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pubmed: (skolasky, richard l...

NCBI: db=pubmed; Term=(Skolasky, Richard L[Full Author Name]) OR (Cohen, David B[Full Author Name]) OR (Kebaish, Khaled M[Full Author Name]) OR (Neuman, Brian J[Full Author Name]) OR (Riley III, Lee H[Full Author Name])
  1. Fatty infiltration of the cervical extensor musculature, cervical sagittal balance, and clinical outcomes: An analysis of operative adult cervical deformity patients.

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    Fatty infiltration of the cervical extensor musculature, cervical sagittal balance, and clinical outcomes: An analysis of operative adult cervical deformity patients.

    J Clin Neurosci. 2020 Jan 08;:

    Authors: Passias PG, Segreto FA, Horn SR, Lafage V, Lafage R, Smith JS, Naessig S, Bortz C, Klineberg EO, Diebo BG, Sciubba DM, Neuman BJ, Hamilton DK, Burton DC, Hart RA, Schwab FJ, Bess S, Shaffrey CI, Nunley P, Ames CP, International Spine Study Group

    Abstract
    PURPOSE: To assess preliminary associations between fatty-infiltration (FI) of cervical spine extensor musculature, cervical sagittal balance, and clinical outcomes in cervical deformity (CD) patients.
    METHODS: Operative CD patients (C2-C7 Cobb > 10°, CL > 10°, cSVA > 4 cm, or CBVA > 25°) with pre-operative (BL) MRIs and 1-year (1Y) post-operative MRIs or CTs were assessed for fatty-infiltration of cervical extensor musculature, using dedicated imaging software at each C2-C7 intervertebral level and the apex of deformity (apex). FI was gauged as a ratio of fat-free-muscle-cross-sectional-area (FCSA) over total-muscle-CSA (TCSA), with lower ratio values indicating greater FI. BL-1Y associations between FI, sagittal alignment, and clinical outcomes were assessed using appropriate parametric and non-parametric tests.
    RESULTS: 22 patients were included (Age 59.22, 71.4%F, BMI 29.2, CCI:0.75, Frailty: 0.43). BL deformity presentation: TS-CL: 29.0°, C2-C7 Sagittal Cobb:-1.6°, cSVA:30.4 mm. No correlations were observed between BL fatty-infiltration, sagittal alignment, frailty, or clinical outcomes (p > 0.05). Following surgical correction, C2-C7 (BL: 0.59 vs 1Y:0.67, p = 0.005) and apex (BL: 0.59 vs. 1Y: 0.66, p = 0.33) fatty-infiltration decreased. Achievement of lordotic curvature correlated with C2-C7 fatty infiltration reduction (Rs: 0.495, p < 0.05), and patients with residual postoperative TS-CL and cSVA malalignment were associated with greater apex fatty-infiltration (Rs: -0.565, -0.561; p < 0.05). C2-C7 FI improvement was associated with NRS back pain reduction (Rs: -0.630, p < 0.05), and greater apex fatty-infiltration at BL was associated with minor perioperative complication occurrence (Rs: 0.551, p = 0.014).
    CONCLUSIONS: Deformity correction and sagittal balance appear to influence the reestablishment of cervical muscle tone from C2-C7 and reduction of back pain for severely frail CD patients. This analysis helps to understand cervical extensor musculature's role amongst CD patients.

    PMID: 31926664 [PubMed - as supplied by publisher]

    https://www.ncbi.nlm.nih.gov/pubmed/31926664?dopt=Abstract
  2. Devastating Vertebral Osteomyelitis After Epidural Steroid Injection: A Case Report.

    Icon for Wolters Kluwer Related Articles

    Devastating Vertebral Osteomyelitis After Epidural Steroid Injection: A Case Report.

    JBJS Case Connect. 2019 Dec;9(4):e0028

    Authors: Lobaton GO, Marrache M, Petrusky O, Cohen DB, Jain A

    Abstract
    CASE: A 62-year-old man with no comorbidities presented with back and bilateral leg pain and progressive paraplegia that developed over a 1-week period. He had received 2 lumbar epidural steroid injections (LESIs) for lumbar stenosis 39 and 25 days before presentation. Workup revealed osteomyelitis of L4 and L5 with epidural abscesses. He ultimately underwent all-posterior L4 and L5 corpectomy with reconstruction and L1-pelvis arthrodesis, followed by 8 weeks of intravenous antibiotics. His weakness improved, but neurological deficits persisted.
    CONCLUSIONS: This case illustrates a catastrophic complication after LESI, resulting in permanent neurological injury in a patient with no apparent risk factors.

    PMID: 31850954 [PubMed - in process]

    https://www.ncbi.nlm.nih.gov/pubmed/31850954?dopt=Abstract
  3. Minimally Invasive Fixation for Spinopelvic Dissociation: Percutaneous Triangular Osteosynthesis with S2 Alar-Iliac and Iliosacral Screws: A Case Report.

    Icon for Wolters Kluwer Related Articles

    Minimally Invasive Fixation for Spinopelvic Dissociation: Percutaneous Triangular Osteosynthesis with S2 Alar-Iliac and Iliosacral Screws: A Case Report.

    JBJS Case Connect. 2019 Dec;9(4):e0119

    Authors: El Dafrawy MH, Shafiq B, Vaswani R, Osgood GM, Hasenboehler EA, Kebaish KM

    Abstract
    CASE: Traumatic U- and H-type sacral fractures are often unstable, causing spinopelvic dissociation. We describe a minimally invasive approach that allows percutaneous spinopelvic fixation of unstable H-type sacral fractures using a triangular osteosynthesis construct with S2 alar-iliac screws. We present the case of a patient with traumatic lumbopelvic dissociation who underwent percutaneous S2 alar-iliac and iliosacral screw fixation.
    CONCLUSIONS: Combined percutaneous S2 alar-iliac and iliosacral screw fixation is a safe option for spinopelvic fixation and avoids the soft-tissue compromise of open approaches. The triangular osteosynthesis construct provides adequate pelvic anchor points to allow immediate weight-bearing.

    PMID: 31833978 [PubMed - in process]

    https://www.ncbi.nlm.nih.gov/pubmed/31833978?dopt=Abstract