika D., Dettori, Joseph R.
      Pages: 095 - 100
      Abstract: Study Design Systematic review. Clinical Question What is the prevalence of incidental magnetic resonance imaging (MRI) findings of the spine in asymptomatic pediatric patients' Methods Electronic databases and reference lists of key articles were searched up to December 15, 2013, to identify studies reporting the incidence or prevalence of incidental findings on MRI in asymptomatic pediatric patients. Athletes or children with a known history of trauma, infection, or congenital abnormalities were excluded. Results Seven publications, one prospective cohort, and six cross-sectional studies met the inclusion criteria. The most commonly reported findings on MRI were disc-related and included degenerative disc disease (seven studies, prevalence 19.6%), disc herniation/protrusion (four studies, 2.9%), disc height/narrowed disc space (two studies, 33.7%), and endplate changes (two studies, 5.3%). Other disc-related findings, reported by one study each, included bulging disc, abnormal nucleus shape, annular tear, high intensity zone, and nerve root compression, with prevalences ranging from 4.5 to 51.6%. Spondylolisthesis and spondylolysis were reported by one study each with a prevalence of 2.3 and 0%, respectively. Other findings reported included tumors and infections (one study, 0% for both) and Scheuermann-type changes (one study, 7.7%). Conclusions The prevalence of positive MRI findings in the asymptomatic pediatric population is higher than previously assumed, particularly in regard to disc morphology, highlighting the importance of correlating the history and physical examination to the MRI findings to avoid misdiagnosis or over-treatment in the pediatric population.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 095-100
      PubDate: 2014-09-24T15:27:08+01:00
      DOI: 10.1055/s-0034-1386753
      Issue No: Vol. 05, No. 02 (2014)
       
  • Outpatient Surgery in the Cervical Spine: Is It Safe'
    • Authors: Lee; Michael J., Kalfas, Iain, Holmer, Haley, Skelly, Andrea
      Pages: 101 - 111
      Abstract: Study Design Systematic review. Study Rationale As the length of stay after cervical spine surgery has decreased substantially, the feasibility and safety of outpatient cervical spine surgery come into question. Although minimal length of stay is a targeted metric for quality and costs for medical centers, the safety of outpatient cervical spine surgery has not been clearly defined. Objective The objective of this article is to evaluate the safety of inpatient versus outpatient surgery in the cervical spine for adult patients with symptomatic or asymptomatic degenerative disc disease. Methods A systematic review of the literature was undertaken for articles published through February 19, 2014. Electronic databases and the bibliographies of key articles were searched to identify comparative studies evaluating the safety of inpatient versus outpatient surgery in the cervical spine. Spinal cord stimulation, spinal injections, and diagnostic procedures were excluded. Two independent reviewers assessed the strength of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system, and disagreements were resolved by consensus. Results Five studies that met the inclusion criteria were identified. One study reported low risk of hematoma (0% of outpatients and 1.6% of inpatients). Two studies reported on mortality and both reported no deaths in either group following surgery. Dysphagia risks ranged from 0 to 10% of outpatients and 1.6 to 5% of inpatients, and infection risks ranged from 0 to 1% of outpatients and 2 to 2.8% of inpatients. One study reported that no (0) outpatients were readmitted to the hospital due to a complication, compared with four inpatients (7%). The overall strength of evidence was insufficient for all safety outcomes examined. Conclusion Though the studies in our systematic review did not suggest an increased risk of complication with outpatient cervical spine surgery, the strength of evidence to make a recommendation was insufficient. Further study is needed to more clearly define the role of outpatient cervical spine surgery.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 101-111
      PubDate: 2014-09-24T15:27:08+01:00
      DOI: 10.1055/s-0034-1389088
      Issue No: Vol. 05, No. 02 (2014)
       
  • To the Occiput or Not' C1–C2 Ligamentous Laxity in Children with
           Down Syndrome
    • Authors: Siemionow; Kris, Chou, Dean
      Pages: 112 - 118
      Abstract: Study Design Retrospective case review. Objective Atlantoaxial instability with and without basilar invagination poses a considerable challenge in management regarding reduction, surgical approach, decompression, instrumentation choice, and extent of fusion. A variety of strategies have been described to reduce and stabilize cranial settling with basilar invagination. Modern instrumentation options included extension to the occiput, C1–C2 transarticular fixation, and C1 lateral mass–C2 pars among others. Since not all cases of cranial settling are the same, their treatment strategies also differ. Factors such as local vascular anatomy, amount of subluxation, need for distraction, and shape of occipital condyles will dictate level and type of instrumentation. The objective of this study was to outline treatment options and provide a rationale for the surgical plan. Methods Two cases of C1–C2 instability in patients with Down syndrome are described. Case 2 underwent C1–C2 instrumented fusion, whereas case 1 involved posterior instrumented fusion to the occiput. Results Both patients tolerated the procedures well. There were no complications. Minimum follow-up was 1 year. There was no loss of reduction. Solid arthrodesis was achieved in both cases. Conclusion Successful reduction can be achieved with both C1–C2 instrumented fusion as well as O–C instrument fusion. Factors such as local vascular anatomy, amount of subluxation, need for distraction, and shape of occipital condyles will dictate level and type of instrumentation.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 112-118
      PubDate: 2014-09-24T15:27:03+01:00
      DOI: 10.1055/s-0034-1386749
      Issue No: Vol. 05, No. 02 (2014)
       
  • Commentary on: “To the Occiput or Not' C1–C2 Ligamentous Laxity in
           Children with Down Syndrome”
    • Evidence-Based Spine-Care Journal 2014; 05: 119-120
      DOI: 10.1055/s-0034-1386758



      Georg Thieme Verlag KG Stuttgart · New York

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     Volltext

      Evidence-Based Spine-Care Journal 2014; 05: 119-1202014-09-24T15:27:04+01:00
      Issue No: Vol. 05, No. 02 (2014)
       
  • Vertebral Artery Anomalies at the Craniovertebral Junction: A Case Report
           and Review of the Literature
    • Authors: Abtahi; Amir M., Brodke, Darrel S., Lawrence, Brandon D.
      Pages: 121 - 125
      Abstract: Study Design Case report. Objective The objective of this study was to report a case of an unstable C1 burst fracture in the setting of a vertebral artery anomaly at the craniovertebral junction. Methods A 55-year-old man was admitted to the hospital with severe neck pain after falling approximately 15 feet and landing on his head. Computed tomography scan of the cervical spine revealed an unstable fracture of the C1 ring with magnetic resonance imaging evidence of a transverse ligament rupture as well as a congenital synchondrosis of the posterior arch of C1. He was neurologically intact. CT angiography (CTA) of the neck revealed an anomalous course of the right vertebral artery at the C1–C2 level. Results Surgical intervention consisted of occiput–C3 fusion, thus avoiding the placement of C1 lateral mass screws and risking vertebral artery injury. Conclusion We present a case of an unstable C1 burst fracture with an anomalous course of the right vertebral artery demonstrated by CTA. The presence of vertebral artery anomalies at the craniovertebral junction may prevent safe placement of C1 lateral mass screws and therefore influence the treatment options for upper cervical spine pathologies. To minimize the risk of vertebral artery injury, we elected to perform an occiput to C3 fusion. Thorough assessment of the vascular anatomy is recommended before operative intervention in the upper cervical spine to minimize the risk of complications.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 121-125
      PubDate: 2014-09-24T15:27:04+01:00
      DOI: 10.1055/s-0034-1386751
      Issue No: Vol. 05, No. 02 (2014)
       
  • Commentary on: “Vertebral Artery Anomalies at the Craniovertebral
           Junction: A Case Report and Review of the Literature”
    • Evidence-Based Spine-Care Journal 2014; 05: 126-126
      DOI: 10.1055/s-0034-1386757



      Georg Thieme Verlag KG Stuttgart · New York

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     Volltext

      Evidence-Based Spine-Care Journal 2014; 05: 126-1262014-09-24T15:27:09+01:00
      Issue No: Vol. 05, No. 02 (2014)
       
  • Sterile Seroma Resulting from Multilevel XLIF Procedure as Possible
           Adverse Effect of Prophylactic Vancomycin Powder: A Case Report
    • Authors: Youssef; Jim A., Orndorff, Douglas G., Scott, Morgan A., Ebner, Rachel E., Knewitz, Allison P.
      Pages: 127 - 133
      Abstract: Study Design Case report. Objective The objective of this study was to present the unusual case of a 59-year-old woman with a reoccurring sterile postoperative seroma. Methods A patient was observed postoperatively for any complications or adverse side effects resulting from an initial multilevel anterior/posterior lumbar fusion surgery where 2 g (1 g combined with the bone graft used for posterolateral fusion and 1 g placed in the soft tissues) of prophylactic vancomycin powder was placed within the soft tissues posteriorly before wound closure. The patient's progress was monitored through 6 months following the initial procedure. Six weeks postoperatively, the patient sustained a fall and had increased pain. Magnetic resonance imaging, computed tomography, and X-rays demonstrated a displaced sacral fracture, a large epidural fluid collection, and severe compression of the thecal sac at the lumbar operative sites (L3–5). Results On the basis of the aforementioned imaging studies and the patient's progressive neurologic deficit, it was apparent at the 6-week follow-up that emergent surgical intervention was necessary. Drainage and examination of an epidural fluid collection along with treatment of a displaced sacral fracture (S1–S2) were performed. The patient had an uneventful postoperative course with resolution of her back pain and neurologic deficit; however, recurrence of the epidural fluid collection requiring serial aspirations confounded the patients' clinical presentation. Conclusions With the recurrent nature of the seroma being unusual, the cause of the fluid collection and formation is undetermined. With lack of bone morphogenetic protein usage, and few confounding variables accountable, an acute allergic response to topical vancomycin powder is a possible etiology. Analysis with larger patient populations comparing postoperative adverse effects of prophylactic vancomycin powder is recommended.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 127-133
      PubDate: 2014-09-24T15:27:06+01:00
      DOI: 10.1055/s-0034-1386754
      Issue No: Vol. 05, No. 02 (2014)
       
  • Commentary on: “Sterile Seroma Resulting from Multilevel XLIF Procedure
           as Possible Adverse Effect of Prophylactic Vancomycin Powder: A Case
           Report”
    • Evidence-Based Spine-Care Journal 2014; 05: 134-135
      DOI: 10.1055/s-0034-1386759



      Georg Thieme Verlag KG Stuttgart · New York

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     Volltext

      Evidence-Based Spine-Care Journal 2014; 05: 134-1352014-09-24T15:27:09+01:00
      Issue No: Vol. 05, No. 02 (2014)
       
  • Hydrocephalus Following Bilateral Dumbbell-Shaped C2 Spinal Neurofibromas
           Resection and Postoperative Cervical Pseudomeningocele in a Patient with
           Neurofibromatosis Type 1: A Case Report
    • Authors: Montemurro; Nicola, Cocciaro, Ardico, Meola, Antonio, Lutzemberger, Ludovico, Vannozzi, Riccardo
      Pages: 136 - 138
      Abstract: Study Design Case report. Objective To present a rare case of hydrocephalus following bilateral dumbbell-shaped C2 spinal neurofibromas resection and postoperative cervical pseudomeningocele in a patient with neurofibromatosis type 1 (NF1). Methods The patient's clinical course is retrospectively reviewed. A 37-year-old man affected by NF1 referred to our department for progressive weakness of both lower extremities and gait disturbance. Radiological imaging showed bilateral dumbbell-shaped C2 spinal neurofibromas. After its resection, at the 1-month follow-up evaluation, the patient reported headache and nausea. A CT brain scan showed a postoperative cervical pseudomeningocele and an increase in the ventricular sizes, resulting in hydrocephalus. Results A ventriculoperitoneal shunting was performed using a programmable valve opening pressure set to 120 mmH20. After surgery, the patient's neurological status markedly improved. Conclusion Hydrocephalus must be considered a possible complication of cervical spine tumor resection.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 136-138
      PubDate: 2014-09-24T15:27:01+01:00
      DOI: 10.1055/s-0034-1387805
      Issue No: Vol. 05, No. 02 (2014)
       
  • Commentary on: “Hydrocephalus Following Bilateral Dumbbell-Shaped C2
           Spinal Neurofibromas Resection and Postoperative Cervical
           Pseudomeningocele in a Patient with Neurofibromatosis Type 1: A Case
           Report”
    • Evidence-Based Spine-Care Journal 2014; 05: 139-140
      DOI: 10.1055/s-0034-1387802



      Georg Thieme Verlag KG Stuttgart · New York

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     Volltext

      Evidence-Based Spine-Care Journal 2014; 05: 139-1402014-09-24T15:27:09+01:00
      Issue No: Vol. 05, No. 02 (2014)
       
  • Lumbar Intervertebral Discal Cyst: A Rare Cause of Low Back Pain and
           Radiculopathy. Case Report and Review of the Current Evidences on
           Diagnosis and Management
    • Authors: Certo; Francesco, Visocchi, Massimiliano, Borderi, Alessandro, Pennisi, Claudia, Albanese, Vincenzo, Barbagallo, Giuseppe M. V.
      Pages: 141 - 148
      Abstract: Study Design Case Report and review of the literature. Objective The objective of the article is to report an illustrative case successfully treated by microsurgery and to review the literature on the current evidence on diagnosis and management of lumbar discal cysts. Methods A 43-year-old male patient presented with severe back pain, radiating down to the right leg, as well as with paraesthesias in the right L3 and L4 dermatomes. Magnetic resonance imaging of the lumbar spine revealed an intraspinal, extradural space-occupying lesion at the L3–L4 disc level, causing compression of the neural structures. The lesion was surgically removed and a diagnosis of lumbar discal cyst was made. Postoperatively, symptoms improved and the patient was discharged with no complications. A systematic review of pertinent articles published up to February 2014 was performed. Key articles were searched to identify studies describing the diagnosis and management modalities of lumbar discal cysts and the comparative effectiveness and safety of microsurgery versus endoscopic treatment. Conclusions Discal cysts are rare causes of low back pain and radiculopathy. Few cases have been reported; however, conclusive information about their natural history is not available and the best mode of treatment remains controversial. We submit that lumbar intervertebral disc cysts, with their peculiar radiological and anatomic features, should be considered in the differential diagnosis among rare causes of low back pain and radiculopathy.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 141-148
      PubDate: 2014-09-24T15:27:02+01:00
      DOI: 10.1055/s-0034-1387806
      Issue No: Vol. 05, No. 02 (2014)
       
  • Commentary on: “Lumbar Intervertebral Discal Cyst: A Rare Cause of Low
           Back Pain and Radiculopathy. Case Report and Review of the Current
           Evidences on Diagnosis and Management”
    • Evidence-Based Spine-Care Journal 2014; 05: 149-150
      DOI: 10.1055/s-0034-1387803



      Georg Thieme Verlag KG Stuttgart · New York

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     Volltext

      Evidence-Based Spine-Care Journal 2014; 05: 149-1502014-09-24T15:27:08+01:00
      Issue No: Vol. 05, No. 02 (2014)
       
  • L4 and L5 Spondylectomy for En Bloc Resection of Giant Cell Tumor and
           Review of the Literature
    • Authors: Santiago-Dieppa; David R., Hwang, Lee S., Bydon, Ali, Gokaslan, Ziya L., McCarthy, Edward F., Witham, Timothy F.
      Pages: 151 - 157
      Abstract: Study Design Case report and review of the literature. Objective We present the case of a two-level lumbar spondylectomy at L4 and L5 for en bloc resection of a giant cell tumor (GCT) and lumbopelvic reconstruction. Methods A 58-year-old woman presented with a 7-month history of progressive intractable back and leg pain secondary to a biopsy-proven Enneking stage III GCT of the L4 and L5 vertebrae. The patient underwent a successful L4–L5 spondylectomy and lumbopelvic reconstruction using a combined posterior and anterior approach over two operative stages. Results Postoperative complications included a deep wound infection and a cerebrospinal fluid leak; however, following surgical debridement and long-term antibiotic treatment, the patient was neurologically intact with minimal pain and there was no evidence of tumor recurrence or instrumentation failure at more than 2 years of follow-up. Conclusion Spondylectomy that achieves en bloc resection is a viable and effective treatment option that can be curative for Enneking stage III GCTs involving the lower lumbar spine. The lumbosacral junction represents a challenging anatomic location for spinal reconstruction after spondylectomy with unique technical considerations.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 151-157
      PubDate: 2014-09-24T15:27:05+01:00
      DOI: 10.1055/s-0034-1387804
      Issue No: Vol. 05, No. 02 (2014)
       
  • Commentary on: “L4 and L5 Spondylectomy for En Bloc Resection of Giant
           Cell Tumor and Review of the Literature”
    • Evidence-Based Spine-Care Journal 2014; 05: 158-159
      DOI: 10.1055/s-0034-1387801



      Georg Thieme Verlag KG Stuttgart · New York

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     Volltext

      Evidence-Based Spine-Care Journal 2014; 05: 158-1592014-09-24T15:27:09+01:00
      Issue No: Vol. 05, No. 02 (2014)
       
  • Predictive Factors for Acute Proximal Junctional Failure after Adult
           Deformity Surgery with Upper Instrumented Vertebrae in the Thoracolumbar
           Spine
    • Authors: Annis; Prokopis, Lawrence, Brandon D., Spiker, William R., Zhang, Yue, Chen, Wei, Daubs, Michael D., Brodke, Darrel S.
      Pages: 160 - 162
      Abstract: Study Type Retrospective cohort study. Introduction Acute proximal junctional failure (APJF) was recently defined by the International Spine Study Group as: postoperative fracture of the upper instrumented vertebrae (UIV) or UIV + 1; UIV implant failure; proximal junctional kyphosis (PJK) increase > 15 degrees; or need for proximal extension of the fusion within 6 months of surgery.1 The incidence and revision rates of APJF have been reported to be higher when the UIV is located in the lower thoracolumbar (TL) spine mostly because of high incidence of UIV or UIV + 1 fractures.2 Sagittal deformity overcorrection has been considered as a potential risk factor.3 4 Objective The purpose of this study is to assess independent predictive factors and timing for revisions of APJF in adult deformity patients with UIV in the TL (T9–L2) spine. Methods Retrospective review of 135 consecutive patients with minimum 2-year follow-up, treated at a single institution for adult spinal deformity, all with UIV in the TL spine (T9–L2). Fusions were divided into three cohorts based on the UIV location (T9–T10 vs. T11–T12 vs. L1–L2). Demographic data were reviewed and radiographic parameters were measured preoperatively, immediately postoperatively, at 6 months and at the final follow-up. Incidence and failure modes of APJF, as well as timing for APJF revision are reported. Risk factors for APJF were assessed with univariate and multivariate regression analysis models. Results A total of 135 consecutive patients were reviewed, with mean follow-up 42 months (24–126). Mean age was 66 years (24–86). There were no differences in the preoperative radiographic parameters between patients in any of the three cohorts with APJF. The incidence of APJF was 38.5%, with a trend toward higher APJF in the T9–T10 group (p = 0.07) (Table 1). When UIV was at T10, the incidence of APJF was 57.1%, significantly higher than the adjacent vertebrae, T9 and T11 (p = 0.03 and p = 0.01, respectively). The overall revision rate for APJF was 17%, most often for UIV fracture, while PJK > 15 degrees alone had the highest 2 and 5 years survival (100%) (Fig. 1). Univariate analysis revealed preoperative sagittal vertical axis > 5 cm, postoperative PJA > 5 degrees and thoracic kyphosis > 30 degrees, and instrumentation to the pelvis as risk factors for APJF (Table 2). Multivariate regression analysis confirmed postoperative PJA > 5 degrees, and greater correction of lumbar lordosis (LL) as independent risk factors for APJF (Table 3). Conclusion The incidence of APJF in adult deformity patients is high if the UIV is in the lower thoracic or lumbar spine, with a trend toward higher rates when the UIV is at T10. Fracture at the UIV lead to the highest revision rate, while PJK > 15 degrees without fracture or hardware failure had the longest revision-free survival. Postoperative PJA > 5 degrees and greater correction of LL are independent risk factors for APJF.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 160-162
      PubDate: 2014-09-24T15:27:10+01:00
      DOI: 10.1055/s-0034-1386755
      Issue No: Vol. 05, No. 02 (2014)
       
  • Correlation of Posterior Occipitocervical Angle and Surgical Outcomes for
           Occipitocervical Fusion
    • Authors: Maulucci; Christopher M., Ghobrial, George M., Sharan, Ashwini D., Harrop, James S., Jallo, Jack I., Vaccaro, Alexander R., Prasad, Srinivas K.
      Pages: 163 - 165
      Abstract: Study Type Retrospective cohort study. Introduction Craniocervical instability is a surgical disease, most commonly due to rheumatoid arthritis, trauma, erosive pathologies such as tumors and infection, and advanced degeneration. Treatment involves stabilization of the craniovertebral junction by occipitocervical instrumentation and fusion. However, the impact of the fixed occipitocervical angle on surgical outcomes, in particular the need for revision surgery and the incidence of dysphagia, remains unknown. Occipitocervical fusions (OCFs) at a single institution were reviewed to evaluate the relationships between postoperative neck alignment, the need for revision surgery, and dysphagia. Objective The objective of this study is to determine whether an increased posterior occipital cervical angle results in an increase in the need for revision surgery, and secondary, dysphagia. Methods A retrospective review of spinal surgery patients from January 2007 to June 2013 was conducted searching for patients who underwent an occipitocervical instrumented fusion utilizing diagnostic and procedural codes. Specifically, a current procedural code of 22590 (arthrodesis, posterior technique [craniocervical]) was queried, as well those with a description of “craniocervical” or “occipitocervical” arthrodesis. Ideal neck alignment before rod placement was judged by the attending surgeon. A review of all cases for revision surgery or evidence of dysphagia was then conducted. Results From January 2007 to June 2013, 107 patients were identified (31 male, 76 female, mean age 63). Rheumatoid arthritis causing myelopathy was the most common indication for OCF, followed by trauma. Twenty of the patients were lost to follow-up and seven died within the perioperative period. Average follow-up for the remaining 80 patients was 16.4 months. The mean posterior occipitocervical angle (POCA), defined as the angle formed by the intersection of a line drawn tangential to the posterior aspect of the occipital protuberance and a line determined by the posterior aspect of the facets of the third and fourth cervical vertebrae, calculated after stabilization, was 107.1 degrees (range, 72–140 degrees). Reoperation was required in 11 patients (11/107, 10.3%). The mean POCA for the reoperation group was 109.5 degrees (range, 72–123) and was not significantly different than patients not requiring reoperation (106.5, p > 0.05). However, for all pathologies excluding infection as a cause for reoperation, the mean POCA was significantly higher, 115.14 degrees (p = 0.039) (Table 1). Seven patients (6.5%) complained of dysphagia postoperatively with a significantly higher POCA of 115 degrees (p = 0.039). Of these seven patients, six underwent posterior-only procedures. One patient underwent anterior and posterior procedures for a severe kyphotic deformity. The dysphagia resolved in six patients over a mean of 3 weeks (range, 2–4 weeks). One patient, whose surgery was posterior only, required the insertion of a gastrostomy tube. Conclusions An elevated POCA may result in need for reoperation due to increased biomechanical stress upon adjacent segments or the construct itself due to flexion in an attempt to maintain forward gaze. Further, an elevated POCA seems to also correlate with a higher incidence of dysphagia. Further investigation is necessary to determine the ideal craniocervical angle which is likely individualized to a particular patient based on global and regional spinal alignments.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 163-165
      PubDate: 2014-09-24T15:27:07+01:00
      DOI: 10.1055/s-0034-1386756
      Issue No: Vol. 05, No. 02 (2014)
       
  • Definition of Levels of Evidence (LoE) and Overall Strength of Evidence
           (SoE)
    • Evidence-Based Spine-Care Journal 2014; 05: 166-166
      DOI: 10.1055/s-0034-1394106



      Georg Thieme Verlag KG Stuttgart · New York

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     Volltext

      Evidence-Based Spine-Care Journal 2014; 05: 166-1662014-09-24T15:27:03+01:00
      Issue No: Vol. 05, No. 02 (2014)
       
  • Treating Spinal Storage Diseases with Macro Data'
    • Evidence-Based Spine-Care Journal 2014; 05: 001-001
      DOI: 10.1055/s-0034-1372332



      Georg Thieme Verlag KG Stuttgart · New York

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     Volltext

      Evidence-Based Spine-Care Journal 2014; 05: 001-0012014-03-28T12:57:21+0100
      Issue No: Vol. 05, No. 01 (2014)
       
  • Credibility Matters: Mind the Gap
    • Evidence-Based Spine-Care Journal 2014; 05: 002-005
      DOI: 10.1055/s-0034-1371445



      Georg Thieme Verlag KG Stuttgart · New York

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     Volltext

      Evidence-Based Spine-Care Journal 2014; 05: 002-0052014-03-28T12:57:20+0100
      Issue No: Vol. 05, No. 01 (2014)
       
  • The Concomitance of Cervical Spondylosis and Adult Thoracolumbar Spinal
           Deformity
    • Authors: Weber; Michael H., Hong, C. H., Schairer, William W., Takemoto, Steven, Hu, Serena S.
      Pages: 006 - 011
      Abstract: Study Design Retrospective cross-sectional study. Clinical Question What is the prevalence of cervical spondylosis (CS) and thoracolumbar (TL) spinal deformity in an administrative database during a 4-year study period' Is the prevalence of CS or TL deformity higher in patients who have the other spine diagnosis compared with the overall study population' Are patients with both diagnoses more likely to have undergone spine surgery' Patients and Methods An administrative claims database containing 53 million patients with either Medicare (2005–2008) or private payer (2007–2010) insurance was used to identify patients with diagnoses of CS and/or TL deformity. Disease prevalence between groups was compared using a χ 2 test and reported using prevalence ratios (PR). Results The prevalence of CS was higher in patients with TL deformity than without TL deformity, for both Medicare (PR = 2.81) and private payer (PR = 1.79). Similarly, the prevalence of TL deformity was higher in patients with CS than without CS for both Medicare (PR = 3.19) and private payer (PR = 2.05). Patients with both diagnoses were more likely to have undergone both cervical (Medicare, PR = 1.44; private payer, PR = 2.03) and TL (Medicare, PR = 1.68; private payer, PR = 1.74) spine fusion. All comparisons were significant with p 
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 006-011
      PubDate: 2014-03-28T12:57:18+0100
      DOI: 10.1055/s-0034-1368668
      Issue No: Vol. 05, No. 01 (2014)
       
  • Comparison between C1–2 Fixation with and without Supplemental
           Posterior Wiring
    • Authors: Tran; Mai, Wadhwa, Rishi, Ziewacz, John, Mummaneni, Praveen, Chou, Dean
      Pages: 012 - 015
      Abstract: Study Design Retrospective analysis. Clinical Question Is there a difference between the screw–rod construct (SRC) procedure without wiring and the SRC procedure with wiring with respect to fusion, implant failure, reoperation, donor-site morbidity, and complication rates' Patients and Methods We performed a retrospective analysis of 26 patients who underwent C1–2 fixation between 2004 and 2012 (SRC with wiring and structural bone graft, 13 patients; SRC with autograft but without wiring, 13 patients). Fusion was assessed using dynamic X-rays in all patients and computed tomographic scans in selected cases. Pseudoarthrosis was confirmed during reoperation. Results The mean follow-up time was 2 years and 5 months for the SRC without wiring group and 2 years and 1 month for the SRC with wiring group. Patients with less than 1-year follow-up time were excluded. The fusion rate, implant failure rate, and reoperation rates for the SRC without wiring group were 92, 8, and 8%, respectively. The fusion, implant failure, and reoperation rates for the SRC with wiring group were 100, 0, and 0%, respectively. There were no donor-site morbidities or complications in either group (both 0%). There were no differences in parameters we examined between the two groups (p > 0.05 for each rate, Fisher exact test). Conclusions The results suggest that supplementing the SRC procedure with wiring may increase fusion rate, but this difference is not statistically significant. Although the sample size was small, there was not a significant discrepancy in outcomes between the two groups at an average follow-up of 2 years.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 012-015
      PubDate: 2014-03-28T12:57:13+0100
      DOI: 10.1055/s-0034-1371972
      Issue No: Vol. 05, No. 01 (2014)
       
  • Vertebral Artery Anomaly and Injury in Spinal Surgery
    • Authors: Molinari; Robert, Bessette, Matthew, Raich, Annie L., Dettori, Joseph R., Molinari, Christine
      Pages: 016 - 027
      Abstract: Study Design Systematic review. Study Rationale The purpose of this review is to further define the published literature with respect to vertebral artery (VA) anomaly and injury in patients with degenerative cervical spinal conditions. Objectives In adult patients with cervical spine or degenerative cervical spine disorders receiving cervical spine surgery, what is the incidence of VA injury, and among resulting VA injuries, which treatments result in a successful outcome and what percent are successfully repaired' Materials and Methods A systematic review of pertinent articles published up to April 2013. Studies involving traumatic onset, fracture, infection, deformity or congenital abnormality, instability, inflammatory spinal diseases, or neoplasms were excluded. Two independent reviewers assessed the level of evidence quality using the Grades of Recommendation Assessment, Development and Evaluation criteria; disagreements were resolved by consensus. Results From a total of 72 possible citations, the following met our inclusion criteria and formed the basis for this report. Incidence of VA injuries ranged from 0.20 to 1.96%. None of the studies reported using preoperative imaging to identify anomalous or tortuous VA. Primary repair and ligation were the most effective in treating VA injuries. Conclusion The incidence of VA injuries in degenerative cervical spinal surgery might be as high as 1.96% and is likely underreported. Direct surgical repair is the most effective treatment option. The most important preventative technique for VA injuries is preoperative magnetic resonance imaging or computed tomography angiographic imaging to detect VA anomalies. The overall strength of evidence for the conclusions is low.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 016-027
      PubDate: 2014-03-28T12:57:14+0100
      DOI: 10.1055/s-0034-1366980
      Issue No: Vol. 05, No. 01 (2014)
       
  • Lumbar Lateral Interbody Fusion (LLIF): Comparative Effectiveness and
           Safety versus PLIF/TLIF and Predictive Factors Affecting LLIF Outcome
    • Authors: Barbagallo; Giuseppe M. V., Albanese, Vincenzo, Raich, Annie L., Dettori, Joseph R., Sherry, Ned, Balsano, Massimo
      Pages: 028 - 037
      Abstract: Study Design Systematic review. Study Rationale The surgical treatment of adult degenerative lumbar conditions remains controversial. Conventional techniques include posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF). A new direct approach known as lumbar lateral interbody fusion (LLIF), or extreme lateral interbody fusion (XLIF®) or direct lateral interbody fusion (DLIF), has been introduced. Objectives The objective of this article is to determine the comparative effectiveness and safety of LLIF, at one or more levels with or without instrumentation, versus PLIF or TLIF surgery in adults with lumbar degenerative conditions, and to determine which preoperative factors affect patient outcomes following LLIF surgery. Materials and Methods A systematic review of the literature was performed using PubMed and bibliographies of key articles. Articles were reviewed by two independent reviewers based on predetermined inclusion and exclusion criteria. Each article was evaluated using a predefined quality rating scheme. Results The search yielded 258 citations and the following met our inclusion criteria: three retrospective cohort studies (all using historical cohorts) (class of evidence [CoE] III) examining the comparative effectiveness and safety of LLIF/XLIF®/DLIF versus PLIF or TLIF surgery, and one prospective cohort study (CoE II) and two retrospective cohort studies (CoE III) assessing factors affecting patient outcome following LLIF. Patients in the LLIF group experienced less estimated blood loss and a lower mortality risk compared with the PLIF group. The number of levels treated and the preoperative diagnosis were significant predictors of perioperative or early complications in two studies. Conclusion There is insufficient evidence of the comparative effectiveness of LLIF versus PLIF/TLIF surgery. There is low-quality evidence suggesting that LLIF surgery results in fewer complications or reoperations than PLIF/TLIF surgery. And there is insufficient evidence that any preoperative factors exist that predict patient outcome after LLIF surgery.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 028-037
      PubDate: 2014-03-28T12:57:16+0100
      DOI: 10.1055/s-0034-1368670
      Issue No: Vol. 05, No. 01 (2014)
       
  • Surgical Correction of Scoliosis in Children with Spastic Quadriplegia:
           Benefits, Adverse Effects, and Patient Selection
    • Authors: Legg; Julian, Davies, Evan, Raich, Annie L., Dettori, Joseph R., Sherry, Ned
      Pages: 038 - 051
      Abstract: Study Rationale Cerebral palsy (CP) is a group of nonprogressive syndromes of posture and motor impairment associated with lesions of the immature brain. Spastic quadriplegia is the most severe form with a high incidence of scoliosis, back pain, respiratory compromise, pelvic obliquity, and poor sitting balance. Surgical stabilization of the spine is an effective technique for correcting deformity and restoring sitting posture. The decision to operate in this group of patients is challenging. Objectives The aim of this study is to determine the benefits of surgical correction of scoliosis in children with spastic quadriplegia, the adverse effects of this treatment, and what preoperative factors affect patient outcome after surgical correction. Materials and Methods A systematic review was undertaken to identify studies describing benefits and adverse effects of surgery in spastic quadriplegia. Factors affecting patient outcome following surgical correction of scoliosis were assessed. Studies involving adults and nonspastic quadriplegia were excluded. Results A total of 10 case series and 1 prospective and 3 retrospective cohort studies met inclusion criteria. There was significant variation in the overall risk of complications (range, 10.9−70.9%), mortality (range, 2.8−19%), respiratory/pulmonary complications (range, 26.9−57.1%), and infection (range, 2.5−56.8%). Factors associated with a worse outcome were a significant degree of thoracic kyphosis, days in the intensive care unit, and poor nutritional status. Conclusion Caregivers report a high degree of satisfaction with scoliosis surgery for children with spastic quadriplegia. There is limited evidence of preoperative factors that can predict patient outcome after scoliosis. There is a need for well-designed prospective studies of scoliosis surgery in spastic quadriplegia.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 038-051
      PubDate: 2014-03-28T12:57:15+0100
      DOI: 10.1055/s-0034-1370898
      Issue No: Vol. 05, No. 01 (2014)
       
  • A Case of Tophaceous Gout in the Lumbar Spine: A Review of the Literature
           and Treatment Recommendations
    • Authors: Jegapragasan; Mithulan, Calniquer, Alejandro, Hwang, William D., Nguyen, Quynh T., Child, Zachary
      Pages: 052 - 056
      Abstract: Study Design Case report. Objective The objective of this study is to report the occurrence of tophaceous gout in the lumbar spine. Methods Using a case report to illustrate the key points of gout in the spine, we provide a brief review of gout in the literature as it relates to its orthopedic and spinal manifestations as well as guidelines for management. Results This case report details the occurrence of a large and clinically significant finding of tophaceous gout in the lumbar spine in a 24-year-old man with a known history of gout and a 3-year history of progressive back pain. Conclusion A high index of suspicion can assist in diagnosis of patients presenting with back pain or neurologic findings with a history of gout. A previous history of gout (especially the presence of tophi), hyperuricemia, and the radiological characteristics presented here should aid the clinician in making the diagnosis of spinal gout. Early diagnosis has the potential to prevent the need for surgical intervention.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 052-056
      PubDate: 2014-03-28T12:57:18+0100
      DOI: 10.1055/s-0034-1366979
      Issue No: Vol. 05, No. 01 (2014)
       
  • Cervical Stenosis in a Patient with Arthrogryposis: Case Report
    • Authors: Du; Jerry, Aichmair, Alexander, Lykissas, Marios, Girardi, Federico
      Pages: 057 - 062
      Abstract: Study Design Case report. Objective Amyoplasia-type arthrogryposis is a rare congenital disease that presents as multiple contractures involving various areas of the body. To the authors' knowledge, there have been no reports of adults with amyoplasia in the current literature. We report a case of an adult patient with cervical stenosis in the setting of amyoplasia. Patients and Methods A 48-year-old patient with amyoplasia and over 30 previous orthopedic reconstructive surgeries presented with neck pain radiating down his left shoulder and into the fingers, dysesthesia in his fingertips, and left-sided periauricular headache. A diagnosis of central spinal canal stenosis and bilateral foraminal stenosis at C3–C7 with radiculopathy was made based on computed tomography scans. Because of a prior right-side sternocleidomastoid muscle transfer, a left-side C3–C4, C5–C7 anterior cervical discectomy and fusion procedure was performed. Results The patient experienced significant improvement in symptoms that was transient. Symptoms returned to preoperative values after 1 year, despite significant and persistent improvement in stenosis. Conclusions Both amyoplasia and cervical stenosis can manifest in neurologic symptoms. Distinguishing the causing pathology can be challenging. The radiographic improvement of cervical stenosis in a patient with amyoplasia is not always associated with long-standing pain relief.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 057-062
      PubDate: 2014-03-28T12:57:20+0100
      DOI: 10.1055/s-0034-1368669
      Issue No: Vol. 05, No. 01 (2014)
       
  • Retro-Odontoid Calcium Pyrophosphate Dehydrate Deposition: Surgical
           Management and Review of the Literature
    • Authors: Klineberg; Eric, Bui, Tuan, Schlenk, Richard, Lieberman, Isador
      Pages: 063 - 069
      Abstract: Study Design Case report and review of the literature. Objective A retro-odontoid mass is a rare cause of cervical compression and myelopathy. The differential diagnosis includes the following: metastatic disease, primary tumor, collagen disorder, or inflammatory disease. Calcium pyrophosphate dihydrate (CPPD) deposition has been referred to as “crowned dens syndrome” when there are periodontoideal calcifications. There are only a few reported cases where CPPD presents as a cystic retro-odontoid mass in the atlanto-dens interval. In previous descriptions of surgical intervention, transoral resection of the mass is associated with significant morbidity and usually requires stabilization. The objective of this article is to report a case of an unusual presentation of CPPD disease of C1/C2, where we used a novel, minimally invasive surgical technique for decompression without fusion. Patients and Methods An 83-year-old female patient presented with progressive cervical myelopathy over a 3-month period. Computed tomography and magnetic resonance imaging demonstrated a cystic odontoid mass with a separate retro-odontoid compressive mass. A novel, minimally invasive transoral aspiration was performed. Histologic confirmation of CPPD was obtained. Results Postop imaging showed satisfactory decompression, which was maintained at the 6-month follow-up. This correlated with clinical improvement postop and 6-month follow-up. Conclusion CPPD in the atlanto-dens interval may present as a cystic retro-odontoideal mass and should be included in the differential. We used a transoral minimally invasive approach to aspirate the cyst. This novel technique avoided the need for a stabilization procedure or morbid transoral resection and provided excellent results immediately and at 6 months.
      Citation: Evidence-Based Spine-Care Journal 2014; 05: 063-069
      PubDate: 2014-03-28T12:57:22+0100
      DOI: 10.1055/s-0034-1370897
      Issue No: Vol. 05, No. 01 (2014)
       
  • Occam's Paradox' A Variation of Tapia Syndrome and an Unreported
           Complication of Guidewire-Assisted Pedicle Screw Insertion
    • Evidence-Based Spine-Care Journal 2014; 05: 070-070
      DOI: 10.1055/s-0034-1371444



      Georg Thieme Verlag KG Stuttgart · New York

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     Volltext

      Evidence-Based Spine-Care Journal 2014; 05: 070-0702014-03-28T12:57:22+0100
      Issue No: Vol. 05, No. 01 (2014)
       
  • Definition of Classes of Evidence (CoE) and Overall Strength of Evidence
           (SoE)
    • Evidence-Based Spine-Care Journal 2014; 05: 071-071
      DOI: 10.1055/s-0034-1373841



      Georg Thieme Verlag KG Stuttgart · New York

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     Volltext

      Evidence-Based Spine-Care Journal 2014; 05: 071-0712014-03-28T12:57:15+0100
      Issue No: Vol. 05, No. 01 (2014)
       
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
 


Your IP address: 18.204.55.168
 
Home (Search)
API
About JournalTOCs
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-