Zero-profile Hyperlordotic Spacer for Cervical Deformity Correction: Case Presentation and Technical Note
Cervical spine deformity (CSD) can negatively affect the health-related quality of life (HRQOL) of patients, particularly the elderly, thus representing a socioeconomic problem of increasing importance. While surgical deformity correction has been linked to improved HRQOL, no universally accepted consensus exists for the operative management of CSD. The authors demonstrate the feasibility of CSD correction, implementing anterior and posterior cervical osteotomies combined with the placement of multiple consecutive zero-profile hyperlordotic interbody spacers in a 55-year-old male with cervical kyphosis. This technique resulted in the satisfactory restoration of the patient's cervical alignment and significantly ameliorated his presenting symptoms. The patient demonstrated maintained cervical lordosis and he remained symptom-free at theÂ one-year follow-up. The use of multiple consecutive zero-profile cervical interbody spacers can effectively and safely be utilized for the treatment of CSD. Further studies are needed to compare this technique with other standard surgeries used for CSD correction.
Etiology and Surgical Management of Cervical Spinal Epidural Abscess (SEA):: A Systematic Review
Study Design/UNASSIGNED:Systematic analysis and review. Objective/UNASSIGNED:Evaluation of the presentation, etiology, management strategies (including both surgical and nonsurgical options), and neurological functional outcomes in patients with cervical spinal epidural abscess (SEA). Methods/UNASSIGNED:The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria were used to create a framework based on which articles pertaining to cervical SEA were chosen for review following a search of the Ovid and PubMed databases using the search terms "epidural abscess" and "cervical." Included studies needed to have at least 4 patients aged 18 years or older, and to have been published within the past 20 years. Results/UNASSIGNED:Database searches yielded 521 potential articles in PubMed and 974 potential articles in Ovid. After review, 11 studies were ultimately identified for inclusion in this systematic review. Surgery appears to be a well-tolerated management strategy with limited complications for patients with cervical SEA. However, the quantity of data comparing medical and surgical treatment of cervical SEA is limited and the bulk of the data is derived from low quality studies. Conclusion/UNASSIGNED:Data reporting was heterogeneous among studies making it difficult to draw discrete conclusions. Early surgical intervention may be appropriate in selected patients with cervical epidural abscess, but it is not clear what distinguishes these patients from those who are successfully managed nonoperatively.
Role of minimally invasive surgery for adult spinal deformity in preventing complications
With the aging population, there is a rising prevalence of degenerative spinal deformity and need of surgical care for these patients. Surgical treatment for adult spinal deformity (ASD) is often fraught with a high rate of complications. Minimally invasive surgery (MIS) has for the past decade been adopted by spine surgeons to treat ASD in the hopes of reducing access-related morbidity and perioperative complications. The benefits of MIS approach in general and recent development of MIS techniques to avoid long-term complications such as pseudoarthrosis or proximal junctional kyphosis are reviewed.
Advancing critical care medicine with stem cell therapy and hypothermia for cerebral palsy
With limited clinical trials on stem cell therapy for adult stroke underway, the assessment of efficacy also needs to be considered for neonatal hypoxic-ischemic brain injury, considering its distinct symptoms. The critical nature of this condition leads to establishment of deficits that last a lifetime. Here, we will highlight the progress of current translational research, commenting on the critical nature of the disease, stem cell sources, the use of hypothermia, safety and efficacy of each treatment, modes of action, and the possibility of combination therapy. With this in mind, we reference translational guidelines established by a consortium of research partners called Stem cell Therapeutics as an Emerging Paradigm for Stroke (STEPS). The guidelines of STEPS are directed toward evaluating outcomes of cell therapy in adult stroke; however, we identify the overlapping pathology, as we believe that these guidelines will serve well in the investigation of neonatal hypoxic-ischemic therapy. Finally, we discuss emerging treatments and a case report, altogether suggesting that the potential for these treatments to be used in synergy has arrived and the time for advancing stem cell use in combination with hypothermia for cerebral palsy is now.
An Update on Translating Stem Cell Therapy for Stroke from Bench to Bedside
With a constellation of stem cell sources available, researchers hope to utilize their potential for cellular repair as a therapeutic target for disease. However, many lab-to-clinic translational considerations must be given in determining their efficacy, variables such as the host response, effects on native tissue, and potential for generating tumors. This review will discuss the current knowledge of stem cell research in neurological disease, mainly stroke, with a focus on the benefits, limitations, and clinical potential.
In vivo animal stroke models: a rationale for rodent and non-human primate models
On average, every four minutes an individual dies from a stroke, accounting for 1 out of every 18 deaths in the United States. Approximately 795,000 Americans have a new or recurrent stroke each year, with just over 600,000 of these being first attack . There have been multiple animal models of stroke demonstrating that novel therapeutics can help improve the clinical outcome. However, these results have failed to show the same outcomes when tested in human clinical trials. This review will discuss the current in vivo animal models of stroke, advantages and limitations, and the rationale for employing these animal models to satisfy translational gating items for examination of neuroprotective, as well as neurorestorative strategies in stroke patients. An emphasis in the present discussion of therapeutics development is given to stem cell therapy for stroke.