Neurosurgery: Spine surgery
Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor in Essentials of Geriatric Neuroanesthesia, 2019
Degenerative diseases of spine can be divided in to four types: Degenerative disc disease: Occurs due to reduced water content, decrease in disc space, and alteration of the collagen content in the disc.Spondylolisthesis: Slipping or displacement of the one vertebra over another. It is common at L4/L5 (3).Prolapse of the disc: Leads to radicular pain of the nerve roots. This occurs due to the irritation and inflammation of the nerve root by the biologically active tissue within the disc, such as nucleus pulposus.Spinal stenosis: Due to narrowing of the spinal canal.
Spinous Process Distractive Devices for Lumbar Spinal Stenosis
Alexander R. Vaccaro, Christopher M. Bono in Minimally Invasive Spine Surgery, 2007
The ideal patient for the X STOP implantation has predominantly lower extremity complaints with or without LBP secondary to lumbar spinal stenosis at one or two levels. The clinical diagnosis of spinal stenosis should be confirmed with either MRI or computed tomography (CT) scan with or without a myelogram. The symptoms must be relieved with flexion. AS sitting places the lumbar spine in relative flexion, patients should be able to sit for about an hour without the pain. X STOP would be particularly indicated for the patients unable to undergo general anesthesia. The X STOP in its current design appears to be suitable for implantation at the L5/S1 levels in most patients, although in the clinical study conducted in the United States, patients with symptomatic stenosis at L5/S1 were excluded. In Europe, the X STOP is being successfully implanted at the L5/S1 level. Approximately one-third of patients in the United States have received implants at two levels, while triple levels procedures were not allowed in the U.S. study. As with L5/S1 procedures, triple level procedures are performed in Europe, but infrequently. Based on experience gained from more than 3000 X STOP procedures that have been performed worldwide, there appears to be a considerable amount of overlap in patients indicated for surgical decompression and patients indicated for the X STOP.
Individual conditions grouped according to the international nosology and classification of genetic skeletal disorders*
Christine M Hall, Amaka C Offiah, Francesca Forzano, Mario Lituania, Michelle Fink, Deborah Krakow in Fetal and Perinatal Skeletal Dysplasias, 2012
Prognosis: viable – affected individuals usually have normal intellect and life span; however, a number of complications can develop. The reduced size of the skull base and the foramen magnum can predispose to cervicomedullary compression, hydrocephalus and obstructive sleep apnoea. Unexpected death can occur in 2%–5% of patients during the first years of life. Frequent middle ear infection can lead to deafness. Crowded teeth are secondary to the relatively reduced jaw size. Hypotonia can lead to lumbar kyphosis in the first months of life. Later, lumbar hyperlordosis and genu varum are usually present. Lumbar spinal stenosis occurs. Mean adult height is 124–130 cm.
CJP Special Edition—Proceedings of the Michael G. Degroote Institute for Pain Research and Care Annual Symposium—Director’s introduction
Published in Canadian Journal of Pain, 2020
One of the very challenging clinical problems in pain care is dealing with the effects of spinal stenosis. Dr. Luciana Macedo of the McMaster School of Rehabilitation Science has received seed grant funding to analyze historical data about spinal stenosis from the Canadian Spine Outcomes Research Network database and reports on this protocol here. Dr. Cheryl Chow, a postdoctoral researcher in the McMaster Department of Psychology, has a research program examining pediatric perioperative anxiety. The review she presents here is an extension of that body of work, specifically examining the effects of anxiety on persistent postsurgical pain in pediatrics. This review highlights several areas for future work to address the significant gaps in the literature. Finally, doctoral student Chad Brown, under the supervision of Dr. Karun Singh of the Stem Cell Research Institute, reports on a novel exploration of work connecting the genetics of autism and pain in developing a neuronal cell model upon which to test novel therapeutics.
Treatment for lumbar spinal stenosis in elderly patients using percutaneous endoscopic lumbar discectomy combined with postoperative three-dimensional traction
Published in Expert Review of Medical Devices, 2019
Dexin Hu, Jun Fei, Genjun Chen, Yongjie Yu, Zhen Lai
Lumbar spinal stenosis is a common orthopedic disease in patients more than 40 years old, seriously affecting the quality of life of patients. Surgery solely for the purposes of alleviating pain does not meet the requirements of modern elderly patients, and traditional surgical treatment cannot relieve pain and improve patients’ quality of the life at the same time. A total of 180 elderly patients with lumbar spinal stenosis were chosen to evaluate the clinical efficacy of percutaneous endoscopic lumbar discectomy (PELD) combined with postoperative three-dimensional traction in the treatment of lumbar spinal stenosis compared with PELD and traditional surgery in this study. The results showed that PELD combined with postoperative three-dimensional traction reduced surgical trauma, provided adequate decompression for the spine, improved surgical outcomes, and improved the quality of life of patients, indicating that PELD combined with postoperative three-dimensional traction was an effective and promising treatment for lumbar spinal stenosis.
Association between spinal stenosis and wild-type ATTR amyloidosis
Published in Amyloid, 2021
Amandeep Godara, Ron I. Riesenburger, Diana X. Zhang, Cindy Varga, Teresa Fogaren, Nauman S. Siddiqui, Anthony Yu, Andy Wang, Michael Mastroianni, Richard Dowd, Tara J. Nail, Ellen D. McPhail, Paul J. Kurtin, Jason D. Theis, Denis Toskic, Knarik Arkun, Monika Pilichowska, James Kryzanski, Ayan R. Patel, Raymond Comenzo
ATTRwt has been found in the tendons, ligaments and joints of elderly patients but the significance of its presence is not well understood [8–12]. Spinal stenosis (SS) is also a degenerative condition that primarily affects people older than 60 years, and surgical management involves the excision of the ligamentum flavum [13]. ATTRwt in the ligamentum flavum has been reported in 33–45% of the patients undergoing surgery for SS; its prevalence has been associated with increased age and increased thickness of ligamentum flavum, suggesting a pathologic role in this process [9–11,14]. However, evaluation for concurrent cardiac amyloidosis was not undertaken until recently. In a recently published study by Eldhagen et al., 250 patients were evaluated for amyloid deposition in the ligamentum flavum, of which 93 (37%) were identified to have ATTR deposition and cardiac investigations did not reveal any involvement with amyloidosis.
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