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Spinal column shortening for secondary tethered cord syndrome: radiographic, clinical, patient-reported, and urodynamic short-term outcomes.

J Neurosurg Pediatr 2021 May 7:1-10. Epub 2021 May 7.

1Section of Pediatric Neurosurgery, Department of Neurological Surgery, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis.

Objective: Tethered cord syndrome (TCS) is a clinical and radiographic diagnosis of pathological stretching of the spinal cord leading to progressive loss of neurological function. The gold standard treatment for TCS is a tethered cord release. However, detethering involves significant risks of spinal cord injury and high rates of retethering. Read More

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Slacklining as therapy to address non-specific low back pain in the presence of multifidus arthrogenic muscle inhibition.

World J Orthop 2021 Apr 18;12(4):178-196. Epub 2021 Apr 18.

INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Université de Lyon, Lyon 69000, France.

Low back pain (LBP) represents the most prevalent, problematic and painful of musculoskeletal conditions that affects both the individual and society with health and economic concerns. LBP is a heterogeneous condition with multiple diagnoses and causes. In the absence of consensus definitions, partly because of terminology inconsistency, it is further referred to as non-specific LBP (NSLBP). Read More

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Radiographic Analysis of the Sagittal Alignment of Spine and Pelvis in Asymptomatic Indian Population.

Asian Spine J 2021 May 10. Epub 2021 May 10.

Department of Spine Services, Indian Spinal Injuries Center, New Delhi, India.

Study Design: This is a descriptive observational study.

Purpose: The objective of this study is to analyze and document the sagittal alignment of the spine and pelvis in normal Indian adult volunteers and compare these parameters with the study population of other races and ethnicities.

Overview Of Literature: Given the importance of the spinopelvic parameters, there is a need to describe the parameters differentially in relation to the ethnicity of the studied individual. Read More

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Spinal fractures incurred by sports related injuries.

World Neurosurg 2021 May 3. Epub 2021 May 3.

Department of Neurosurgery, Wessex Neurological Centre, Southampton, United Kingdom; Department of Neurosurgery, Queens Hospital, Barking Havering Redbridge University Trust, London, United Kingdom.

Background: Sports related injuries are the third commonest cause of spine fractures. Spinal fractures incurred as a result of partaking in sport by their nature are different to those associated with frailty and road traffic accidents. The patient demographics and nature of fractures associated with sports activities is not well documented. Read More

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Neuroanatomical organization of Methionine-enkephalinergic system in the brain of the Mozambique tilapia Oreochromis mossambicus.

J Chem Neuroanat 2021 May 3:101963. Epub 2021 May 3.

Neuroendocrinology Research Laboratory, Department of Studies in Zoology, Karnatak University, Dharwad, 580 003, India.

Enkephalins are a class of opioid peptides implicated in several physiological and neuroendocrine responses in vertebrates. In this study, using immunocytochemical or immunofluorescence technique, we examined the neuroanatomical distribution of methionine enkephalin (M-ENK) immunoreactivity in the central nervous system (CNS) of the cichlid fish Oreochromis mossambicus. In the telencephalon, no M-ENK-like-immunoreactive (M-ENK-L-ir) perikarya, but sparsely distributed fibres were detected in the glomerular layer and the granular cell layer of the olfactory bulb. Read More

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Feasibility of Spinal Cord Stimulation in Patients With Refractory Angina Pectoris and a Cardiac Implanted Electronic Device.

Neuromodulation 2021 May 5. Epub 2021 May 5.

Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands.

Objectives: Five to 10% of patients with stable coronary artery disease have refractory angina pectoris (RAP). These patients are restricted in performing daily activities due to angina pectoris. Spinal cord stimulation is a last resort treatment option. Read More

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Hospital outcomes of scoliosis surgery in children with Prader-Willi Syndrome: comparison with adolescent idiopathic scoliosis.

Spine Deform 2021 May 5. Epub 2021 May 5.

Department of Orthopedics, Clinic B, Main Building, Phoenix Children's Hospital, 1919 E Thomas Road, Phoenix, AZ, 85016, USA.

Purpose: The purpose of this study was to evaluate the peri-operative outcomes of patients with Prader-Willi Syndrome (PWS) undergoing spinal deformity correction and compare the outcomes to patients with adolescent idiopathic scoliosis (AIS).

Methods: A retrospective review of the Kid's Inpatient Database was performed from 2000 to 2012 to identify all pediatric patients with scoliosis undergoing spinal fusion. Cohorts were created on the basis of PWS diagnosis and adolescent idiopathic scoliosis. Read More

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Specific Electroencephalographic Signatures for Pain and Descending Pain Inhibitory System in Spinal Cord Injury.

Pain Med 2021 May 5. Epub 2021 May 5.

Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Objectives: The pain related to Spinal Cord Injury (SCI) is difficult to treat and it is associated with significant morbidity. One aspect to improve therapeutics is to explore markers of pain and its correlates in SCI.

Methods: In this cross-sectional neurophysiological analysis of a randomized, double-blind controlled trial, thirty-nine patients with SCI were included. Read More

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Intracranial arachnoid cysts in an infant: A technical note on the innovative use of navigation and flexible endoscopy for cyst fenestration.

Surg Neurol Int 2021 14;12:160. Epub 2021 Apr 14.

Department of Neurological Surgery, University of Miami, Miami, Florida, United States.

Background: Intracranial arachnoid cysts (ACs) are a cerebral spinal fluid (CSF) collection within the meninges. They typically arise during embryologic development. Some are stable overtime with little consequence, but large or growing cysts may require surgical intervention. Read More

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Proportion and risk factors for death by euthanasia in dogs in the UK.

Sci Rep 2021 May 4;11(1):9145. Epub 2021 May 4.

Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, AL9 7TA, Herts, UK.

The loss of a pet can be particularly distressing for owners, whether the method of death is euthanasia or is unassisted. Using primary-care clinical data, this study aimed to report the demographic and clinical factors associated with euthanasia, relative to unassisted death, in dogs. Method of death (euthanasia or unassisted) and clinical cause of death were extracted from a random sample of 29,865 dogs within the VetCompass Programme from a sampling frame of 905,544 dogs under UK veterinary care in 2016. Read More

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Neurodevelopmental and psychiatric disorders in pediatric bladder and bowel dysfunction.

J Pediatr Urol 2021 Apr 3. Epub 2021 Apr 3.

Division of Urology, Hospital for Sick Children and Department of Surgery, University of Toronto, Ontario, Canada. Electronic address:

Background: Bladder and bowel dysfunction (BBD) is a common pediatric problem that describes a constellation of lower urinary tract symptoms associated with constipation and/or encopresis. Its association with neurodevelopmental and psychiatric (NDP) problems is not well understood.

Objectives: Our primary aim was to identify pre-existing NDP disorders in children with BBD. Read More

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Perioperative outcome and complications following single-staged Posterior Spinal Fusion (PSF) using pedicle screw instrumentation in Adolescent Idiopathic Scoliosis (AIS): a review of 1057 cases from a single centre.

BMC Musculoskelet Disord 2021 May 4;22(1):413. Epub 2021 May 4.

Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.

Background: There has been a growing interest in using all pedicle screw construct in posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) surgery in recent years. However, studies focusing on perioperative outcome and complications utilizing only pedicle screw system in AIS population are lacking. This study aims to evaluate perioperative outcomes and to determine the prevalence of major and minor complications following single-staged PSF for AIS. Read More

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Symptomatic Atlas Hypoplasia in a Latin-American Patient: Case Report and Literature Review.

J Am Acad Orthop Surg Glob Res Rev 2021 May 4;5(5):e21.00041. Epub 2021 May 4.

From the Hospital Italiano de Buenos Aires, Spinal Pathology Service, Almagro, CABA, Argentina. Orthopedic Institute "Prof. Dr. Carlos E. Ottolengui", Adult Spine Pathology Service, Hospital Italiano de Buenos Aires, CABA, Argentina.

Background: Atlas hypoplasia is an infrequent cause of upper cervical stenosis. Only 24 cases in nonsyndromic adult population have been published. We are not aware of previous reports describing isolated fully formed atlas hypoplasia in a Latin-American patient. Read More

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Early vocational rehabilitation for people with spinal cord injury: a research protocol using realist synthesis and interviews to understand how and why it works.

BMJ Open 2021 May 3;11(5):e048753. Epub 2021 May 3.

Preventative and Social Medicine, University of Otago, Dunedin, New Zealand.

Introduction: Return to work after spinal cord injury (SCI) is linked to well-being and better physical and mental health outcomes. In New Zealand, work rates after SCI are lower than the general population. Vocational rehabilitation is one method of supporting return to work. Read More

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cGMP signalling in dorsal root ganglia and the spinal cord: Various functions in development and adulthood.

Br J Pharmacol 2021 May 3. Epub 2021 May 3.

Institute of Pharmacology and Clinical Pharmacy, Goethe University, Frankfurt am Main, Germany.

Cyclic GMP (cGMP) is a second messenger that regulates numerous physiological and pathophysiological processes. In recent years, more and more studies have uncovered multiple roles of cGMP signalling pathways in the somatosensory system. Accumulating evidence suggests that cGMP regulates different cellular processes from embryonic development through adulthood. Read More

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A Rare Case of Mycobacterium Monacense Osteomyelitis: A Case Report.

Cureus 2021 Mar 31;13(3):e14199. Epub 2021 Mar 31.

Pulmonary and Critical Care Medicine, BronxCare Health System, Bronx, USA.

is a yellow-pigmented, rapidly growing non-tuberculous mycobacterium (RGM). It is a rare pathogen in humans, and only a very few cases of skin and lung infection related to it have been reported. In this report, we present the case of a 70-year-old Hispanic male who was brought to the hospital with back pain for 11 months. Read More

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Further Support for the Psychometric Properties of the Farsi Version of Perth Alexithymia Questionnaire.

Front Psychol 2021 14;12:657660. Epub 2021 Apr 14.

Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom.

Alexithymia is defined as the lack of words to describe emotions and is associated with different psychopathologies. Various tools have been developed for measuring alexithymia; each has its limitations. A new questionnaire, Perth Alexithymia Questionnaire (PAQ), was developed to simultaneously assess positive and negative dimensions. Read More

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Association of Early Multiple Organ Dysfunction With Clinical and Functional Outcomes Over the Year Following Traumatic Brain Injury: A Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study.

Crit Care Med 2021 May 3. Epub 2021 May 3.

Department of Anesthesiology, Duke University, Durham, NC. Critical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University. Durham, NC. Department of Population Health Sciences, Duke University, Durham, NC. Department of Neurosurgery, University of Washington, Seattle, WA. Department of Biostatistics, University of Washington, Seattle, WA. Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH. Department of Neurosurgery, Duke University, Durham, NC. Department of Emergency Medicine, University of Michigan, Ann Arbor, MI. Department of Neurology, Duke University, Durham, NC. Department of Medicine, Duke University, Durham, NC. Brain and Spinal Injury Center, University of California at San Francisco, San Francisco, CA. Department of Biostatistics and Bioinformatics, Duke University, Durham, NC. Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA.

Objectives: Traumatic brain injury is a leading cause of death and disability in the United States. While the impact of early multiple organ dysfunction syndrome has been studied in many critical care paradigms, the clinical impact of early multiple organ dysfunction syndrome in traumatic brain injury is poorly understood. We examined the incidence and impact of early multiple organ dysfunction syndrome on clinical, functional, and disability outcomes over the year following traumatic brain injury. Read More

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An analysis of tumor-related potential spinal column instability (Spine Instability Neoplastic Scores 7-12) eventually requiring surgery with a 1-year follow-up.

Neurosurg Focus 2021 May;50(5):E6

Departments of1Neurosurgery.

Objective: Within the Spine Instability Neoplastic Score (SINS) classification, tumor-related potential spinal instability (SINS 7-12) may not have a clear treatment approach. The authors aimed to examine the proportion of patients in this indeterminate zone who later required surgical stabilization after initial nonoperative management. By studying this patient population, they sought to determine if a clear SINS cutoff existed whereby the spine is potentially unstable due to a lesion and would be more likely to require stabilization. Read More

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Performance assessment of the metastatic spinal tumor frailty index using machine learning algorithms: limitations and future directions.

Neurosurg Focus 2021 May;50(5):E5

Departments of1Neurosurgery and.

Objective: Frailty is recognized as an important consideration in patients with cancer who are undergoing therapies, including spine surgery. The definition of frailty in the context of spinal metastases is unclear, and few have studied such markers and their association with postoperative outcomes and survival. Using national databases, the metastatic spinal tumor frailty index (MSTFI) was developed as a tool to predict outcomes in this specific patient population and has not been tested with external data. Read More

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Refining the treatment of spinal cord lesions: experience from 500 cases.

Neurosurg Focus 2021 May;50(5):E22

Objective: Tumorous lesions of the spinal cord, as well as some vascular lesions like cavernous hemangiomas, demand careful consideration as to the indication and approach for surgery. As these lesions are rare in any departmental series, refinement of treatment strategies evolves over long periods. In this context, the authors evaluated a series of 500 intramedullary lesions for approach, technique, outcome, complications, and follow-up. Read More

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Clinical characteristics and long-term outcomes for patients who undergo cytoreductive surgery for thoracic meningiomas: a retrospective analysis.

Neurosurg Focus 2021 May;50(5):E18

1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia.

Objective: Primary spinal meningiomas represent a rare indolent neoplasm usually situated in the intradural-extramedullary compartment. They have a predilection for afflicting the thoracic spine and most frequently present with sensory and/or motor symptoms. Resection is the first-line treatment for symptomatic tumors, whereas other clinical factors will determine the need for adjuvant therapy. Read More

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Factors associated with adjacent-level tumor progression in patients receiving surgery followed by radiosurgery for metastatic epidural spinal cord compression.

Neurosurg Focus 2021 May;50(5):E15

Departments of1Neurosurgery.

Objective: Separation surgery followed by spine stereotactic radiosurgery (SSRS) has been shown to achieve favorable rates of local tumor control and patient-reported outcomes in patients with metastatic epidural spinal cord compression (MESCC). However, rates and factors associated with adjacent-level tumor progression (ALTP) in this population have not yet been characterized. The present study aimed to identify factors associated with ALTP and examine its association with overall survival (OS) in patients receiving surgery followed by radiosurgery for MESCC. Read More

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Carbon fiber-reinforced PEEK instrumentation in the spinal oncology population: a retrospective series demonstrating technique, feasibility, and clinical outcomes.

Neurosurg Focus 2021 May;50(5):E13

Departments of1Neurologic Surgery and.

Objective: The authors aimed to demonstrate the feasibility and advantages of carbon fiber-reinforced PEEK (CFRP) composite implants in patients with both primary and secondary osseous spinal tumors.

Methods: Twenty-eight spinal tumor patients who underwent fixation with CFRP hardware were retrospectively identified in a Spine Tumor Quality Database at a single institution. Demographic, procedural, and follow-up data were retrospectively collected. Read More

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Safety and efficacy of cement augmentation with fenestrated pedicle screws for tumor-related spinal instability.

Neurosurg Focus 2021 May;50(5):E12

Objective: Achieving rigid spinal fixation can be challenging in patients with cancer-related instability, as factors such as osteopenia, radiation, and immunosuppression adversely affect bone quality. Augmenting pedicle screws with cement is a strategy to overcome construct failure. This study aimed to assess the safety and efficacy of cement augmentation with fenestrated pedicle screws in patients undergoing posterior, open thoracolumbar surgery for spinal metastases. Read More

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Effects of manual therapy on the diaphragm in the musculoskeletal system: a systematic review.

Arch Phys Med Rehabil 2021 Apr 28. Epub 2021 Apr 28.

Hospital Marqués de Valdecilla. Servicio Cántabro de Salud, Santander, Cantabria, Spain. Electronic address:

Objectives: To analyze the effects at the musculoskeletal level of manual treatment of the diaphragm muscle in adults.

Data Sources: Systematic review using four databases: PubMed, Science Direct, Web of Science and Scopus.

Study Selection And Data Extraction: Two independent reviewers applied the selection criteria and assessed the quality of the studies using the Physiotherapy Evidence Database (PEDro) scale for experimental studies. Read More

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Adaptation and validation of the Japanese version of the Spinal Cord Independence Measure (SCIM III) self-report.

Spinal Cord 2021 Apr 30. Epub 2021 Apr 30.

Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.

Study Design: Psychometric study, cross-sectional validation study.

Objectives: To adapt and validate the Japanese version of the Spinal Cord Independence Measure self-report (SCIM-SR).

Setting: A spinal cord injury (SCI) rehabilitation facility in Japan. Read More

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Single nucleus RNA-sequencing defines unexpected diversity of cholinergic neuron types in the adult mouse spinal cord.

Nat Commun 2021 04 30;12(1):2471. Epub 2021 Apr 30.

Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.

In vertebrates, motor control relies on cholinergic neurons in the spinal cord that have been extensively studied over the past hundred years, yet the full heterogeneity of these neurons and their different functional roles in the adult remain to be defined. Here, we develop a targeted single nuclear RNA sequencing approach and use it to identify an array of cholinergic interneurons, visceral and skeletal motor neurons. Our data expose markers for distinguishing these classes of cholinergic neurons and their rich diversity. Read More

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Complications in ambulatory pediatric patients with nonidiopathic spinal deformity undergoing fusion to the pelvis using the sacral-alar-iliac technique within 2 years of surgery.

J Neurosurg Pediatr 2021 Apr 30:1-8. Epub 2021 Apr 30.

Objective: Significant investigation in the adult population has generated a body of research regarding proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) following long fusions to the sacrum and pelvis. However, much less is known regarding early complications, including PJK and PJF, in the ambulatory pediatric patient. As such, the objective of this study was to address the minimal literature on early complications after ambulatory pediatric patients underwent fusion to the sacrum with instrumentation to the pelvis in the era of sacral-alar-iliac (S2AI) instrumentation. Read More

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Protein Considerations for Athletes With a Spinal Cord Injury.

Front Nutr 2021 13;8:652441. Epub 2021 Apr 13.

Department of Health and Physical Education, Mount Royal University, Calgary, AB, Canada.

Athlete participation in the Paralympic games is steadily increasing; prompting research focused on the unique needs of this population. While the Paralympic Games includes a diversity of athletes, athletes with a spinal cord injury (PARA-SCI) represent a subgroup that requires specialized recommendations. Nutritional guidelines designed to optimize performance, in the context of the neurological impairments, are required. Read More

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