Medical Specialties Commons^™

In Vivo Evaluation Of Stem Cell Aggregates On Osteochondral Regeneration., Banupriya Sridharan, Amy D. Laflin, Michael A. Holtz, Donna M. Pacicca, Nicholas K. Wischmeier, Michael S. Detamore

Manuscripts, Articles, Book Chapters and Other Papers

To date, many osteochondral regenerative approaches have utilized varied combinations of biocompatible materials and cells to engineer cartilage. Even in cell-based approaches, to date, no study has utilized stem cell aggregates alone for regenerating articular cartilage. Thus, the purpose of this study was to evaluate the performance of a novel stem cell-based aggregate approach in a fibrin carrier to regenerate osteochondral defects in the Sprague-Dawley rat trochlear groove model. Two different densities of rat bone marrow mesenchymal stem cell (rBMSC) aggregates were fabricated by the hanging drop technique. At 8 weeks, the cell aggregates supported the defects and served as …

Biomechanical Testing Of An Exercise For Strengthening The Proximal Femur., Alyssa Osbourne

Electronic Theses and Dissertations

Based on the principles of cutting edge bone remodeling research, a unique therapeutic exercise device was designed specifically to improve bone quality at the most critical location of the proximal femur prone to fracture: the superior-lateral femoral neck where the fracture first initiates during a fall. The exercise/device is intended to work by inducing enough strain in the bone to stimulate the body’s natural bone remodeling mechanisms to increase bone density in the proximal femur and consequently prevent a fracture from arising if a fall to the side does occur.

In order to test the proposed exercise, experiments simulating the …

Custom Software For The 3d Printing Of Patient Specific Plate Bending Templates In Pelvic Fracture Repair., Gordon B Lents

Electronic Theses and Dissertations

The purpose of this work is to reduce the operative time and blood loss incurred during open reduction and internal fixation (ORIF) of traumatic pelvic injuries through the creation of patient specific bending templates for reconstruction plates. These templates are 3D printed in a resin capable of being sterilized and taken into the operating room so that bending may be performed by the surgeon before the patient is opened or by another team member in parallel with the surgeon.

A novel software extension was created in 3D modeling software to allow a surgeon to individually position screws on a pelvic …

Patient-Reported Disability Measures Do Not Correlate With Electrodiagnostic Severity In Carpal Tunnel Syndrome., Jacob E Tulipan, Kevin F F. Lutsky, Mitchell G. Maltenfort, Mitchell K. Freedman, Pedro Beredjiklian

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Electrophysiologic studies including electromyography and nerve conduction studies play a role in the evaluation of carpal tunnel syndrome (CTS), despite evidence that these studies do not correlate with CTS-specific symptom scores. There is a lack of evidence comparing electrophysiologic data with general measures of function.

METHODS: Fifty patients presenting for CTS treatment over an 8-month period were analyzed retrospectively. All patients completed surveys including the Quick Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH) and the Medical Outcomes Study 12-Item Short-Form Survey [(physical component summary 12, mental component summary (MCS-12)]. Electromyography and nerve conduction studies were performed on …

Improving The Pharmacologic Management Of Patients After Osteoporotic Hip Fractures, Joseph Klaus, Milad Modarresi, Rodrigo Aguilar, Nasreen Benhamed, Franklin D. Shuler

Marshall Journal of Medicine

Abstract

Background

Osteoporotic hip fractures have become an increasingly common healthcare burden with significant morbidity and mortality in the geriatric population. Pharmacological management of the underlying osteoporosis is critical. Our objective is to determine the percentage of patients older than 65 who receive pharmacologic treatment of osteoporosis within six months after a fragility fracture at Cabell Huntington Hospital.

Methods

Data was extracted from medical records for patients age 65 or older who sustained a hip fracture during June 2013 - March 2015. Patients who received any form of pharmacologic treatment within six months after their fractures were identified. All analyses …

Trauma Team Activation For Geriatric Trauma At A Level Ii Trauma Center: Are The Elderly Under-Triaged?, Grant S. Buchanan, Daniel Scott Kahn, Harry Burke, Brian Czarkowski, Richard Boe, Milad Modarresi, Franklin D. Shuler

Marshall Journal of Medicine

Abstract

Geriatric patients often sustain life-threatening injuries from minor trauma. A growing body of research suggests that these patients are often under-triaged in the emergency setting.The purpose of this research was to evaluate whether or not geriatric trauma patients are under-triaged at a community based level II trauma center.

1434 trauma patients over the age of 65 presenting from 2010-2015 were retrospectively reviewed from the Cabell Huntington Hospital trauma registry and analyzed for age, gender, arrival type, ED response, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), injury cause, ICD-9 diagnosis codes, and mortality. Under-triage and over-triage rates were determined …

Corrosion And Tribology Of Materials Used In A Novel Reverse Hip Replacement, Linda Braddon, Zafer Termanini, Steven Macdonald, Jay Parvizi, Jay Lieberman, Victor Frankel, Joseph Zuckerman

Rothman Institute Papers

Total hip arthroplasty has been utilized for the past 50 years as an effective treatment for degenerative, inflammatory and traumatic disorders of the hip. The design of these implants has generally followed the anatomy of the hip as a ball and socket joint with the femoral head representing the ball and the acetabulum representing the socket. We describe a novel hip arthroplasty design in which the "ball" is located on the acetabular side and the "socket" is located on the femoral side. The results of extensive biomechanical testing are described and document wear and corrosion characteristics that are at least …

Lack Of Evidence For Involvement Of Tonebp And Hyperosmotic Stimulus In Induction Of Autophagy In The Nucleus Pulposus., Chao Liu, Hyowon Choi, Zariel I. Johnson, Jiwei Tian, Irving Shapiro, Makarand V Risbud

Department of Orthopaedic Surgery Faculty Papers

Nucleus pulposus (NP) cells reside in a physiologically hyperosmotic environment within the intervertebral disc. TonEBP/NFAT5 is an osmo-sensitive transcription factor that controls expression of genes critical for cell survival under hyperosmotic conditions. A recent report on NP and studies of other cell types have shown that hyperosmolarity triggers autophagy. However, little is known whether such autophagy induction occurs through TonEBP. The goal of this study was to investigate the role of TonEBP in hyperosmolarity-dependent autophagy in NP. Loss-of-function studies showed that autophagy in NP cells was not TonEBP-dependent; hyperosmolarity did not upregulate autophagy as previously reported. NP tissue of haploinsufficient …

Oncology Section Edge Task Force On Urogenital Cancer Outcomes: Clinical Measures Of Lymphedema—A Systematic Review, Joy C. Cohn, Hannah Geyer, Jeannette Lee, Mary Insana Fisher

Physical Therapy Faculty Publications

Background: Valid and reliable tools to assess lymphedema are necessary to accurately evaluate status and to objectively document and measure the results of interventions. Understanding the advantages and disadvantages of each measure can inform the clinician's choice of the appropriate tool to be used in the clinic or research setting.

Purpose: To identify reliable and valid measurement techniques that are sensitive to change for assessing edema volume or soft tissue change in the lower extremities or genital region of patients with lymphedema.

Methods: A systematic review of the literature was conducted to assess the published psychometric properties and clinical feasibility …

Motor Learning And Adaptation In People With Knee Osteoarthritis And Chronic Pain, Heather Turcotte, Katherine S. Rudolph

Osteopathic Medicine Student Research Posters

Osteoarthritis (OA) affects an estimated 50 million people in the US, and approximately 43% have limitations in daily function due to arthritis pain.3 Individuals with knee osteoarthritis (OA) have heightened sensitization to pain2,5 as well as reduced strength, diminished function and quality of life1 that prompts them to seek care from health care providers. Physical therapists commonly work with patients to improve function and quality of life by helping them learn to move without pain. Unfortunately, chronic pain causes changes to the nervous system that may impact the ability to learn new ways but the extent to which chronic pain …

Long-Term Outcomes In Anterior Cruciate Ligament Reconstruction: A Systematic Review Of Patellar Tendon Versus Hamstring Autografts., Kirsten L. Poehling-Monaghan, Hytham Salem, Kirsten E. Ross, Eric S Secrist, Michael C. Ciccotti, Fotios Tjoumakaris, Michael G. Ciccotti, Kevin B. Freedman

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Much controversy still exists surrounding graft choice in anterior cruciate ligament (ACL) reconstruction. Over the past decade, an increase in comparative studies with longer follow-up has enhanced our understanding of current graft options and outcomes.

PURPOSE: To describe the long-term comparative outcomes of ACL reconstruction with autograft bone-patellar tendon-bone (BPTB) versus autograft hamstring (HS) ACL reconstruction with regard to clinical and radiographic outcomes.

STUDY DESIGN: Systematic review; Level of evidence, 2.

METHODS: A search of the PubMed, MEDLINE, Cochrane, and Scopus databases was performed to identify studies in the English language with outcome data comparing ACL reconstruction utilizing autograft …

Volume Vi (2017), Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Outcome Of Judet's Quadricepsplasty For Knee Contractures And The Effect Of Local Infiltration Of Epinephrine On Reducing Blood Loss, Akber Jalil Zuberi, Haroon Rashid, Rizwan Haroon Rashid, Moiz Ali, Pervaiz Hashmi

Section of Orthopaedic Surgery

Objective: To evaluate the effectiveness of Judet's quadricepsplasty for treatment of knee contractures and to identify the effect of local infiltration of epinephrine on blood loss associated with this procedure.
Methods: A retrospective cohort study was conducted in which all cases of knee contractures managed with Judet's quadricepsplasty from 1st January 2009 to 31st December 2013 were included and were divided into two groups. The epinephrine group included patients who were infiltrated with diluted epinephrine (1:400,000) along with xylocaine, around the operative field 15 min prior to the incision time, while the control group did not receive any infiltration. Judet's …

Does The Spine Surgeon’S Experience Affect Fracture Classification, Assessment Of Stability, And Treatment Plan In Thoracolumbar Injuries?, Shanmuganathan Rajasekaran, Rishimugesh Kanna, Gregory D. Schroeder, Frank C. Oner, Luiz Vialle, Jens R. Chapman, Marcel Dvorak, Michael Fehlings, Ajoy P. Shetty, Klaus J. Schnake, Frank M. Kandziora, Alex R. Vaccaro

Rothman Institute Papers

Study Design: Prospective survey-based study. Objectives: The AO Spine thoracolumbar injury classification has been shown to have good reproducibility among clinicians. However, the influence of spine surgeons’ clinical experience on fracture classification, stability assessment, and decision on management based on this classification has not been studied. Furthermore, the usefulness of varying imaging modalities including radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) in the decision process was also studied. Methods: Forty-one spine surgeons from different regions, acquainted with the AOSpine classification system, were provided with 30 thoracolumbar fractures in a 3-step assessment: first radiographs, followed by CT and MRI. …

Clinical Application Of Ceramics In Anterior Cervical Discectomy And Fusion: A Review And Update, Shayan A. Zadegan, Aidin Abedi, Seyed B. Jazayeri, Hirbod Bonaki, Alex R. Vaccaro, Vafa Rahimi-Movaghar

Rothman Institute Papers

Study Design: Narrative review. Objectives: Anterior cervical discectomy and fusion (ACDF) is a reliable procedure, commonly used for cervical degenerative disc disease. For interbody fusions, autograft was the gold standard for decades; however, limited availability and donor site morbidities have led to a constant search for new materials. Clinically, it has been shown that calcium phosphate ceramics, including hydroxyapatite (HA) and tricalcium phosphate (TCP), are effective as osteoconductive materials and bone grafts. In this review, we present the current findings regarding the use of ceramics in ACDF. Methods: A review of the relevant literature examining the clinical use of ceramics …

Internal Hernia Of The Greater Omentum: Cadaveric Findings Of A Previously Unreported Variant., Andrea Andrea, Vy Tran, Cameron K Schmidt, Christian Fisahn, Joe Iwanaga, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Transomental hernias (TOHs) are a rare finding, constituting a fraction of all intestinal hernias. Here, we report the cadaveric discovery of a spontaneous TOH involving the sigmoid colon in an 82-year-old female and discuss the relevant literature. To our knowledge, a TOH involving the sigmoid colon has not been previously reported.

Early Versus Delayed Rehabilitation After Arthroscopic Rotator Cuff Repair, Abigail Chang, Jessica Dennis

Physician Assistant Capstones, 2016 to 2019

Objective: To determine how the timing of rehabilitation, early versus delayed, affects clinical results and tendon healing rates after arthroscopic rotator cuff repair. Design: Systematic literature review. Methods: Searches were done in PubMed, utilizing the terms arthroscopic rotator cuff repair, rehabilitation, early, and delayed. In PubMed the following filters and terms were used: published in the last 10 years, humans, randomized controlled trial, free full-text articles, and English. Results: The Keener et al study was included because it evaluated clinical results and tendon healing rates after arthroscopic repair using two distinct rehabilitation protocols, early versus delayed …

Effects Of Glucosamine Versus Chondroitin Sulfate In Reducing Joint Space Narrowing In Knee Osteoarthritis, Caroline Horton, Ashani Andrews

Physician Assistant Capstones, 2016 to 2019

Objective: To determine if over the counter supplements, chondroitin sulfate and glucosamine, in combination or alone, are effective in the treatment of joint space narrowing (JSN) in knee osteoarthritis.

Design: Systematic Literature Review

Methods: Database search of PubMed and MEDLINE using the search terms “glucosamine”, “chondroitin sulfate”, “osteoarthritis”, and joint space narrowing. Filters were implemented to include articles that only dealt with human subjects, that were published in 2000 or later, and were full-text. Articles were excluded if they were cohort studies, reviews, non-English papers, or had pain as the only outcome.

Results: Sawitzke et al.primary outcomes revealed no …

Bupivacaine Vs. Ropivacaine: Looking At The Chondrotoxic Effects Of Intraarticular Anesthetics In Osteoarthritic Joints, Sarah Burke, Lauren Price

Physician Assistant Capstones, 2016 to 2019

Objectives: Intraarticular injections of corticosteroids used in combination with local anesthetics are commonly used in orthopedic practice for osteoarthritic pain relief. Many orthopedists question whether these anesthetics have chondrotoxic effects on human articular cartilage. The purpose of this meta- analysis is to examine the chondrotoxic effects of local anesthetics on osteoarthritic human articular cartilage and to determine whether ropivacaine has fewer chondrotoxic effects than bupivacaine.

Methods: Studies were found using PubMed with the search terms, “Ropivacaine,” “Bupivacaine,” and “Chondrocytes.” Initially 20 studies were found. Several studies were eliminated using the following excluding factors: human studies, published in last 10 years, …

Undetected Small Accessory Mental Foramina Using Cone-Beam Computed Tomography., Joe Iwanaga, Koichi Watanabe, Tsuyoshi Saga, Shogo Kikuta, Yoko Tabira, Sadaharu Kitashima, Christian Fisahn, Fernando Alonso, R Shane Tubbs, Jingo Kusukawa, Koh-Ichi Yamaki

Articles, Abstracts, and Reports

INTRODUCTION: The accessory foramina could not be identified on some imaging modalities such as surface-rendered images. The purpose of this study was to investigate the ability of surface-rendered images in detecting these foramina.

MATERIALS AND METHODS: We analyzed 20 accessory mental foramina (AMF) in nine mandibles removed from cadavers with cone-beam computed tomography (CBCT) and assessed in surface-rendered images. All AMF were divided into three groups depending on their visibility.

RESULTS: Group 1 included AMF that were clearly visible as foramina, Group 2 were not clearly visible but could be recognized with concave parts, and Group 3 were not visible …

Defining Outcome Measures For Psoriatic Arthritis: A Report From The Grappa-Omeract Working Group., Alexis Ogdie, Maarten De Wit, Kristina Callis Duffin, Willemina Campbell, Jeffrey Chau, Laura C Coates, Lihi Eder, Musaab Elmamoun, Oliver Fitzgerald, Dafna D Gladman, Niti Goel, Jana James, Umut Kalyoncu, John Latella, Chris Lindsay, Philip Mease, Denis O'Sullivan, Ingrid Steinkoenig, Vibeke Strand, William Tillett, Ana-Maria Orbai

Articles, Abstracts, and Reports

The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)-Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis (PsA) Core Set working group recently published the updated 2016 psoriatic arthritis (PsA) core domain set, a set of disease features that should be measured in all clinical trials. At the GRAPPA annual meeting in July 2016, the PsA working group presented the updated PsA core domain set endorsed by 90% of participants at OMERACT in May 2016 and drafted a roadmap for the development of the PsA core outcome measurement set. In this manuscript, we review the development process of the …

The Effect Of Three Different Ankle Braces On Vertical Jump Performance In Female College Volleyball Players, Ashley M. Jefferson

Undergraduate Theses

Background/Purpose: Ankle braces are often used to stabilize the ankle joint of an athlete to reduce the risk of initial injury while participating in athletic activity or to protect the joint from re-injury when returning to play. The purpose of this study was to examine the effects of application of three different braces on vertical jump performance in collegiate female volleyball players. A secondary aim was to compare participant preference and satisfaction on selected characteristics of each of the three different braces.

Subjects: 31 female varsity/club college volleyball players >18 years of age.

Materials/Methods: Health History Assessment and a dynamic …

Posterior Interosseous Nerve Localization Within The Proximal Forearm - A Patient Normalized Parameter, Srinath Kamineni, Crystal R. Norgren, Evan M. Davidson, Ellora P. Kamineni, Andrew S. Deane

Orthopaedic Surgery and Sports Medicine Faculty Publications

AIM

To provide a "patient-normalized" parameter in the proximal forearm.

METHODS

Sixty-three cadaveric upper extremities from thirty-five cadavers were studied. A muscle splitting approach was utilized to locate the posterior interosseous nerve (PIN) at the point where it emerges from beneath the supinator. The supinator was carefully incised to expose the midpoint length of the nerve as it passes into the forearm while preserving the associated fascial connections, thereby preserving the relationship of the nerve with the muscle. We measured the transepicondylar distance (TED), PIN distance in the forearm's neutral rotation position, pronation position, supination position, and the nerve width. …

Anatomic Femoral And Tibial Tunnel Placement During Anterior Cruciate Ligament Reconstruction: Anteromedial Portal All-Inside And Outside-In Techniques, Jeremy M. Burnham, Chaitu S. Malempati, Aaron Carpiaux, Mary Lloyd Ireland, Darren L. Johnson

Orthopaedic Surgery and Sports Medicine Faculty Publications

Tunnel malposition is one of the most common technical reasons for anterior cruciate ligament reconstruction failure. Small changes in tunnel placement can result in significant differences in outcome. More anatomic placement of the tunnels can lead to greater knee stability and a more accurate reproduction of native knee kinematics. This Technical Note describes 2 tibial tunnel–independent methods to obtain anatomic femoral tunnel placement. The all-inside anteromedial portal technique requires only minimal surgical incisions but allows precise femoral tunnel placement. However, hyperflexion of the knee is required, adequate surgical assistance is necessary, and this technique may be susceptible to graft-tunnel mismatch. …

Rare Complications Of Cervical Spine Surgery: Pseudomeningocoele., Tamir Ailon, Justin S. Smith, Ahmad Nassr, Zachary A. Smith, Wellington K. Hsu, Michael G. Fehlings, David E. Fish, Jeffrey C. Wang, Alan S. Hilibrand, Praveen V. Mummaneni, Dean Chou, Rick C. Sasso, Vincent C. Traynelis, Paul M. Arnold, Thomas E. Mroz, Zorica Buser, Elizabeth L L. Lord, Eric M. Massicotte, Arjun S. Sebastian, Khoi D. Than, Michael P. Steinmetz, Gabriel A. Smith, Jonathan Pace, Mark Corriveau, Sungho Lee, K. Daniel Riew, Christopher Shaffrey

Rothman Institute Papers

STUDY DESIGN: This study was a retrospective, multicenter cohort study.

OBJECTIVES: Rare complications of cervical spine surgery are inherently difficult to investigate. Pseudomeningocoele (PMC), an abnormal collection of cerebrospinal fluid that communicates with the subarachnoid space, is one such complication. In order to evaluate and better understand the incidence, presentation, treatment, and outcome of PMC following cervical spine surgery, we conducted a multicenter study to pool our collective experience.

METHODS: This study was a retrospective, multicenter cohort study of patients who underwent cervical spine surgery at any level(s) from C2 to C7, inclusive; were over 18 years of age; and …

Iatrogenic Spinal Cord Injury Resulting From Cervical Spine Surgery., Alan H. Daniels, Robert A. Hart, Alan S. Hilibrand, David E. Fish, Jeffrey C. Wang, Elizabeth L. Lord, Zorica Buser, P. Justin Tortolani, D. Alex Stroh, Ahmad Nassr, Bradford L. Currier, Arjun S. Sebastian, Paul M. Arnold, Michael G. Fehlings, Thomas E. Mroz, K. Daniel Riew

Rothman Institute Papers

STUDY DESIGN: Retrospective cohort study of prospectively collected data.

OBJECTIVE: To examine the incidence of iatrogenic spinal cord injury following elective cervical spine surgery.

METHODS: A retrospective multicenter case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network was conducted. Medical records for 17 625 patients who received cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, were reviewed to identify occurrence of iatrogenic spinal cord injury.

RESULTS: In total, 3 cases of iatrogenic spinal cord injury following cervical spine surgery were identified. Institutional incidence rates ranged …

Epidemiology And Outcomes Of Vertebral Artery Injury In 16 582 Cervical Spine Surgery Patients: An Aospine North America Multicenter Study., Wellington K. Hsu, Abhishek Kannan, Harry T. Mai, Michael G. Fehlings, Zachary A. Smith, Vincent C. Traynelis, Ziya L. Gokaslan, Alan S. Hilibrand, Ahmad Nassr, Paul M. Arnold, Thomas E. Mroz, Mohamad Bydon, Eric M. Massicotte, Wilson Z. Ray, Michael P. Steinmetz, Gabriel A. Smith, Jonathan Pace, Mark Corriveau, Sungho Lee, Robert E Isaacs, Jeffrey C. Wang, Elizabeth L. Lord, Zorica Buser, K. Daniel Riew

Rothman Institute Papers

STUDY DESIGN: A multicenter retrospective case series was compiled involving 21 medical institutions. Inclusion criteria included patients who underwent cervical spine surgery between 2005 and 2011 and who sustained a vertebral artery injury (VAI).

OBJECTIVE: To report the frequency, risk factors, outcomes, and management goals of VAI in patients who have undergone cervical spine surgery.

METHODS: Patients were evaluated on the basis of condition-specific functional status using the Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA) score, the Nurick scale, and the 36-Item Short-Form Health Survey (SF-36).

RESULTS: VAIs were identified in a total of 14 of 16 582 …

C5 Palsy After Cervical Spine Surgery: A Multicenter Retrospective Review Of 59 Cases., Sara E. Thompson, Zachary A. Smith, Wellington K. Hsu, Ahmad Nassr, Thomas E. Mroz, David E. Fish, Jeffrey C. Wang, Michael G. Fehlings, Chadi A. Tannoury, Tony Tannoury, P. Justin Tortolani, Vincent C. Traynelis, Ziya Gokaslan, Alan S. Hilibrand, Robert E. Isaacs, Praveen V. Mummaneni, Dean Chou, Sheeraz A. Qureshi, Samuel K. Cho, Evan O. Baird, Rick C. Sasso, Paul M. Arnold, Zorica Buser, Mohamad Bydon, Michelle J Clarke, Anthony F. De Giacomo, Adeeb Derakhshan, Bruce Jobse, Elizabeth L. Lord, Daniel Lubelski, Eric M. Massicotte, Michael P. Steinmetz, Gabriel A. Smith, Jonathan Pace, Mark Corriveau, Sungho Lee, Peter I. Cha, Dhananjay Chatterjee, Erica L. Gee, Erik N. Mayer, Owen J. Mcbride, Allison K. Roe, Marisa Y. Yanez, D. Alex Stroh, Khoi D. Than, K. Daniel Riew

Rothman Institute Papers

STUDY DESIGN: A multicenter, retrospective review of C5 palsy after cervical spine surgery.

OBJECTIVE: Postoperative C5 palsy is a known complication of cervical decompressive spinal surgery. The goal of this study was to review the incidence, patient characteristics, and outcome of C5 palsy in patients undergoing cervical spine surgery.

METHODS: We conducted a multicenter, retrospective review of 13 946 patients across 21 centers who received cervical spine surgery (levels C2 to C7) between January 1, 2005, and December 31, 2011, inclusive. P values were calculated using 2-sample t test for continuous variables and χ(2) tests or Fisher exact tests for …

Epidural Hematoma Following Cervical Spine Surgery., Gregory D. Schroeder, Alan S. Hilibrand, Paul M. Arnold, David E. Fish, Jeffrey C. Wang, Jeffrey L. Gum, Zachary A. Smith, Wellington K. Hsu, Ziya L. Gokaslan, Robert E. Isaacs, Adam S. Kanter, Thomas E. Mroz, Ahmad Nassr, Rick C. Sasso, Michael G. Fehlings, Zorica Buser, Mohamad Bydon, Peter I. Cha, Dhananjay Chatterjee, Erica L. Gee, Elizabeth L. Lord, Erik N. Mayer, Owen J. Mcbride, Emily C. Nguyen, Allison K. Roe, P. Justin Tortolani, D. Alex Stroh, Marisa Y. Yanez, K. Daniel Riew

Rothman Institute Papers

STUDY DESIGN: A multicentered retrospective case series.

OBJECTIVE: To determine the incidence and circumstances surrounding the development of a symptomatic postoperative epidural hematoma in the cervical spine.

METHODS: Patients who underwent cervical spine surgery between January 1, 2005, and December 31, 2011, at 23 institutions were reviewed, and all patients who developed an epidural hematoma were identified.

RESULTS: A total of 16 582 cervical spine surgeries were identified, and 15 patients developed a postoperative epidural hematoma, for a total incidence of 0.090%. Substantial variation between institutions was noted, with 11 sites reporting no epidural hematomas, and 1 site reporting an …

Misplaced Cervical Screws Requiring Reoperation., Jeremy C. Peterson, Paul M. Arnold, Zachary A. Smith, Wellington K. Hsu, Michael G. Fehlings, Robert A. Hart, Alan S. Hilibrand, Ahmad Nassr, Ra'kerry K. Rahman, Chadi A. Tannoury, Tony Tannoury, Thomas E. Mroz, Bradford L. Currier, Anthony F. De Giacomo, Jeremy L. Fogelson, Bruce C. Jobse, Eric M. Massicotte, K. Daniel Riew

Rothman Institute Papers

STUDY DESIGN: A multicenter, retrospective case series.

OBJECTIVE: In the past several years, screw fixation of the cervical spine has become commonplace. For the most part, this is a safe, low-risk procedure. While rare, screw backout or misplaced screws can lead to morbidity and increased costs. We report our experiences with this uncommon complication.

METHODS: A multicenter, retrospective case series was undertaken at 23 institutions in the United States. Patients were included who underwent cervical spine surgery from January 1, 2005, to December 31, 2011, and had misplacement of screws requiring reoperation. Institutional review board approval was obtained at all …