Is the likelihood of dysphagia different in patients undergoing one-level versus two-level anterior cervical discectomy and fusion?

Background Context: Dysphagia following anterior cervical discectomy and fusion (ACDF) is a common complication, the etiology of which has not been established. Given that one potential mechanism for dysphagia is local tissue edema, it is thought that a greater number of operative levels may result in higher dysphagia rates. However, prior reports comparing one-level to two-level ACDF have shown varying results.

Retrospective Review of Immediate Restoration of Lordosis in Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Comparison of Static and Expandable Interbody Cages.

Background: Sagittal alignment is an important consideration in spine surgery. The literature is conflicted regarding the effect of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) on sagittal parameters and the role of expandable cage technology.

Objective: To compare lordosis generated by static and expandable cages and to determine what factors affect postoperative sagittal parameters.

Predictive Factors of Postoperative Dysphagia in Single-Level Anterior Cervical Discectomy and Fusion.

Study Design: Retrospective review of prospectively collected data.

Objective: To investigate if zero profile devices offer an advantage over traditional plate/cage constructs for dysphagia rates in single level anterior cervical discectomy and fusion (ACDF).

Summary Of Background Data: Dysphagia rates following ACDF have been reported to be as high as 83%, most cases are self-limiting, but chronic dysphagia can continue in up to 35% of patients.

Restoration of lumbar lordosis after minimally invasive transforaminal lumbar interbody fusion: a systematic review.

Background: Transforaminal lumbar interbody fusion (TLIF) is a well-accepted surgical technique for the treatment of degenerative spinal conditions and spinal deformity. The TLIF procedure can be performed open or using minimally invasive techniques. While several studies have found that minimally invasive TLIF (MI-TLIF) has advantages over open TLIF procedures with less blood loss, postoperative pain and hospital length of stay, opponents of the minimally invasive technique cite the lack of restoration of lumbar lordosis as a major drawback.

Urinary N-Telopeptide Can Predict Pseudarthrosis After Anterior Cervical Decompression and Fusion: A Prospective Study.

Study Design: Prospective cohort study.

Objective: To examine preoperative urinary cross-linked n-telopeptide (uNTx) and assess for association with fusion rates in patients undergoing single and multi-level anterior cervical decompression and fusion (ACDF).

Summary Of Background Data: Although high rates of fusion have been reported for ACDF, the risk of pseudarthrosis remains substantial.

Overpowering the Previously Posterior Instrumented Cervical Spine With Cage-Assisted Anterior Cervical Discectomy and Fusion: A Cadaveric Study.

Purpose: Cervical spines previously posteriorly instrumented and fused with a kyphotic deformity represent a surgical challenge. Current treatment strategies include C7 pedicle subtraction osteotomy or a posterior-anterior-posterior approach, which carry the risk of significant complications. The objective of this study was to attempt to achieve lordosis with multiple anterior cervical discectomy and fusion (ACDF) cages to overpower the posterior instrumentation.

Can Posterior Lumbar Instrumentation and Fusion Be Overpowered by Anterior Lumbar Fusion With Hyperlordotic Cages? A Cadaveric Study.

Study Design: Technical report on cadavers.

Objective: To evaluate preliminary feasibility and safety of lumbar sagittal alignment correction with anterior hyperlordotic cages used to overpower previous posterior spinal instrumentation.

Methods: Hyperlordotic 30° anterior lumbar interbody fusion (ALIF) cages were inserted in collapsed L5-S1 disc space of 2 cadavers to overpower prior posterior L5-S1 pedicle screws and rod constructs.

Overpowering posterior lumbar instrumentation and fusion with hyperlordotic anterior lumbar interbody cages followed by posterior revision: a preliminary feasibility study.

OBJECTIVE The authors' aim in this study was to evaluate whether sagittal plane correction can be obtained from the front by overpowering previous posterior instrumentation and/or fusion with hyperlordotic anterior lumbar interbody fusion (ALIF) cages in patients undergoing revision surgery for degenerative spinal conditions and/or spinal deformities. METHODS The authors report their experience with the application of hyperlordotic cages at 36 lumbar levels for ALIFs in a series of 20 patients who underwent revision spinal surgery at a single institution. Included patients underwent staged front-back procedures: ALIFs with hyperlordotic cages (12°, 20°, and 30°) followed by removal of posterior instrumentation and reinstrumentation from the back.

Anterior hyperlordotic cages: early experience and radiographic results.

OBJECTIVE The aim of this study was to evaluate the segmental correction obtained from 20° and 30° hyperlordotic cages (HLCs) used for anterior lumbar interbody fusion in staged anterior and posterior fusion in adults with degenerative spinal pathology and/or spinal deformities. METHODS The authors report a retrospective case series of 69 HLCs in 41 patients with adult degenerative spine disease and/or deformities who underwent staged anterior, followed by posterior, instrumentation and fusion. There were 29 females and 12 males with a mean age of 55 years (range 23-76 years).

Vertebral body fracture after TLIF: a new complication.

Background: The transforaminal posterior approach (TLIF) procedure was first described in 1982. Current literature indicates its equality in outcomes for fusion constructs as other anterior-posterior procedures. As a procedure becomes more popular and is more frequently performed the types and number of complications that occur increase.

Anatomical considerations for percutaneous trans ilio-sacroiliac S1 and S2 screw placement.

Objective: To determine the presence of a consistent osseous corridor through S1 and S2 and fluoroscopic landmarks thereof, which could be used for safe trans ilio-sacroiliac screw fixation of posterior pelvic ring disorders.

Study Design: Computed tomography (CT) based anatomical investigation utilising multiplanar image and trajectory reconstruction (Agfa-IMPAX Version 5.2 software).

Self-control training leads to enhanced cardiovascular exercise performance.

The purpose of the study was to investigate the effects of two weeks of self-control strength training on maximum cardiovascular exercise performance. Forty-one participants completed a cognitive self-control depletion task (Stroop task) followed by a maximal graded cycling test and were randomized to training (maximal endurance contractions of spring handgrip trainers, twice daily) or no-treatment control groups. At follow-up (2 weeks), half of each group completed either a time-matched or trial-matched Stroop task followed by another maximal graded cycling test.

Sources of self-efficacy and coach/instructor behaviors underlying relation-inferred self-efficacy (RISE) in recreational youth sport.

Interpersonal feedback from coaches may be instrumental in the formation of children's self-efficacy to learn or perform sport skills. We report on two studies that explored perceived sources of self-efficacy and relation-inferred self-efficacy (RISE) in one-on-one interviews with sport camp participants (N = 61; ages 7-12) and focus groups with recreational league participants (N = 28; ages 8-12). Participants' responses indicated that prior experiences and socially constructed interactions contributed to the development of self-efficacy and RISE beliefs.

Determinants of clients' efficacy in their interventionists and effects on self-perceptions for exercise in cardiac rehabilitation.

Objective: To examine characteristics of client-interventionist interactions that may contribute to development of exercise-related efficacy beliefs of cardiac rehabilitation (CR) participants.

Participants And Design: Study 1 used a correlational design to investigate relationships between CR program experience and proxy efficacy for in-class and self-regulated exercise in a sample of CR participants (N = 222). Study 2 used an experimental design and mentalizing procedure to manipulate proxy efficacy of CR participants (N = 49) and compared responses to hypothetical scenarios depicting either positive and supportive or interpersonally neutral interactions with CR interventionists.

Medial approach for hindfoot arthrodesis with a valgus deformity.

Background: Surgical correction of valgus deformity of the hindfoot has traditionally been via a lateral incision, often complicated by wound healing problems and sural nerve damage. Potential advantages of a medial approach especially for a valgus deformity include excellent wound healing, no risk of damage to the sural nerve and extensibility of the approach to include additional procedures such as navicular fusion or tendon transfer if indicated.

Materials And Methods: We present a retrospective review of 18 consecutive patients with valgus deformity of the hindfoot, all undergoing arthrodesis via a medial approach.

Osteoporosis by forearm bone densitometry in postmenopausal women in West Virginia.

Forearm bone densitometry examination predicts the relative risk of osteoporotic fracture, but not as reliably as central densitometry of the hip and spine. The ease of performance, inexpensiveness, and mobility of this technique makes it especially appealing in rural states like West Virginia. After evaluating 1,321 Caucasian women in West Virginia by peripheral bone densitometry at the proximal 1/3 radius region, we found a 26.

Cutting crime: the analysis of the "uniqueness" of saw marks on bone.

Witness marks produced on bone by the use of saws have traditionally been examined using stereomicroscopy. The marks are typically found on the kerf wall or floor and give important information about the implement that made them. This paper describes a new approach to the analysis of witness marks left on kerf walls and floors from crimes involving dismemberment.

Cost-effectiveness strategies to treat osteoporosis in elderly women.

Background: Comparing the cost-effectiveness of various antiosteoporotic drugs has not been defined.

Methods: We determined the cost-effectiveness of calcitonin, raloxifene, bisphosphates and PTH in a base-case cohort of women aged 65 or older with osteoporosis. After bone densitometry, women were stratified into groups of treatment or no treatment.

Temporal and spatial profiling of the modification of an electroactive polymeric interface using neutron reflectivity.

Electropolymerized films of the functionalized pyrrole, pentafluorophenyl-3-(pyrrol-1-yl)propionate (PFP), were reacted with a solution-phase nucleophile, ferrocene ethylamine. This reaction was chosen as a model representative of a postdeposition modification of the polymer membrane's properties. For the first time, a nondestructive method for direct chemical analysis of the reaction profile within the electrodeposited polymer membrane after nucleophilic substitution is presented.

Factors determining calcium intake in elderly women of Appalachia.

Background: Although it has been recommended that women aged 65 and older consume at least 1,500 mg of calcium daily, no studies are available that define the factors associated with adequate intake.

Methods: We studied 184 elderly women to determine the relationship between foodstuff calcium consumption and anthropomorphic measurements and numerous life-style changes.

Results: The mean foodstuff calcium consumption was 563.

Post-menopausal osteoporosis and estrogens. Who should be treated and why.

Estrogen deficiency after menopause results in loss of skeletal calcium and increased risk of bone fractures. Administration to postmenopausal women of a daily dose of 0.625 mg of conjugated equine estrogen, 1 mg estradiol-17 beta, or 0.