Changes of lumbar vertebrae after Cosmos-1887 space flight.
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Cosmos (plant)
Weightlessness
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To present a new sonographic approach for lumbar transforamianal injection and compared it with traditional fluoroscopicguided approach.This interventional clinical study was conducted on 30 patients with a history of radicular lowback pain and a recent MRI indicating root compression. On the prone position, with the curve of ultrasound transducer on the parasagittal oblique position, a peripheral venous catheter (# 16) was advanced to the lamina through out-of-plane technique. Then, the transducer position was changed to axial position and an epidural catheter was placed about 8 cm away from midline and advanced under sonography guide with the in-plane technique to the intervertebral foramen. The level and the situation of needle was controlled with fluoroscopy and documented when the corticosteroid (triamcinolone) was injected. Also, pain scores for patients were documented and analyzed with SPSS-22 software.After controlling with fluoroscopy, from all 38 levels of injection, 36 levels were correctly achieved. Of all 36 injections on right levels, all injections were performed in the correct position (in intervertebral foramen). The patients? pain dramatically decreased during the first month after injection (p < 0.001), but after that, it remained unchanged.In our study, transforaminal injection was administered using the modified new technique, which was found to be safe and accurate in comparison with the fluoroscopy, as the popular gold standard technique.
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Spinal Surgery
Spinal disease
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Radicular pain
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Objectives: To evaluate the surgical effect of the inicroinvasive operation on hypertensive intraventricular haemorrhage combined.Methods:The lumbar subarachnoid space unilateral or bilateral ventricular continuous drainage was performed in 45 and 28 cases respectively.Results: postoperative outcome was evaluated by Gos Grad I 4 cases,Ⅱ 28 cases,Ⅲ 20 cases,Ⅳ 11 cases,Ⅴ 9 cases.Conclusions: Uni-1 bilateral ventricular combined lumbar subarachnoid space continuous drainage was an effective surgical option in the treafment of WIH.
Subarachnoid space
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Background Context: Combined anterior/posterior (A/P) spinal fusion with instrumentation has been used for many years in the treatment of adult thoracolumbar and lumbar (TL/L) scoliosis. However, the risk factors for complications and poor clinical outcomes with this procedure are not well known. Purpose: To assess the risk factors for poor clinical outcomes in a series of adult lumbar or scoliosis patients undergoing combined A/P-instrumented spinal fusion. Study Design: This study was a retrospective case series of surgically treated adult lumbar or thoracolumbar scoliosis patients. Patient Sample: From 1998 to 2006, 57 patients with diagnoses of adult idiopathic scoliosis or degenerative TL/L scoliosis underwent combined A/P spinal instrumentation and fusion at 1 institution, performed by 1 senior author. Outcome Measurements: The preoperative and postoperative outcome measurements included self-report measurements, physiological measurements, and functional measurements. Materials and Methods: A retrospective review of this patient group was performed to evaluate patient satisfaction, functional outcomes, pain, curve progression, and complications. Radiographic measurements included coronal balance, sagittal vertical axis, Cobb angle, thoracic kyphosis, lumbar lordosis, and pelvic incidence preoperatively, immediately postoperatively, and during follow-up. In terms of risk factors, bone mineral density, body mass index, age, kyphosis, and fusion to the sacrum were reviewed. Postoperative Scoliosis Research Society Patient Questionnaire outcome scores, Oswestry Disability Index (ODI), and anterior surgical site pain (ASSP) were also evaluated. Means were compared with the Student t test and the χ2 test. Logistic regression analyses were used to predict the probabilities and the odds ratios (ORs) of the risk factors for poor clinical outcomes. A P-value of <0.05 with a confidence interval of 95% was considered significant. Results: Fifty patients had adult idiopathic scoliosis, and 7 patients had degenerative scoliosis. The average age at surgery was 53.8 years (34–74 y), and the average follow-up was 4.8 years (2–11 y). Coronal correction for thoracic, thoracolumbar, and lumbosacral curves improved significantly. The degree of sagittal curve and coronal and sagittal balance were not significantly changed after surgery or at the final follow-up. ODI, the pain intensity domain of the ODI, and ASSP were significantly worse in obese and overweight patients, whereas OR time, estimated blood loss, and number of fused vertebrae were not different in the entire group (P=0.03 for ODI, P=0.002 for pain domain of ODI, and P=0.003 for ASSP). Logistic regression analyses for the risk factors of poor clinical outcomes indicated obesity and overweight as risk factors for poor clinical outcomes (OR=6.25 for ODI and 5.88 for ODI pain intensity score). A significantly higher rate of major complications occurred in this group compared to the entire group (30.4%, P=0.04). Low bone mineral density, old age, kyphosis, and fusion to the sacrum were not risk factors for poor clinical outcomes. Conclusions: Despite the good function scores and acceptable pain levels in most patients, the ODI scores of obese and overweight patients were worse compared to the rest of the patients in this study. Significantly worse scores on the pain intensity domain of the ODI and ASSP differences were likely caused by extensive dissection of the abdominal wall and psoas muscles and the technical difficulty of achieving an anterior approach to the thoracolumbar spine. Radiographs revealed no progression of the TL/L curves. This study indicates that obesity and overweight are potential risk factors for combined A/P-instrumented spinal fusion in patients with adult TL/L scoliosis, perhaps due to the technical difficulty of achieving an anterior approach to the thoracolumbar spine.
Oswestry Disability Index
Cobb angle
Kyphosis
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To decrease postoperative complications in patients with adult lumbar degenerative scoliosis (ALDS), short-segment fusion surgery was used in this study. However, the incidence of adjacent segment disease was found to be remarkable. Therefore, we applied the hybrid treatment (short-segment fusion for responsibility levels plus nonfusion stabilization of lumbar segments, which was called the Wallis system, for the proximal level) to patients enrolled into this study. The purpose of this study was to investigate the feasibility of a novel hybrid therapeutic approach for treating patients with ALDS.From January 2011 to January 2017, a retrospective study was conducted consisting of 16 patients with ALDS who were treated with hybrid treatment. All patients were treated with short-segment decompression and fusion for responsibility levels and nonfusion stabilization of lumbar segments for the proximal levels. The imaging outcomes were evaluated preoperatively and at the time of follow-up.The mean visual analog score for back pain decreased from 6.1 ± 2.0 preoperatively to 2.1 ± 0.7 at 2-year follow-up (P < .05), and the mean visual analog score for leg pain reduced from 8.1 ± 0.6 preoperatively to 1.3 ± 0.8 at 2-year follow-up (P < .05). The Oswestry disability index scores improved from 65.4 ± 16.3% preoperatively to 18.3 ± 5.6% at 2-year follow-up (P < .05). The mean Cobb angle was 22.1 ± 6.2° preoperatively, and 13.8 ± 6.8° at 2-year follow-up (P < .05). The lumbar lordosis changed from -40.4 ± 14.8° to -43.5 ± 11.2° at 2-year follow-up (P < .05). Solid fusion was achieved in all the patients, and no incidence of adjacent segment disease was noted as well.The proposed hybrid treatment for patients with ALDS can achieve favorable clinical outcomes and a lower incidence of ALDS. However, the correction of deformity is still limited that highlights the necessity of further study.
Oswestry Disability Index
Cobb angle
Therapeutic effect
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Objective:To analyze and evaluate the CT diagnosis value of postoperation syndrom of lumbar intervertebral disc herniation and to offer dependable basis for postoperation treatment.Methods:Twenty-four patients with lumbar intervertebral disc herniation by surgical resection were reviewed retrospectively.Including clinical data,symptoms,signs and CT findings.Results:The more disnormal of CT findings,the more difficulty were performed by operation and incidence rate of postoperation syndrom was higher.Conclusion:The CT detect of postoperation syndrome of lumbar intervertebral disc herniation is advantageous to estimating effect of operation and prognosis.
Lumbar disc herniation
Disc herniation
Intervertebral Disc
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