Sensory sparing does not change long-term outcomes in motor complete spinal cord injuries.

Background Context: In the acute postinjury setting, the prognostic value of sensory sparing among motor complete spinal injury patients has been well demonstrated. However, once final AIS grade is achieved 1 year postinjury, the value of sensory sparing alone has not been elucidated. We hypothesized that sensory sparing would lead to better outcomes in AIS B over AIS A patients at long-term, postrecovery follow-up.

Perioperative major neurologic deficits as a complication of spine surgery.

Study Design: Retrospective review of spine surgery patients with new major neurologic complication.

Objective: To define the causes and severity of new neurologic damage to the spinal cord or cauda equina caused by spinal surgery.

Materials And Methods: Consult records were reviewed for all postoperative spine surgery patients referred to a tertiary spinal cord injury rehabilitation center over a 12-year period.

Combined Motor and Sensory Intraoperative Neuromonitoring for Cervical Spondylotic Myelopathy Surgery Causes Confusion: A Level-1 Diagnostic Study.

Study Design: Level-1 diagnostic study.

Objective: The purpose of this study was to evaluate the sensitivity and specificity of combined motor and sensory intraoperative neuromonitoring (IONM) for cervical spondylotic myelopathy (CSM).

Summary Of Background Data: Intraoperative neuromonitoring during spine surgery began with sensory modalities with the goal of reducing neurological complications.

Patterns of spinal cord injury in automobiles versus motorcycles and bicycles.

Study Design: Retrospective case series.

Objectives: To examine the patterns and relative rates of occurrence of spinal cord injury (SCI) in automobiles compared to motorcycles and bicycles.

Setting: Los Angeles County, California.

Non-locality and the misdiagnosis of Spinal Cord Injury Without Radiographic Abnormality: proof of concept.

Study Design: This is a retrospective review.

Objectives: To validate the concept of "non-locality" to explain cases of Spinal Cord Injury Without Radiographic Abnormality (SCIWORA) previously deemed inexplicable. To investigate and challenge the source data for the SCIWORA hypothesis which has the built-in assumption that a traumatic spinal cord injury (SCI) can only be caused by a local or adjacent spinal column injury and which, therefore, postulates that the pediatric spinal column is inherently more flexible than the spinal cord to explain SCI whenever a local spinal column injury is not detected.

Paraplegic patients: how to measure balance and what is normal or functional?

Purpose: To review the current understanding and data of sagittal balance and alignment considerations in paraplegic patients.

Methods: A PubMed literature search was conducted to identify all relevant articles relating to sagittal alignment and sagittal balance considerations in paraplegic and spinal cord injury patients.

Results: While there are numerous studies and publications on sagittal balance in the ambulatory patient with spinal deformity or complex spine disorders, there is paucity of the literature on "normal" sagittal balance in the paraplegic patients.

American Spinal Injury Association A (sensory and motor complete) is not different from American Spinal Injury Association B (sensory incomplete, motor complete) in gunshot-related spinal cord injury.

Background Context: We receive a large number of patients with spinal cord injury (SCI) due to penetrating gunshot wounds (GSW) at our national rehabilitation center. Although many patients are labeled American Spinal Injury Association (ASIA) B sensory incomplete because of sensory sparing, especially deep anal pressure, with purported prognostic value, we have not observed a clinical difference from patients labeled ASIA A complete. We hypothesized that sensory sparing, if meaningful, should reduce the occurrence of pressure ulcers.

Inadequate Surgical Decompression in Patients with Cervical Myelopathy: A Retrospective Review.

Study Design: Retrospective study.

Objective: We reviewed cases of surgically treated cervical spondylotic myelopathy (CSM) or chronic, degenerative myelopathy of the subaxial cervical spine to study the incidence of inadequate surgical decompression.

Methods: We included all persons treated at our institution after a first surgical decompression for CSM over a 3-year period.

Surgical Management of Civilian Gunshot-Induced Spinal Cord Injury: Is It Overutilized?

Study Design: Retrospective chart review.

Objective: Assess appropriate utilization of surgery for civilian gunshot-induced spinal cord injuries (CGSWSCI) according to literature standards in a large cohort.

Summary Of Background Data: CGSWSCI are mechanically stable injuries that rarely require surgery.

Overutilization of bracing in the management of penetrating spinal cord injury from gunshot wounds.

OBJECTIVE Penetrating gunshot wounds (GSWs) to the spinal column are stable injuries and do not require spinal orthoses or bracing postinjury. Nonetheless, a high number of GSW-related spinal cord injury (SCI) patients are referred with a brace to national rehabilitation centers. Unnecessary bracing may encumber rehabilitation, create skin breakdown or pressure ulcers, and add excessive costs.

Accuracy of percutaneous lumbar pedicle screw placement using the oblique or "owl's-eye" view and novel guidance technology.

Object: This study was conducted to assess the in vivo safety and accuracy of percutaneous lumbar pedicle screw placement using the owl's-eye view of the pedicle axis and a new guidance technology system that facilitates orientation of the C-arm into the appropriate fluoroscopic view and the pedicle cannulation tool in the corresponding trajectory.

Methods: A total of 326 percutaneous pedicle screws were placed from L-3 to S-1 in 85 consecutive adult patients. Placement was performed using simple coaxial imaging of the pedicle with the owl's-eye fluoroscopic view.

Scoliosis and interspinous decompression with the X-STOP: prospective minimum 1-year outcomes in lumbar spinal stenosis.

Background Context: The X-STOP interspinous decompression device, as a treatment for neurogenic intermittent claudication (NIC) because of lumbar spinal stenosis (LSS), has been shown to be superior to nonoperative control treatment. Current Food and Drug Administration labeling limits X-STOP use to NIC patients with a maximum of 25° concomitant lumbar scoliosis. This value was arrived at arbitrarily by the device developers and is untested.

Corrective osteotomies and osteosynthesis for supination contracture of the forearm in children.

Purpose: The purpose of this study was to present the authors' experience with corrective osteotomies of the forearm for supination contracture in children.

Methods: Fourteen patients with supination contracture of the forearm due to brachial plexus lesion (11), poliomyelitis residuals (2), or Monteggia fracture malunion (1) underwent distal ulnar osteotomy without fixation and subsequent midradial osteotomy with plate fixation to produce a position of greater pronation. A minimum of 6 months' follow-up was required to be included in the series.

Identification of mitogen-activated protein kinase kinase as a chemoresistant pathway in MCF-7 cells by using gene expression microarray.

Background: Components of the mitogen-activated protein kinase (MAPK) cascade have been implicated in apoptotic regulation. This study used gene expression profiling analysis to identify and implicate mitogen-activated protein kinase kinase (MEK5)-BMK1 (big mitogen-activated kinase-1)/extracellular signal related protein kinase (ERK5) pathway as a novel target involved in chemoresistance.

Methods: Differential gene expression between apoptotically sensitive (APO+) and apoptotically resistant (APO-) MCF-7 cell variants was determined by using microarray and confirmed by reverse transcriptase- polymerase chain reaction (RT-PCR).