bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidural Hematoma Following Cervical Spine Surgery
Authors: Schroeder Gregory D. , Hilibrand Alan S. , Arnold Paul M. , Fish David E. , Wang Jeffrey C. , Gum Jeffrey L. , Smith Zachary A. , Hsu Wellington K. , Gokaslan Ziya L. , Isaacs Robert E. , Kanter Adam S. , Mroz Thomas E. , Nassr Ahmad , Sasso Rick C. , Fehlings Michael G. , Buser Zorica , Bydon Mohamad , Cha Peter I. , Chatterjee Dhananjay , Gee Erica L. , Lord Elizabeth L. , Mayer Erik N. , McBride Owen J. , Nguyen Emily C. , Roe Allison K. , Tortolani P. Justin , Stroh D. Alex , Yanez Marisa Y. , Riew K. Daniel 
Published: April 2017

Study Design: A multicentered retrospective case series. Objective: To determine the incidence and circumstances surrounding the development of a symptomatic postoperative epidural hematoma in the cervical spine. Methods: Patients who underwent cervical spine surgery between January 1, 2005, and December 31, 2011, at 23 institutions were reviewed, and all patients who developed an epidural hematoma were identified. Results: A total of 16 582 cervical spine surgeries were identified, and 15 patients developed a postoperative epidural hematoma, for a total incidence of 0.090%. Substantial variation between institutions was noted, with 11 sites reporting no epidural hematomas, and 1 site reporting an incidence of 0.76%. All patients initially presented with a neurologic deficit. Nine patients had complete resolution of the neurologic deficit after hematoma evacuation; however 2 of the 3 patients (66%) who had a delay in the diagnosis of the epidural hematoma had residual neurologic deficits compared to only 4 of the 12 patients (33%) who had no delay in the diagnosis or treatment ( P = .53). Additionally, the patients who experienced a postoperative epidural hematoma did not experience any significant improvement in health-related quality-of-life metrics as a result of the index procedure at final follow-up evaluation. Conclusion: This is the largest series to date to analyze the incidence of an epidural hematoma following cervical spine surgery, and this study suggest that an epidural hematoma occurs in approximately 1 out of 1000 cervical spine surgeries. Prompt diagnosis and treatment may improve the chance of making a complete neurologic recovery, but patients who develop this complication do not show improvements in the health-related quality-of-life measurements.
Rare Complications of Cervical Spine Surgery: Pseudomeningocoele
Authors: Ailon Tamir , Smith Justin S. , Nassr Ahmad , Smith Zachary A. , Hsu Wellington K. , Fehlings Michael G. , Fish David E. , Wang Jeffrey C. , Hilibrand Alan S. , Mummaneni Praveen V. , Chou Dean , Sasso Rick C. , Traynelis Vincent C. , Arnold Paul M. , Mroz Thomas E. , Buser Zorica , Lord Elizabeth L. , Massicotte Eric M. , Sebastian Arjun S. , Than Khoi D. , Steinmetz Michael P. , Smith Gabriel A. , Pace Jonathan , Corriveau Mark , Lee Sungho , Riew K. Daniel , Shaffrey Christopher 
Published: April 2017

Study Design: This study was a retrospective, multicenter cohort study. Objectives: Rare complications of cervical spine surgery are inherently difficult to investigate. Pseudomeningocoele (PMC), an abnormal collection of cerebrospinal fluid that communicates with the subarachnoid space, is one such complication. In order to evaluate and better understand the incidence, presentation, treatment, and outcome of PMC following cervical spine surgery, we conducted a multicenter study to pool our collective experience. Methods: This study was a retrospective, multicenter cohort study of patients who underwent cervical spine surgery at any level(s) from C2 to C7, inclusive; were over 18 years of age; and experienced a postoperative PMC. Results: Thirteen patients (0.08%) developed a postoperative PMC, 6 (46.2%) of whom were female. They had an average age of 48.2 years and stayed in hospital a mean of 11.2 days. Three patients were current smokers, 3 previous smokers, 5 had never smoked, and 2 had unknown smoking status. The majority, 10 (76.9%), were associated with posterior surgery, whereas 3 (23.1%) occurred after an anterior procedure. Myelopathy was the most common indication for operations that were complicated by PMC (46%). Seven patients (53%) required a surgical procedure to address the PMC, whereas the remaining 6 were treated conservatively. All PMCs ultimately resolved or were successfully treated with no residual effects. Conclusions: PMC is a rare complication of cervical surgery with an incidence of less than 0.1%. They prolong hospital stay. PMCs occurred more frequently in association with posterior approaches. Approximately half of PMCs required surgery and all ultimately resolved without residual neurologic or other long-term effects.
Carotid Artery Injury in Anterior Cervical Spine Surgery: Multicenter Cohort Study and Literature Review
Authors: Härtl Roger , Alimi Marjan , Abdelatif Boukebir Mohamed , Berlin Connor D. , Navarro-Ramirez Rodrigo , Arnold Paul M. , Fehlings Michael G. , Mroz Thomas E. , Riew K. Daniel 
Published: April 2017

Study Design: Retrospective study and literature review. Objective: To provide more comprehensive data about carotid artery injury (CAI) or cerebrovascular accident (CVA) related to anterior cervical spine surgery. Methods: We conducted a retrospective, multicenter, case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network. Medical records of 17 625 patients who went through cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, were analyzed. Also, we performed a literature review using Medline and PubMed databases. The following terms were used alone, and in combination, to search for relevant articles: cervical, spine, surgery, complication, iatrogenic, carotid artery, injury, cerebrovascular accident, CVA, and carotid stenosis. Results: Among 17 625 patients that were analyzed, no cases were reported to experienced CAI or CVA after cervical spine surgery. Nevertheless, in our PubMed search we found 157 articles, but only 5 articles matched our study objective criteria; 2 cases were reported to present CAI and 3 cases presented CVA. Conclusions: CAI and CVA related to anterior cervical spine surgeries are extremely rare. We were not able to find neither in our retrospective study nor in our literature research a correlation between the type or length of anterior cervical spine procedure with CVA or CAI complications. However, surgeons should be aware of the possibility of vascular complications and minimize intraoperative direct vascular manipulations or retraction. Preoperative screening for underlying vascular pathology and risk factors is also important.
Thoracic Duct Injury Following Cervical Spine Surgery: A Multicenter Retrospective Review
Authors: Derakhshan Adeeb , Lubelski Daniel , Steinmetz Michael P. , Corriveau Mark , Lee Sungho , Pace Jonathan R. , Smith Gabriel A. , Gokaslan Ziya , Bydon Mohamad , Arnold Paul M. , Fehlings Michael G. , Riew K. Daniel , Mroz Thomas E. 
Published: April 2017

Study Design: Multicenter retrospective case series. Objective: To determine the rate of thoracic duct injury during cervical spine operations. Methods: A retrospective case series study was conducted among 21 high-volume surgical centers to identify instances of thoracic duct injury during anterior cervical spine surgery. Staff at each center abstracted data for each identified case into case report forms. All case report forms were collected by the AOSpine North America Clinical Research Network Methodological Core for data processing, cleaning, and analysis. Results: Of a total of 9591 patients reviewed that underwent cervical spine surgery, 2 (0.02%) incurred iatrogenic injury to the thoracic duct. Both patients underwent a left-sided anterior cervical discectomy and fusion. The interruption of the thoracic duct was addressed intraoperatively in one patient with no residual postoperative effects. The second individual developed a chylous fluid collection approximately 2 months after the operation that required drainage via needle aspiration. Conclusions: Damage to the thoracic duct during cervical spine surgery is a relatively rare occurrence. Rapid identification of the disruption of this lymphatic vessel is critical to minimize deleterious effects of this complication.
Evaluation of Adverse Events in Total Disc Replacement: A Meta-Analysis of FDA Summary of Safety and Effectiveness Data
Authors: Anderson Paul A. , Nassr Ahmad , Currier Bradford L. , Sebastian Arjun S. , Arnold Paul M. , Fehlings Michael G. , Mroz Thomas E. , Riew K. Daniel 
Published: April 2017

Study Design: Systematic review and meta-analysis. Objectives: The safety of new technology such as cervical total disc replacement (TDR) is of paramount importance and is best evaluated in randomized clinical trials (RCT). We compared complication risks of TDR to fusion using data from Investigational Device Exemptions. Methods: A systematic review of FDA Summary of Safety and Effectiveness reports of the 8 approved cervical TDRs was performed. These were all randomized controlled trials comparing anterior cervical discectomy and fusion (ACDF) to TDR. Important outcome variables were dysphagia, wound infection, neurologic injuries, heterotopic ossification, death, and secondary surgeries. A random effects model was selected a priori. Data on adverse events was abstracted and analyzed by calculating relative risk of ACDF to TDR by meta-analysis techniques. Results: The study included 3027 patients with 1377 randomized to ACDF and 1652 to TDR. No statistical differences were present between the 2 groups in dysphagia/dysphonia, hardware related, heterotopic ossification, death, and overall neurologic adverse events and incidence of neurologic deterioration. The relative risk of wound-related problems ACDF to TDR was 0.76 (95% confidence interval [CI] = 0.59, 0.98) favoring ACDF, which was statistically significant, but these were minor and never required a second surgical procedure for deep wound infection. The relative risk of ACDF to TDR in surgical-related neurologic events and secondary surgeries was 1.62 (95% CI = 1.04, 2.53) and 1.79 (95% CI = 1.17, 2.74), both favoring TDR. Conclusions: Cervical TDR appears to be as safe as or safer than ACDF at 2-year follow-up.
Perioperative Vision Loss in Cervical Spinal Surgery
Authors: Gabel Brandon C. , Lam Arthur , Chapman Jens R. , Oskouian Rod J. , Nassr Ahmad , Currier Bradford L. , Sebastian Arjun S. , Arnold Paul M. , Hamilton Steven R. , Fehlings Michael G. , Mroz Thomas E. , Riew K. Daniel 
Published: April 2017

Study Design: Retrospective multicenter case series. Objective: To assess the rate of perioperative vision loss following cervical spinal surgery. Methods: Medical records for 17 625 patients from 21 high-volume surgical centers from the AOSpine North America Clinical Research Network who received cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, inclusive, were reviewed to identify occurrences of vision loss following surgery. Results: Of the 17 625 patients in the registry, there were 13 946 patients assessed for the complication of blindness. There were 9591 cases that involved only anterior surgical approaches; the remaining 4355 cases were posterior and/or circumferential fusions. There were no cases of blindness or vision loss in the postoperative period reported during the sampling period. Conclusions: Perioperative vision loss following cervical spinal surgery is exceedingly rare.
Generalized Joint Hypermobility Is Predictive of Hip Capsular Thickness
Authors: Devitt Brian M. , Smith Bjorn N. , Stapf Robert , Tacey Mark , O’Donnell John M. 
Published: April 2017

Background: The pathomechanics of hip microinstability are not clearly defined but are thought to involve anatomical abnormalities, repetitive forces across the hip, and ligamentous laxity. Purpose/Hypothesis: The purpose of this study was to explore the relationship between generalized joint hypermobility (GJH) and hip capsular thickness. The hypothesis was that GJH would be predictive of a thin hip capsule. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A prospective study was performed on 100 consecutive patients undergoing primary hip arthroscopy for the treatment of hip pain. A Beighton test score (BTS) was obtained prior to each procedure. The maximum score was 9, and a score of ≥4 was defined as hypermobile. Capsular thickness at the level of the anterior portal, corresponding to the location of the iliofemoral ligament, was measured arthroscopically using a calibrated probe. The presence of ligamentum teres (LT) pathology was also recorded. Results: Fifty-five women and 45 men were included in the study. The mean age was 32 years (range, 18-45 years). The median hip capsule thickness was statistically greater in men than women (12.5 and 7.5 mm, respectively). The median BTS for men was 1 compared with 4 for women ( P < .001). A statistically significant association was found between BTS and capsular thickness; a BTS of <4 is strongly predictive of having a capsular thickness of ≥10 mm, while a BTS ≥4 correlates with a capsular thickness of <10 mm. There was a statistically greater incidence of LT tears in patients with a capsular thickness of ≤7.5 mm and a BTS of ≥4 ( P < .001). Conclusion: Measurement of the GJH is highly predictive of hip capsular thickness. A BTS of <4 correlates significantly with a capsular thickness of ≥10 mm, while a BTS ≥4 correlates significantly with a thickness of <10 mm.
GISCOME – Genetics of Ischaemic Stroke Functional Outcome network: A protocol for an international multicentre genetic association study
Authors: Maguire Jane M , Bevan Steve , Stanne Tara M , Lorenzen Erik , Fernandez-Cadenas Israel , Hankey Graeme J , Jimenez-Conde Jordi , Jood Katarina , Lee Jin-Moo , Lemmens Robin , Levi Christopher , Norrving Bo , Rannikmae Kristiina , Rost Natalia , Rosand Jonathan , Rothwell Peter M , Scott Rodney , Strbian Daniel , Sturm Jonathan , Sudlow Cathie , Traylor Matthew , Thijs Vincent , Tatlisumak Turgut , Wieloch Tadeusz , Woo Daniel , Worrall Bradford B , Jern Christina , Lindgren Arne 
Published: April 2017

Introduction Genome-wide association studies have identified several novel genetic loci associated with stroke risk, but how genetic factors influence stroke outcome is less studied. The Genetics of Ischaemic Stroke Functional outcome network aims at performing genetic studies of stroke outcome. We here describe the study protocol and methods basis of Genetics of Ischaemic Stroke Functional outcome. Methods The Genetics of Ischaemic Stroke Functional outcome network has assembled patients from 12 ischaemic stroke projects with genome-wide genotypic and outcome data from the International Stroke Genetics Consortium and the National Institute of Neurological Diseases Stroke Genetics Network initiatives. We have assessed the availability of baseline variables, outcome metrics and time-points for collection of outcome data. Results We have collected 8831 ischaemic stroke cases with genotypic and outcome data. Modified Rankin score was the outcome metric most readily available. We detected heterogeneity between cohorts for age and initial stroke severity (according to the NIH Stroke Scale), and will take this into account in analyses. We intend to conduct a first phase genome-wide association outcome study on ischaemic stroke cases with data on initial stroke severity and modified Rankin score within 60–190 days. To date, we have assembled 5762 such cases and are currently seeking additional cases meeting these criteria for second phase analyses. Conclusion Genetics of Ischaemic Stroke Functional outcome is a unique collection of ischaemic stroke cases with detailed genetic and outcome data providing an opportunity for discovery of genetic loci influencing functional outcome. Genetics of Ischaemic Stroke Functional outcome will serve as an exploratory study where the results as well as the methodological observations will provide a basis for future studies on functional outcome. Genetics of Ischaemic Stroke Functional outcome can also be used for candidate gene replication or assessing stroke outcome non-genetic association hypotheses.
Progressive Massive Choroidal Neovascularization
Authors: Cheung Albert Y. , Rao Prethy , Yonekawa Yoshihiro , Thomas Benjamin J. , Shah Aparna , Garretson Bruce R. , Capone Antonio , Hassan Tarek S. 
Published: April 2017

Purpose: A small subset of patients with neovascular age-related macular degeneration (AMD) can have relentless progression of choroidal neovascularization (CNV) and subsequent disciform scarring (DS) with extension beyond the vascular arcades to the equator. We present the clinical courses of this severe phenotype of progressive massive CNV (PM-CNV). Methods: Retrospective case series of 14 eyes of 8 patients who presented with (1) massive DS encompassing the posterior pole and extending to the equator and (2) progressive DS expansion despite treatment between 2004 and 2015 at a tertiary referral center. Demographics, clinical and ocular characteristics, fluorescein angiographic findings, and treatment regimens were reviewed. Results: Baseline characteristics included a mean age of 73.0 years (range, 65.- 86.9 years) with 7 (87.5%) women. Six (75%) patients had bilateral PM-CNV. Mean follow-up was 10.5 years (range, 0.5-18.2 years). Ten (71.4%) eyes underwent intravitreal anti-vascular endothelial growth factor therapy, 3 (21.4%) intravitreal corticosteroid injections, and 3 photodynamic therapy. Most eyes (92.9%) demonstrated subretinal hemorrhage at the edge of the DS prior to DS expansion during treatment. Of the 6 patients with bilateral PM-CNV, 5 developed DS in 1 eye earlier than the subsequent eye (mean time, 63.6 months). Final visual acuity was ≤20/400 in all eyes (20/400 [n = 1]), count fingers (n = 5), hand motions (n = 5), and no light perception (n = 3). Conclusion: Progressive massive CNV is a profound reactivation of DS in some AMD eyes and is associated with severe, often bilateral, vision loss.
Calcium phosphates and silicon: exploring methods of incorporation
Authors: Rodrigues Ana I. , Reis Rui L. , van Blitterswijk Clemens A. , Leonor Isabel B. , Habibović Pamela 
Published: April 2017

Abstract

Background
Bioinorganics have been explored as additives to ceramic bone graft substitutes with the aim to improve their performance in repair and regeneration of large bone defects. Silicon (Si), an essential trace element involved in the processes related to bone formation and remodeling, was shown not only to enhance osteoblasts proliferation but also to stimulate the differentiation of mesenchymal stem cells (MSCs) and preosteoblasts into the osteogenic lineage. In this study, the added value of Si to calcium phosphate (CaP) coatings was evaluated.

Methods
Tissue culture plastic well plates were coated with a thin CaP layer to which traces amounts of Si were added, either by adsorption or by incorporation through coprecipitation. The physicochemical and structural properties of the coatings were characterized and the dissolution behavior was evaluated. The adsorption/incorporation of Si was successfully achieved and incorporated ions were released from the CaP coatings. Human MSCs were cultured on the coatings to examine the effects of Si on cell proliferation and osteogenic differentiation. For the statistical analysis, a one-way ANOVA with Bonferroni post-hoc test was performed.

Results
The results showed that human MSCs ﻿(hMSCs)﻿ responded to the presence of Si in the CaP coatings, in a dose-dependent manner. An increase in the expression of markers of osteogenic differentiation by human MSCs was observed as a result of the increase in Si concentration.

Conclusions
The incorporation/adsorption of Si into CaP coatings was successfully achieved and hMSCs responded with an increase in osteogenic genes expression with the increase of Si concentration. Furthermore, hMSCs cultured on CaP-I coatings expressed higher levels of ALP and OP, indicating that this may be the preferred method of incorporation of bioinorganics into CaPs.
Gestational Diabetes Alters Functions in Offspring’s Umbilical Cord Cells With Implications for Cardiovascular Health
Authors: Amrithraj Ajith Isaac , Kodali Anjaneyulu , Nguyen Linh , Teo Adrian Kee Keong , Chang Cheng Wei , Karnani Neerja , Ng Kai Lyn , Gluckman Peter D. , Chong Yap Seng , Stünkel Walter 
Published: April 2017

Abstract
Because noncommunicable diseases such as type 2 diabetes mellitus have their roots in prenatal development and conditions such as maternal gestational diabetes mellitus (GDM), we aimed to test this hypothesis in primary cells derived from the offspring of mothers with GDM compared with control subjects. We have assessed primary umbilical cord–derived cells such as human umbilical vein endothelial cells (HUVECs) and Wharton’s jelly–derived mesenchymal stem cells from the offspring of mothers with and without GDM. We have compared the primary isolates in cell-based assays measuring proliferation, mitochondrial oxygen consumption, and the ability to support blood vessel growth. We conducted gene expression microarray studies with subsequent pathway analysis and candidate gene validation. We observed striking differences between the two groups, such as lower metabolic rates and impairment of endothelial tube formation in cells with GDM background. HUVECs from subjects with maternal GDM have lower expression of the antiapoptotic protein BCL-xL, suggesting compromised angiogenic capabilities. Comparative gene expression analysis revealed blood vessel formation as a major pathway enriched in the GDM-derived HUVECs with the surface marker CD44 as a gene underexpressed in the GDM group. Functional validation of CD44 revealed that it regulates tube formation in HUVECs, thereby providing insights into a pathway imprinted in primary umbilical cord–derived cells from GDM offspring. Our data demonstrate that primary cells isolated from the umbilical cord of offspring born to mothers with GDM maintain metabolic and molecular imprints of maternal hyperglycemia, reflecting an increased risk for cardiovascular disease later in life.