History Of Spinal Injury Research Articles

Amputation-free Home Management of Infected Lower Extremity Pressure Ulcer through Shared Decision-making: Enhancing the Quality of Life and Highlighting Societal Significance in Home Care.

Home healthcare is important for allowing patients to live their lives. However, home-care bedridden patients often experience pressure ulcers in the lower extremities, which can lead to life-threatening infections requiring decisions on the need for amputation. We herein report a patient with an infected lower-limb pressure ulcer with a history of spinal injury. The patient, his family, and the home-care physician repeatedly shared decision-making to deliver home-based treatment instead of amputation. Administration of wound dressing, AQUACEL® Ag, led to complete epithelialization. Such shared decision-making and dressing were feasible in a home-care setting and broadened its scope.

Inflammatory Bowel Disease as a Risk Factor for Complications and Revisions Following Lumbar Discectomy.

Retrospective cohort study. Patients with IBD are at an increased risk for postoperative complications following surgery. The goal of this study is to investigate if inflammatory bowel disease (IBD) is a risk factor for complications following lumbar discectomy. We identified IBD patients who underwent lumbar discectomy for lumbar disc herniation (LDH) and matched to them with controls without IBD in a1:5 ratio. We excluded patients with a history of spinal injury, cancer, infection, trauma, or surgery to remove the digestive tract. We used multivariate logistic regression analyses to compare postoperative outcomes, including 90-day complications, 90-day emergency department visits, and 90-day readmissions. In addition, 2-year re-discectomy rates and a 3-year lumbar fusion rate were compared between the cohorts. After applying the study criteria, we identified 6134 IBD patients with LDH for further analysis. With the exception of dura tears, patients with IBD had significantly higher rates of medical complications, incision-related complications, ED visits, and readmission rates compared to patients without IBD, especially for the 2-year and 3-year rates of disc recurrence and revision surgery. Patients with IBD who underwent lumbar discectomy are at a significantly higher rate of complications. Therefore, spine surgeons and other health care providers should be aware of this higher risk associated with IBD patients and properly treat the patients' IBD before surgery to lower these risks.

Trunk Isokinetic Dynamometry Evaluation of Elite Swimmers: A Comparative Study Between Symetric And Asymmetric Styles

PURPOSE: To compare performance of trunk flexor and extensor muscles between symmetric and asymmetric styles swimmers. METHODS: Twelve elite velocity swimmers, divided in symmetric swim group (N = 12 (11 male); 20.5 ± 3.1 years; BMI = 22.9 ± 1.5 Kg/m2) and asymmetric swim group (N = 8 (7 male); 21.3 ± 5.5 years; BMI = 23.0 ± 2.4 Kg/m2), and without a history of spinal injury were studied, were submitted to an trunk (agonist-antagonist) isokinetic evaluation (Cybex 6000 isokinetic dynamometer) at 90 degree/sec (4 repetitions) and 120 degree/sec (4 repetitions). Peak torque (PT), time to PT, power and agonist-antagonist (flex/ext) ratio were compared between groups. RESULTS: Asymmetric swim group displayed higher extensor muscles power (P < 0.05) for both 90 (±) and 120 degree/sec (±), and lower time to PT of extensor muscles (P < 0.05). There were no significantly differences in any other variable assessed. CONCLUSIONS: In asymmetric swimmers, the trunk extensor muscles show higher power (muscular work as a function of time) when compared to the symmetric swimmers.TABLE 1: Isokinetic evaluation (* Different (P < 0.05) from Symmetric-Extension).

Navigated minimally invasive thoracolumbar pedicle screw placement with flat panel 3-D imaging. A feasibility study

The current study involves a cadaveric specimen with navigated pedicle screw placement using conventional reference markers and isocentric 3D fluoroscopy and also minimally invasive reference marker use with a flat panel 3D scanner. To test the feasibility of a novel minimally invasive reference marker system for navigated pedicle screw placement in combination the use of a new imaging modality i.e. flat panel 3D imaging. A major limiting factor of navigated pedicle screw placement is the requirement for intraosseous fixation of reference markers. This usually necessitates an open approach to the spinous process. To address this issue, the current authors have developed a minimally-invasive fixation device for spinal reference marker fixation. A fresh-frozen cadaver with no history of spinal injury or deformity was positioned prone on a radiolucent table. L3 and L4 vertebrae were randomly selected for conventional pedicle screw insertion while T5 and T6 were selected for the percutaneous technique. A flat detector 3D C-arm (Ziehm vision FD 3D; Ziehm, Nuremberg, Germany) was used to evaluate the position of the pedicle screws at the vertebral levels targeted in the study. All screws placed within the lumbar spine involved conventional reference markers. The average depth deviation was 0.73 mm and the average axis deviation was 1.67 mm. Within the thoracic spine, the minimally-invasive marker fixation devices were used. The average depth deviation was 0.85 mm and the average axis deviation was 1.75 mm. In both cases, the plan and navigation were performed satisfactorily. The Y-jaw clamp for minimally-invasive reference fixation seemed to provide stable and robust fixation of the markers, requiring only two small incisions. The minimally invasive reference marker system produced results which were comparable to the conventional intra-osseous markers while the flat detector-based navigation was shown to be easier to use and faster than isocentric Iso-3D technology.

Spontaneous Pyogenic Spondylitis Caused by Klebsiella pneumoniae

A 72-year-old woman without a history of spinal injury was admitted to our hospital with prolonged severe back pain and high fever. Clinical laboratory findings and magnetic resonance imaging (MRI) revealed severe inflammation of the L2 and L3 lumbar vertebrae. Meropenem trihydrate administration improved her symptoms. Klebsiella pneumoniae isolated from the patient's blood indicated that the organism caused the spontaneous pyogenic spondylitis.