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  • 1
    Language: English
    In: Global Spine Journal, December 2013, Vol.3(4), pp.265-271
    Description: Study Design Systematic review. Objective We assessed the current state of spine registries by collecting spine trauma data and assessing their compliance to defined registry standards of being clinical quality. We ascertained if these registries collected spinal cord injury data alone or with spine column trauma data. Methods A systematic review was performed using MEDLINE and Embase databases for articles describing dedicated spinal cord and spine column databases published between January 1990 and April 2011. Correspondence with these registries was performed via e-mail or post. When no correspondence was possible, the registries were analyzed with best information available. Results Three hundred eight full-text articles were reviewed. Of 41 registries identified, 20 registries fulfilled the criteria of being clinical quality. The main reason for failure to attain clinical quality designation was due to the unavailability of patient outcomes. Eight registries collected both spine column and spinal cord injury data with 33 collecting only traumatic spinal cord injury data. Conclusion There is currently a paucity of clinical quality spine trauma registries. Clinical quality registries are important tools for demonstrating trends and outcomes, monitoring care quality, and resolving controversies in the management of spine trauma. An international spine trauma data set (containing both spinal cord and spine column injury data) and standardized approach to recording and analysis are needed to allow international multicenter collaboration and benchmarking.
    Keywords: Clinical Quality ; Registry ; Database ; Spine Trauma ; Benchmarking
    ISSN: 2192-5682
    E-ISSN: 2192-5690
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  • 2
    In: Spine, 2011, Vol.36(23), pp.1997-1997
    Keywords: Terminology As Topic ; Cervical Vertebrae -- Pathology ; Physicians -- Standards ; Spinal Fractures -- Classification;
    ISSN: 0362-2436
    E-ISSN: 15281159
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  • 3
    In: Spine, 2013, Vol.38(12), pp.999-1007
    Description: STUDY DESIGN.: Retrospective review on prospective cohort and explicit chart review. OBJECTIVE.: To identify early spine trauma predictors of functional disability and to assess management compliance to established spine trauma treatment algorithms. SUMMARY OF BACKGROUND DATA.: Identification of early (within 48 hours) spine trauma predictors of functional disability is novel and may assist in the management of patients with trauma. Also, with significant global variation, spine trauma treatment algorithms are essential. METHODS.: Analysis was performed on patients with spine trauma from May 1, 2009, to January 1, 2011. Functional outcomes were determined using the Glasgow Outcome Scale (GOS) at 1 year. Univariate and multivariate regressions were applied to investigate the effects of the injury severity score, age, blood sugar level, vital signs, traumatic brain injury, comorbidities, coagulation profile, neurology, and spine injury characteristics. A compliance study was performed using the SLIC and TLICS spine trauma algorithms. RESULTS.: The completion rate for the GOS was 58.8%. The completed GOS cohort was 4.2 years younger in terms of mean age, had more number of patients with severe polytrauma, but less number of patients with severe spinal cord injuries (ASIA [American Spinal Injury Association] A, B, and C) in comparison with the uncompleted GOS cohort. Multivariate logistic regression revealed 3 independent early spine trauma predictors of functional disability with statistical significance (P 〈 0.05). They were (1) hypotension (OR [odds ratio] = 1.98; CI [confidence interval] = 1.13–3.49), (2) hyperglycemia (OR = 1.67; CI = 1.09–2.56), and (3) moderate/severe traumatic brain injury (OR = 5.88; CI = 1.71–20.16). There were 305 patients with subaxial cervical spine injuries and 653 patients with thoracolumbar spine injuries. The subaxial cervical spine injury classification and thoracolumbar injury classification and severity score compliance studies returned agreements of 96.1% and 98.9%, respectively. CONCLUSION.: Early independent spine trauma predictors of functional disability identified in a level 1 trauma center with high compliance to the subaxial cervical spine injury classification and thoracolumbar injury classification and severity score algorithms were hypotension, hyperglycemia, and moderate or severe traumatic brain injury. Spine trauma injury variables alone were shown not to be predictive of functional disability.Level of Evidence: 3
    Keywords: Disability Evaluation ; Trauma Centers ; Spinal Injuries -- Diagnosis ; Spine -- Physiopathology;
    ISSN: 0362-2436
    E-ISSN: 15281159
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  • 4
    In: Spine, 2013, Vol.38(2), pp.169-177
    Description: STUDY DESIGN.: Retrospective cohort study. OBJECTIVE.: To identify early independent mortality predictors after spine trauma. SUMMARY OF BACKGROUND DATA.: Spine trauma consists of spinal cord and spine column injury. The ability to identify early (within 24 hours) risk factors predictive of mortality in spine trauma has the potential to reduce mortality and improve spine trauma management. METHODS.: Analysis was performed on 215 spine column and/or spinal cord injured patients from July 2008 to August 2011. Univariate and multivariate logistic regression models were applied to investigate the effects of the Injury Severity Score, age, mechanism of injury, blood glucose level, vital signs, brain trauma severity, morbidity before trauma, coagulation profile, neurological status, and spine injuries on the risk of in-hospital death. RESULTS.: Applying a multivariate logistic regression model, there were 7 independent early predictive factors for mortality after spine injury. They were (1) Injury Severity Score more than 15 (odds ratio [OR] = 3.67; P = 0.009), (2) abnormal coagulation profile (OR = 6; P 〈 0.0001), (3) patients 65 years or older (OR = 3.49; P = 0.007), (4) hypotension (OR = 2.9; P = 0.033), (5) tachycardia (OR = 4.04; P = 0.005), (6) hypoxia (OR = 2.9; P = 0.033), and (7) multiple comorbidities (OR = 3.49; P = 0.007). Severe traumatic brain injury was also associated with mortality but was excluded from multivariate analysis because there were no patients with this variable in the comparison group. CONCLUSION.: Mortality predictors for spine trauma patients are similar to those for general trauma patients. Spine injury variables were shown not to be independent predictors of spine trauma mortality.
    Keywords: Aged–Epidemiology ; Australia–Diagnosis ; Cause of Death–Mortality ; Comorbidity–Diagnosis ; Early Diagnosis–Mortality ; Female–Mortality ; Humans–Mortality ; Male–Mortality ; Prognosis–Mortality ; Retrospective Studies–Mortality ; Risk Factors–Mortality ; Spinal Cord Injuries–Mortality ; Spinal Injuries–Mortality ; Survival Rate–Mortality ; Time Factors–Mortality ; Trauma Severity Indices–Mortality ; Vital Signs–Mortality;
    ISSN: 0362-2436
    E-ISSN: 15281159
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  • 5
    Language: English
    In: Journal of neurosurgery, October 2014, Vol.121(4), pp.924-8
    Description: The authors report the first case of vasogenic cerebral edema due to a cell-mediated hypersensitivity reaction to a nickel-containing aneurysm clip. The patient initially presented for elective clipping of a right middle cerebral artery aneurysm, and on long-term follow-up she demonstrated relapsing-remitting cerebral edema. Four years post-aneurysm clipping, she underwent an exploratory craniotomy given unsuccessful conservative management of her headaches and imaging evidence of cerebral edema with mass effect. During surgery, gross parenchymal edema and inflammatory nodules were observed. Histopathology was consistent with a cell-mediated (Type IV) hypersensitivity reaction. Concerns regarding nickel allergy are often reported in the cardiac literature. This case highlights the possibility of nickel hypersensitivity when using nickel-containing aneurysm clips, especially in patients with known nickel allergies.
    Keywords: Mca = Middle Cerebral Artery ; PAS-D = Periodic Acid–Schiff Diastase ; Aneurysm Clip ; Cell-Mediated Allergy ; Cerebral Aneurysm ; Nickel ; Vascular Disorders ; Brain Edema -- Etiology ; Hypersensitivity -- Etiology ; Intracranial Aneurysm -- Surgery ; Surgical Instruments -- Adverse Effects ; T-Lymphocytes -- Immunology
    ISSN: 00223085
    E-ISSN: 1933-0693
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  • 6
    Article
    Article
    Language: English
    In: Journal of neurosurgery, July 2015, Vol.123(1), pp.293
    Keywords: Brain Edema -- Etiology ; Hypersensitivity -- Etiology ; Intracranial Aneurysm -- Surgery ; Surgical Instruments -- Adverse Effects ; T-Lymphocytes -- Immunology
    ISSN: 00223085
    E-ISSN: 1933-0693
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  • 7
    Language: English
    In: European Spine Journal, 2016, Vol.25(5), pp.1467-1473
    Description: To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s00586-015-4347-6 Byline: Yoni Goldenberg (1), Jin W. Tee (1), Cesar M. Salinas-La Rosa (2), Michael Murphy (1) Keywords: Metallosis; Metalloma; Spinal stenosis; Posterior lumbar fusion; Spinal instrumentation Abstract: Purpose To document a rarely reported complication associated with spinal instrumentation and to evaluate the current literature on spinal metallosis and spinal metalloma. Methods A local case report is presented. EBSCOhost, PubMed and ScienceDirect databases were used to conduct a systematic review for articles describing spinal metallosis and spinal metalloma. Results A total of 836 articles were identified using the terms "metalloma" or "metallosis". Exclusion of arthroplasty-related abstracts retrieved 46 articles of which 3 full text articles presenting spinal metalloma as a causative pathological finding responsible for neurological signs and symptoms in patients with previous spinal fusion instrumentation were reviewed. Our case is the first described with titanium-composed posterior instrumentation and fifth reported, demonstrating the phenomena of neurological symptoms and signs attributed directly to neural tissue compression by spinal metalloma after spinal instrumentation. Conclusion Spinal metallosis can present weeks to years after spinal instrumentation surgery and is a potential cause of neural compression. This process appears to be independent of the instrument composition as metallosis has now been demonstrated in both titanium and stainless steel constructs. Author Affiliation: (1) Department of Neurosurgery and Neurosciences, St Vincent's Hospital, Level 10 IPS Building, 59 Victoria Parade, Fitzroy, Melbourne, VIC, 3065, Australia (2) Department of Anatomical Pathology, St Vincent's Hospital, Melbourne, VIC, Australia Article History: Registration Date: 28/11/2015 Received Date: 15/03/2015 Accepted Date: 28/11/2015 Online Date: 05/01/2016
    Keywords: Metallosis ; Metalloma ; Spinal stenosis ; Posterior lumbar fusion ; Spinal instrumentation
    ISSN: 0940-6719
    E-ISSN: 1432-0932
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  • 8
    Language: English
    In: World Neurosurgery, October 2017, Vol.106, pp.790-805
    Description: Obesity is an important consideration in neurosurgical practice. Of Australian adults, 28.3% are obese and it is estimated that more than two thirds of Australia's population will be overweight or obese by 2025. This review of the effects of obesity on neurosurgical procedures shows that, in patients undergoing spinal surgery, an increased body mass index is a significant risk factor for surgical site infection, venous thromboembolism, major medical complications, prolonged length of surgery, and increased financial cost. Although outcome scores and levels of patient satisfaction are generally lower after spinal surgery in obese patients, obesity is not a barrier to deriving benefit from surgery and, when the natural history of conservative management is taken into account, the long-term benefits of surgery may be equivalent or even greater in obese patients than in nonobese patients. In cranial surgery, the impact of obesity on outcome and complication rates is generally lower. Specific exceptions are higher rates of distal catheter migration after shunt surgery and cerebrospinal fluid leak after posterior fossa surgery. Minimally invasive approaches show promise in mitigating some of the adverse effects of obesity in patients undergoing spine surgery but further studies are needed to develop strategies to reduce obesity-related surgical complications.
    Keywords: Body Mass Index ; Complications ; Neurosurgery ; Obesity ; Outcome ; Spine
    ISSN: 1878-8750
    E-ISSN: 1878-8769
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  • 9
    Language: English
    In: European Spine Journal, 2017, Vol.26(8), pp.2220-2221
    Description: To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s00586-017-5190-8 Byline: Yoni Goldenberg (1), Jin W. Tee (1), Cesar M. Salinas-La Rosa (2), Michael Murphy (1) Author Affiliation: (1) Department of Neurosurgery and Neurosciences, St Vincent's Hospital, Level 10 IPS Building, 59 Victoria Parade, Fitzroy, Melbourne, VIC, 3065, Australia (2) Department of Anatomical Pathology, St Vincent's Hospital, Melbourne, VIC, Australia Article History: Registration Date: 12/06/2017 Received Date: 07/06/2017 Accepted Date: 10/06/2017 Online Date: 15/06/2017
    Keywords: Medicine & Public Health ; Surgical Orthopedics ; Neurosurgery;
    ISSN: 0940-6719
    E-ISSN: 1432-0932
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  • 10
    Language: English
    In: BMJ Case Reports, 28 June 2014, Vol.2014
    Description: The authors report a rare case of an oculomotor nerve palsy attributed to mass effect from an aberrant posterior cerebral artery. The patient presented with complete ptosis, mydriasis and ophthalmoplegia of the affected eye. MRI demonstrated distortion of the oculomotor nerve as it traversed inferior to the non-aneurysmal P1 segment of an aberrant posterior cerebral artery. The oculomotor nerve palsy resolved spontaneously.
    Keywords: Brain;
    ISSN: 09675868
    E-ISSN: 1757-790X
    E-ISSN: 1757790X
    E-ISSN: 15322653
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