Association of hospital characteristics with outcomes for pediatric neurosurgical accidental trauma patients.

Objective: In the pediatric population, few studies have examined outcomes for neurosurgical accidental trauma care based on hospital characteristics. The purpose of this study was to explore the relationship between hospital ownership type and children's hospital designation with primary outcomes.

Methods: This retrospective cohort study utilized data from the Healthcare Cost and Utilization Project 2006, 2009, and 2012 Kids' Inpatient Database.

A Retrospective Pilot Study for Preoperative Screening to Prevent Iatrogenic Cervical Spinal Cord Injury.

Purpose: The preoperative medical clearance process is well established to screen for medical comorbidities and therefore must be thorough. However, screening for potential cervical spine disease is often overlooked. In older surgical candidates, the presence of cervical spondylosis can increase risk of iatrogenic cervical spine injury during prolonged neck extension in non-spinal surgeries.

Effects of Glucose Deprivation on ATP and Proteoglycan Production of Intervertebral Disc Cells under Hypoxia.

As the most common cause of low back pain, the cascade of intervertebral disc (IVD) degeneration is initiated by the disappearance of notochordal cells and progressive loss of proteoglycan (PG). Limited nutrient supply in the avascular disc environment restricts the production of ATP which is an essential energy source for cell survival and function such as PG biosynthesis. The objective of this study was to examine ATP level and PG production of porcine IVD cells under prolonged exposure to hypoxia with physiological glucose concentrations.

Postoperative Sexual Activity Recommendations: Survey of Neurosurgeons/Spine Surgeons.

Objective: The impact of various types of spinal surgeries on sexual health and postoperative sexual activity is a common question among both patients and health care professionals. Unfortunately, there is no clear answer to this question in the scientific literature. Our goal was to survey the current practices and recommendations of neurosurgeons to see if there was a clinical consensus.

Interlaminar stabilization and decompression for the treatment of bilateral juxtafacet cysts: Case report and literature review.

Introduction: Lumbar juxtafacet cysts (JFCs) are a common cause of lumbar radiculopathy which tend to occur in areas of increased facet mobility. While resection alone is a possible treatment, recent publications suggest that laminectomy alone for JFCs may not yield as favorable an outcome as laminotomies reinforced with posterior dynamic hardware. The Coflex is a novel interlaminar stabilization device that has been shown to achieve comparable results to rigid fusion in the management of lumbar stenosis in patients with no more than grade one anterolisthesis, and superior performance compared to laminectomy alone when a combined outcome score was used.

Lack of Current Recommendations for Resuming Sexual Activity Following Spinal Surgery.

Patients are faced with many questions surrounding the after effects of the various surgical procedures and their ability to return to preoperative activities. While patients often question whether surgery would provide alleviation of pain, weakness, and instability, they often have additional questions about sexual activity during their convalescence that are not always addressed. Although the literature shows postsurgical improvement in sexual activity in association with improved low back pain, reports vaguely address the variability in sexual activity recommendations based on anatomic location and type of spinal surgery.

Does the Cage Position in Transforaminal Lumbar Interbody Fusion Determine Unilateral versus Bilateral Screw Placement?: A Review of the Literature.

This literature review examines the relative placement of the interbody cage with respect to the unilateral screw construct to address the need for bilateral screw placement versus unilateral screw placement. Transforaminal lumbar interbody fusion (TLIF) has become a widely used technique for correcting lumbar intervertebral pathologies. This review addresses the necessity for further study on the effects of the relative position of intervertebral cage placement on the outcome of lumbar spine surgery after TLIF with unilateral pedicle screw fixation.

Preoperative skin antisepsis with chlorhexidine gluconate versus povidone-iodine: a prospective analysis of 6959 consecutive spinal surgery patients.

OBJECTIVE The aim of this study was to determine the efficacy of 2 common preoperative surgical skin antiseptic agents, ChloraPrep and Betadine, in the reduction of postoperative surgical site infection (SSI) in spinal surgery procedures. METHODS Two preoperative surgical skin antiseptic agents-ChloraPrep (2% chlorhexidine gluconate and 70% isopropyl alcohol) and Betadine (7.5% povidone-iodine solution)-were prospectively compared across 2 consecutive time periods for all consecutive adult neurosurgical spine patients.

Enhancement of Energy Production of the Intervertebral Disc by the Implantation of Polyurethane Mass Transfer Devices.

Insufficient nutrient supply has been suggested to be one of the etiologies for intervertebral disc (IVD) degeneration. We are investigating nutrient transport into the IVD as a potential treatment strategy for disc degeneration. Most cellular activities in the IVD (e.

Percutaneous Drainage of Chronic Destructive Lumbar Osteomyelitis Abscess Via the Use of Bilateral Transpedicular Trocar Access.

Background: Pyogenic spondylodiskitis is an infection of intervertebral disks and spinal vertebral bodies. Various minimally invasive approaches to the infected disk spaces/abscesses have been described for management of early stages of the infection. Patients with chronic occurrence present with extensive infection, neurologic deficits, and bone destruction.

Influences of Nutrition Supply and Pathways on the Degenerative Patterns in Human Intervertebral Disc.

Study Design: Investigation of the effects of the impairment of different nutritional pathways on the intervertebral disc degeneration patterns in terms of spatial distributions of cell density, glycosaminoglycan content, and water content.

Objective: The aim of this study was to test the hypothesis that impairment of different nutritional pathways would result in different degenerative patterns in human discs.

Summary Of Background Data: Impairment of nutritional pathways has been found to affect cell viability in the disc.

A murine model of hypertonic saline as a treatment for acute spinal cord injury: effects on autonomic outcome.

Object: spinal cord injury (SCI) continues to be a problem without a definitive cure. Research based on improved understanding of the immunological aspects of SCI has revealed targets for treating and ameliorating the extent of secondary injury. Hypertonic saline (HTS), a substance both easy to create and to transport, has been investigated as an immunologically active material that can be used in a clinically relevant interval after injury.

An unusual case of footdrop: anterior disc herniation mimicking a nerve sheath tumor.

Objective: Extreme lateral disc herniations are described. Usually, the herniated disc is described as being at the lateral edge of the neural foramen. Herniated discs that lodge beyond this location need to be included in the differential of retroperitoneal lesions impinging on nerve roots.

Transplantation of autologous Schwann cells for the repair of segmental peripheral nerve defects.

Peripheral nerve injuries are a source of chronic disability. Incomplete recovery from such injuries results in motor and sensory dysfunction and the potential for the development of chronic pain. The repair of human peripheral nerve injuries with traditional surgical techniques has limited success, particularly when a damaged nerve segment needs to be replaced.

Small mammal MRI imaging in spinal cord injury: a novel practical technique for using a 1.5 T MRI.

The field of spinal cord injury research is an active one. The pathophysiology of SCI is not yet entirely revealed. As such, animal models are required for the exploration of new therapies and treatments.

Neuroendoscopy for spinal disorders: a brief review.

Neuroendoscopy has grown rapidly in the last 20 years as a therapeutic modality for treating a variety of spinal disorders. Spinal endoscopy has been widely used to treat patients with cervical, thoracic, and lumbosacral disorders safely and effectively. Although it is most commonly used with minimally invasive lumbar spine surgery, endoscopy has gained widespread acceptance for the treatment of thoracic disc herniations and for anterior release and rod implantation in the correction of thoracic spinal deformity.