bluuebunny/crossref_metadata_2025_split huggingface dataset:
A therapeutic time window for anti-CD11d monoclonal antibody treatment yielding reduced secondary tissue damage and enhanced behavioral recovery following severe spinal cord injury
Authors: Ditor David S. , Bao Feng , Chen Yuhua , Dekaban Gregory A. , Weaver Lynne C. 
Published: January 2008

Object
The purpose of this study was to investigate the therapeutic time window for antiinflammatory treatment within the first 24 hours of spinal cord injury (SCI). The authors have shown that an anti-CD11d antibody treatment attenuates leukocyte infiltration and improves neurological function when administered beginning 2 hours after SCI. A more clinically relevant time for the initiation of treatment after SCI, however, is 6 or more hours postinjury.

Methods
In Study 1, the T-4 vertebrae in four groups of rats were injured by a 50-g clip-induced compression method, and the anti-CD11d antibody (1 mg/kg) was intravenously administered starting 2, 6, 12, or 24 hours postinjury. All groups received subsequent doses at 24 and 48 hours, and animals were killed at 72 hours. The anti-CD11d antibody treatment starting at 6 hours postinjury caused significant attenuation of leukocyte infiltration, reactive oxygen species–associated enzymes, and secondary tissue damage. Based on these findings, Study 2 included two groups of rats receiving the aforementioned injury and treatment beginning at 6 hours postinjury (with subsequent treatments at 24 and 48 hours) with the anti-CD11d or a control antibody (1B7); these rats were then observed for 5 weeks. Basso-Beattie-Bresnahan (BBB) scores were significantly higher in anti-CD11d–treated rats (mean BBB score 8.9 ± 0.1) than controls (mean BBB score 7.7 ± 0.1) 5 weeks postinjury. Increases in mean arterial pressure during colon distension were smaller in anti-CD11d–treated rats (19.5 ± 3.7 mm Hg) than in controls (37.4 ± 4.7 mm Hg).

Conclusions
These findings suggest that antiinflammatory treatments that reduce secondary tissue damage after SCI may be delayed until 6 hours postinjury and still be effective.
Anterior transvertebral transposition of the spinal cord for the relief of paraplegia associated with congenital cervicothoracic kyphoscoliosis
Authors: Shenouda Emad F. , Nelson Ian W. , Nelson Richard J. 
Published: January 2008

✓The authors describe a technique for the relief of spinal cord compression associated with congenital kyphoscoliosis. A 13-year-old girl with congenital cervicothoracic kyphoscoliosis had undergone in situ fusion; spastic paraparesis and bladder disturbance developed postoperatively. Spinal cord detethering and posterolateral decompression temporarily arrested the neurological deterioration; however, the patient’s condition then progressed to paraplegia with a partial sensory level at L-1. Imaging demonstrated persisting cord compression at the apex of the kyphotic curve. Transvertebral transposition of the spinal cord was performed using sagittal vertebrotomies, preserving the lateral aspects of the vertebral bodies, pedicles, and fusion mass. By 2 years postoperatively she had recovered normal sensation and good bladder function and was walking unaided.
Transposition of the spinal cord may be used to relieve spinal cord compression associated with complex spinal deformities.
Pathognomonic radiological signs for predicting prognosis in patients with chronic atlantoaxial rotatory fixation
Authors: Ishii Ken , Chiba Kazuhiro , Maruiwa Hirofumi , Nakamura Masaya , Matsumoto Morio , Toyama Yoshiaki 
Published: January 2008

Object
The authors conducted a study to assess the correlation between radiological features and clinical courses in patients with chronic atlantoaxial rotatory fixation (AARF) and to determine diagnostic imaging signs for predicting prognosis.

Methods
There were 24 patients (eight boys and 16 girls) whose mean age was 7.8 years (range 4–14 years) and in whom AARF was diagnosed. The mean follow-up duration was 3.7 years (range 5 weeks–12 years). There were two groups of patients: 15 patients who visited the hospital less than 8 weeks after symptom (torticollis) onset comprised the acute group, and nine patients in whom the diagnosis of AARF was established later than 3 months after symptom onset comprised the chronic group. The chronic group was divided into two subgroups: those in whom the closed reduction could be achieved and those in whom it could not. Clinical data and radiographic studies, including plain radiographs and plain and three-dimensional (3D) computed tomography (CT) reconstructions, were reviewed retrospectively.
A deformity of the superior C-2 facet joint was frequently observed in the group of patients with chronic AARF (p < 0.0001). This sign represented a risk factor for recurrent dislocation (p = 0.0003, Fisher exact test). Prominent lateral inclination of C-1 was an impeding factor for reduction of chronic AARF (p < 0.0001, analysis of variance with Fisher post hoc test). Greater than 20° of lateral inclination of the atlas indicated an irreducible subluxation (p = 0.0023, Fisher exact test).

Conclusions
Both facet joint deformity and lateral inclination observed on 3D CT reconstructions can be useful signs to predict the prognosis and the treatment of choice in patients with chronic AARFs.
Cervical spine epidural abscess: experience with microsurgical treatment in eight cases
Authors: Muzii Vitaliano Francesco , Mariottini Aldo , Zalaffi Alessandro , Carangelo Biagio Roberto , Palma Lucio 
Published: January 2008

Object
The authors report a series of eight consecutive cases in which epidural abscesses in the cervical spine were treated by microsurgery without arthrodesis, including two cases of concomitant pyogenic and tubercular infection.

Methods
The authors used a minimally invasive surgical approach consisting of single-level anterior microsurgical discectomy and drainage of the epidural abscess via a silicone catheter, and then initiated antibiotic therapy. At follow-up examination (mean duration 39 months), six patients exhibited complete recovery and two suffered from minor residual deficits. In all cases, spontaneous vertebral fusion occurred. Sagittal alignment was maintained in seven patients, and in one there was slight asymptomatic kyphosis. In two patients, tubercular and pyogenic infections were found. Prior intervention for dental infection was recorded in four cases.

Conclusions
In the absence of preoperative spinal instability, microsurgical drainage of the abscess followed by specific antibiotic therapy resulted in spinal cord decompression and neurological recovery, thereby facilitating spontaneous fusion and vertebral stability. The presence of combined tubercular and pyogenic infections of the cervical spine should be considered, especially in patients whose immune systems are depressed.
Evaluation of postoperative spinal epidural hematoma after microendoscopic posterior decompression for lumbar spinal stenosis: a clinical and magnetic resonance imaging study
Authors: Ikuta Ko , Tono Osamu , Tanaka Takayuki , Arima Junichi , Nakano Soichiro , Sasaki Kosuke , Oga Masayoshi 
Published: January 2008

Object
The incidence of postoperative spinal epidural hematoma (SEH) is low, and to the best of the authors’ knowledge, no researchers have evaluated its actual incidence and clinical features. The purpose of this study was to investigate the clinical consequences of SEH after microendoscopic posterior decompression (MEPD) in patients with lumbar spinal stenosis.

Methods
Data obtained in 30 patients undergoing MEPD for lumbar spinal stenosis were reviewed. At 1 week after surgery, magnetic resonance (MR) imaging documented SEHs in 10 patients (33% [Group 1]) and no evidence of SEHs in 20 patients (67% [Group 2]). The authors compared MR imaging findings, postoperative morbidities, and clinical outcomes between the groups.
Three Group 1 patients had symptomatic SEHs. All symptoms were mild without associated neurological deterioration and spontaneously subsided within 3 weeks of surgery. Magnetic resonance imaging demonstrated spontaneous regression of the SEH in all patients at 3 months after surgery. In Group 1 patients, however, the authors observed less expansion of the dural sac after 1 year despite sufficient widening of the osseous spinal canal. Low-back pain within 1 week of surgery was moderate in Group 1 and mild in Group 2. Improvements at the final follow up were greater in Group 2 patients.

Conclusions
The incidence of postoperative SEHs may be greater than reported. Postoperative SEHs caused poor expansion of the dural sac despite its spontaneous regression. In addition, postoperative SEHs caused a delay in the patient’s recovery and led to a poor clinical improvement. The prevention of postoperative SEHs might be required to prevent not only neurological deterioration but also a delay in the patient’s recovery.
Anatomical relationships between the V2 segment of the vertebral artery and the cervical nerve roots
Authors: Paolini Sergio , Lanzino Giuseppe 
Published: January 2008

Object
During surgical procedures focused on the cervical nerve roots, the surgeon works in proximity to the V2 segment of the vertebral artery (VA). Depending on the specific surgical approach, it may be necessary to identify, expose, or mobilize the artery. In most cases, the artery may be left undisturbed. To reduce the risk of iatrogenic injury to the V2 segment during anterior and anterolateral approaches to the cervical spine, the authors analyzed the relationship between the V2 segment and the proximal segment of the C3–6 nerve roots.

Methods
Six cadaveric cervical spines (12 sides) were fixed with formalin, injected with red and blue latex, and investigated intraoperatively using different magnifications (× 3–40).
The VA rested on the anteromedial surface of the cervical nerve roots at the level of each intertransverse space. The exiting nerve roots intersected the VA at a distance ranging from 4.5 to 8.1 mm (mean 6.3 ± 1.06 mm) from the dural sac. The distance was slightly shorter at cephalad levels, suggesting that the artery is more posteriorly and medially situated at those levels. Arterial pedicles anchored the VA to the cervical nerve roots at various levels. These arteries gave rise to purely radicular, ligamentous, and medullary branches without a predictable pattern. After reaching the nerve roots on their lower margin, the nonligamentous branches pierced the radicular dural sheath within the neural foramen at a distance of 2 to 4 mm from the VA.

Conclusions
Proximal-to-distal dissection of a cervical nerve root may proceed with relative safety for at least 4 mm. The V2 segment of the VA gives rise to at least one radicular arterial pedicle between C-4 and C-6. These trunks give rise to purely radicular, ligamentous, and medullary branches in an unpredictable pattern.
Tumoral calcinosis in bilateral facet joints of the lumbar spine in scleroderma
Authors: Shibuya Sei , Kawaguchi Yoji , Arima Nobuo , Yamamoto Tetsuji , Dobashi Hiroaki , Tokuda Michiaki 
Published: January 2008

✓Tumoral calcinosis commonly occurs in the articular soft tissues of the extremities but rarely in the spine. The authors performed surgery to treat lumbar tumoral calcinosis in a patient with scleroderma, in whom symptoms of neurological dysfunction had manifested.
This 49-year-old woman presented with low-back pain and gait disturbance. Seven years before presentation, scleroderma had been diagnosed, and the patient had received medical treatment ever since. Imaging revealed tumoral calcinosis centered at the bilateral facet joints between L-3 and L-4, marked stenosis of the spinal canal, L-3 spondylolisthesis, and intervertebral instability. Surgery was performed to excise the lesion en bloc. After neural decompression, posterolateral fusion and pedicle screw fixation were undertaken. Symptoms improved after surgery.
In this case, the underlying scleroderma that predisposes to calcinosis and facet joint degeneration due to lumbar spondylolisthesis were probably factors leading to the development of tumoral calcinosis in the lumbar spine.
Endoscopic vertebroplasty for the treatment of chronic vertebral compression fracture
Authors: Hoshino Masatoshi , Nakamura Hiroaki , Konishi Sadahiko , Nagayama Ryuichi , Terai Hidetomi , Tsujio Tadao , Namikawa Takashi , Kato Minori , Takaoka Kunio 
Published: January 2008

✓ The authors describe a new vertebroplasty technique for the treatment of chronic painful vertebral compression fractures (VCFs).
A urinary balloon catheter is introduced into the vertebral body (VB) via a bilateral transpedicular approach and inflated with contrast medium to obtain sufficient space for endoscopic observation. The granulation tissue occupying the VB is then removed using a punch or curette inserted through one pedicle, with the guidance of an endoscope introduced through the contralateral pedicle. After endoscopic resection of granulation tissue in the fractured VB, vertebroplasty is performed by injecting calcium phosphate cement (CPC) into the VB.
Fourteen patients in whom chronic painful VCFs were diagnosed underwent surgery involving the aforementioned technique. In all cases, intractable pain and ambulatory function improved after surgery, and there were no significant systemic complications. On radiological evaluation in eight cases in which the follow-up period exceeded 1 year, the mean height of the fractured VB improved from 38% of that of adjacent intact VBs to 85%. Although a slight loss of correction was routinely observed at 1 month postoperatively, an additional loss of VB height was not noted up to 1 year later. Bone formation was commonly seen along the anterior wall of the involved vertebrae in all cases.
Vertebroplasty involving the endoscopic removal of granulation tissue proved to be an efficacious procedure for the treatment of chronic painful VCFs. The osteoconductive capacity of CPC facilitated callus formation and ultimately restoration of vertebral bone structure.
Postoperative factors affecting neurological recovery after surgery for cervical spondylotic myelopathy
Authors: Ogawa Yuto , Chiba Kazuhiro , Matsumoto Morio , Nakamura Masaya , Takaishi Hironari , Toyama Yoshiaki 
Published: January 2008

Object
Many prognostic factors associated with surgery for cervical spondylotic myelopathy (CSM) have been detailed in the literature. All of these factors, however, are defined preoperatively. If it is possible to clarify factors influencing surgical results that can be modulated after surgery, then the overall results of surgery may improve. The purpose of this study was to elucidate such postoperative factors affecting neurological recovery.

Methods
The authors assessed the surgical outcomes obtained in 183 patients with CSM who underwent expansive open-door laminoplasty between 1993 and 2004 and who underwent follow up for a minimum of 1 year. They classified the cases into two groups according to the degree of neurological recovery: an excellent recovery group, comprising patients in whom the recovery rates were greater than 75%, and a poor recovery group, composed of patients in whom the recovery rates were lower than 30%. Comparisons of various clinical and imaging parameters revealed that the mean age at surgery was significantly lower in patients in the excellent recovery group than that in the poor recovery group. Therefore, the authors repeated the same analyses after adjustment for age. Postoperative cervical range of motion (ROM) was significantly more reduced in the excellent recovery group than in the poor recovery group. There was a significant positive correlation between reduced cervical ROM and recovery rate in the poor recovery group.

Conclusions
Dynamic stress may ameliorate functional recovery of the degenerated spinal cord even after sufficient decompression. Postoperative preservation of cervical ROM may not always be beneficial for neurological recovery in patients with CSM.
Quality of life of lumbar stenosis–treated patients in whom the X STOP interspinous device was implanted
Authors: Hsu Ken Y. , Zucherman James F. , Hartjen Charles A. , Mehalic Thomas F. , Implicito Dante A. , Martin Michael J. , Johnson Donald R. , Skidmore Grant A. , Vessa Paul P. , Dwyer James W. , Cauthen Joseph C. , Ozuna Richard M. 
Published: January 2008

Object
This study was conducted to compare the quality of life (QOL) in patients with neurogenic intermittent claudication (NIC) secondary to lumbar spinal stenosis (LSS). Using the 36-Item Short Form (SF-36) questionnaire, the authors compared the results obtained in patients treated with the X STOP Interspinous Process Decompression (IPD) System with those obtained in patients who underwent nonoperative therapies.

Methods
Patients with LSS were enrolled in a prospective 2-year multicenter study and randomized either to the X STOP or nonoperative group. The SF-36 survey was used to assess the QOL before treatment and at 6 weeks, 6 months, 1 year, and 2 years posttreatment. An analysis of variance was used to compare individual pre- and posttreatment mean SF-36 domain scores between the two groups and within each treatment group.
At all posttreatment time points, the authors observed the following: 1) mean domain scores in X STOP–treated patients were significantly greater than those in patients treated nonoperatively, with the exception of the mean General Health (GH), Role Emotional, and Mental Component Summary scores at 2 years; and 2) mean posttreatment domain scores documented in X STOP–treated patients were significantly greater than mean pretreatment scores, with the exception of mean GH scores at 6, 12, and 24 months.

Conclusions
The results of this study demonstrate that the X STOP device is significantly more effective than non-operative therapy in improving the QOL in patients with LSS. The results are comparable with those reported in other studies involving traditional decompressive techniques for LSS and suggest that the X STOP implant can provide an effective treatment compared with nonoperative and conventional surgical therapies.
Approach to the cervical portion of the vagus nerve via the posterior cervical triangle: a cadaveric feasibility study with potential use in vagus nerve stimulation procedures
Authors: Tubbs R. Shane , Loukas Marios , Shoja Mohammadali M. , Salter E. George , Oakes W. Jerry , Blount Jeffrey P. 
Published: January 2008

Object
The authors describe a technique in which the cervical portion of the vagus nerve is exposed during procedures such as neuroma resection or, more commonly, during the placement of a vagus nerve stimulator.

Methods
To test their hypothesis that a posterolateral approach to the vagus nerve may be feasible and efficacious, the authors performed dissection of the left-sided vagus nerve in 13 adult cadavers. The carotid sheath was exposed via the posterior cervical triangle, and the vagus nerve was identified posterolaterally. Measurements were made of the length of available nerve, and the anatomical approach was documented. As part of a comparison study regarding the available length of nerve, the authors exposed the left vagus nerve in five additional adult cadavers via a standard anterior approach to the carotid sheath, and compared the results obtained with each technique.
A mean length of 12 cm of the vagus nerve was isolated when using the posterior approach to the carotid sheath, whereas a mean length of 11 cm of the nerve was documented when using the anterior approach. With the aforementioned posterior approach, no obvious injury occurred to the vagus nerve or other local neurovascular structures such as the spinal accessory nerve.

Conclusions
Evaluation of the findings obtained in the present cadaveric study showed that a posterior approach to the vagus nerve is feasible. The technique for posterior exposure of the carotid sheath may prove useful in surgical exposures of the vagus nerve when a standard anterior method is not possible.
Charité lumbar artificial disc retrieval: use of a lateral minimally invasive technique
Authors: Pimenta Luiz , Díaz Roberto Carlos , Guerrero Luis Guerrero 
Published: January 2008

✓Indications for total disc replacement (TDR) may include implant loosening, malposition, displacement, early wear, and infection. Each indication is likely to require different preoperative planning, testing, and strategies. Preoperative planning is the first and most important step in performing a TDR revision. An organized approach reduces operative time, minimizes risks, decreases stress, and increases the success rate. Primary revision of a failed total disc arthroplasty can be planned as a posterior fusion, leaving the TDR device in place, but an unstable anterior column may require retrieval and revision of the interbody device. An anterior revision approach is associated with significant risk due to scarring and adhesions resulting from the primary procedure, making mobilization of the vessels very difficult, especially at the L4–5 bifurcation.
The authors describe a new alternative for retrieval and revision of a TDR device. They present the details of two cases of TDR device revision in which they performed a minimally invasive extreme-lateral interbody fusion to effect a safer access route that avoids vascular structures and the creation of scar tissue.
Corpectomy followed by the placement of instrumentation with titanium cages and recombinant human bone morphogenetic protein–2 for vertebral osteomyelitis
Authors: Aryan Henry E. , Lu Daniel C. , Acosta Frank L. , Ames Christopher P. 
Published: January 2008

ObjectThe treatment of vertebral osteomyelitis includes antibiotics with or without surgical intervention. The decision to place instrumentation into an infected spinal column remains controversial. The use of recombinant human bone morphogenetic protein–2 (rhBMP-2) in patients with osteomyelitis is also extremely controversial. The authors review their experience in performing corpectomy and fusion with titanium cages and rhBMP-2 in patients with vertebral instability and/or neurological compromise due to vertebral osteomyelitis.MethodsData obtained in 15 patients treated between 2001 and 2005 were included in this analysis. Nine patients presented primarily with axial pain and six with radiculopathy or myelopathy. Seven patients had an associated epidural abscess. The cervical spine was affected in six patients, the thoracic spine in five, and the lumbar spine in four. All patients underwent corpectomy of the involved vertebral bodies; the authors then performed spinal reconstruction, placing a titanium cage–plate system with morcellized allograft/autograft and rhBMP-2. In 10 patients, supplemental posterolateral screw–rod fixation was conducted.A one-level corpectomy was performed in one patient, a two-level corpectomy in 13, and a six-level corpectomy in one. A morcellized allograft and rhBMP-2–filled titanium cage was used in 10 patients, and an autograft and rhBMP-2–filled cage in five patients. The most common pathogen wasStaphylococcus aureus. All patients received intravenous antibiotics for at least 6 weeks postoperatively, and life-long antibiotic therapy was required in three patients with coccidiomycoses, candida, and tuberculosis osteomyelitis, respectively. There were no recurrent infections. Radiography demonstrated evidence of fusion in all patients at the last follow-up examination. The mean follow-up period was 20 months.ConclusionsCorpectomy followed by titanium cage–plate reconstruction and the placement of rhBMP-2 may be a safe and effective treatment for selected patients with vertebral osteomyelitis. This surgical therapy does not appear, at least based on preliminary results, to lead to recurrent hardware infections. Based on the results obtained in this limited series, the authors found that rhBMP-2 can be used in the setting of active infection with excellent fusion rates and without complication. The morbidity associated with the autograft donor site is avoided when using cages. Antibiotic therapy tailored to the specific organism should be continued for at least 6 weeks after surgery, and life-long therapy is required in cases of fungal or tuberculosis infections.