Publications by authors named "John A Carrino"

Purpose: Computed tomography (CT) scans are widely used clinically in the diagnosis of ossification of the posterior longitudinal ligament (OPLL). Conventionally acquired magnetic resonance imaging (MRI) is limited by insufficient signal intensity within bone tissue. Osseus conspicuity may be enhanced by applying sequences with "CT-like" bone contrast zero-echo time (ZTE) MRI.

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Weight-bearing computed tomography (WBCT) was introduced in 2012 for foot and ankle applications as a breakthrough technology that enables full weight-bearing, three-dimensional imaging unaffected by x-ray beam projections or foot orientation. The literature describing the use of WBCT in the treatment of foot and ankle disorders is growing, and this article provides an overview of what can be measured with WBCT.

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Background: A range of sacroiliac joint (SIJ) MRI protocols are used in clinical practice but not all were specifically designed for diagnostic ascertainment. This can be confusing and no standard diagnostic SIJ MRI protocol is currently accepted worldwide.

Objective: To develop a standardised MRI image acquisition protocol (IAP) for diagnostic ascertainment of sacroiliitis.

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Article Synopsis
  • The study looks at kids who hurt their ACLs (a ligament in the knee) to see how many had bone bruises and where those bruises were located.
  • It focuses on comparing injuries that happened from contact (like a tackle) versus non-contact (like twisting the knee).
  • The researchers reviewed MRIs from 109 kids, finding that most had non-contact injuries, but there were no major differences in age or other injury details between the two groups.
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Computed tomography (CT) is a common modality employed for musculoskeletal imaging. Conventional CT techniques are useful for the assessment of trauma in detection, characterization and surgical planning of complex fractures. CT arthrography can depict internal derangement lesions and impact medical decision making of orthopedic providers.

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Objective: There are limited data about the influence of the lumbar paraspinal muscles on the maintenance of sagittal alignment after pedicle subtraction osteotomy (PSO) and the risk factors for sagittal realignment failure. The authors aimed to investigate the influence of preoperative lumbar paraspinal muscle quality on the postoperative maintenance of sagittal alignment after lumbar PSO.

Methods: Patients who underwent lumbar PSO with preoperative lumbar MRI and pre- and postoperative whole-spine radiography in the standing position were included.

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Article Synopsis
  • - The study aimed to explore how pre-surgery evaluations of paraspinal muscle characteristics affect recovery outcomes and neck alignment after anterior cervical discectomy and fusion (ACDF) surgery.
  • - Researchers analyzed the muscle areas and fat infiltration of specific neck muscles in patients, correlating these with changes in neck disability scores and spinal alignment over time.
  • - Results indicated that larger muscle areas and lower fat content in certain muscles were linked to better postoperative alignment and less disability, emphasizing the value of assessing muscle condition prior to surgery.
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Study Design: Retrospective study.

Objective: The aim of this study was to evaluate the association between severity and level of cervical central stenosis (CCS) and the fat infiltration (FI) of the cervical multifidus/rotatores (MR) at each subaxial levels.

Summary Of Background Data: The relationship between cervical musculature morphology and the severity of CCS is poorly understood.

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Inter-reader reliability of a new scoring system for evaluating joint inflammation and enthesitis in whole body MRI (WBMRI) in juvenile idiopathic arthritis was tested. The scoring system grades 732 item-region combinations of bone marrow and soft tissue changes for commonly involved joints and entheseal sites. Five radiologists rated 17 WBMRI scans through an online rating platform.

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  • Biplanar imaging (2D) has traditionally been used for positioning pedicle screws (PS), but recent advancements with intraoperative 3D imaging using the Gertzbein-Robbins system (GRS) may provide more accurate assessments.
  • A study analyzed data from 204 patients undergoing spinal surgery, finding that many screws could be falsely validated as correctly placed using only 2D imaging, whereas 3D imaging confirmed their actual positioning.
  • The research concluded that intraoperative 3D scans are as reliable as postoperative CT scans in assessing PS placement, suggesting that they could be a better method to avoid misreading screw positions with 2D imaging before surgery ends.
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  • The study was a retrospective longitudinal analysis investigating the link between lumbar intervertebral disk degeneration (DD) and vertebral bone quality (VBQ) scores, focusing on patients who experienced low back pain and underwent MRI scans over a three-year period.
  • Results showed a significant increase in VBQ scores from baseline to follow-up, with a positive correlation between various levels of disk degeneration and bone quality observed over time.
  • The conclusion suggests that advanced and persistent DD is linked to lower VBQ scores, indicating that higher bone marrow fat content may lead to potentially stronger bone, highlighting the influence of DD on bone quality assessments.
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Objective: The cervical multifidus and rotatores muscles are innervated by the posterior rami of the spinal nerves of the corresponding level, and it has been hypothesized that cervical foraminal stenosis (CFS) affecting the spinal nerves results in changes in these muscles. The purpose of this study was to evaluate the relationship between the severity of CFS and fat infiltration (FI) of the multifidus and rotatores muscles.

Methods: Patients who received preoperative cervical MRI, underwent anterior cervical decompression and fusion between 2015 and 2018, and met inclusion and exclusion criteria were included.

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Background And Purpose: Spinal segment variants are highly prevalent and can potentially lead to incorrect spinal enumeration and, consequently, interventions or surgeries at the wrong vertebral levels. Our aim was to assess the prevalence of spinal segment variants and to study the potential association among these variants in a population without histories of spine symptoms.

Materials And Methods: Consecutive computed tomography exams of 450 young adults originally evaluated for non-spinal conditions and without a history of spinal diseases from a single institution.

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Study Design: Retrospective review of prospectively collected data.

Objective: The authors aim to investigate the association between muscle functional group characteristics and sagittal alignment parameters in patients undergoing anterior cervical discectomy and fusion.

Summary Of Background Data: The relationship between the morphology of cervical paraspinal muscles and sagittal alignment is not well understood.

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Unlabelled: Poor bone quality is a risk factor for complications after spinal fusion surgery. This study investigated pre-operative bone quality in postmenopausal women undergoing spine fusion and found that those with small bones, thinner cortices and surgeries involving more vertebral levels were at highest risk for complications.

Purpose: Spinal fusion is one of the most common surgeries performed worldwide.

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Magnetic resonance neurography (MRN) is increasingly used to visualize peripheral nerves in vivo. However, the implementation and interpretation of MRN in the brachial and lumbosacral plexi are challenging because of the anatomical complexity and technical limitations. The purpose of this article was to review the clinical context of MRN, describe advanced magnetic resonance (MR) techniques for plexus imaging, and list the general categories of utility of MRN with pertinent imaging examples.

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Article Synopsis
  • The study aimed to investigate if there were imaging and clinical differences between men and women that influenced their likelihood of undergoing fusion surgery for lumbar degenerative spondylolisthesis.
  • Analysis of 380 patients revealed that women exhibited different spinal characteristics and had a higher fusion surgery success rate (78%) compared to men (65%).
  • Factors influencing fusion success differed between genders, with women benefiting more from less comorbidity and greater spinal diastasis, while men showed a significant association with opioid use and greater spinal translation.
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Background Context: Although the effect of lumbar spinal stenosis (LSS) on the lower extremities is well documented, limited research exists on the effect of spinal stenosis on the posterior paraspinal musculature (PPM). Similar to neurogenic claudication, moderate to severe spinal canal compression can also interfere with the innervation of the PPM, which may result in atrophy and increased fatty infiltration (FI).

Purpose: This study aims to assess the association between LSS and atrophy of the PPM.

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Study Design: A randomized, double-blinded, placebo-controlled trial.

Objective: To examine the effect of intravenous ketorolac (IV-K) on hospital opioid use compared with IV-placebo (IV-P) and IV acetaminophen (IV-A).

Summary Of Background Data: Controlling postoperative pain while minimizing opioid use after lumbar spinal fusion is an important area of study.

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Study Design: Retrospective analysis of longitudinal data.

Objective: To assess the association between the paraspinal musculature (PM) and lumbar endplate degeneration.

Background: The PM is essential for spinal stability, while the vertebral endplate is pivotal for nutrient transport and force distribution.

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Article Synopsis
  • The phase III studies of subcutaneous tanezumab assessed joint safety due to concerns about rapidly progressive osteoarthritis (RPOA) in patients with moderate to severe hip or knee osteoarthritis.
  • A pooled analysis indicated that 3.2% of patients receiving tanezumab had composite joint safety events (CJSE), with a higher incidence among those on higher doses compared to placebo or NSAID groups.
  • The risk of RPOA and total joint replacement was notably higher in patients with more severe osteoarthritis at baseline, particularly those with Kellgren-Lawrence grades 2, 3, and 4, indicating a connection between the severity of OA and risks associated with tanezumab treatment.
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CT is one of the most widely used modalities for musculoskeletal imaging. Recent advancements in the field include the introduction of four-dimensional CT, which captures a CT image during motion; cone-beam CT, which uses flat-panel detectors to capture the lower extremities in weight-bearing mode; and dual-energy CT, which operates at two different x-ray potentials to improve the contrast resolution to facilitate the assessment of tissue material compositions such as tophaceous gout deposits and bone marrow edema. Most recently, photon-counting CT (PCCT) has been introduced.

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