Aims: To evaluate the use of hybrid (telehealth and in-person) care on visitation and glycaemia in older adults with type 1 diabetes (T1D).
Methods: In this retrospective study, we examined clinical characteristics, number of visits (telehealth and in-person) and continuous glucose monitoring (CGM) metrics for older adults (≥65 years) with T1D from electronic health records during the pre-COVID-19 pandemic (March 1, 2019-March 1, 2020; in-person) and pandemic (September 1, 2020-August 31, 2021; hybrid) periods. Main outcomes were the number of visits and changes in glycaemic control (HbA1c), and in a sub-group of older adults using CGM, changes in CGM metrics between in-person and hybrid care.
This review article explores the advancements in sacropelvic fixation, comparing traditional and modern techniques, with a focus on iliac and sacral 2 alar-iliac screw fixations. It addresses the biomechanical challenges inherent in securing the lumbosacral junction and discusses the integration of current and future technologies like robotics and augmented reality to improve surgical outcomes. The article underscores the importance of these innovations in enhancing stability and reducing complications in complex spinal surgeries.
View Article and Find Full Text PDFBackground: Magnetic resonance imaging (MRI) is increasingly used as an adjunct to spinal soft tissue evaluation in cervical spine (C-spine) trauma; however, the utility of this information remains controversial. In this consecutive observational study, we reviewed the utility of MRI in patients with C-spine trauma.
Methods: We identified patients in real time over a 2-year period as they presented to our level 1 trauma center for C-spine computed tomography (CT) scan followed by MRI.
Objective: Odontoid fractures are the most common fracture of the cervical spine in adults older than 65 years of age. Fracture management remains controversial, given the inherently increased surgical risks in older patients. The objective of this study was to compare fusion rates and outcomes between operative and nonoperative treatments of type II odontoid fractures in the older population.
View Article and Find Full Text PDFBackground: COVID-19 has impacted neurosurgical care around the world. But reports describing patient admission trends during the pandemic have provided limited time frames and diagnoses. The purpose of this paper was to analyze the impact of COVID-19 on neurosurgical care provided to our emergency department during the outbreak.
View Article and Find Full Text PDFBackground: Spinal hematomas are a rare entity with broad etiologies, which stem from idiopathic, tumor-related, and vascular malformation etiologies. Less common causes include traumatic blunt nonpenetrating spinal hematomas with very few cases being reported. In the present manuscript presents a case report and review of the literature of a rare traumatic entity of a cervical subarachnoid hematoma in association with Brown-Séquard syndrome in a patient on anticoagulants.
View Article and Find Full Text PDFBackground: Complete cervical spinal cord injury is devastating with the currently available treatment modalities offering no hope for improvement. Intrathecal pressure is raised following spinal cord injury due to injured and edematous spinal cord. Due to constraints of the thecal sac, this sets up a vicious cascade leading to further spinal cord injury.
View Article and Find Full Text PDFStudy Design: Systematic Review and Meta-Analysis.
Objectives: The elderly have an increased risk of perioperative complications for Adult Spinal Deformity (ASD) corrections. Stratification of these perioperative complications based on risk type and specific risk factors, however, remain unclear.
Objective: To conduct a bibliometric review of literature on posterior ligamentous complex (PLC) injury in thoracolumbar trauma to guide future research.
Methods: A keyword-based search was conducted from January 2000 to September 2021 using the Scopus database. Relevant publications were analyzed for year of publication, authorship, publishing journal, institution and country of origin, subject matter, and article type.
Objective: We sought to determine the extent to which polytrauma significantly impacts intrahospital mortality among patients with complete cervical spinal cord injury (cSCI) and to assess whether an organ system-based approach would be appropriate as a mortality predictor as compared with conventional standards to help guide prognosis and management.
Methods: We retrospectively reviewed patient medical records and assessed the type of associated trauma at presentation. We then reviewed its correlation with mortality in patients who were admitted at our institution between 2012 and 2021.
Background: Acute traumatic central cord syndrome (ATCCS) is the most common form of spinal cord injury in the United States. Treatment remains controversial, which is a consequence of ATCCS having an inherently different natural history from conventional spinal cord injury, thus requiring a separate classification system. We devised a novel Central Cord Score (CCscore), which both guides treatment and tracks improvement over time with symptoms specific to ATCCS.
View Article and Find Full Text PDFThis article reviews the historical origins of central cord syndrome (CCS), the mechanism of injury, pathophysiology, and clinical implications. CCS is the most common form of incomplete spinal cord injury. CCS involves a spectrum of neurologic deficits preferentially affecting the hands and arms.
View Article and Find Full Text PDFBackground: Spinal trauma is common in polytrauma; spinal cord injury (SCI) is present in a subset of these patients. Penetrating SCI has been studied in the military; however, civilian SCI is less studied. Civilian injury pathophysiology varies given the generally lower velocity of the projectiles.
View Article and Find Full Text PDFObjective: Cervical disc arthroplasty (CDA) is an accepted motion-sparing technique associated with favorable patient outcomes. However, heterotopic ossification (HO) and adjacent-segment degeneration are poorly understood adverse events that can be observed after CDA. The purpose of this study was to retrospectively examine 1) the effect of the residual exposed endplate (REE) on HO, and 2) identify risk factors predicting radiographic adjacent-segment disease (rASD) in a consecutive cohort of CDA patients.
View Article and Find Full Text PDFBackground: The border between the United States (US) and Mexico is an international boundary spanning 3000 km, where unauthorized crossings occur regularly. We examine patterns of neurotrauma, health care utilization, and financial costs at our level 1 trauma center incurred by patients from wall-jumping into the US.
Objective: To determine the clinical and socioeconomic consequences from neurotrauma as a result of jumping over the US-Mexico border wall.
Objective: Ewing sarcoma (ES) is among the most prevalent of bone sarcomas in young people. Less often, it presents as a primary lesion of the spine (5%-15% of patients with ES).
Methods: A systematic literature search was performed, querying several scientific databases per PRISMA guidelines.
Inflammatory changes after spinal cord injury (SCI) have been reported in animal models, but human studies are relatively limited. We examined cerebrospinal fluid (CSF) collected from subjects enrolled in a phase II placebo-controlled trial of minocycline for evidence of inflammatory and structural changes after acute human SCI. CSF was collected from 29 subjects every 6 h for 7 days and investigated for eight molecules.
View Article and Find Full Text PDFBackground: Only a few case reports and case series exist reporting on primary chondrosarcomas of the spine. The objective of this study was to gain a better understanding of this patient population and surgical techniques used for treatment.
Methods: A systematic literature search was performed in January 2018 querying several scientific databases, per PRISMA guidelines.