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Stefan Lakemeier - One of the best experts on this subject based on the ideXlab platform.
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Set Screw fracture with cage dislocation after two level transforaminal lumbar interbody fusion tlif a case report
Journal of Medical Case Reports, 2015Co-Authors: Philip Johannes Felix Leute, Ahmed Hammad, Isabel Hoffmann, Sebastian Hoppe, H M Klinger, Stefan LakemeierAbstract:Introduction Transforaminal lumbar interbody fusion is a popular procedure used to achieve spondylodesis in patients with degenerative lumbar spinal diseases. We present a rare case of a patient with a Set Screw fracture with cage dislocation after an open transforaminal lumbar interbody fusion procedure. To the best of our knowledge, this case is the first of its kind to be reported.
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Set Screw fracture with cage dislocation after two level transforaminal lumbar interbody fusion tlif a case report
Journal of Medical Case Reports, 2015Co-Authors: Philip Johannes Felix Leute, Ahmed Hammad, Isabel Hoffmann, Sebastian Hoppe, H M Klinger, Stefan LakemeierAbstract:Transforaminal lumbar interbody fusion is a popular procedure used to achieve spondylodesis in patients with degenerative lumbar spinal diseases. We present a rare case of a patient with a Set Screw fracture with cage dislocation after an open transforaminal lumbar interbody fusion procedure. To the best of our knowledge, this case is the first of its kind to be reported. A 44-year-old Caucasian woman attended a follow-up appointment at our hospital 3 months after treatment for second-degree lumbar spondylolisthesis (L4/L5) and osteochondrosis (L5/S1) with transforaminal lumbar interbody fusion and dorsal spondylodesis. She complained of severe leg pain on the left side. Her physical examination revealed a normal neurological status, except for paresthesia of the entire left lower limb and at the ball of the left foot. Radiological imaging showed breaking of the Set Screws with cage dislocation. Surgical revision was then performed with exchange of the whole dorsal instrumentation and the dislocated cage. Six weeks post-operatively, the patient was seen again at our clinic without neurological complaints, except for decreased sensitivity on the dorsum of her left foot. The wound healing and radiological follow-up were uneventful. Hardware-related complications are rarely seen in patients with open transforaminal lumbar interbody fusion, but must be kept in mind and can potentially cause severe neurological deficits.
J H Foreman - One of the best experts on this subject based on the ideXlab platform.
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dose titration of the clinical efficacy of intravenously administered flunixin meglumine in a reversible model of equine foot lameness
Equine Veterinary Journal, 2012Co-Authors: J H Foreman, B Bergstrom, K S Golden, J J Roark, D S Coren, C Foreman, S A SchumacherAbstract:Summary Reasons for performing study There are no refereed controlled documentations of the skeletal analgesic efficacy of different dosages of flunixin meglumine (FM). Objectives The objective of this experiment was to compare the efficacy of various dosages of FM with a negative control. The hypothesis was that higher doses would result in improved efficacy in a dose-dependent manner when tested in a reversible model of foot lameness. Methods Ten horses shod with adjustable heart bar shoes had weekly modified AAEP grade 4.0/5.0 lameness induced by tightening a Set Screw against the heart bar. Heart rate (HR) and lameness score (LS) were monitored by one double-blinded investigator at rest; every 20 min after lameness induction for 5 h and hourly for another 8 h. One hour after lameness induction, treatments were administered i.v. in a randomised order: negative control (isotonic saline: SAL) or FM at 0.55 (half-dose), 1.1 (single-dose) or 2.2 (double-dose) mg/kg bwt. Results were compared using RM ANOVA and Student–Newman–Keul's test with the level of significance Set at P<0.05. Results Compared to SAL, half-dose FM reduced HR at 2.33, 2.67, 4.0–8.0, and 10.0 h and LS at 1.33–12.0 h (P<0.05). Single- and double-dose FM reduced HR from 0.67 to 12.0 h and LS from 1.0 to 12.0 h post administration (P<0.05). Compared with half-dose FM, single- and double-dose LS were further decreased from 1.67 to 12.0 h post administration (P<0.05). Mean peak and decaying plasma FM concentrations were different between dosages in a dose-dependent manner through 6 h post administration (P<0.05). Conclusions Flunixin meglumine administration affected dependent variables in a dose-dependent manner with half-dose FM clinically effective for a shorter period. Higher dosages did not perform differently from one another. Potential relevance Practitioners must be aware that half-doses of FM are less efficacious than single doses but double doses are not more efficacious and yet are potentially more toxic.
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efficacy of single dose intravenous phenylbutazone and flunixin meglumine before during and after exercise in an experimental reversible model of foot lameness in horses
Equine Veterinary Journal, 2010Co-Authors: J H Foreman, T L Grubb, O J Inoue, S E Banner, K T BallAbstract:Summary Reasons for performing study: Objective blinded efficacy data during exercise are lacking on the use of single-dose i.v. nonsteroidal anti-inflammatory drugs (NSAIDs) before, during and after exercise. Hypothesis: Single i.v. doses of either phenylbutazone (PBZ) or flunixin meglumine (FM) would prove more efficacious than negative saline control (SAL) before, during and after exercise in a reversible model of foot lameness. Methods: Six Quarter Horse mares had lameness induced by tightening a Set Screw against a heart bar shoe 1 h prior to treatment. Randomised blinded treatments included PBZ (4.4 mg/kg bwt i.v.), FM (1.1 mg/kg bwt i.v.), and SAL (1 ml/45 kg i.v.). Heart rate and lameness score (LS) were recorded at rest; every 20 min after lameness induction for 5 h and at the end of 2 min treadmill workloads of 2 and 4 m/s. Heart rate was also recorded from 0.5–60 min post exercise. Results were compared using RM ANOVA and Student-Newman-Keul's test (HR) and Wilcoxon signed rank test (%ΔLS) with significance Set at P<0.05. Results: Pre-exercise mean HR was decreased for both NSAIDs compared to SAL from 1:20–4 h post treatment (P 0.05), but mean %ΔLS was decreased for both NSAIDs compared to SAL (P<0.01). Mean recovery HR was decreased for PBZ and FM from 1–60 min compared to SAL (P<0.05). Conclusions: PBZ and FM demonstrated definitive clinical efficacy after single i.v. doses before, during and after exercise. Use of single i.v. doses during competition may mask lameness and may affect the ability of judges in determining the soundness of horses in competition.
Philip Johannes Felix Leute - One of the best experts on this subject based on the ideXlab platform.
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Set Screw fracture with cage dislocation after two level transforaminal lumbar interbody fusion tlif a case report
Journal of Medical Case Reports, 2015Co-Authors: Philip Johannes Felix Leute, Ahmed Hammad, Isabel Hoffmann, Sebastian Hoppe, H M Klinger, Stefan LakemeierAbstract:Introduction Transforaminal lumbar interbody fusion is a popular procedure used to achieve spondylodesis in patients with degenerative lumbar spinal diseases. We present a rare case of a patient with a Set Screw fracture with cage dislocation after an open transforaminal lumbar interbody fusion procedure. To the best of our knowledge, this case is the first of its kind to be reported.
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Set Screw fracture with cage dislocation after two level transforaminal lumbar interbody fusion tlif a case report
Journal of Medical Case Reports, 2015Co-Authors: Philip Johannes Felix Leute, Ahmed Hammad, Isabel Hoffmann, Sebastian Hoppe, H M Klinger, Stefan LakemeierAbstract:Transforaminal lumbar interbody fusion is a popular procedure used to achieve spondylodesis in patients with degenerative lumbar spinal diseases. We present a rare case of a patient with a Set Screw fracture with cage dislocation after an open transforaminal lumbar interbody fusion procedure. To the best of our knowledge, this case is the first of its kind to be reported. A 44-year-old Caucasian woman attended a follow-up appointment at our hospital 3 months after treatment for second-degree lumbar spondylolisthesis (L4/L5) and osteochondrosis (L5/S1) with transforaminal lumbar interbody fusion and dorsal spondylodesis. She complained of severe leg pain on the left side. Her physical examination revealed a normal neurological status, except for paresthesia of the entire left lower limb and at the ball of the left foot. Radiological imaging showed breaking of the Set Screws with cage dislocation. Surgical revision was then performed with exchange of the whole dorsal instrumentation and the dislocated cage. Six weeks post-operatively, the patient was seen again at our clinic without neurological complaints, except for decreased sensitivity on the dorsum of her left foot. The wound healing and radiological follow-up were uneventful. Hardware-related complications are rarely seen in patients with open transforaminal lumbar interbody fusion, but must be kept in mind and can potentially cause severe neurological deficits.
Paul D Sponseller - One of the best experts on this subject based on the ideXlab platform.
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sacral alar iliac fixation in children with neuromuscular scoliosis minimum 5 year follow up
World Neurosurgery, 2017Co-Authors: Amit Jain, Brian T Sullivan, Anne M Kuwabara, Khaled M Kebaish, Paul D SponsellerAbstract:Objective To investigate the 5-year outcomes of children with neuromuscular scoliosis treated with sacral-alar-iliac Screws. Methods We reviewed clinical and radiographic records of patients aged ≤18 years treated by 1 pediatric orthopedic surgeon for neuromuscular scoliosis with spinal fusion using sacral-alar-iliac pelvic anchors. Thirty-eight patients with a minimum 5-year radiographic follow-up (mean, 6.0 ± 1.2 years) were studied. The mean patient age was 13 ± 2.0 years, and 47% were female. The mean number of levels fused was 18 ± 0.7. Two-thirds (66%) of the patients were diagnosed with cerebral palsy. Results Between the preoperative period and final follow-up, the patients exhibited a mean correction of the major coronal curve of 79% (preoperative, 85° to final, 18°) and a mean 57% correction of the pelvic obliquity (preoperative, 16° to final, 7°). Patients maintained the correction of mean pelvic obliquity from the early postoperative period (6°) to final follow-up (7°). Preoperatively, 76% of the patients had a pelvic obliquity of >10°, compared with 26% of patients postoperatively. There were no cases of neurologic or vascular complications or pseudarthrosis. Radiographs revealed bilateral sacral-alar-iliac Screw lucency in 8 patients; 4 of these patients had deep wound infections, and the other 4 were asymptomatic. Unilateral Screw fracture was found in 1 patient with an 8-mm-diameter Screw (1.3%; 1 of 76 Screws); the patient was observed and remained asymptomatic. There were no cases of Set Screw displacement, Screw back-out, or rod dislodgement. Conclusions Sacral-alar-iliac Screws are safe and effective pelvic anchors for use in children with neuromuscular scoliosis.
S A Schumacher - One of the best experts on this subject based on the ideXlab platform.
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dose titration of the clinical efficacy of intravenously administered flunixin meglumine in a reversible model of equine foot lameness
Equine Veterinary Journal, 2012Co-Authors: J H Foreman, B Bergstrom, K S Golden, J J Roark, D S Coren, C Foreman, S A SchumacherAbstract:Summary Reasons for performing study There are no refereed controlled documentations of the skeletal analgesic efficacy of different dosages of flunixin meglumine (FM). Objectives The objective of this experiment was to compare the efficacy of various dosages of FM with a negative control. The hypothesis was that higher doses would result in improved efficacy in a dose-dependent manner when tested in a reversible model of foot lameness. Methods Ten horses shod with adjustable heart bar shoes had weekly modified AAEP grade 4.0/5.0 lameness induced by tightening a Set Screw against the heart bar. Heart rate (HR) and lameness score (LS) were monitored by one double-blinded investigator at rest; every 20 min after lameness induction for 5 h and hourly for another 8 h. One hour after lameness induction, treatments were administered i.v. in a randomised order: negative control (isotonic saline: SAL) or FM at 0.55 (half-dose), 1.1 (single-dose) or 2.2 (double-dose) mg/kg bwt. Results were compared using RM ANOVA and Student–Newman–Keul's test with the level of significance Set at P<0.05. Results Compared to SAL, half-dose FM reduced HR at 2.33, 2.67, 4.0–8.0, and 10.0 h and LS at 1.33–12.0 h (P<0.05). Single- and double-dose FM reduced HR from 0.67 to 12.0 h and LS from 1.0 to 12.0 h post administration (P<0.05). Compared with half-dose FM, single- and double-dose LS were further decreased from 1.67 to 12.0 h post administration (P<0.05). Mean peak and decaying plasma FM concentrations were different between dosages in a dose-dependent manner through 6 h post administration (P<0.05). Conclusions Flunixin meglumine administration affected dependent variables in a dose-dependent manner with half-dose FM clinically effective for a shorter period. Higher dosages did not perform differently from one another. Potential relevance Practitioners must be aware that half-doses of FM are less efficacious than single doses but double doses are not more efficacious and yet are potentially more toxic.
