1
|
Ghasemi A, Luna R, Kheterpal A, Debs P, Fayad L. Axial T1-weighted imaging of the lumbar spine: a redundancy or an asset? Skeletal Radiol 2024; 53:1061-1070. [PMID: 38040899 DOI: 10.1007/s00256-023-04522-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVE To determine the diagnostic value of axial T1-weighted imaging for patients suffering from lower back pain. MATERIALS AND METHODS In this retrospective study, 100 consecutive lumbar spine MRIs obtained in patients with chronic low back pain were reviewed in two sessions: First, readers viewed core sequences (sagittal T1-weighted, STIR and T2-weighted, and axial T2-weighted) with axial T1-weighted sequences, and second, readers viewed cores sequences alone. Readers recorded the presence of disc degeneration, nerve root compromise, facet joint arthritis, and stenosis at each lumbar spine level as well as the presence of lipoma of filum terminale (LFT), spondylolisthesis, transitional vertebrae, and fractures. The McNemar, Wilcoxon signed-rank, and student T tests were utilized. RESULTS For 100 studies, 5 spine levels were evaluated (L1-L2 through L5-S1). There were cases of disc disease (444/500 bulges, 56/500 herniations), nerve root compromise (1/500 nerve enlargement, 36/500 contact only, 20/500 displacement or compression), facet arthritis (438/500), stenosis (58/500 central canal, 64/500 lateral recess, 137/500 neuroforaminal), 6/100 LFTs, and other abnormalities (58/500 spondylolisthesis, 10/100 transitional vertebrae, 10/500 fracture/spondylolysis). There was no difference in diagnostic performance between the interpretation sessions (with and without axial T1-weighted imaging) at any level (p > 0.05), although four small additional LFTs were identified with axial T1-weighted imaging availability. CONCLUSION There was no clinically significant difference in the interpretation of lumbar spine MRI viewed with and without axial T1-weighted imaging, suggesting that the axial T1-weighted sequence does not add diagnostic value to routine lumbar spine MRI.
Collapse
Affiliation(s)
- Ali Ghasemi
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Rodrigo Luna
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Arvin Kheterpal
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Patrick Debs
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Laura Fayad
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
- Department of Orthopaedic Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
| |
Collapse
|
2
|
Wronski ML, Plessow F, Kerem L, Asanza E, O'Donoghue ML, Stanford FC, Bredella MA, Torriani M, Soukas AA, Kheterpal A, Eddy KT, Holmes TM, Deckersbach T, Vangel M, Holsen LM, Lawson EA. Corrigendum to "A randomized, double-blind, placebo-controlled clinical trial of 8-week intranasal oxytocin administration in adults with obesity: Rationale, study design, and methods" [Contemporary Clinical Trials 122 (2022) 1-11/106909]. Contemp Clin Trials 2024:107511. [PMID: 38522969 DOI: 10.1016/j.cct.2024.107511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Affiliation(s)
- Marie-Louis Wronski
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Franziska Plessow
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Liya Kerem
- Division of Pediatric Endocrinology, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Elisa Asanza
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Michelle L O'Donoghue
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Fatima C Stanford
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Division of Pediatric Endocrinology, Department of Pediatrics, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Miriam A Bredella
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Martin Torriani
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Alexander A Soukas
- Center for Genomic Medicine, Diabetes Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Arvin Kheterpal
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Tara M Holmes
- Translational and Clinical Research Centers, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Thilo Deckersbach
- Diploma Hochschule, University of Applied Sciences, Bad Sooden-Allendorf, Germany
| | - Mark Vangel
- Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Laura M Holsen
- Division of Women's Health, Department of Medicine and Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Elizabeth A Lawson
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
3
|
Wronski ML, Plessow F, Kerem L, Asanza E, O'Donoghue ML, Stanford FC, Bredella MA, Torriani M, Soukas AA, Kheterpal A, Eddy KT, Holmes TM, Deckersbach T, Vangel M, Holsen LM, Lawson EA. A randomized, double-blind, placebo-controlled clinical trial of 8-week intranasal oxytocin administration in adults with obesity: Rationale, study design, and methods. Contemp Clin Trials 2022; 122:106909. [PMID: 36087842 PMCID: PMC10329413 DOI: 10.1016/j.cct.2022.106909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/28/2022] [Accepted: 09/02/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Obesity affects more than one-third of adults in the U.S., and effective treatment options are urgently needed. Oxytocin administration induces weight loss in animal models of obesity via effects on caloric intake, energy expenditure, and fat metabolism. We study intranasal oxytocin, an investigational drug shown to reduce caloric intake in humans, as a potential novel treatment for obesity. METHODS We report the rationale, design, methods, and biostatistical analysis plan of a randomized, double-blind, placebo-controlled clinical trial of intranasal oxytocin for weight loss (primary endpoint) in adults with obesity. Participants (aged 18-45 years) were randomly allocated (1:1) to oxytocin (four times daily over eight weeks) versus placebo. Randomization was stratified by biological sex and BMI (30 to <35, 35 to <40, ≥40 kg/m2). We investigate the efficacy, safety, and mechanisms of oxytocin administration in reducing body weight. Secondary endpoints include changes in resting energy expenditure, body composition, caloric intake, metabolic profile, and brain activation via functional magnetic resonance imaging in response to food images and during an impulse control task. Safety and tolerability (e.g., review of adverse events, vital signs, electrocardiogram, comprehensive metabolic panel) are assessed throughout the study and six weeks after treatment completion. RESULTS Sixty-one male and female participants aged 18-45 years were randomized (mean age 34 years, mean BMI 37 kg/m2). The study sample is diverse with 38% identifying as non-White and 20% Hispanic. CONCLUSION Investigating intranasal oxytocin's efficacy, safety, and mechanisms as an anti-obesity medication will advance the search for optimal treatment strategies for obesity and its associated severe sequelae.
Collapse
Affiliation(s)
- Marie-Louis Wronski
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Franziska Plessow
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Liya Kerem
- Division of Pediatric Endocrinology, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Elisa Asanza
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Michelle L O'Donoghue
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Fatima C Stanford
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Division of Pediatric Endocrinology, Department of Pediatrics, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Miriam A Bredella
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Martin Torriani
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Alexander A Soukas
- Center for Genomic Medicine, Diabetes Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Arvin Kheterpal
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Tara M Holmes
- Translational and Clinical Research Centers, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Thilo Deckersbach
- Diploma Hochschule/University of Applied Sciences, Bad Sooden-Allendorf, Germany
| | - Mark Vangel
- Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Laura M Holsen
- Division of Women's Health, Department of Medicine and Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Elizabeth A Lawson
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
4
|
Winston LG, Winkler ML, Kheterpal A, Villalba JA. Case 36-2021: A 22-Year-Old Man with Pain and Erythema of the Left Hand. N Engl J Med 2021; 385:2078-2086. [PMID: 34818483 DOI: 10.1056/nejmcpc2107357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Lisa G Winston
- From the Department of Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, and the Department of Medicine, University of California, San Francisco - both in San Francisco (L.G.W.); and the Departments of Medicine (M.L.W.), Radiology (A.K.), and Pathology (J.A.V.), Massachusetts General Hospital, and the Departments of Medicine (M.L.W.), Radiology (A.K.), and Pathology (J.A.V.), Harvard Medical School - both in Boston
| | - Marisa L Winkler
- From the Department of Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, and the Department of Medicine, University of California, San Francisco - both in San Francisco (L.G.W.); and the Departments of Medicine (M.L.W.), Radiology (A.K.), and Pathology (J.A.V.), Massachusetts General Hospital, and the Departments of Medicine (M.L.W.), Radiology (A.K.), and Pathology (J.A.V.), Harvard Medical School - both in Boston
| | - Arvin Kheterpal
- From the Department of Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, and the Department of Medicine, University of California, San Francisco - both in San Francisco (L.G.W.); and the Departments of Medicine (M.L.W.), Radiology (A.K.), and Pathology (J.A.V.), Massachusetts General Hospital, and the Departments of Medicine (M.L.W.), Radiology (A.K.), and Pathology (J.A.V.), Harvard Medical School - both in Boston
| | - Julian A Villalba
- From the Department of Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, and the Department of Medicine, University of California, San Francisco - both in San Francisco (L.G.W.); and the Departments of Medicine (M.L.W.), Radiology (A.K.), and Pathology (J.A.V.), Massachusetts General Hospital, and the Departments of Medicine (M.L.W.), Radiology (A.K.), and Pathology (J.A.V.), Harvard Medical School - both in Boston
| |
Collapse
|
5
|
Li W, Bryan RG, Kheterpal A, Simeone FJ, Chang CY, Torriani M, Huang AJ. The effect of music on pain and subjective experience in image-guided musculoskeletal corticosteroid injections: a randomized controlled trial. Skeletal Radiol 2020; 49:435-441. [PMID: 31435716 DOI: 10.1007/s00256-019-03298-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 08/01/2019] [Accepted: 08/11/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate the role of music on subjects undergoing routine image-guided musculoskeletal corticosteroid injections and its effect on post-procedure pain and subjective overall experience. MATERIALS AND METHODS This prospective study was IRB-approved and HIPAA-compliant. A total of 126 subjects referred for outpatient image-guided musculoskeletal corticosteroid injections were enrolled in the study and randomized into a music offered group ((+)MO) and a no music offered group ((-)MO). (+)MO subjects were given the opportunity to listen to music during their corticosteroid injection. All subjects were then given an anonymous survey on which they recorded their pre-procedural and post-procedural pain on a scale from 0 to 9 and rated their overall experience and how likely they were to recommend our department for musculoskeletal procedures on scales from 1 to 5. RESULTS (+)MO subjects had significantly lower post-procedural pain (p = 0.013) and significantly greater decrease in pain (p = 0.031) compared to (-)MO subjects. Among the (+)MO subjects, there was no statistically significant difference in post-procedure pain (p = 0.34) or change in pain (p = 0.62) if music was accepted or declined. However, subjects who listened to music did have lower post-procedural pain compared to those who did not listen to music (p = 0.012), although the differences in the decrease of pain between the two groups did not quite reach statistical significance (p = 0.062). CONCLUSIONS Playing music during image-guided musculoskeletal corticosteroid injections may reduce patients' post-procedure pain. Offering patients some measure of control over their procedure may be a factor that contributes to decreased post-procedure pain as well.
Collapse
Affiliation(s)
- Weier Li
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Roy G Bryan
- Santa Barbara Radiology Medical Group, Santa Barbara, CA, 93105, USA
| | - Arvin Kheterpal
- Department of Radiology, Division of Musculoskeletal Imaging and Intervention, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA
| | - Frank J Simeone
- Department of Radiology, Division of Musculoskeletal Imaging and Intervention, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA
| | - Connie Y Chang
- Department of Radiology, Division of Musculoskeletal Imaging and Intervention, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA
| | - Martin Torriani
- Department of Radiology, Division of Musculoskeletal Imaging and Intervention, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA
| | - Ambrose J Huang
- Department of Radiology, Division of Musculoskeletal Imaging and Intervention, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA.
| |
Collapse
|
6
|
Yang H, Im GH, Nielsen GP, Kheterpal A, Schwab JH. Primary thoracic giant cell tumor of bone sensitive to steroids. Skeletal Radiol 2018; 47:1431-1435. [PMID: 29502130 DOI: 10.1007/s00256-018-2911-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 02/02/2018] [Accepted: 02/05/2018] [Indexed: 02/02/2023]
Abstract
Spinal giant cell tumor of bone (GCTB) is a rare benign, but locally aggressive, entity. We report the case of a 40-year-old man diagnosed with GCTB of the thoracic spine. The only symptom upon presentation was progressive back pain with pain radiating to the chest. Magnetic resonance imaging showed that the soft tissue mass extended posteriorly into the spinal canal, causing severe spinal cord compression. We initially treated this case with Decadron (Fresenius kabi, Bad Homburg vor der Hohe, Germany) for 1 week. This led to a reduction of tumor size and decompression of the spinal cord. To the best of our knowledge, there have been no prior reports of primary GCTB sensitive to steroid therapy within the existing literature.
Collapse
Affiliation(s)
- Huiliang Yang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
- Department of Orthopaedic Surgery, Orthopaedic Spine and Oncology Services, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gi Hye Im
- Department of Orthopaedic Surgery, Orthopaedic Spine and Oncology Services, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gunnlaugur Petur Nielsen
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Arvin Kheterpal
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Joseph H Schwab
- Department of Orthopaedic Surgery, Orthopaedic Spine and Oncology Services, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
7
|
Eajazi A, Kheterpal A, Kattapuram S, Nielsen GP, Rosenthal DI. Multiple giant cell tumors of bone arising from multiple fatty tumors. Skeletal Radiol 2017; 46:117-121. [PMID: 27771752 DOI: 10.1007/s00256-016-2498-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/19/2016] [Accepted: 09/22/2016] [Indexed: 02/02/2023]
Abstract
We describe a patient with a history of giant cell tumor who over the course of 18 years developed multiple fat containing osseous lesions in the pelvis and spine. Two of these lesions subsequently evolved into biopsy proven giant cell tumor of bone. To our knowledge, this phenomenon of giant cell tumors evolving from fat containing lesions has not been described.
Collapse
Affiliation(s)
- Alireza Eajazi
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA
| | - Arvin Kheterpal
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA.
| | - Susan Kattapuram
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA
| | - Gunnlaugur Petur Nielsen
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Warren 2, 55 Fruit Street, Boston, MA, USA
| | - Daniel Ira Rosenthal
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA
| |
Collapse
|
8
|
Kheterpal A, Zoga A, McClure K. Acute calcific tendinitis of the flexor pollicis longus in an 8-year-old boy. Skeletal Radiol 2014; 43:1471-5. [PMID: 24867130 DOI: 10.1007/s00256-014-1908-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 04/07/2014] [Accepted: 05/05/2014] [Indexed: 02/02/2023]
Abstract
Calcific tendinitis is a common source of musculoskeletal pain in adults; however, it is rarely encountered in children. Calcific tendinitis is the most commonly encountered manifestation of hydroxyapatite deposition disease, in which calcium hydroxyapatite crystal deposition occurs in tendons. It may cause acute or chronic pain, or may be entirely asymptomatic. We describe a case of acute calcific tendinitis of the flexor pollicis longus tendon in an 8-year-old boy, who initially presented to our department for workup of a mass felt along the volar aspect of the right wrist.
Collapse
Affiliation(s)
- Arvin Kheterpal
- Musculoskeletal Radiology Division, Thomas Jefferson University Hospital, Philadelphia, PA, 19107, USA,
| | | | | |
Collapse
|
9
|
Heary RF, Kheterpal A, Mammis A, Kumar S. Stackable Carbon Fiber Cages for Thoracolumbar Interbody Fusion After Corpectomy: Long-term Outcome Analysis. Neurosurgery 2011; 68:810-8; discussion 818-9. [DOI: 10.1227/neu.0b013e3182077a9f] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND:
Reconstruction of the thoracolumbar spine after corpectomy is a challenge for fractures, infections, and tumors.
OBJECTIVE:
To analyze fusion rates, clinical outcomes, and the percent of vertebral body coverage achieved by using stackable carbon fiber–reinforced polyetheretherketone cages in thoracolumbar corpectomies, and to measure the actual size of the cages and compare this measurement with the size of the vertebra(e) replaced by the cage.
METHODS:
A retrospective study of 40 patients who underwent thoracolumbar corpectomies was performed. Preoperative imaging included plain films, computed tomography scans, and magnetic resonance imaging. Postoperatively, plain films and computed tomography scans were obtained, and the width of decompression and cross-sectional area of the cage were measured. The ratio of the area of the cage to the calculated area of the replaced vertebral body was used to determine the percent of vertebral body coverage.
RESULTS:
The mean follow-up period was 43 months. Successful fusion was observed in 39 patients. One patient experienced cage subsidence with kyphosis. One additional patient incurred a neurological complication that was corrected without long-term consequence. The mean correction of sagittal alignment was 10°, and the mean width of bony decompression was 20 mm. The mean ratio of the area of the carbon fiber cage to the area of the resected vertebral body was 60%.
CONCLUSION:
Stackable carbon fiber cages are effective devices for achieving thoracolumbar fusions. No failures of the cages occurred over long-term follow-up. Excellent clinical and radiographic results were achieved by covering a mean of 60% of the vertebral body with the cage.
Collapse
Affiliation(s)
- Robert F Heary
- Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, New Jersey
| | - Arvin Kheterpal
- Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, New Jersey
| | - Antonios Mammis
- Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, New Jersey
| | - Sanjeev Kumar
- Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, New Jersey
| |
Collapse
|