Recent backbone items

Single vs. Dual Adjustment Cervical Collars: A Critical Patient Evaluation

Thu, 3 Sep 2020 00:00:00 +0000

The purpose of this study was to assess the benefits, if any, of having dual adjustment on the cervical neck collar -- which allows for height adjustment and allows tilting of the neck slightly to the right or to the left. The collars are used for treatment of acute neck injury, painful cervical degenerative changes as well as post-surgical neck cases. Results indicate that dual adjustable collars provide more comfort and pain relief and allow for more air circulation and less skin irritation for patients as opposed to the single adjustment control collars.

Review of Human Coronaviruses and Other Respiratory Viruses and their Neurological Impact on the Central Nervous System

Thu, 2 Apr 2020 00:00:00 +0000

Comprehensive reporting shows that some pathogens, including COVID-19, influenza A and SARS-CoV have sometimes caused pandemics and were linked to more serious diseases and death. A number of respiratory viruses can travel from the respiratory tract to the central nervous system, causing alterations and damage and resulting in long-term neurological diseases.⁵

Treating Doctors Must be Proactive to Obtain Approval of Treatment for Injured Workers

Thu, 2 Apr 2020 00:00:00 +0000

Preface: Many spine surgeons handle cases of injured workers. This article, which includes in-depth research on workers' compensation laws, provides physicians with an insightful look into the legal side of spine practice.

Narrative Review: Disc Herniation After Motor Vehicular Trauma

Wed, 1 Jan 2020 00:00:00 +0000

Spinal pain that arises from motor vehicular trauma is challenging to the treating physician due to the wide spectrum of presenting symptoms and responses to treatment, including traumatic disc herniations. The severity of injuries varies from patient to patient, with imaging often not strictly correlating to symptomatology. However, with a systematic approach, including an understanding of the limitations of magnetic resonance imaging (MRI) and the role of cytokines and inflammatory mediators, the treatment and diagnosis from patients suffering from traumatic disc herniations can be improved^1,2. Furthermore, evidence supports conservative management before escalation to more invasive procedures such as epidurals or surgery, specifically in uncomplicated spinal injury patients with no evidence of neural compromise warranting emergency surgery^3,4. Should surgery be needed, mounting evidence supports intervention with minimally invasive discectomy for...

Normal lumbar MRI scans in patients with lower back pain following injury

Sat, 11 May 2019 00:00:00 +0000

Background: There have been numerous studies highlighting abnormal lumbar spine magnetic resonance imaging (MRI) findings in asymptomatic patients, exhibiting a correlation of increased findings with age; however, little research has been done to investigate the likelihood of normal MRI scans in patients who present with lower back pain.¹This study is pertinent to understanding (1) whether MRI scans are given to patients who do not necessarily require such extensive testing and whether current profligate medical and (2) work-related expenses can be avoided.

Methods: In this study, 189 lumbar spine MRI scans of patients who were 30 years or younger, presenting with lower back pain following a personal or work-related injury, were analyzed for potential findings or lack thereof. The patients were grouped into categories of “normal MRI” and “abnormal MRI” findings based on criteria created by two board certified orthopedic surgeons.

Results:...

Feasibility of Single Use Surgical Equipment in a Spine Surgical Setting: A Review of the Literature

Sat, 11 May 2019 00:00:00 +0000

Surgical procedures are costly due to staffing, medication use and processing and maintenance of surgical equipment. Surgical procedures involve a varying quantity of instrumentation depending on several factors including the degree of difficulty of the procedure and the individual surgeon’s needs and preferences. Most facilities process unused surgical tools wasting labor and costs. Trimming costs while maintaining quality of care is a constant challenge in healthcare. This review discusses utilizing lean methodology to discover waste with surgical tools, implementing changes to common surgical tools and the feasibility of incorporating disposable tools.

Anterior Cervical Corpectomy and Fusion with the C-VBR

Sun, 11 Nov 2018 00:00:00 +0000

Abstract

Introduction: Anterior Cervical Corpectomy and Fusion (ACCF) procedures are increasing as the population ages and cancer treatments improve. Currently, one expandable and one non-expandable cervical Vertebral Body Replacement (VBR) devices have been FDA 510(k) approved. Cervical VBR device specific data has yet to be established.

Object: To present the efficacy and safety data of the first non-expandable cervical VBR device to receive FDA 510(k) approval.

Methods: A retrospective consecutive series of 56 female and 41 male ACCF patients, from a single institution, were followed for an average of 30 months. ACCF patients were, on average, taking 11 different daily medications, 40 (41%) were smokers and 39 (40%) were on anticoagulation therapy that required pre- and post-operation management. Eighty-nine percent were American Society of Anesthesiologists (ASA)...

Anesthesia Pitfalls and Considerations for Spine Surgery

Sat, 10 Nov 2018 00:00:00 +0000

Surgery on the spine and spinal cord involves a wide variety of surgical procedures whose pathologies depend on the age of the patient. For children and teenagers the most common reason to need spine surgery is to either correct spinal deformities or oncologic disease. The pathologies that adult spine patients typically present with are trauma, infection, malignancy causing neurologic compromise, idiopathic spinal deformity, and degenerative disease. This can lead to a wide range of spinal surgeries including minimally invasive decompression procedures to major deformity correction involving osteotomies and major blood loss. These adult patients have a unique set of anesthetic challenges and the goal should be to provide an individualized anesthetic plan to optimize outcomes.