Publications by authors named "Brandon Couch"
Article Synopsis
- Corticosteroids, known for their anti-inflammatory properties, may be helpful in treating peripheral nerve injuries, despite limited current use.
- A systematic review of studies revealed that corticosteroids can provide pain relief and support nerve regeneration in conditions like cubital tunnel syndrome and chronic inflammatory demyelinating polyradiculoneuropathy.
- While promising, the research suggests more clinical trials are needed to fully understand the potential benefits and safety of corticosteroid treatment for peripheral nerve pathologies.
Article Synopsis
- The study investigates how total hip arthroplasty (THA) affects lower back movement during walking in patients with hip-spine syndrome, aiming to understand improvements in back pain.
- Thirteen patients with severe hip osteoarthritis were analyzed before and six months after THA, using various questionnaires and measurements of spinal and pelvic orientation during walking.
- Results indicated significant improvements in hip and back pain scores after THA, but no changes in static spinal positioning; however, there were notable changes in lumbar spine movement that may contribute to reduced pain.
Purpose: Lumbar spinal stenosis (LSS) is the most common reason for spinal surgery in patients over the age of 65, and there are few effective non-surgical treatments. Therefore, the development of novel treatment or preventative modalities to decrease overall cost and morbidity associated with LSS is an urgent matter. The cause of LSS is multifactorial; however, a significant contributor is ligamentum flavum hypertrophy (LFH) which causes mechanical compression of the cauda equina or nerve roots.
View Article and Find Full Text PDFWhile reperfusion of autologous blood using the Cellsaver (CS) device is routine in cardiothoracic surgery, there is a paucity of evidence-based literature regarding its use in trauma. Utility of CS was compared in these two distinct populations at a Level 1 trauma center from 2017 to 2022. CS was successfully used in 97% and 74% of cardiac and trauma cases, respectively.
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- The study involved a retrospective analysis of patients with spine fractures due to ankylosing conditions, specifically ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH).
- It aimed to explore differences in treatment methods and mortality rates between these two groups over a nine-year period.
- Findings indicated that AS patients experienced more severe fractures and required surgery more often than DISH patients, yet there was no significant difference in 1-year mortality rates between the two groups.
Objective: The aim of this study was to investigate the effect of degenerative spondylolisthesis (DS) on psoas anatomy and the L4-5 safe zone during lateral lumbar interbody fusion (LLIF).
Methods: In this retrospective, single-institution analysis, patients managed for low-back pain between 2016 and 2021 were identified. Inclusion criteria were adequate lumbar MR images and radiographs.
Article Synopsis
- A prospective cohort study aimed to explore how various patient factors influence the movement of adjacent spinal segments after anterior cervical discectomy and fusion (ACDF) using advanced biplane radiography.
- Previous research has linked patient characteristics to adjacent segment disease (ASD), but this study uniquely examined how these factors relate to the spinal mechanics involved in ASD development.
- Results indicated that specific preoperative conditions like disc height and bulging, alongside lifestyle factors such as smoking and medication use, are significant predictors of changes in adjacent segment motion post-surgery.
Background: Previous animal models of intervertebral disc degeneration (IDD) rely on open surgical approaches, which confound the degenerative response and pain behaviors due to injury to surrounding tissues during the surgical approach. To overcome these challenges, we developed a minimally invasive percutaneous puncture procedure to induce IDD in a rat model.
Methods: Ten Fischer 344 male rats underwent percutaneous annular puncture of lumbar intervertebral discs (IVDs) at L2-3, L3-4, and L4-5.
Necrotizing soft tissue infections (NSTIs) cause rapidly progressing destruction of skin and soft tissue, leaving large soft tissue defects and necessitating complex reconstruction. RECELL, an autologous cell harvesting device, provides a regenerative epidermal suspension (RES) from a small split-thickness skin biopsy for the substitution of (or in addition to) split-thickness skin grafting (STSG). We present a case of a 56-year-old man with extensive NSTI managed by serial debridement, leading to a degloving injury to the right upper extremity, axilla, flank and back, which was later reconstructed using RES application in conjunction with STSG and Integra placement.
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- The study is a retrospective cohort analysis aimed at assessing how the level of caudal instrumentation affects revision rates after posterior cervical laminectomy and fusion.
- It involved analyzing a database of 204 patients over a minimum follow-up of one year, dividing them into two groups based on where their fusion ended—cervical (C7) or thoracic (T1/T2).
- Findings indicated that the overall revision rate was similar between both groups (7.3% for cervical and 10.4% for thoracic), and no independent risk factors for revision surgery were identified, suggesting that fusion constructs can safely end at the cervical spine without increasing revision risk.
Background: Peripheral nerve and infraclavicular brachial plexus injury following proximal humerus fractures are commonplace, but diagnosing a concomitant nerve injury in the acute setting is challenging. Fracture displacement has been identified as a qualitative risk factor for nerve injury, and additional attention should be paid to the neurologic exams of patients with proximal humerus fractures with significant medial shaft displacement. However, a quantitative relationship between the risk of nerve injury and medialization of the humeral shaft has not been shown, and additional risk factors for this complication have not been assessed.
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- - The study aimed to evaluate how the type of graft used during anterior cervical discectomy and fusion (ACDF) affects residual motion and patient-reported outcomes, particularly looking at the influence of smoking.
- - Using dynamic imaging, researchers assessed 48 participants one year post-surgery, finding that those with allograft showed a trend toward more residual motion compared to autograft, although the difference wasn't statistically significant.
- - There were no notable differences in patient-reported outcomes based on graft type or smoking status, but smokers with allograft tended to report worse outcomes compared to other groups.
Background: Intervertebral disc degeneration contributes to low back pain. The avascular intervertebral disc consists of a central hypoxic nucleus pulpous (NP) surrounded by the more oxygenated annulus fibrosus (AF). Lactic acid, an abundant end-product of NP glycolysis, has long been viewed as a harmful waste that acidifies disc tissue and decreases cell viability and function.
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- - The study was a retrospective cohort analysis aimed at understanding how bariatric surgery affects outcomes after elective lumbar fusion surgery, primarily looking at the rates of surgical site infections and other complications.
- - Researchers reviewed data from patients treated at a large medical center between 2012 and 2018, comparing those with prior bariatric surgery to a control group of patients without such surgery.
- - Results showed that patients who had bariatric surgery experienced higher rates of surgical site infections requiring additional surgery, more issues with adjacent segments, and increased chronic pain, while other complications like prolonged wound drainage were similar between the two groups.
Significance: Financial relationships between industry and physicians are a key aspect for the advancement of surgical practice and training, but these relationships also result in a conflict of interest with respect to research. Financial payments to physicians are public within the United States in the Open Payments Database, but the rate of accurate financial disclosure of payments has not previously been studied in trauma surgery publications.
Objective: To determine the rate of accurate financial disclosure in major surgical trauma journals compared with the Open Payments Database.
Article Synopsis
- In vitro biomechanical studies of the spine help in understanding normal biomechanics, injury mechanisms, and the impact of surgical interventions on spine mechanics.
- This study aimed to compare in vitro loading tests with actual in vivo neck movements to see how well lab results reflect real-life spine behavior.
- Findings showed that in vitro testing often does not accurately mimic in vivo spine mechanics, particularly regarding the center of rotation and disc height, which is important for developing effective spinal devices like cervical disc replacements.
Article Synopsis
- The study investigates how rabbit annulus fibrosus (AF) cells produce neuropeptide Y (NPY) when subjected to mechanical and inflammatory stress, with the aim of understanding its role in intervertebral disc health.
- Researchers exposed lumbar AF cells from young rabbits to different levels of tensile stress and inflammatory markers, finding that inflammatory conditions significantly increased NPY expression, while mechanical strain alone had minimal effect.
- The presence of NPY receptor-type 1 (NPY-1R) in rabbit AF cells was confirmed, suggesting that increased NPY production in response to stress could be linked to intervertebral disc degeneration and associated low back pain.
Objective: Low back pain is frequently treated with nonsteroidal anti-inflammatory drugs (NSAIDs), but little is known about intervertebral disc metabolism of the prostaglandins that are diminished by these drugs. Hence, this study aimed at delineating prostaglandin actions in cytokine activated disc cells by comparing the response of nucleus pulposus (NP) cells to the pro-inflammatory cytokine interleukin (IL)-1β with and without cyclooxygenase 2 (COX-2) inhibition.
Methods: NP cells cultured in alginate beads were activated with IL-1β ± the COX-2 inhibitor Sc-58125.