bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of “Burst” Fractures of Dorsal and Lumbar Spine, with Circumferential Arthrodesis and Only Single Posterior Approach
Authors: Viola Aldo , Melo Marcelo , Ferrero Andres , Rodriguez Juan , Pearson Lucas 
Published: May 2015

Introduction This work is a retrospective analysis of our experience, from 2004 to date in the treatment of “Burst” type fractures of the dorsal and lumbar spine, with or without involvement of the spinal canal, posterior column injury, and/or neurological injury. Patients and Methods A total of 20 cases of types A2, A3, A4, and B fractures were retrospectively evaluated, with or without involvement of the spinal canal, posterior column injury, and/or neurological injury, the minimum follow-up was 1 year. All patients were treated only by posterior approach with anterior contribution (interbody autologous anterior strut bone and mesh cell type) and pedicle screws, one level above and one level below the injury. Results All patients had a satisfactory clinical result, with a free spinal channel, without added neurological injury. Conclusion We intend to show that it is a safe treatment, saving fusion levels, and reproducible results.
Radiological Results of Treatment of Thoracolumbar Fractures with Bony Failure of the Posterior Tension Band by Percutaneous Pedicle Fixation
Authors: Valencia Manuel , Leiva Andres , Riera Jose Antonio , Thibaut Carlos , Novoa Felipe , Bravo Oscar 
Published: May 2015

Introduction Currently, we have multiple options for surgical treatment of thoracolumbar fractures. Among these, percutaneous pedicle fixation raises several advantages, particularly in terms of reduced soft tissue injury and the ability to recover motion segments in cases with consolidation potential as type B1 and some type B2 fractures. Our objective is to analyze the radiological results of treatment of these fractures by percutaneous pedicle fixation and the preservation of motion segments after implant removal. Patients and Methods Prospective, observational, and descriptive study of radiological follow-up case series of patients with thoracolumbar spine fractures with bony failure of the posterior tension band and without neurological involvement treated by percutaneous pedicle fixation surgery. Radiological results were evaluated by measurement of preoperative regional kyphosis, correction achieved, correction preservation, bone healing, and recovery of mobile segments post removal of fixation. For statistical analysis, the Student t test for paired samples was used. Results A total of 13 patients, 12 men and 1 woman, with a mean age of 40 years. Overall, five type B1 and eight type B2 fractures between T9 and L2. Fixation for two levels was performed in all of them. An average correction of 8 degrees ( p = 0.0036), reaching normal levels in 10 patients was achieved. At 6 months' follow-up, loss of correction was observed in all patients. The average loss was 7 degrees ( p = 0.0021), a regional kyphosis remained within the normal range in eight patients. Consolidation was observed at 8 months' follow-up in all the patients. Material removal was performed in seven patients. Of these, five had a preservation of mobility within normal ranges. No intra- or postoperative complications occurred. Overall, two patients had partial loosening of the fixation system. Conclusion Percutaneous pedicle fixation presents an effective alternative in treating thoracolumbar fractures with the bony failure of posterior tension band with consolidation potential. The results in our experience are comparable to those described for both minimally invasive and traditional techniques. The possibility of removal of material for preserving mobile levels presents an important advantage compared with techniques involving fusion.
Combination of Upper Thoracic Fracture and Sternum Fracture
Authors: Bazan Pedro , Betemps Alejandro , Ciccioli Nicolas , Borri Alvaro , Medina Marin 
Published: May 2015

Introduction The upper thoracic spine differs from other regions of the spine for extra stability given by the complex rib sternum. Isolated fractures of the sternum are considered harmless. The association between sternum and spine fracture was first described by Fowler and more recently by Park. This association may increase the instability of the spinal injury. The objectives of this presentation are as follows: (1) analyze the kinematics causing this association; (2) describe the impact of the injury; (3) and evaluate the treatment performed. Patients and Methods Four cases are analyzed, quantifying displacement, and angulation of the sternum, and the characteristics of the spinal injury and deformity. Results Most of vertebral lesions were classified as type A, the most affected region was T5 and T10. Three patients with neurological symptoms ASIA E. The majority of the sternum injuries were caused by direct trauma. Conclusion The association of sternum and spine fracture was seen in patients who had suffered high-energy trauma during a car accident. We found no relationship between the angulation of the sternum and its translation to the degree of kyphosis in the thoracic spine. It is important to do good radiographic studies involving the sternum to suspect this relationship.
Incomplete Neurological Injury Secondary to High Energy Asia B L3L4 Fracture Dislocation by Trauma in the Lumbar Region: A Case Report
Authors: Caldera Gustavo 
Published: May 2015

Introduction In fracture dislocations of the lumbar region, two anatomical facts can help patients preserve neurological damage in comparison less trauma to the cervical or thoracic region. First place in adults, the spinal cord extends only to the level of the lower border of the first lumbar vertebra, second, the vertebral hole large in this region gives ample space to the roots of the cauda equina, so both nerve injury may be minimal in this region because in this area are housed nerve roots with great space, less content, and more continent. Patients and Methods We present the case of a 48-year-old male, construction worker, who suffered a fall from a height of approximately 15 m beating directly on the lumbar region against a beam, presenting pain and inability to move the legs, brought to the emergency room 1 hour after the accident, is assessed clinically, X-rays and CT scan are taken, and diagnosed as L3–L4 fracture dislocation with ASIA B. The patient was surgically intervened 3 hours after the accident with reduction via posterior transpedicular fixation. One week later anterior approach was performed with intersomatic vertebral cage. Results The patient progressed to ASIA C 24 hours after the first surgery. Three months later, he became a functional patient with ASIA D and control of sphincters. Conclusion The author's purpose is to show the results obtained by an intervention in the early hours of the trauma which helped promote a nonfunctional injury to a functional lesion, and almost total recovery.
A Model of Metastatic Bone Cancer Pain in the Lumbar Spine
Authors: Sarabia-Estrada Rachel , Goodwin C. Rory , Ruiz-Valls Alejandro , L Gokaslan Ziya , Sciubba Daniel M 
Published: May 2015

Introduction Bone is the third most common site for metastasis representing a poor prognosis in patients with cancer. Metastases to the spine are a common source of pain. Its secondary effects such as fractures, hypercalcemia, and neurological deficits significantly reduce patient's quality of life. Microfractures occur in metastatic regions of cancerous bone that can no longer handle ordinary loading, causing deformation of the spine and impingement of nerves. As the disease progresses, pain severity increases and it becomes more difficult to treat, causing further decrease in the quality of life of the patients. A key obstacle in the study of this disease is the lack of reliable, practical, and reproducible animal models to study spine metastatic pain. Materials and Methods Behavioral evaluation was conducted in a group of 30 athymic rats: 10 tumor-implanted (human mammary adenocarcinoma, L5 vertebral body); 10 sham (surgery performed, no tumor implanted), and 10 control rats (nontumor or surgery). Randall–Selitto and pincher tests were used to evaluate the nociceptive response in rats. Tumor growth was monitored by bioluminescent imaging (BLI) and CT. Results The mechanic nociceptive response was significantly reduced (day 45) in time and pressure applied in tumor rats compared with control or sham; a slight nonsignificant reduction was observed in the paw withdrawal in tumor-implanted rats. BLI revealed severe tumor invasion in the lower spine that was qualitatively related with lytic lesions in two or three vertebral bodies. These lesions were characterized by a decrease in the density of the bone in lumbar spine consistent with tumor location on bioluminescence. There was near-complete ablation of the posterior elements of the spine. Locomotion gait analysis showed a disruption in the normal pattern of the rat's gait. Conclusions Our intraspinal metastatic tumor model animals showed locomotor and sensory signs that are in accordance with some of the clinical manifestations in humans. These signs included a locomotor deficit and an increase in noxious sensation. Our model offers a reliable method to evaluate alternative approaches to treat pain in patients with metastatic spine disease.
Effects of Spinal Blocks in Patients with Chronic Sciatica
Authors: Reyes Luis , Davila Victor , Morillo Olga 
Published: May 2015

Introduction The pain interventionism is the fourth step in the pharmacological treatment of back pain, being used longer than the spinal blocks. The purpose of this study is to evaluate the effects of spinal blockade in patients with chronic sciatica. Patients and Methods A total of 29 patients with chronic sciatica spine surgery unit of the University Hospital “Dr. Manuel Nunez Tovar” were evaluated by identifying the degree of pain and functional disability by visual analog scale (VAS) and Oswestry Disability Index (ODI), underwent spinal block procedure, according to the affected level and subsequently performed feedbacks to the first and fourth week. Results The mean VAS score was 8.59 at baseline and 5.21 and 4.72 for the first and fourth week, showing an improvement in the perception of moderate-to-severe pain. The ODI was 56.21% at start and 39.45% and 32.38% at the first and fourth week, obtaining a reduction of severe functional disability to moderate. The patient's history was not a determining factor in the perception of pain and functional capacity. No evidence of significant statistical relationships between the results of the VAS and ODI application type, number of injection, and corticosteroid use were observed. Conclusion Spinal blocks are an effective method per se for the management of chronic low back pain with radicular commitment and its effects are not altered by the type of corticosteroid, number, and type of injection.
Major Vertebral Resections (Vertebrectomy) and Reconstruction with Massive Allografts: A Review of 13 Cases (Follow-Up: From 3 to 16 Years)
Authors: Luzzati Alessandro , Perrucchini Giuseppe , Scotto Gennaro , Mauri Orietta 
Published: May 2015

Introduction Spine surgery allografts show a lower fusion rate than autografts in posterior arthrodesis, but they demonstrated their full effect in reconstructions of the anterior column, probably for biomechanical reasons (load compression forces on the graft). Patients and Methods We report our experience in 13 patients affected by spine tumors and treated with total vertebrectomy (12 patients one level, 2 patients two levels, and 1 patient three levels) and reconstruction with massive bone bank graft (femoral diaphysis rings) filled in 2 cases with acrylic cement and in 12 cases with fresh iliac autografts. The demographic was five metastasis, three hemangioendotheliomas, one chordoma, two germ cell tumors, and one multiple endocrine neoplasia. The follow-up ranges from 192 to 36 months, with a mean of 97, the mean age 49 years, the levels treated from D1 to L5, the length of the vertebral resection ranges from 30 to 75 mm. All patients were monitored with X-ray standard at 3, 6, 9, and 12 months after surgery, spiral CT, and standard X-rays on an annual basis from the first year. Results X-ray revealed excellent stability with complete interbody fusion in all patients after 12 to 15 months from surgery. We have found lines of radiolucency in 15% of patients at the proximal and distal screws but without any associated clinical sign. Discussion Although the small series, the mean follow-up of 8.1 years allows us to say that this technique could be useful in clinical treatment of complex diseases of the spine where a circumferential reconstruction is required, achieving to a final, complete, and stable interbody fusion.
Evolution and Analysis of 445 Cases of Lumbar Discal Hernia Treated with Hemilaminoforaminotomy and Discectomy
Authors: Gardea Loera Gilberto 
Published: May 2015

Introduction The purpose of this study is to show the good results, we can obtain by making hemilaminectomy with foraminotomy and discectomy for herniated lumbar disc disease. Lumbar disc disease is a common affliction. Surgical intervention provides excellent results in carefully selected patients. Discectomy with hemilaminoforaminotomy through a small incision with surgery loupes or microscope permits an accurate decompression of the root with results from good to excellent. Methods The surgical records of 445 patients, who underwent surgical intervention for herniated lumbar disc disease in an 18.5-year period between March 1996 and September 2014, were checked. A total 202 were women and 243 men. The range age was 14 to 83 years with an average of 48.5 years. All the patients had root pain in a dermatome pattern because of herniated lumbar disc disease with or without foramen stenosis and they were evaluated with imaging studies as: MRI and some of them with CT. Patients older than 60 years (128 patients) had foramen stenosis and they had the same procedure. They were treated with hemilaminoforaminotomy and discectomy through a small incision: 236 patients were operated on one level, 169 were operated on two levels and the other 40 patients were underwent more than two levels. The outcome results were collected at a range from 2 months to 18 years. Over 293 patients have a 10-year follow-up. The procedure was hemilaminectomy with foraminotomy and discectomy using microscope or surgery loupes. Hospitalization was from 12 to 24 hours. Results The results were defined according to Macnab scale as excellent 84, good 10, regular 4, and poor 2% (Fig. 1). Conclusion The results of these series indicate that most patients do well after hemilaminoforaminotomy with discectomy and root decompression. It is safe and it does not have destabilization risk. With this procedure, the outcomes are from good to excellent, although the patients had to be well selected by examination and radiological findings. This kind of minimal invasion surgery allows patients to have a fast recovery with low cost, it enables a quick reincorporate to work and esthetically pleasant.
Our Experiences in Complications in Spinal Disk Herniation Surgery
Authors: Giménez Carlos , Laconich Diego , Ucedo Oscar , Marin Elio 
Published: May 2015

Introduction In the teaching hospital of the National University of Asuncion, approximately 85% of patients presenting to the query in the neurosurgery service, do so for back pain radiating to the lower limbs. In the time period spanning from January 2013 to September 2014, 43 were operated herniated discs. We discuss our experience on postoperative complications. Material and Methods This study is an observational retrospective study. We used the medical records registered in the office of Neurosurgery Hospital of Clinics of the National University of Asuncion and records of surgical techniques in patients undergoing herniated discs from January 2013 to September 2014. Excel is a form of USU to record data. The variables observed were satisfactory or postsurgical evolution, age, sex, and job occupation. Results Of the 43 patients operated, we had the following six complications: two infections of surgical wounds, an error of level, two reherniation, and one seroma. These complications occurred in five of 43 patients, 11.6% of them. Conclusion We conclude that our rate of complication is not low considering the number of patients operated. We had infection in 4.6%, error of level in 2.3%, rehernation in 4.6%, and seroma in 2.3%. We had complications whose origin could have been avoided as infections in which we find the probably fault in the line of asepsis during surgery and in the postoperative care.
Aseptic Spondylodiscitis after Lumbar Discectomy: Case Report and Literature Review
Authors: Molina Marcelo , Delgado Matias , Campos Mauricio , Román Javier 
Published: May 2015

Introduction Aseptic inflammatory changes in the vertebral bone marrow, end plates and intervertebral discs have been described as part of different entities such as Modic changes (MCs). MCs are classified in three types according to the formation of vascularized fibrous, fatty, or cicatricial bone tissue. Radiologically, each type is distinguished by particular magnetic resonance imaging (MRI) findings. MCs can be seen as part of normal spinal degeneration or secondary to spine surgical procedures such as lumbar discectomy. Even though their prevalence varies between studies, in clinical practice they generally are infrequent radiological findings. Patient and Methods: A case report of a 26-year-old man with 10 days of postoperative intense low back pain refractory to oral analgesia after L4–L5 lumbar discectomy is presented. A nonsystematic literature review about postoperative MCs was conducted. Results The patient evolved with difficult pain management needing to be hospitalized and studied with laboratory examinations and spinal images. Elevation of inflammatory parameters and lumbar spine MRI with T1-weighted image hypointensity, T2-weighted image hyperintensity, and increased signal with gadolinium at vertebral bone marrow and end plates adjacent to L4–L5 disc were the main findings. Septic spondylodiscitis was suspected as differential diagnosis, but conservative treatment was followed by clinical observation and evaluation of inflammatory parameters. The patient evolved with a progressive decrease of back pain and slight elevation of control inflammatory parameters but neither antibiotic treatment nor surgery was needed. At 9th day of hospitalization, the patient was discharged given positive clinical response with no pain at rest and slight pain with movement. Ambulatory follow-up with laboratory and imaging study exhibited normalization of inflammatory parameters and resolution of vertebral bone marrow and end plates changes accompanied by remission of patient's pain. Conclusion MCs are infrequent radiological findings. Type 1 MCs show similar MRI findings to those seen in the infectious process of the spine, which turns septic discitis/spondylodiscitis the main differential diagnosis to discard. When MCs are present, laboratory and imaging evaluation has to be performed to rule out an infectious etiology. Evaluation of inflammatory parameters, diffusion-enhanced MRI, and analysis of MRI contrast enhancement patterns are useful tools for this purpose. Because of the significant association between MCs and low back pain, symptomatic MCs must be treated with a first-line conservative treatment of analgesia and physical activity restriction.
Idiopathic Scoliosis: Correction and Fusion with Pedicle Screws, without Instrumentation at the Apex
Authors: Rizzi Pablo , Bruzzone Mauro , Maldonado Dante , Canteros Leyes Daniel , Bernis Joaquin , Benedetto Abel , Reartes Mauricio 
Published: May 2015

Introduction Vertebrae of the scoliosis apex are more difficult to instrument with pedicle screws, because they are commonly the most rotated and dystrophic. We evaluated the postoperative radiographical results of scoliosis surgery with pedicle screws, without instrumenting the apex vertebra or its adjacent vertebrae. Patients and Methods This study is a radiographical retrospective study. A total of 24 patients with diagnosis of idiopathic scoliosis, with a minimum of 2 years' follow-up, were treated with correction and fusion, using pedicle screws. The apex vertebrae or its adjacent vertebrae were not instrumented (one to four levels). The correction index, sagittal and coronal alignment, clavicle angle, and rotation of the apex were measured at the immediate postoperative period and 2 years after surgery. The correlation between correction and apical levels without instrumentation was also calculated. Results The correlation between correction and the noninstrumented levels around the apex was not significant ( r =  − 0.18; p = 0.41). Radiographical parameters of correction were acceptable at the immediate postoperative and 2 years after surgery. Conclusion There was no correlation between correction and noninstrumented levels around the apex. Not instrumenting the apex could be an option that shows some potential benefits. The correction indexes and both sagittal and coronal balance were acceptable. There was no correction loss at 2 years after surgery.
Sacroiliac Joint Pain: Analysis of Results in Ecatepec ISSEMyM Medical Center and Hospital Ruber Madrid, Spain
Authors: Valencia Carlos Tariacuri , Fuentes Rivera Miguel Angel , Gonzalez Moga Amado , Guzman Carranza Juan Enrique 
Published: May 2015

Introduction Low back pain originates in the sacroiliac joints in 15 to 20% of cases. The special configuration and joint anatomy of the determined morphological suffering throughout life produce a degeneration transformations which can act in extrinsic (trauma and stress) or intrinsic (inflammatory or infectious) factors. The clinical parameters, tests of physical examination, and imaging studies are often nonspecific, causing a big problem at diagnosis. Objective This study aims to present the treatment and outcome of patients diagnosed with sacroiliitis on CMIE and Ruber hospital in Madrid, Spain. Methods A total of 74 patients with sacroiliitis, in whom 136 were performed diathermocoagulation treatments, frequency of presentation, gender, number of repeat treatment, age, and patient improvement with the Oswestry scale was analyzed and reviewed. Results A total of 26 patients with sacroiliitis associated with L4–S1 fusion mainly, average age 55 years, 75.6% female, presentation box pain between 6 and 18 months after the transpedicular fixation, 40% received two diatermocoagulaciones, improvements were reported in scale Oswestry 28%. Sacroiliac fusion is presented as an alternative treatment in cases of difficult management. Conclusion The challenge in treating sacroiliitis is to reach a proper diagnosis. The key to achieve maximum effectiveness with these tests and avoid mistakes is to have knowledge of the causes of pain, even as adjacent segment disease and effectiveness of treatments. Sacroiliac fusion is presented as an alternative treatment in cases of difficult management.