bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictive factors for subsequent vertebral fracture after percutaneous vertebroplasty
Authors: Ahn Yong , Lee June Ho , Lee Ho-Yeon , Lee Sang-Ho , Keem Sang-Hyun 
Published: February 2011

Object
The purpose of this study was to evaluate the predictive factors for subsequent vertebral fracture occurring after percutaneous vertebroplasty (PVP) at the neighboring levels (adjacent vs nonadjacent levels).

Methods
The medical records of 508 consecutive patients treated with PVP between January 2000 and December 2002 were retrospectively reviewed. A total of 45 patients with 49 painful vertebral fractures occurring after PVP was identified based on clinical and radiological findings. New vertebral fractures, developing at any of the 3 consecutive vertebral bodies (VBs) above or below the previously treated level, were the focus of the study. The patients were divided into 3 groups: an adjacent-level fracture group, nonadjacent-level fracture group, and a control group composed of 50 randomly selected patients in whom there was no evidence of a new fracture. Clinical, imaging, and procedure-related factors for each group were statistically analyzed.

Results
In 31 patients 35 VBs were classified as adjacent-level fractures, and in 14 patients 14 VBs were classified as nonadjacent-level fractures. After further vertebroplasty, the overall pain intensity and satisfaction rate in patients with post-PVP fractures were similar to those in the control group. In cases involving adjacent fractures, lower body mass index and intradiscal cement leakage were the significant predictive factors of fracture. In contrast, lower mobility of the index segment was related to nonadjacent-level fracture.

Conclusions
According to the authors' results, the mechanisms of subsequent fracture at adjacent and nonadjacent vertebrae are different. A direct pillar effect (that is, the difference in strength caused by cement augmentation) may provoke an adjacent-level fracture, whereas a dynamic hammer effect (the difference in segmental mobility) may lead to a nonadjacent fracture.
Single-level instrumented mini-open transforaminal lumbar interbody fusion in elderly patients
Authors: Lee Dong Yeob , Jung Tag-Geun , Lee Sang-Ho 
Published: February 2011

Object
The purpose of this study was to analyze the surgical outcomes in cases involving elderly patients who underwent single-level instrumented mini-open transforaminal lumbar interbody fusion (TLIF).

Methods
The authors performed a retrospective review of 27 consecutive cases involving elderly patients (≥ 65 years of age) who underwent single-level instrumented mini-open TLIF and were followed up for at least 3 years. Degenerative spondylolisthesis was diagnosed in 16 patients, stenosis with instability in 8, and lytic spondylolisthesis in 3. All cases were Grade I or II based on the American Society of Anesthesiologists' classification system. Clinical outcomes were assessed using a visual analog scale, the Oswestry Disability Index, and patients' subjective satisfaction. Sagittal balance, bone union, and adjacent segment degeneration (ASD) were assessed using plain radiography and 3D CT.

Results
The mean age of patients at the time of surgery was 69.3 years (range 65–80 years). Minor complications occurred in 2 patients (7.4%) in the perioperative period. At a mean follow-up duration of 38.6 months (range 36–42 months), clinical success was achieved in 88.9% of cases. The mean segmental lordosis and sacral tilt significantly increased after surgery (from 11.9 and 33.5° to 13.9 and 37.2°, p = 0.024 and p = 0.001, respectively). Solid fusion was achieved in 77.8% of the patients. Adjacent segment deterioration was found in 44.4% of the patients. No patients underwent revision surgery due to nonunion or ASD. The development of ASD was significantly related to postoperative sacral tilt (p = 0.006).

Conclusions
Single-level instrumented mini-open TLIF yielded good clinical and radiological outcomes with a low complication rate in elderly patients.
Traumatic spondyloptosis of the thoracolumbar spine
Authors: Yadla Sanjay , LeBude Bryan , Tender Gabriel C. , Sharan Ashwini D. , Harrop James S. , Hilibrand Alan S. , Vaccaro Alexander R. , Ratliff John K. 
Published: February 2011

Object
Traumatic Grade V thoracolumbar spondylolisthesis, or traumatic spondyloptosis (severe translation injuries), are uncommon spinal injuries. To the best of the authors' knowledge, this article represents the first reported case series of these unique spinal lesions.

Methods
The authors undertook a retrospective review of a tertiary care regional spinal cord injury patient population treated over a 10-year period (1997–2007). They analyzed data regarding age, sex, mechanism of injury, neurological status, and treatment.

Results
Five patients were identified (3 men and 2 women) with ages ranging from 17 to 44 years. All patients had sustained high-energy closed spinal injuries: 3 motor vehicle accidents, 1 injured in a building collapse, and 1 hurt by a fallen steel beam. Four patients, all with sagittal-plane spondyloptosis, had a complete neurological deficit (American Spinal Injury Association [ASIA] Grade A), and 1, with coronal-plane spondyloptosis, presented with an incomplete neurological deficit (ASIA Grade C). Four patients had sustained concurrent multisystem trauma. All patients underwent surgery: an isolated posterior fusion in 2 and combined posterior-anterior fusion in 3. Only the patient with an incomplete neurological deficit (coronal-plane spondyloptosis) recovered neurological function postoperatively.

Conclusions
Traumatic thoracolumbar junction spondyloptosis is rare. Surgical reconstruction and stabilization allow for early mobilization and rehabilitation. In the present series, a patient with coronal-plane spondyloptosis presented with preserved neurological function. This may be due to the result of differences in resultant neurological compression due to displacement mechanics compared with sagittally displaced injuries.
Surgical treatment of cervical spondylotic myelopathy with anterior compression: a review of 67 cases
Authors: Gok Beril , Sciubba Daniel M. , McLoughlin Gregory S. , McGirt Matthew , Ayhan Selim , Wolinsky Jean-Paul , Bydon Ali , Gokaslan Ziya L. , Witham Timothy F. 
Published: February 2011

ObjectIn patients with cervical spondylotic myelopathy (CSM), ventral disease and loss of cervical lordosis are considered to be relative indications for anterior surgery. However, anterior decompression and fusion operations may be associated with an increased risk of swallowing difficulty and an increased risk of nonunion when extensive decompression is performed. The authors reviewed cases involving patients with CSM treated via an anterior approach, paying special attention to neurological outcome, fusion rates, and complications.MethodsRetrospectively, 67 cases involving consecutive patients with CSM requiring an anterior decompression were reviewed: 46 patients underwent anterior surgery only (1-to3-level anterior cervical discectomy and fusion [ACDF] or 1-level corpectomy), and 21 patients who required > 3-level ACDF or ≥ 2-level corpectomy underwent anterior surgery supplemented by a posterior instrumented fusion procedure.ResultsPostoperative improvement in Nurick grade was seen in 43 (93%) of 46 patients undergoing anterior decompression and fusion alone (p < 0.001) and in 17 (81%) of 21 patients undergoing anterior decompression and fusion with supplemental posterior fusion (p = 0.0015). The overall complication rate for this series was 25.4%. Interestingly, the overall complication rate was similar for both the lone anterior surgery and combined anterior-posterior groups, but the incidence of adjacent-segment disease was greater in the lone anterior surgery group.ConclusionsSignificant improvement in Nurick grade can be achieved in patients who undergo anterior surgery for cervical myelopathy for primarily ventral disease or loss of cervical lordosis. In selected high-risk patients who undergo multilevel ventral decompression, supplemental posterior fixation and arthrodesis allows for low rates of construct failure with acceptable added morbidity.
Posterolateral protrusion of the vertebral artery over the posterior arch of the atlas: quantitative anatomical study using three-dimensional computed tomography angiography
Authors: Yamaguchi Satoshi , Eguchi Kuniki , Kiura Yoshihiro , Takeda Masaaki , Kurisu Kaoru 
Published: February 2011

Object
The vertebral artery (VA) often takes a protrusive course posterolaterally over the posterior arch of the atlas. In this study, the authors attempted to quantify this posterolateral protrusion of the VA.

Methods
Three-dimensional CT angiography images obtained for various cranial or cervical diseases in 140 patients were reviewed and evaluated. Seven patients were excluded for various reasons. To quantify the protrusive course of the VA, the diameter of the VA and 4 parameters were measured in images of the C1–VA complex obtained in the remaining 133 patients. The authors also checked for anomalies and anatomical variations.

Results
When there was no dominant side, mean distances from the most protrusive part of the VA to the posterior arch of the atlas were 6.73 ± 2.35 mm (right) and 6.8 ± 2.15 mm (left). When the left side of the VA was dominant, the distance on the left side (8.46 ± 2.00 mm) was significantly larger than that of the right side (6.64 ± 2.0 mm). When compared by age group (≤ 30 years, 31–60 years, and ≥ 61 years), there were no significant differences in the extent of the protrusion. When there was no dominant side, the mean distances from the most protrusive part of the VA to the midline were 30.73 ± 2.51 mm (right side) and 30.79 ± 2.47 mm (left side). When the left side of the VA was dominant, the distance on the left side (32.68 ± 2.03 mm) was significantly larger than that on the right side (29.87 ± 2.53 mm). The distance from the midline to the intersection of the VA and inner cortex of the posterior arch of the atlas was ~ 12 mm, irrespective of the side of VA dominance. The distance from the midline to the intersection of the VA and outer cortex of the posterior arch was ~ 20 mm on both sides. Anatomical variations and anomalies were found as follows: bony bridge formation over the groove for the VA on the posterior arch of C-1 (9.3%), an extracranial origin of the posterior inferior cerebellar artery (8.2%), and a VA passing beneath the posterior arch of the atlas (1.8%).

Conclusions
There may be significant variation in the location and branches of the VA that may place the vessel at risk during surgical intervention. If concern is noted about the vulnerability of the VA or its branches during surgery, preoperative evaluation by CT angiography should be considered.
Intradural microanatomy of the nerve roots S1–S5 at their origin from the conus medullaris
Authors: Hauck Erik F. , Wittkowski Werner , Bothe Hans W. 
Published: February 2011

Object
The conus medullaris and the nerve roots from S-1 to S-5 regulate bladder function as well as movement and sensation of the lower extremities. This most caudal region of the spinal cord has not been studied in great detail anatomically despite its important regulatory role. The goal of this analysis is to characterize the normal intradural microanatomy of the sacral nerve roots at their origin from the conus medullaris.

Methods
The thecal sacs from 20 cadavers were fixated in formaldehyde and dissected under the operative microscope.

Results
More than 50 rootlets originated from the conus medullaris over a distance of < 3 cm. The rootlets were loosely organized into bundles by the arachnoid membrane with decreasing diameters. These diameters were 1.7 mm (ventral)/2.4 mm (dorsal) at S-1, and 0.17 mm (ventral)/0.4 mm (dorsal) at S-5. The roots were separated by neither the dentate ligament nor interradicular gaps. The number of rootlets decreased in the rostrocaudal direction with 2 ventral and 5 dorsal rootlets at S-1, but only 1 ventral (inconsistently found) and 2 dorsal rootlets at S-5. Typically, 1 nerve anastomosis was present between adjacent dorsal roots from S-1 to S-4. Nerve anastomoses between ventral roots or rootlets of the same root were less frequent. The dorsal segment of origin (linea radicularis) decreased in length from 7.2 mm at S-1 to 4.8 mm at S-5.

Conclusions
The current study provides anatomical details and specific morphometric data of the intradural contents at the level of the conus medullaris. This information is valuable for intraoperative orientation, endoscopic navigation, and possible intradural nerve stimulation.
Treatment of neuroinflammation by soluble tumor necrosis factor receptor Type II fused to a thermally responsive carrier
Authors: Shamji Mohammed F. , Jing Liufang , Chen Jun , Hwang Priscilla , Ghodsizadeh Odelia , Friedman Allan H. , Richardson William J. , Setton Lori A. 
Published: February 2011

ObjectBiochemical irritation of the dorsal root ganglion (DRG) after intervertebral disc herniation contributes to radiculopathy through tumor necrosis factor–α (TNFα)–mediated inflammation. Soluble TNF receptor Type II (sTNFRII) sequesters this cytokine, providing clinical benefit. Previous work involving conjugation of sTNFRII with thermally responsive elastin-like polypeptide (ELP) yielded a chimeric protein (ELP–sTNFRII) with in vitro anti-TNFα bioactivity. Furthermore, temperature-triggered ELP aggregation into a “depot” prolongs protein residence time following perineural injection. In this study the authors evaluated the inflammatory phenotype of DRG explants after TNFα stimulation, and assessed the abilities of sTNFRII or ELP–sTNFRII to attenuate these neuro-inflammatory changes.MethodsRat lumbar DRGs (35 animals) were treated in 6 groups, as follows: control; TNFα (25 ng/ml); TNFα with low-(0.2 μg/ml) or high-dose (1 μg/ml) sTNFRII; and TNFα with low-(52.5 μg/ml) or high-dose (262.5 μg/ml) ELP–sTNFRII. After 24 hours, supernatant was evaluated for inflammatory cytokines (interleukin [IL]–1, IL-6, and IL-10); prostaglandin E2; and metabolites (glutamate, lactate, and pyruvate). Single-factor analysis of variance with post hoc Dunn analysis (α = 0.05) was used to assess treatment differences.ResultsIncubation of explants with TNFα caused metabolic stress reflected by an increased lactate/pyruvate ratio (1.8 ± 0.5–fold) and extracellular glutamate (79 ± 8% increase). Inflammatory activation was observed with heightened IL-6 release (5.2 ± 1.4–fold) and prostaglandin E2production (14 ± 3–fold). An autoregulatory response occurred with an 11.8 ± 0.6–fold increase in sTNFRI shedding. Treatment with high doses of sTNFRII or ELP–sTNFRII reversed all changes. Values are expressed as the mean ± standard deviation.ConclusionsThese results demonstrate that TNFα stimulation of DRG explants yields a phenotype of neurotoxic metabolite release and inflammatory mediator expression. Coincubation with either sTNFRII or ELP–sTNFRII antagonizes TNFα activity to abrogate these changes, suggesting potential for therapeutic intervention to treat peripheral nerve inflammatory disease.
Mitomycin protection of peridural fibrosis in lumbar disc surgery
Authors: Çelik Suat E. , Altan Tugrul. , Çelik Sevinç , Göksu Kamber , İnce İrfan , Kapran Ziya 
Published: February 2011

ObjectIn this prospective, randomized clinical study the authors sought to evaluate the effects of locally applied mitomycin C on peridural fibrosis during lumbar microdiscectomy.MethodsPatients undergoing lumbar disc surgery were randomly divided into 2 groups. Thirty patients had 1 mg/ml mitomycin C applied at the site of discectomy for 5 minutes, and 30 age- and sex-matched patients underwent lumbar microdiscectomy without mitomycin C application as the control group. The groups were compared for degree of postoperative neurological function, radicular/back pain, and degree of peridural fibrosis on MR imaging 6 months after the operation.ResultsThe median follow-up was 18 months. No serious drug adverse effects and no clinically significant laboratory adverse effects were reported in patients in the mitomycin C group. Patients in both groups showed similar clinical recoveries postoperatively. On postoperative evaluation of the MR images, pain scores, and neurological function, patients given mitomycin C have shown no reduction of peridural fibrosis either clinically or radiographically.ConclusionsMitomycin C is easy to use and safe in patients undergoing lumbar microdiscectomy. However, no benefit was observed either clinically or radiographically in this study.
The cervical end of an occipitocervical fusion: a biomechanical evaluation of 3 constructs
Authors: Finn Michael A. , Fassett Daniel R. , Mccall Todd D. , Clark Randy , Dailey Andrew T. , Brodke Darrel S. 
Published: February 2011

Object
Stabilization with rigid screw/rod fixation is the treatment of choice for craniocervical disorders requiring operative stabilization. The authors compare the relative immediate stiffness for occipital plate fixation in concordance with transarticular screw fixation (TASF), C-1 lateral mass and C-2 pars screw (C1L-C2P), and C-1 lateral mass and C-2 laminar screw (C1L-C2L) constructs, with and without a cross-link.

Methods
Ten intact human cadaveric spines (Oc–C4) were prepared and mounted in a 7-axis spine simulator. Each specimen was precycled and then tested in the intact state for flexion/extension, lateral bending, and axial rotation. Motion was tracked using the OptoTRAK 3D tracking system. The specimens were then destabilized and instrumented with an occipital plate and TASF. The spine was tested with and without the addition of a cross-link. The C1L-C2P and C1L-C2L constructs were similarly tested.

Results
All constructs demonstrated a significant increase in stiffness after instrumentation. The C1L-C2P construct was equivalent to the TASF in all moments. The C1L-C2L was significantly weaker than the C1L-C2P construct in all moments and significantly weaker than the TASF in lateral bending. The addition of a cross-link made no difference in the stiffness of any construct.

Conclusions
All constructs provide significant immediate stability in the destabilized occipitocervical junction. Although the C1L-C2P construct performed best overall, the TASF was similar, and either one can be recommended. Decreased stiffness of the C1L-C2L construct might affect the success of clinical fusion. This construct should be reserved for cases in which anatomy precludes the use of the other two.
Excitations, affects et expression somatique chez le bébé
Authors: Belot Rose-Angélique 
Published: February 2011

Résumé Si l’affect occupe, en lien avec la représentation, une large place dans la littérature psychanalytique et réalise, toujours avec la représentation, les fondements du travail psychique, quelles sont sa place et sa dimension dans le développement somato-psychique du bébé et particulièrement dans l’éclosion de l’expression somatique précoce ? Après un bref survol des données essentielles liées au développement du bébé, à la notion d’affect, d’excitation et de pare-excitation, la présentation d’une situation clinique détaillée nous permet de mesurer la place de l’affect et ses vicissitudes dans les interactions du bébé avec ses partenaires privilégiés.
L'automutilation : un rituel à même la peau ?
Authors: Brossard Baptiste 
Published: February 2011

Résumé Cet article prend appui sur une enquête sociologique menée par entretiens approfondis avec des adolescents. Il se propose d’analyser la pratique des blessures auto-infligées en liant trois éléments : l’histoire personnelle des enquêtés, les modalités concrètes de leurs blessures et le système émotionnel qui leur donne sens. Cette démarche aboutit à l’idée suivante : l’automutilation est une pratique visant à maintenir ou rétablir un ordre émotionnel et symbolique donné.
Autour d'un enfant, dialogue difficile entre professionnels
Authors: Tessarech Sarah 
Published: February 2011

Résumé Cet article présente la prise en charge orthophonique d’un enfant diagnostiqué psychotique, ainsi qu’une approche des rapports complexes avec sa mère et les institutions recevant cet enfant ; ou comment la pathologie mentale rend difficiles les relations transférentielles et contre-transférentielles, même pour les professionnels. L’auteur propose une place possible pour l’intervenant travaillant en libéral et cherche à montrer l’importance du travail cognitif et médiatisé, notamment en ce qui concerne les émotions.
« les mauvais jours finiront »
Authors: Boutan Pierre 
Published: February 2011

25 ans après les lois Ferry, Ferdinand Buisson posait la question de savoir si l’école primaire était en voie de progrès : c’est dire que la perception des changements, même les plus importants, peut subir bien des avatars. Un siècle plus tard, et dans un contexte historique encore plus bouleversé, ne serait-ce que par le vertigineux accroissement des connaissances et de leur diffusion, la question se pose encore, après des dizaines d’années d’efforts marquées par le « Plan de Rénovation de l’enseignement du français à l’école primaire de 1970 », le travail de l’Association des enseignants de français, la création des IUFM : comment faire franchir les limites visibles de la démocratisation d’accès aux études longues, où la maitrise de la langue joue un rôle essentiel ? Et sans céder à la vague réactionnaire niant que tout cela relève du rationnel.
De la « critique d'humeur » à l'analyse critique
Authors: Bruno Pierre 
Published: February 2011

La crise des approches militantes de l’enseignement du français s’explique par des logiques qui lui sont propres mais aussi par des variables extérieures à cette discipline défavorables au courant « progressiste » incarné par l’AFEF. Alors que les fictions cinématographiques et littéraires se structurent autour d’une fausse alternative (« sécuritaires » / « humanistes ») qui laisse peu de place à toute autre perspective, les représentations progressistes de l’enseignement du français se heurtent aussi à la diffusion d’une doxa médiatique qui leur est souvent hostile et à l’évolution des paradigmes scientifiques dominants. Par ailleurs, accompagnant la révision idéologique de la gauche dite « de gouvernement », certaines revendications (comme l’élargissement des corpus à la littérature pour la jeunesse) ont pu aboutir avec des objectifs et au nom de principes très différents de ceux qui les sous-tendaient à l’origine.
L'AFEF, quelques témoignages
Authors: Youx Viviane 
Published: February 2011

À travers les témoignages de quelques-uns des anciens responsables de l’AFEF, nous parcourons quarante années de la vie de l’association, depuis sa genèse comme AFPF dans les 1960 jusqu’à la crise des années 2000. L’enthousiasme toujours présent témoigne de la profondeur de leur engagement ainsi que de leur fidélité aux valeurs énoncées dans le Manifeste de Charbonnières, et jamais démenties depuis. Ils répondent d’abord sur le rôle qu’a joué l’AFEF dans leur parcours personnel et professionnel, puis ils s’interrogent sur la place qu’elle peut encore tenir aujourd’hui. Sans nier les difficultés actuelles, ils proposent quelques pistes pour éclairer l’avenir. Par juxtaposition et tissage, ce texte, s’il ne livre pas l’intégralité des réponses, tente de faire apparaitre la dynamique interne de chaque intervention.