45 research outputs found
Recommended from our members
Neurologic Findings of Craniovertebral Junction Disease
Abstract
IN THIS REVIEW, we explain the origins of central cord syndrome and Bell's cruciate paralysis and the intricate detail of neural pathways located in this region and their influence on motor and sensory function. Although lesion studies and tract tracing studies on primates over the past 50 years refute the theory of a somatotopically organized corticospinal tract, this concept continues to pervade many neuroanatomic texts. We categorized the various pathologies of the craniovertebral junction and their unique neurologic presentations. New developments in the fields of neuroscience of spinal tract lesioning are also discussed
Recommended from our members
Update of Comprehensive Review of the Safety Profile of Bone Morphogenetic Protein in Spine Surgery
Recommended from our members
A Comprehensive Review of the Safety Profile of Bone Morphogenetic Protein in Spine Surgery
Abstract WE REVIEW OUR current understanding of the development and potential clinical applications of bone morphogenetic protein (BMP) in spine surgery. We also review the evidence for adverse events associated with the use of BMP and suggest potential reasons for these events and means of complication avoidance. Bone morphogenetic protein 2 (rhBMP-2) is approved by the Food and Drug Administration for anterior lumbar interbody fusion; rhBMP-7, on the other hand, is approved for long bone defects and has received a humanitarian device exemption for revision posterolateral lumbar operations and recalcitrant long bone unions. Nevertheless, “off-label” use in various spinal procedures has been reported and is increasing in frequency. Specific guidelines for rhBMP-2 and rhBMP-7 use are lacking because of the limited availability of randomized controlled clinical trials and its diverse use in many spinal applications. Mechanisms of delivery, carrier type, graft position, surgical location, and variations in BMP concentration may differ from one surgery to the next. Adverse events linked to either rhBMP-2 or rhBMP-7 use include ectopic bone formation, bone resorption or remodeling at the graft site, hematoma, neck swelling, and painful seroma. Other potential theoretical concerns include carcinogenicity and teratogenic effects. In this review, we provide the reader with a historical perspective on BMP, current and past research to support its use in spinal procedures, and a critical analysis of the complications reported thus far
Recommended from our members
An anatomical study of the lumbosacral plexus as related to the minimally invasive transpsoas approach to the lumbar spine : Laboratory investigation
The Role of NELL-1, a Growth Factor Associated with Craniosynostosis, in Promoting Bone Regeneration
Recommended from our members
Occiput to Thoracic Fusion After Surgical Resection of Desmoid Tumor
Desmoid tumors are rare clinical entities that cause significant morbidity based on their locally aggressive nature. Complete resection with wide margins is the standard of care; however, when arising in the neck, resection is limited due to proximity of the lesion to critical structures.
We describe a complete resection of a desmoid tumor requiring extensive resection of cervical extensor musculature. We were able to achieve a total resection of a cervical desmoid tumor with no evidence of recurrence at follow-up.
Complete resection of desmoid tumors is the standard of care. In this case, we felt that complete resection would lead to iatrogenic instability; therefore, an occiput to thoracic fusion was performed at the time of the resection