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Pesquisa : A02.513.514.350 [Categoria DeCS]
Referências encontradas : 519 [refinar]
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PMID:29201301
Autor:Farajpour H; Jamshidi N
Endereço:Department of Biomedical Engineering, Faculty of Engineering, University of Isfahan, Isfahan, Iran.
Título:Effects of Different Angles of the Traction Table on Lumbar Spine Ligaments: A Finite Element Study.
Fonte:Clin Orthop Surg; 9(4):480-488, 2017 Dec.
ISSN:2005-4408
País de publicação:Korea (South)
Idioma:eng
Resumo:Background: The traction bed is a noninvasive device for treating lower back pain caused by herniated intervertebral discs. In this study, we investigated the impact of the traction bed on the lower back as a means of increasing the disc height and creating a gap between facet joints. Methods: Computed tomography (CT) images were obtained from a female volunteer and a three-dimensional (3D) model was created using software package MIMICs 17.0. Afterwards, the 3D model was analyzed in an analytical software (Abaqus 6.14). The study was conducted under the following traction loads: 25%, 45%, 55%, and 85% of the whole body weight in different angles. Results: Results indicated that the loading angle in the L3-4 area had 36.8%, 57.4%, 55.32%, 49.8%, and 52.15% effect on the anterior longitudinal ligament, posterior longitudinal ligament, intertransverse ligament, interspinous ligament, and supraspinous ligament, respectively. The respective values for the L4-5 area were 32.3%, 10.6%, 53.4%, 56.58%, and 57.35%. Also, the body weight had 63.2%, 42.6%, 44.68%, 50.2%, and 47.85% effect on the anterior longitudinal ligament, posterior longitudinal ligament, intertransverse ligament, interspinous ligament, and supraspinous ligament, respectively. The respective values for the L4-5 area were 67.7%, 89.4%, 46.6%, 43.42% and 42.65%. The authenticity of results was checked by comparing with the experimental data. Conclusions: The results show that traction beds are highly effective for disc movement and lower back pain relief. Also, an optimal angle for traction can be obtained in a 3D model analysis using CT or magnetic resonance imaging images. The optimal angle would be different for different patients and thus should be determined based on the decreased height of the intervertebral disc, weight and height of patients.
Tipo de publicação: JOURNAL ARTICLE


  2 / 519 MEDLINE  
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PMID:29201299
Autor:Lee KY; Kim MW; Seok SY; Kim DR; Im CS
Endereço:Department of Orthopedic Surgery, Dong-A University College of Medicine, Busan, Korea.
Título:The Relationship between Superior Disc-Endplate Complex Injury and Correction Loss in Young Adult Patients with Thoracolumbar Stable Burst Fracture.
Fonte:Clin Orthop Surg; 9(4):465-471, 2017 Dec.
ISSN:2005-4408
País de publicação:Korea (South)
Idioma:eng
Resumo:Background: To determine the relationship between superior disc-endplate complex injury and correction loss after surgery in a group of young adult patients with a stable thoracolumbar burst fracture. Methods: The study group was comprised of young adult patients who had undergone short-segment posterior fixation and bone grafting under the diagnosis of a stable thoracolumbar burst fracture from March 2008 to February 2014. Follow-up was available for more than 1 year. Before surgery, magnetic resonance imaging was performed to determine injury to the anterior longitudinal ligament, posterior longitudinal ligament, and superior and inferior intervertebral discs and endplates. Correction loss was evaluated by the Cobb angle, intervertebral disc height, upper intervertebral disc angle, vertebral wedge angle, and vertebral body height. Results: No significant relation was noted between correction loss and an injury to the anterior longitudinal ligament, posterior longitudinal ligament, inferior intervertebral disc/endplate, and fracture site, whereas an injury to the superior endplate alone and superior disc-endplate complex showed a significant association. Specifically, a superior intervertebral disc-endplate complex injury showed statistically significant relation to postoperative changes in Cobb angle ( = 0.026) and vertebral wedge angle ( = 0.047). Conclusions: A superior intervertebral disc-endplate complex injury may have an influence on the prognosis after short-segment fixation in young adult patients with a stable thoracolumbar burst fracture.
Tipo de publicação: JOURNAL ARTICLE


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PMID:28764607
Autor:Jovanovic M; Radojkovic M; Djordjevic P; Rancic D; Jovanovic N; Rancic Z
Endereço:1 Medical Faculty of Nis, Nis, Serbia.
Título:Recycling and Reinforcing Intimomedial Flap of the Infrarenal Aorta Using Anterior Longitudinal Ligament in Patients With Acute Trauma With Bowel Injuries.
Fonte:Vasc Endovascular Surg; 51(7):501-505, 2017 Oct.
ISSN:1938-9116
País de publicação:United States
Idioma:eng
Resumo:We present a patient with blunt abdominal trauma with severe acute right limb ischemia and clinical signs of diffuse peritonitis. Computed tomography angiography showed circumferential dissection of the infrarenal aorta with occlusion of the right common iliac artery. We opted for simultaneous abdomen exploration and open repair of injured aorta. Critical weakening of the aortic wall with imminent rupture was identified intraoperatively. Aortotomy cranially from bifurcation showed circumferential intimomedial dissection. The fixation of fragile intimomedial flap of aortic dissection was achieved with reinforcement using an anterior longitudinal ligament. The long aortoiliac arteriotomy was repaired using a great saphenous vein patch. Patient had uneventful postoperative course and was discharged after 7 days. In patients with abdominal polytrauma with peritonitis, and no available endovascular tools, open surgery for circumferential aortic dissection is possible and successful. Described reinforcement of the posterior aortic wall to the anterior longitudinal ligament should be added to the armamentarium of aortic injury treatment.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE


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PMID:28591038
Autor:Bai C; Li K; Guo A; Fei Q; Li D; Li J; Wang B; Yang Y
Endereço:aDepartment of Orthopedics, Beijing Friendship Hospital Affiliated of Capital Medical University, Beijing bDepartment of Orthopedics, Xiangya Hospital, Central South University, Changsha, China.
Título:Indication for hypertrophy posterior longitudinal ligament removal in anterior decompression for cervical spondylotic myelopathy.
Fonte:Medicine (Baltimore); 96(23):e7043, 2017 Jun.
ISSN:1536-5964
País de publicação:United States
Idioma:eng
Resumo:The retrospective study aimed to investigate the indication for hypertrophy posterior longitudinal ligament (HPLL) removal in anterior decompression for cervical spondylotic myelopathy (CSM). A total of 138 consecutive patients with CSM were divided into 2 groups with developmental cervical stenosis (DCS) (group S) and non-DCS (group N), according to the Pavlov ratio. These 2 groups were subdivided into 2 further subgroups, according to whether HPLL was removed or preserved: group SR (49 patients) and group SP (32 patients) in group S, group NR (21 patients) and group NP (36 patients) in group N. The modified Japanese Orthopedic Association score (mJOA), the modified recovery rate (mRR), quality of life (QoL), and relevant clinical data were used for clinical and radiological evaluation. The mJOA scores improved from 7.3 ±â€Š2.2 to 15.0 ±â€Š1.8 in the SR group and from 7.9 ±â€Š2.3 to 14.2 ±â€Š1.5 in the SP group (P = .036), with postoperative QoL significantly higher in the SR group than the SP group. A reduction in the diameter of enlarged spinal canals occurred at a significantly faster rate in the SP group compared with the SR group (P = .002). Multivariate regression analyses showed removal of HPLL correlated with mJOA scores (coefficient = 7.337, P = .002), mRR (%) (coefficient = 9.117, P = .005), PCS (coefficient = 12.129, P < .001), and MCS (coefficient = 14.31, P < .001) in the S group at 24 months postoperatively, while removal of HPLL did not correlate with clinical outcomes in the N group. The HPLL should, therefore, be removed when mobility was reduced and the spinal cord remained compressed after anterior decompression procedures in the patients with DCS. However, in non-DCS patients, it remains unclear as to whether removal of HPLL provides any clinical benefit, thus, HPLL removal may not be necessary.
Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY


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PMID:28511807
Autor:Hyldmo PK; Horodyski M; Conrad BP; Aslaksen S; Røislien J; Prasarn M; Rechtine GR; Søreide E
Endereço:Department of Research, Norwegian Air Ambulance Foundation, Drøbak, Norway; Trauma Unit, Sørlandet Hospital, Kristiansand, Norway. Electronic address: pkh@sshf.no.
Título:Does the novel lateral trauma position cause more motion in an unstable cervical spine injury than the logroll maneuver?
Fonte:Am J Emerg Med; 35(11):1630-1635, 2017 Nov.
ISSN:1532-8171
País de publicação:United States
Idioma:eng
Resumo:OBJECTIVE: Prehospital personnel who lack advanced airway management training must rely on basic techniques when transporting unconscious trauma patients. The supine position is associated with a loss of airway patency when compared to lateral recumbent positions. Thus, an inherent conflict exists between securing an open airway using the recovery position and maintaining spinal immobilization in the supine position. The lateral trauma position is a novel technique that aims to combine airway management with spinal precautions. The objective of this study was to compare the spinal motion allowed by the novel lateral trauma position and the well-established log-roll maneuver. METHODS: Using a full-body cadaver model with an induced globally unstable cervical spine (C5-C6) lesion, we investigated the mean range of motion (ROM) produced at the site of the injury in six dimensions by performing the two maneuvers using an electromagnetic tracking device. RESULTS: Compared to the log-roll maneuver, the lateral trauma position caused similar mean ROM in five of the six dimensions. Only medial/lateral linear motion was significantly greater in the lateral trauma position (1.4mm (95% confidence interval [CI] 0.4, 2.4mm)). CONCLUSIONS: In this cadaver study, the novel lateral trauma position and the well-established log-roll maneuver resulted in comparable amounts of motion in an unstable cervical spine injury model. We suggest that the lateral trauma position may be considered for unconscious non-intubated trauma patients.
Tipo de publicação: JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL


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PMID:28427722
Autor:Khuyagbaatar B; Kim K; Park WM; Kim YH
Endereço:Department of Mechanical Engineering, Kyung Hee University, Yongin, Republic of Korea.
Título:Biomechanical investigation of post-operative C5 palsy due to ossification of the posterior longitudinal ligament in different types of cervical spinal alignment.
Fonte:J Biomech; 57:54-61, 2017 May 24.
ISSN:1873-2380
País de publicação:United States
Idioma:eng
Resumo:Post-operative C5palsies are among the most common complications seen after cervical surgery for ossification of the posterior longitudinal ligament (OPLL). Although C5 palsy is a well-known complication of cervical spine surgery, its pathogenesis is poorly understood and depends on many other factors. In this study, a finite element model of the cervical spine and spinal cord-nerve roots complex structures was developed. The changes in stress in the cord and nerve roots, posterior shift of the spinal cord, and displacement and elongation of the nerve roots after laminectomy for cervical OPLL were analyzed for three different cervical sagittal alignments (lordosis, straight, and kyphosis). The results suggest that high stress concentrated on the nerve roots after laminectomy could be the main cause of C5 palsy because ossification of ligaments increases spinal cord shifting and root displacement. The type of sagittal alignment had no influence on changes in cord stress after laminectomy, although cases of kyphosis with a high degree of occupying ratio resulted in greater increases in nerve root stress after laminectomy. Therefore, kyphosis with a high OPLL occupying ratio could be a risk factor for poor surgical outcomes or post-operative complications and should be carefully considered for surgical treatment.
Tipo de publicação: JOURNAL ARTICLE


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PMID:28385821
Autor:Nouri A; Fehlings MG
Endereço:Spinal Cord Injury Clinical Research Unit (Nouri), Toronto Western Hospital, University Health Network; Division of Neurosurgery, Department of Surgery, and Spinal Program (Fehlings), University of Toronto, Toronto, Ont.
Título:Diffuse idiopathic skeletal hyperostosis with cervical myelopathy.
Fonte:CMAJ; 189(10):E410, 2017 03 13.
ISSN:1488-2329
País de publicação:Canada
Idioma:eng
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE


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PMID:28351288
Autor:Muheremu A; Li H; Ma J; Ma Y; Ma Y
Endereço:Department of Spine Surgery, The Sixth Affiliated Hospital of Xinjiang Medical University, Xinjiang Urumqi, China.
Título:Establishment of a three-dimensional finite element model of severe kyphotic deformity secondary to ankylosing spondylitis.
Fonte:J Int Med Res; 45(2):639-646, 2017 Apr.
ISSN:1473-2300
País de publicação:England
Idioma:eng
Resumo:Objective To establish a three-dimensional (3D) finite element (FE) model of ankylosing spondylitis (AS) kyphosis that is a digital platform for further studies. Methods A 30-year-old man with AS kyphosis underwent computed tomography transverse scanning from T1 to the sacrococcyx. The images were imported into Mimics® 17.0 software to establish a 3D model of the posterior spine, which was then imported into Studio Geomagic 2013 software. Posterior spine convex geometry was established on the 3D geometric model for subsequent optimization of image processing. Unigraphics NX 8.5 produced the spinal kyphosis surface model. Modeled calcification of ligaments and partial resection of useless sacral bone were added. The model was imported into ANSYS 15.0 FE analysis software. Ligaments were added. Parameters were set to generate a 3D FE model of AS. Results and Conclusion A 3D FE model of AS was successfully established, providing a reliable digital platform for subsequent biomechanical analysis.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE


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PMID:28351070
Autor:Nassr A; Aleem IS; Eck JC; Woods B; Ponnappan RK; Donaldson WF; Kang JD
Endereço:*Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN†Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI‡Center for Sports Medicine and Orthopedics, Chattanooga, TN§Rothman Institute, Thomas Jerfferson University, Philadelphia, PA¶Jersey Spine Associates, Somers Point, NJ||Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, PA**Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA.
Título:Does Resection of the Posterior Longitudinal Ligament Impact the Incidence of C5 Palsy After Cervical Corpectomy Procedures?: A Review of 459 Consecutive Cases.
Fonte:Spine (Phila Pa 1976); 42(7):E392-E397, 2017 Apr 01.
ISSN:1528-1159
País de publicação:United States
Idioma:eng
Resumo:STUDY DESIGN: Retrospective review. OBJECTIVE: To evaluate key risk factors for the development of C5 palsy after cervical corpectomy, including resection of the posterior longitudinal ligament (PLL). SUMMARY OF BACKGROUND DATA: Postoperative C5 palsy is a well-known complication after cervical spine surgery. It is unknown whether resection of the PLL affects the incidence of C5 palsy. METHODS: We performed a retrospective review of 459 consecutive patients undergoing anterior cervical corpectomies over a 15-year period. Medical records were reviewed to gather demographic data, operative details, and the incidence of C5 palsy. We performed regression analyses to identify variables that predicted the development of C5 palsy. RESULTS: Our final analysis included 397 patients (females 51.4%, mean age 55.6 ±â€Š11.6 yrs). Anterior corpectomy alone was performed in 255 (64.2%) patients, and combined anterior and posterior fusion was performed in 142 (35.8%) patients. Twenty-four patients (6.0%) developed C5 nerve palsy. Univariable regression demonstrated age greater than 65 (odds ratio, OR 2.7, 95% confidence interval, CI 1.2 to 6.3), corpectomy of three or more levels (OR 6.3, 95% CI 2.1 to 18.9), presence of ossification of the PLL (OR 4.3, 95% CI 1.6 to 11.7), and complete or partial resection of the PLL (OR 2.6, 95% CI 1.0 to 6.7) predicted development of C5 palsy. Multivariable regression demonstrated that the odds of getting C5 palsy with complete or partial resection of the PLL is 4.0 times (95% CI 1.5 to 10.5) higher compared with patients with an intact PLL. There were no significant differences in C5 palsy rates based on surgical approach (anterior vs. anterior plus posterior), sex, smoking status, or diabetes. CONCLUSION: Age greater than 65 years, corpectomy of three or more levels, presence of ossification of the PLL, and complete or partial resection of the PLL significantly predicted the development of C5 palsy. LEVEL OF EVIDENCE: 4.
Tipo de publicação: JOURNAL ARTICLE


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PMID:28241722
Autor:Zhang H; Xu C; Liu Y; Yuan W
Endereço:First Department of Spinal Surgery, Changzheng Hospital Affiliated to Second Military Medical University, Shanghai 200003, China.
Título:[MicroRNA-563 promotes the osteogenic differentiation of posterior longitudinal ligament cells by inhibiting SMURF1].
Fonte:Zhonghua Wai Ke Za Zhi; 55(3):203-207, 2017 Mar 01.
ISSN:0529-5815
País de publicação:China
Idioma:chi
Resumo:To investigate the function and mechanism of miR-563 in regulating the ossification of posterior longitudinal ligament (OPLL) cells. Posterior longitudinal ligament cells were isolated and cultured from both OPLL patients ( =6) and non-ossified ligament patients (PLL, =4) who underwent spine surgery from March to June 2015 in First Department of Spinal Surgery, Changzheng Hospital Affiliated to Second Military Medical University. The expression levels of miR-563 in OPLL and PLL groups were analyzed using real-time PCR. MicroRNA mimics were utilized to over express miR-563, and microRNA inhibitors were designed to knockdown its expression. Using the over expression and inhibition method, the level of Alizarin Red staining, alkaline phosphatase and ossification related genes in miR-563 were analyzed over expressed or inhibited and ossification induced ligament cells. After that the potential target of miR-563 was predicted using Targetscan and verified using dual-luciferase reporter assay. The results between the groups were compared by test. The expression level of miR-563 was significantly higher in OPLL than PLL groups (8.53±0.84 . 1.00±0.12, '=21.629, =0.000). The over expression of miR-563 resulted in higher level of alizarin red staining (2.52±0.25 .1.00±0.14), alkaline phosphatase activities (3.11±0.55 .1.00±0.11) and ossification related genes (RUNX2: 3.25±0.55 .1.00±0.10; IBSP: 2.35±0.32 . 1.00±0.14; 7.43 to 10.99, all =0.000), while the inhibition resulted in lower level (alizarin red staining: 0.52±0.21 . 1.00±0.12; alkaline phosphatase activities: 0.41±0.12 . 1.00±0.09; RUNX2: 0.35±0.13 . 1.00±0.12; IBSP: 0.55±0.12 .1.00±0.11; 4.36 to 8.45, all <0.05). Combining the prediction results of Targetscan and expression profiles between OPLL and PLL, SMURF1 was found as a potential target of miR-563, and dual-luciferase reporter assay also identified their relationship. By over expression, the expression level of SMURF1 was significantly decreased (0.25±0.06 .1.00±0.10, =-12.862, =0.000), which again verified the hypothesis. miRNA-563 significantly promotes the osteogenic differentiation of posterior longitudinal ligament cells and the mechanism of which is possibly through down regulating SMURF1.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (MicroRNAs); EC 2.3.2.26 (SMURF1 protein, human); EC 2.3.2.27 (Ubiquitin-Protein Ligases); EC 3.1.3.1 (Alkaline Phosphatase)



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