Spine Institute Research Articles

Commentary: Use of Antibacterial Envelopes for Prevention of Infection in Neuromodulation Implantable Pulse Generators.

Michigan Head and Spine Institute, Southfield, Michigan, USA Correspondence: Ramiro Perez de la Torre, MD, Michigan Head and Spine Institute, 29275 Northwestern Hwy, Suite 100, Southfield, MI48034, USA. Email: [email protected]

Commentary: Incidence and Risk Factors of Mechanical Complications After Posterior-Based Osteotomies for Correction of Moderate to Severe Adult Cervical Deformity: 1-Year and 2-Year Follow-up.

*Department of Orthopedic Surgery, NYU Langone Medical Center, NYU Langone Orthopedic Hospital, NYU School of Medicine, New York Spine Institute, New York, New York, USA; ‡Department of Neurologic Surgery, NYU Langone Medical Center, NYU Langone Orthopedic Hospital, NYU School of Medicine, New York Spine Institute, New York, New York, USA Correspondence: Peter G. Passias, MD, Division of Spine Surgery, Department of Orthopedic Surgery, NYU Langone Medical Center, NYU Langone Orthopedic Hospital, NYU School of Medicine, New York Spine Institute, 301 East 17th St, New York, NY 10003, USA. Email: [email protected]

Retrospective epidemiological study and rehabilitation benefit of patient with sub-axial cervical spine injuries in western India

Study design: Retrospective study.Purpose: to extract epidemiological data related to sub-axial cervical spine injury managed at our spine institute and evaluate outcome with rehabilitation protocol.Overview of literature: sub-axial cervical spine injuries are very serious injuries in all spinal injuries and usually associated with SCI or with neurological deficit and have highest morbidity and mortality in all type of spinal injuries.Method: Total of 142 patients study included who were admitted with sub-axial cervical (C3-C7) spine injury our spine institute western India from period of Feb 2018 to December 2019 and managed conservatively or operative manner and Rehabilitation protocol were given. Detailed information on epidemiological study was analyzed based on the medical records of patients and follow-up and final outcome evaluated.Results: most common age group was 30-50 yrs.48%, 94% male and 6% female with male to female ratio of 14:1. The commonest mode of trauma was fall from height 56% followed by 37% of RTA, 77% were laborers, average admission delay was 6.1 days, admission to surgery delay was 2.3 days, 53% had incomplete & 44% complete neurological deficit, 73% had involvement of bladder/ bowel, 74%were managed conservative while 26% operated, 6% had other associated injuries, 86% had received complete rehabilitation protocol, average hospital stay around 26 days, and significant improvement in ASIA score with rehabilitation protocol.Conclusion: This study evaluate epidemiological data and burden of sub-axial cervical spine injury in community, so improving awareness, infrastructure build up and early recognition and proper management and rehabilitation protocol have high chances of improvement with low mortality or morbidity.

First person – Bertille Bance and Shailaja Seetharaman

ABSTRACT First Person is a series of interviews with the first authors of a selection of papers published in Journal of Cell Science, helping early-career researchers promote themselves alongside their papers. Bertille Bance and Shailaja Seetharaman are co-first authors on ‘Microtubule acetylation but not detyrosination promotes focal adhesion dynamics and astrocyte migration’, published in JCS. Bertille is a post-doc in the lab of Marc Sanson, at The Brain and Spine Institute (ICM), Paris, France, where she is interested in mechanisms controlling cell proliferation, polarity and migration in normal and tumor cells. Shailaja is a PhD student in the lab of Sandrine Etienne-Manneville at Institut Pasteur, Paris, France investigating the role of the cytoskeleton in cell migration and mechanotransduction.

Efficacy of Exome-Targeted Capture Sequencing to Detect Mutations in Known Cerebellar Ataxia Genes

Molecular diagnosis is difficult to achieve in disease groups with a highly heterogeneous genetic background, such as cerebellar ataxia (CA). In many patients, candidate gene sequencing or focused resequencing arrays do not allow investigators to reach a genetic conclusion. To assess the efficacy of exome-targeted capture sequencing to detect mutations in genes broadly linked to CA in a large cohort of undiagnosed patients and to investigate their prevalence. Three hundred nineteen index patients with CA and without a history of dominant transmission were included in the this cohort study by the Spastic Paraplegia and Ataxia Network. Centralized storage was in the DNA and cell bank of the Brain and Spine Institute, Salpetriere Hospital, Paris, France. Patients were classified into 6 clinical groups, with the largest being those with spastic ataxia (ie, CA with pyramidal signs [n = 100]). Sequencing was performed from January 1, 2014, through December 31, 2016. Detected variants were classified as very probably or definitely causative, possibly causative, or of unknown significance based on genetic evidence and genotype-phenotype considerations. Identification of variants in genes broadly linked to CA, classified in pathogenicity groups. The 319 included patients had equal sex distribution (160 female [50.2%] and 159 male patients [49.8%]; mean [SD] age at onset, 27.9 [18.6] years). The age at onset was younger than 25 years for 131 of 298 patients (44.0%) with complete clinical information. Consanguinity was present in 101 of 298 (33.9%). Very probable or definite diagnoses were achieved for 72 patients (22.6%), with an additional 19 (6.0%) harboring possibly pathogenic variants. The most frequently mutated genes were SPG7 (n = 14), SACS (n = 8), SETX (n = 7), SYNE1 (n = 6), and CACNA1A (n = 6). The highest diagnostic rate was obtained for patients with an autosomal recessive CA with oculomotor apraxia-like phenotype (6 of 17 [35.3%]) or spastic ataxia (35 of 100 [35.0%]) and patients with onset before 25 years of age (41 of 131 [31.3%]). Peculiar phenotypes were reported for patients carrying KCND3 or ERCC5 variants. Exome capture followed by targeted analysis allows the molecular diagnosis in patients with highly heterogeneous mendelian disorders, such as CA, without prior assumption of the inheritance mode or causative gene. Being commonly available without specific design need, this procedure allows testing of a broader range of genes, consequently describing less classic phenotype-genotype correlations, and post hoc reanalysis of data as new genes are implicated in the disease.

Effectiveness of core stabilization exercises and routine exercise therapy in management of pain in chronic non-specific low back pain: A randomized controlled clinical trial.

Background & Objective:Low back pain is a frequent problem faced by the majority of people at some point in their lifetime. Exercise therapy has been advocated an effective treatment for chronic low back pain. However, there is lack of consensus on the best exercise treatment and numerous studies are underway. Conclusive studies are lacking especially in this part of the world. Thisstudy was designed to compare the effectiveness of specific stabilization exercises with routine physical therapy exerciseprovided in patients with nonspecific chronic mechanical low back pain.Methods:This is single blinded randomized control trial that was conducted at the department of physical therapy Orthopedic and Spine Institute, Johar Town, Lahore in which 120 subjects with nonspecific chronic low back pain participated. Subjects with the age between 20 to 60 years and primary complaint of chronic low back pain were recruited after giving an informed consent. Participants were randomly assigned to two treatment groups A & B which were treated with core stabilization exercise and routine physical therapy exercise respectively. TENS and ultrasound were given as therapeutic modalities to both treatment groups. Outcomes of the treatment were recorded using Visual Analogue Scale (VAS) pretreatment, at 2nd, 4th and 6th week post treatment.Results:The results of this study illustrate that clinical and therapeutic effects of core stabilization exercise program over the period of six weeks are more effective in terms of reduction in pain, compared to routine physical therapy exercise for similar duration. This study found significant reduction in pain across the two groups at 2nd, 4th and 6th week of treatment with p value less than 0.05. There was a mean reduction of 3.08 and 1.71 on VAS across the core stabilization group and routine physical therapy exercise group respectively.Conclusion:Core stabilization exercise is more effective than routine physical therapy exercise in terms of greater reduction in pain in patients with non-specific low back pain.

Low Back Pain and Sciatica as the Prominent Clinical Manifestations of Pelvic Venous Congestion Syndrome. A Case Report

Introduction Although back pain / sciatica are common conditions in the general population and their etiology is very well understood, there is a strong interest in non-musculoskeletal origins of pelvic pain masked by symptoms resembling radicular pain such as in the case of circulatory disorders in anatomic sites beyond the spine. This study presents a particular case of low back pain & sciatica as the main symptoms of pelvic venous congestion syndrome. Material and Methods A 25 year old female presented to the Spine Institute of New England complaining of 90% low back pain and 10% right lower extremity constant pain affecting the lateral aspect of her thigh and averaging around 6/10 with reported flare-ups up to 10/10 especially at the end of a long day full of activities and with prolonged standing. She has also been complaining of sleep disturbances over the last 6–9 months. She has tried land physiotherapies in the past unsuccessfully. She complained of mild dyspareunia as well. Clinical assessment suggested pain of discogenic and/or facetogenic nature, questionable meralgia paresthetica, and sciatica; however, plain radiographs were equivocal. One month prior to the patient's visit to our clinic, Gynecological laboratories ordered by primary care physician were unremarkable. The patient followed a conservative treatment plan consisted of simple analgesics, non-steroidal (Meloxicam), and steroidal (Methylprednisolone) anti-inflammatory medication, antidepressant (Fluoxetine) and antiepileptic drugs for neuropathic pain (Gabapentin). One month later, she reported no significant improvement especially on her right thigh stating that cortisone has helped initially; NSAID's were somehow helpful unlike Gabapentin, which did not help at all. The patient was followed up with MRI, which demonstrated a tubular fluid-filled structure in the region of the right adnexa in addition to mild effacement of the thecal sac at the L3-L4 level, not a strong evidence of discogenic/radicular pain. Subsequently, a transabdominal US revealed prominent pelvic veins bilaterally – more pronounced on the right side – reflecting the likelihood of pelvic venous congestion syndrome. EMG excluded nerve root compression at the spinal level, while a thorough gynecological clinical examination confirmed the aforementioned diagnosis at initial stage due to hormonal dysfunction. Results The patient has been placed on cortisone treatment for ovarian function suppression showing encouraging early outcomes. Conclusion Even though pelvic venous congestion syndrome is diagnosed via exclusion of other pathological conditions that most likely cause symptoms of low back pain and/or sciatica, this case report comes to highlight the importance of integrated initial systemic clinical assessment, particularly when more than one medical specialties are involved in the region of interest.

CATI: A large instrument for muticenter neuroimaging

CATI was born out of a consortium of neuroimaging research laboratories who have complementary expertise: NeuroSpin (the French high-field MR imaging center of the CEA) and four teams located in La Pitie-Salpetriere Hospital: ARAMIS and CENIR (the neuroimaging analysis research team and the neuroimaging platform of the Brain and Spine Institute), the Institute for Memory and Alzheimer's disease (IM2A) and LIB (an Inserm/UPMC unit focusing on research on functional imaging). These teams have been collaborating for several years, and in 2011, they were granted €9m by the French Alzheimer's disease initiative to create CATI – a national platform aiming to support multicenter neuroimaging studies. CATI's services cover the standardization of MRI and PET/SPECT data acquisitions, the data transfer to a centralized database, monitoring, quality control and image analysis. Initially designed to address Alzheimer's disease specific needs, the platform is now open to academic research projects and therapeutic trials targeting any neuropsychiatric disorder. CATI's core laboratories have many years of experience in the coordination of multi-site neuroimaging research. CATI's infrastructure stretches across the country, collecting additional know-how from all the French groups and organizations involved in neuroimaging, in order to offer the best tools for scientific projects. In agreement with the French societies of neuroradiology, radiology and nuclear medicine, CATI has been harmonizing imaging acquisitions across a network of over 40 French sites and this reach can be extended on demand. Twenty additional European sites will join the network from 2015. Although data accessibility policy is specifically chosen by the PI of each study, CATI nevertheless aims at making data sharing across studies easy and promotes it as much as possible. The platform is already in charge of the imaging protocols of more than thirty large French multicenter studies, including several therapeutic trials and the Memento cohort of the French Alzheimer initiative. Three European projects are also relying on the platform from 2015. In the context of Memento, which images 2300 subjects with isolated memory complaints or mild cognitive impairment, CATI is closely linked with the French network of memory centers in charge of recruiting Alzheimer's disease patients. Nevertheless, CATI is also involved in projects focusing on other neuropsychiatric disorders. CATI embeds a team of MRI and PET physicists, engineers and researchers in charge of standardizing acquisitions, and monitoring MRI and PET scanners within the CATI network. The Keosys Company deals with the secure transfer of imaging data to the CATI central database through a web service that is accessible from imaging acquisition sites. A team of research assistants performs quality control of the incoming raw datasets. For data analysis, CATI provides broad expertise in image processing and statistical meta-analysis tools, which are operated by engineers and technicians. CATI can provide assistance at any stage of the study and will perform additional imaging harmonization or dedicated algorithmic R&D according to requests from new facilities.

Noradrenaline and dopamine neurons integrate reward value and effort cost: a direct electrophysiological comparison in behaving monkeys

Event Abstract Back to Event Noradrenaline and dopamine neurons integrate reward value and effort cost: a direct electrophysiological comparison in behaving monkeys Chiara Varazzani1, 2*, Aurore San-Galli1 and Sebatien Bouret1 1 ICM - Brain & Spine Institute, France 2 Université Paris Descartes-Sorbonne, France Neuromodulation is essential for numerous aspects of behavior, but the specific contribution of each neuromodulator to motivation remains unclear. Here, we take advantage of a dual effect of effort: the perspective of a physical effort reduces the action value as it represents a cost, but it also boosts the mobilization of physiological energy necessary to perform the action. We hypothesize that these 2 aspects differentially involve dopamine (DA) and noradrenaline (NA). We record single unit activity from 60 NA neurons from locus coeruleus (LC) and 47 DA neurons from substantia nigra pars compacta (SNc) of two rhesus macaques who must produce a given effort (3 force levels) in order to obtain a given reward (3 reward sizes). Force level and reward size are visually cued. Abandon rates increase as reward is lower and as effort is higher, indicating that reward value is discounted by the amount of effort required to obtain it. Both NA and DA neurons show a significant increase (p<.01) in firing rates 100-400 ms after cue onset (DA: n=38/47, 83%; NA: n=50/60, 85%) and -100-400 ms around effort onset (DA: n=34/47, 74%; NA: n=47/60, 80%). Cue-response is positively modulated by expected reward in both populations (DA: 24%, n=11/47, NA: 20%, n=12/60. Population-level analyses reveal a correlation between action value and cue-response in DA neurons (r=.15, p<.01), but not in NA neurons. Conversely, during the action itself, we found that response magnitudes of NA neurons positively correlate with the amount of exerted force (r=.17, p<.01) and with pupil dilation (r=.13, p<.01), while DA neurons do not. We conclude that NA and DA neurons share many similarities in reward and effort encoding, but the extent to which our experimental factors affect such activities differs: DA neurons are more sensitive to reward and action value, whereas NA neurons are more sensitive to effort. Keywords: Dopamine, Electrophysiology, Motivation, noradrenaline, effort, non-human primates Conference: XII International Conference on Cognitive Neuroscience (ICON-XII), Brisbane, Queensland, Australia, 27 Jul - 31 Jul, 2014. Presentation Type: Poster Topic: Cognition and Executive Processes Citation: Varazzani C, San-Galli A and Bouret S (2015). Noradrenaline and dopamine neurons integrate reward value and effort cost: a direct electrophysiological comparison in behaving monkeys. Conference Abstract: XII International Conference on Cognitive Neuroscience (ICON-XII). doi: 10.3389/conf.fnhum.2015.217.00382 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 19 Feb 2015; Published Online: 24 Apr 2015. * Correspondence: Mrs. Chiara Varazzani, ICM - Brain & Spine Institute, Paris, France, chiaravara@gmail.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Chiara Varazzani Aurore San-Galli Sebatien Bouret Google Chiara Varazzani Aurore San-Galli Sebatien Bouret Google Scholar Chiara Varazzani Aurore San-Galli Sebatien Bouret PubMed Chiara Varazzani Aurore San-Galli Sebatien Bouret Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Spine surgery training: is it time to consider categorical spine surgery residency?

Spine surgery training: is it time to consider categorical spine surgery residency? Alan H. Daniels, MD*, Christopher P. Ames, MD, Steven R. Garfin, MD, Christopher I. Shaffrey, MD, K. Daniel Riew, MD, Justin S. Smith, MD, PhD, Paul A. Anderson, MD, Robert A. Hart, MD Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, 2 Dudley Street. Providence, RI 02905, USA Department of Neurological Surgery, University of California San Francisco, 505 Parnassus Ave., Rm. M779, San Francisco, CA 94143, USA Department of Orthopaedic Surgery, University of California San Diego, Perlman Ambulatory Care Center, 9350 Campus Point Drive, La Jolla, CA 92037, USA Department of Neurological Surgery, University of Virginia, P.O. Box 800386, Charlottesville, VA, 22908, USA Department of Orthopaedic Surgery, Washington University, Cervical Spine Institute. 4921 Parkview Place, A12, St. Louis, MO 63110, USA Department of Orthopaedic Surgery, University of Wisconsin, 1685 Highland Ave., UWMFCB – 6215, Madison, WI 53705, USA Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, USA

Bruno Dubois: transforming the diagnosis of Alzheimer's disease

541 It’s not uncommon to fi nd that medicine runs in families, but in the case of Bruno Dubois the association is a little more extreme. From his father all the way back for fi ve generations, the Dubois family has been associated with medicine. Even more incredibly, each generation has cultivated an interest in the relationship between the brain and behaviour. His great-great-great-grandfather kept up a correspondence with one of the fathers of modern neurology, Duchenne de Boulogne, while his grandfather was trained by Joseph Babinski at the Pitie-Salpetriere Hospital in Paris, France, where Dubois and his father both trained, and where Dubois now leads a team at the Brain and Spine Institute (ICM). Far from being boastful when it comes to his rich neurological pedigree, Dubois rather shies away from talking about his family. He’s far more comfortable, and instantly engaging, when he’s talking about the work of his Cognition, Neuroimaging, and Brain Diseases team at the ICM. The team grew at the interface between the departments of neuropsychology and neurochemistry, which were led by Dubois’ two great mentors, Francois Lhermitte and Yves Agid, respectively, with the aim to further our understanding of the role of the frontal lobes in the organisation of the systems that underpin cognition. And what happens when those systems go wrong? Naturally, neurodegenerative diseases are a major focus of the team’s research and of Dubois’ clinical work, and eagle-eyed readers of The Lancet Neurology will probably already have recognised Dubois as an author of several seminal papers that have changed the way Alzheimer’s disease is conceptualised.

Commentary: Morris-Coole/Epilepsia prize.

Commentary: Morris-Coole/Epilepsia prize.

Correction: New Findings in a Global Approach to Dissect the Whole Phenotype of PLA2G6 Gene Mutations

There were errors in the Funding section. The correct funding information is as follows: MAS and co-authors are thankful to the Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia, for supporting the work through the research group project number RGP-VPP-301. RC was supported by the Gebert Ruf Foundation (grant number GRS-046/09). GS was supported by the French National Agency for Research(ANR), Association Contre les Syndromes Cerebelleux, France, The Verum Foundation, the European Union (Omics call, Neuromics), The Fondation Roger de Spoelberch and the program Investissements d'avenir ANR-10-IAIHU-06 (to the Brain and Spine Institute). HA was supported by Association Francaise contre les Myopathies (AFM), France. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Evaluation of Spinal Alignment

Dr. Kuntz is Professor and Vice Chairman, Department of Neurosurgery, University of Cincinnati College of Medicine, Mayfield Clinic & Spine Institute, 222 Piedmont Ave, Ste 3100, Cincinnati, OH 45219; E-mail: [email protected]. All faculty and staff in a position to control the content of this CME activity have disclosed that they and their spouses/life partners (if any) have no financial relationships with, or financial interests in, any commercial organizations related to this CME activity. Category: Spine Lippincott Continuing Medical Education Institute, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc. designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation on the enclosed form, answering at least 70% of the quiz questions correctly. This activity expires on July 30, 2014.

Detailed analysis of the clinical effects of cell therapy for thoracolumbar spinal cord injury: an original study

Detailed analysis of the clinical effects of cell therapy for thoracolumbar spinal cord injury: an original study Alok Sharma,1 Nandini Gokulchandran,1 Hemangi Sane,2 Prerna Badhe,1 Pooja Kulkarni,2 Mamta Lohia,3 Anjana Nagrajan,3 Nancy Thomas3 1Department of Medical Services and Clinical Research, 2Department of Research and Development, 3Department of Neurorehabilitation, NeuroGen Brain and Spine Institute, Surana Sethia Hospital and Research Centre, Chembur, Mumbai, India Background: Cell therapy is amongst the most promising treatment strategies in spinal cord injury (SCI) because it focuses on repair. There are many published animal studies and a few human trials showing remarkable results with various cell types. The level of SCI determines whether paraplegia or quadriplegia is present, and greatly influences recovery. The purpose of this study was to determine the significance of the clinical effects and long-term safety of intrathecal administration of autologous bone marrow-derived mononuclear cells, along with changes in functional independence and quality of life in patients with thoracolumbar SCI. Methods: We undertook a retrospective analysis of a clinical study in which a nonrandomized sample of 110 patients with thoracolumbar SCI underwent autologous bone marrow-derived mononuclear cell transplantation intrathecally and subsequent neurorehabilitation, with a mean follow-up of 2 years &plusmn; 1 month. Changes on any parameters were recorded at follow-up. The data were analyzed using the Wilcoxon&#39;s signed-rank test and McNemar&#39;s test. Functional Independence Measure and American Spinal Injury Association (ASIA) scores were recorded, and a detailed neurological assessment was performed. Results: Overall improvement was seen in 91% of patients, including reduction in spasticity, partial sensory recovery, and improvement in trunk control, postural hypotension, bladder management, mobility, activities of daily living, and functional independence. A significant association of these symptomatic improvements with the cell therapy intervention was established by the statistical analysis. Some patients showed a shift on the ASIA scale and changes in electrophysiological studies or functional magnetic resonance imaging. No major side effects were noted. Conclusion: In patients with thoracolumbar SCI, there were statistically significant beneficial effects, both symptomatic and functional, from intrathecal autologous bone marrow-derived mononuclear cell therapy and rehabilitation. This was a safe and viable therapeutic option with no long-term side effects at 2 years. This analytical study is an early documentation of cell therapy, and can be used as a guide to devise larger more refined clinical trials. Keywords: cell therapy, spinal cord injury, autologous, bone marrow-derived mononuclear cells, intrathecal administration

TranS1 VEO system: a novel psoas-sparing device for transpsoas lumbar interbody fusion

Minimally invasive approaches for lumbar interbody fusion have been popularized in recent years. The retroperitoneal transpsoas approach to the lumbar spine is a technique that allows direct lateral access to the intervertebral disc space while mitigating the complications associated with traditional anterior or posterior approaches. However, a common complication of this procedure is iatrogenic injury to the psoas muscle and surrounding nerves, resulting in postsurgical motor and sensory deficits. The TranS1 VEO system (TranS1 Inc, Raleigh, NC, USA) utilizes a novel, minimally invasive transpsoas approach to the lumbar spine that allows direct visualization of the psoas and proximal nerves, potentially minimizing iatrogenic injury risk and resulting clinical morbidity. This paper describes the clinical uses, procedural details, and indications for use of the TranS1 VEO system.

Perianeursymal Cyst Development after Endovascular Treatment of a Ruptured Giant Aneurysm

Journal of NeuroimagingVolume 24, Issue 5 p. 515-517 Case Report Perianeursymal Cyst Development after Endovascular Treatment of a Ruptured Giant Aneurysm Ramesh Grandhi MD, Corresponding Author Ramesh Grandhi MD University of Pittsburgh Medical Center – Neurological Surgery, Pittsburgh, PACorrespondence: Address correspondence to Nathan Zwagerman, University of Pittsburgh Medical Center – Neurological Surgery 200 Lothrop St. B400, Pittsburgh, PA 15213, USA. E-mail: zwagermannt@upmc.edu.Search for more papers by this authorRobert A. Miller MD, Robert A. Miller MD University of Pittsburgh Medical Center – Neurological Surgery, Pittsburgh, PASearch for more papers by this authorNathan T. Zwagerman MD, Corresponding Author Nathan T. Zwagerman MD University of Pittsburgh Medical Center – Neurological Surgery, Pittsburgh, PACorrespondence: Address correspondence to Nathan Zwagerman, University of Pittsburgh Medical Center – Neurological Surgery 200 Lothrop St. B400, Pittsburgh, PA 15213, USA. E-mail: zwagermannt@upmc.edu.Search for more papers by this authorL. Dade Lunsford MD, L. Dade Lunsford MD University of Pittsburgh Medical Center – Neurological Surgery, Pittsburgh, PASearch for more papers by this authorMichael Horowitz MD, Michael Horowitz MD Pennsylvania Brain and Spine Institute, Pittsburgh, PASearch for more papers by this author Ramesh Grandhi MD, Corresponding Author Ramesh Grandhi MD University of Pittsburgh Medical Center – Neurological Surgery, Pittsburgh, PACorrespondence: Address correspondence to Nathan Zwagerman, University of Pittsburgh Medical Center – Neurological Surgery 200 Lothrop St. B400, Pittsburgh, PA 15213, USA. E-mail: zwagermannt@upmc.edu.Search for more papers by this authorRobert A. Miller MD, Robert A. Miller MD University of Pittsburgh Medical Center – Neurological Surgery, Pittsburgh, PASearch for more papers by this authorNathan T. Zwagerman MD, Corresponding Author Nathan T. Zwagerman MD University of Pittsburgh Medical Center – Neurological Surgery, Pittsburgh, PACorrespondence: Address correspondence to Nathan Zwagerman, University of Pittsburgh Medical Center – Neurological Surgery 200 Lothrop St. B400, Pittsburgh, PA 15213, USA. E-mail: zwagermannt@upmc.edu.Search for more papers by this authorL. Dade Lunsford MD, L. Dade Lunsford MD University of Pittsburgh Medical Center – Neurological Surgery, Pittsburgh, PASearch for more papers by this authorMichael Horowitz MD, Michael Horowitz MD Pennsylvania Brain and Spine Institute, Pittsburgh, PASearch for more papers by this author First published: 02 April 2013 https://doi.org/10.1111/jon.12018Citations: 4 Conflict of Interest: None. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume24, Issue5September/October 2014Pages 515-517 RelatedInformation

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AxiaLIF system: minimally invasive device for presacral lumbar interbody spinal fusion

Lumbar fusion is commonly performed to alleviate chronic low back and leg pain secondary to disc degeneration, spondylolisthesis with or without concomitant lumbar spinal stenosis, or chronic lumbar instability. However, the risk of iatrogenic injury during traditional anterior, posterior, and transforaminal open fusion surgery is significant. The axial lumbar interbody fusion (AxiaLIF) system is a minimally invasive fusion device that accesses the lumbar (L4–S1) intervertebral disc spaces via a reproducible presacral approach that avoids critical neurovascular and musculoligamentous structures. Since the AxiaLIF system received marketing clearance from the US Food and Drug Administration in 2004, clinical studies of this device have reported high fusion rates without implant subsidence, significant improvements in pain and function, and low complication rates. This paper describes the design and approach of this lumbar fusion system, details the indications for use, and summarizes the clinical experience with the AxiaLIF system to date.

Failure of Intramedullary Expandable Tibial Nail and Fragmentation During Extraction

55 Failure of Intramedullary Expandable Tibial Nail and Fragmentation During Extraction Bradley C. Daily, M.D., M. Camden Whitaker, M.D., Steven J. Howell, M.D., Teresa L. Jones, M.P.H., M.T.(ASCP), Jeffrey M. Janzen, B.S. Orthopaedic Sports Health Clinic, Salina, KS Department of Surgery, Section of Orthopaedics, University of Kansas School of Medicine–Wichita Kansas Joint and Spine Institute, Wichita, KS Kansas Orthopaedic Center, P.A., Wichita, KS Via Christi Hospitals Wichita, Inc, Wichita, KS