News Article | May 5, 2017
In normal brains, 20% of neurons are inhibitory, meaning that they send signals that limit communication between other neurons to make sure that signals exchanged within the brain are finely tuned and confined to specific areas, depending on what the person or animal is doing or perceiving. Fragile X syndrome, which is caused by a fault on the X chromosome, leads to defects in how brain neurons communicate with each other. In this study, scientists observed that fruit flies that lack the Fragile X protein have much less inhibition among their brain neurons, possibly leading to "noise" during information processing. Even though the research was performed on fruit flies, there are many analogues between flies and humans that lead to insights into human brain diseases. Prof. Emre Yaksi (Kavli Institute for Systems Neuroscience at NTNU): "The Fragile X protein in fruit flies is very similar to the Fragile X protein in humans. Our research indicates that patients with Fragile X syndrome have 'noisier' brains, impairing their ability to manage and understand the flow of information and making it more difficult to interact with the world. This may explain why many patients show anxiety, have learning and communication difficulties and may fall on the autism spectrum." To achieve the research goals of the project, new approaches to working with model organisms were built from the ground up at KU Leuven, including the technology to perform electrophysiological recordings and process images of individual fruit fly neurons. Now that they have been established, these technologies are now available to the broader scientific research community. Dr. Luis Franco (VIB-KU Leuven): "These new tools helped us test our hypotheses much more rapidly, as they allowed us to collect and process large datasets more efficiently." Based on the results of their research, the scientists propose that pharmacological treatment of Fragile X sufferers that enhances inhibition might reduce anxiety and epileptic seizures that are observed in a subset of Fragile X patients. It may also improve how Fragile X patients process sensory information, alleviating patients' autistic symptoms. Prof. Bassam Hassan (Brain & Spine Institute, Paris, France): "Future research could include testing whether sensory discrimination tasks such as discriminating odors, auditory tones or colors/visual patterns could be used for early diagnosis of Fragile X syndrome. Our next steps are to test drugs that enhance inhibition that are already approved for use in humans, such as benzodiazepines and barbiturates -- first in models, and then in the clinic."
Decompression and coflex interlaminar stabilization compared with decompression and instrumented spinal fusion for spinal stenosis and low-grade degenerative spondylolisthesis: Two-year results from the prospective, randomized, multicenter, food and drug administration investigational device exemption trial
Davis R.J.,Greater Baltimore Neurosurgical Associates |
Errico T.J.,New York University |
Bae H.,Spine Institute |
Auerbach J.D.,Bronx Lebanon Hospital Center
Spine | Year: 2013
STUDY DESIGN.: Prospective, randomized, multicenter, Food and Drug Administration Investigational Device Exemption trial. OBJECTIVE.: To evaluate the safety and efficacy of Coflex interlaminar stabilization compared with posterior spinal fusion in the treatment of 1-and 2-level spinal stenosis and degenerative spondylolisthesis. SUMMARY OF BACKGROUND DATA.: Long-term untoward sequelae of lumbar fusion for stenosis and degenerative spondylolisthesis have led to the search for motion-preserving, less-invasive alternatives. METHODS.: Three hundred twenty-two patients (215 Coflex and 107 fusions) from 21 sites in the United States were enrolled between 2006 and 2010. Subjects were randomized to receive laminectomy and Coflex interlaminar stabilization or laminectomy and posterolateral spinal fusion with spinal instrumentation in a 2:1 ratio. Overall device success required a 15-point reduction in Oswestry Disability Index, no reoperations, no major device-related complications, and no postoperative epidural injections. RESULTS.: Patient follow-up at minimum 2 years was 95.3% and 97.2% in the Coflex and fusion control groups, respectively. Patients taking Coflex experienced significantly shorter operative times (P < 0.0001), blood loss (P < 0.0001), and length of stay (P < 0.0001). There was a trend toward greater improvement in mean Oswestry Disability Index scores in the Coflex cohort (P = 0.075). Both groups demonstrated significant improvement from baseline in all visual analogue scale back and leg parameters. Patients taking Coflex experienced greater improvement in Short-Form 12 physical health outcomes (P = 0.050) and equivalent mental health outcomes. Coflex subjects experienced significant improvement in all Zurich Claudication Questionnaire outcomes measures compared with fusion (symptom severity [P = 0.023]; physical function [P = 0.008]; satisfaction [P = 0.006]). Based on the Food and Drug Administration composite for overall success, 66.2% of Coflex and 57.7% of fusions succeeded (P = 0.999), thus demonstrating noninferiority. The overall adverse event rate was similar between the groups, but Coflex had a higher reoperation rate (10.7% vs. 7.5%, P = 0.426). At 2 years, fusions exhibited increased angulation (P = 0.002) and a trend toward increased translation (P = 0.083) at the superior adjacent level, whereas Coflex maintained normal operative and adjacent level motion. CONCLUSION.: Coflex interlaminar stabilization is a safe and efficacious alternative, with certain advantages compared with lumbar spinal fusion in the treatment of spinal stenosis and low-grade spondylolisthesis. © 2013 Lippincott Williams & Wilkins.
News Article | February 15, 2017
NJ Spine & Orthopedic announces the arrival of Dr. Douglas Slaughter, who joins the expert minimally invasive spine care team as an orthopedic surgeon. NJ Spine & Orthopedic, a nationwide leader in minimally invasive spine surgery, treats patients with back and neck pain using state-of-the-art techniques. Dr. Slaughter is a board-certified orthopedic surgeon, who has been successfully practicing minimally invasive techniques for over 21 years, with a strong focus in reconstructive surgery for spinal injuries. Dr. Slaughter treats patients who experience conditions that affect muscles, bones, and joints due to sports and high-impact activity injuries, as well as age-related injuries due to degenerative spine conditions. Other areas of expertise include spinal stenosis and osteoarthritis. “Dr. Slaughter offers an invaluable level of orthopedic expertise to our team,” Dr. Scott Katzman, founder of NJ Spine & Orthopedic, said. “His dedication to treating every patient with the least invasive methods possible has allowed him to become a leading U.S. spine surgeon and a true asset to the NJSO team and our patients.” One of the many reasons we hired Dr. Slaughter was due to his vast experience with artificial disc replacement. Since we believe in maintaining motion in the cervical spine, his extensive training was a perfect fit to NJ Spine & Orthopedic. Dr. Slaughter’s bed side manner is top notch and patients love his gentle approach. Dr. Slaughter, a veteran of the United States Army Reserves, received his medical degree from The University of Cincinnati College of Medicine and served his residency in orthopedic surgery at Maricopa Medical Center in Phoenix, Arizona. He further honed his orthopedic expertise in spinal reconstructive surgery in New York City at Beth Israel Spine Institute under the direction of Dr. Michael Neuwirth. Other previous spine care experience includes Sonoran Spine Center in Phoenix, Arizona, where he personally developed spinal reconstructive surgery and minimally invasive surgery practices. For more information about Dr. Slaughter and NJ Spine & Orthopedic, visit NJSpineAndOrtho.com. About NJ Spine & Orthopedic NJ Spine & Orthopedic is a minimally invasive spine treatment center with offices throughout New Jersey, New York and Florida. The award-winning team of orthopedic surgeons and medical staff offer the latest technology and treatments to repair conditions of the spine that lead to back and neck pain. With over 50 years of combined surgery experience, NJ Spine & Orthopedic operates under a comprehensive treatment philosophy ranging from pain management methods to minimally invasive surgery, and is committed to finding the least invasive and most effective treatments for patients suffering from neck and back pain.
News Article | December 20, 2016
Dr. Randall F. Dryer, Board-Certified Orthopedic Surgeon, Central Texas Spine Institute, has joined The Expert Network, an invitation-only service for distinguished professionals. Dr. Dryer has been chosen as a Distinguished Doctor™ based on peer reviews and ratings, numerous recognitions, and accomplishments achieved throughout his career. Dr. Dryer outshines others in his field due to his extensive educational background, numerous awards and recognitions, and career longevity. After receiving his Bachelor of Science in Biochemistry and General Science with honors from the University of Iowa, he went on to earn his medical degree, also from the University of Iowa where he then went on to complete his internship and residency in orthopedic surgery at the University of Iowa. He then completed a fellowship in Spine and Hand Surgery at New Addenbrooke's Hospital in Cambridge, England, which he finished in 1984. With 34 years dedicated to medicine, Dr. Dryer brings a wealth of knowledge to his industry, and in particular, to his area of expertise, orthopedic surgery. When asked why he decided to pursue a career in this specialization, Dr. Dryer said: "I wanted to do something in the surgical field that was reconstructive and when I started I wanted to do something that very few people were interested in. The field of spine surgery was actually a wasteland in the early 80s. Now it’s become one of the most sought after types of practice, but it’s only because of the significant advancements that have occurred in spinal care over the last thirty years." Dr. Dryer began his practice serving in the United States Air Force at Wilford Hall, Lackland Air Force Base in San Antonio, Texas where he quickly progressed from staff Orthopedist to Chief of The Orthopedic Surgery Clinic. Following his discharge in 1988, Dr. Dryer joined Dr. William P. Taylor at The Austin Back Clinic, which later expanded to become the Central Texas Spine Institute. In his practice with the Institute today, he offers patients comprehensive spine care, including diagnostic services, conservative treatment modalities, and spine surgery. He has also participated in numerous FDA-approved clinical trials and limits his practice to the cervical and lumbar spine surgery. Committed to high quality, compassionate care in a personalized setting, Dr. Dryer has received the Patients' Choice Award from Vitals on multiple occasions and has attracted patients from all over the world. As a thought-leader in his specialty, Dr. Dryer has provided incalculable insight concerning spine surgery and stem cell therapies to both peers and patients alike. Widely regarded for his research, he has earned many accolades including being named one of sixty Spine Surgeons on the forefront of biologics and stem cells by MDx Medical Inc. He has been invited to speak to audiences from the United Kingdom to New York and has authored numerous articles covering a full range of orthopedic conditions as well as patents for spinal implants and stem cell technologies. With this prominence, Dr. Dryer maintains a unique vantage point from which to follow prevailing trends in Orthopedic Surgery. Discussing several of these trends, he noted: "The main advancement has been minimally invasive techniques, motion preserving techniques such as artificial disc replacement, and advancements in biological treatments. And going forward it's going to be advancements in cell technology in regenerative medicine. Our hope is that this can eliminate or improve patients' conditions without the need for surgery." The Expert Network© has written this news release with approval and/or contributions from Dr. Randall F. Dryer. The Expert Network© is an invitation-only reputation management service that is dedicated to helping professionals stand out, network, and gain a competitive edge. The Expert Network selects a limited number of professionals based on their individual recognitions and history of personal excellence.
News Article | November 16, 2016
On Monday, November 7, 2016, board-certified orthopedic spine surgeon Dr. Nasser Ani performed a minimally invasive anterior cervical discectomy and fusion (ACDF) surgery on a 56-year-old female patient who was experiencing severe arm pain and numbness. The surgery took place at the Metropolitan Surgical Institute, an outpatient surgical center in South Amboy, New Jersey. The patient was suffering from cervical radiculopathy, with symptoms of radiating arm pain, as a result of a severe disc herniation causing compression of the spinal nerve roots at levels C5-6 and C6-7. After failed conservative treatment including physical therapy and spine epidural injections, the patient elected to have a two-level anterior cervical discectomy and fusion. Dr. Ani utilized a minimally invasive surgery to address the patient’s cervical radiculopathy and disc herniation. He chose an anterior surgical approach to gain exposure to the cervical spine through a small transverse incision in the neck. Dr. Ani was able to remove the herniated discs, and free the compressed and pinched nerves. After the discectomy, Dr. Ani inserted SpineFrontier’s biocompatible LES ARENA-C (HA) cervical cages to restore natural disc height between the vertebral bodies using the Less Exposure Surgery (LES) technique and placed a low-profile, two-level LES INVUE MAX cervical plate on the operative levels to provide stability until fusion takes place. Dr. Ani commented on the case: “The LES INVUE plate, when paired with the LES ARENA-C (HA) interbody, was one of the safest, most efficient ways to stabilize this patient’s spine. The instruments and procedural steps are easy. The hydroxyapatite (HA) infused LES ARENA-C spacer, together with a cancellous bone sponge and the patient’s own stem cells will result in an excellent fusion.” Dr. Ani stated that “minimally invasive surgery enables patients to return home just hours after surgery with little to no pain. This patient will be able to return to work in two to three weeks.” Dr. Nasser Ani is a board-certified orthopedic and spine surgeon at Ani Medical Group, Orthopedic and Spine Institute of New Jersey and deals with all aspects of spinal disorders, deformities and scoliosis. Initially, patients are treated in a conservative fashion in an effort to provide pain relief and help them return to functional status. However, in some cases, when conservative treatments fails, surgical options are discussed as a means to return patients back to their normal daily living activities. Dr. Ani is affiliated with multiple hospitals in the area, including Bayshore Community Hospital, Riverview Medical Center, Raritan Bay Medical Center, and Monmouth Medical Center. He is also the Chief of Orthopedics at Bayshore Community Hospital. He received his medical degree from the American University of Beirut, Lebanon. He completed an orthopedic surgery and spine fellowship at McGill University in Montreal, Canada. Dr. Ani has been in practice for over 25 years, double boarded in the fields of orthopedics and spinal surgery, and holds several professional affiliations including the North American Spine Society, Fellow of the American Academy of Orthopedics Surgeons, Fellow of the American College of Surgeons, Fellow of the Royal College of Surgeons, American Society for Laser Medicine and Surgery, and the American Medical Association, just to name a few. About SpineFrontier® Inc. SpineFrontier Inc. (http://www.spinefrontier.com) is a growing medical technology company that designs, develops and markets both implants and instruments for spine surgery based on the Less Exposure Surgery (LES®) Philosophy. These technologies are designed to allow for outpatient surgery due to minimal disruption of normal tissues. SpineFrontier is headquartered in Malden, MA. It is a KICVentures portfolio company and the leader in LES® technologies and instruments. About Less Exposure Surgery Less Exposure Surgery (LES®) is based on a new philosophy of performing surgery. LES® is less invasive than MIS. By developing improved technologies and techniques tailored for pinpointing a problem and fixing it without collateral damage, LES® minimizes tissue disruption.
Can low-grade spondylolisthesis be effectively treated by either coflex interlaminar stabilization or laminectomy and posterior spinal fusion Two-year clinical and radiographic results from the randomized, prospective, multicenter US investigational device exemption trial: Clinical article
Davis R.,Greater Baltimore Neurosurgical |
Auerbach J.D.,Yeshiva University |
Bae H.,Spine Institute |
Errico T.J.,NYU Langone Medical Center
Journal of Neurosurgery: Spine | Year: 2013
Object. Posterolateral spinal fusion (PSF) has long been the standard of care for degenerative spondylolisthesis, but less invasive, motion-preserving alternatives have been proposed to reduce the complications associated with fusion while still providing neural decompression and stabilization. The object of the current study is to evaluate the safety and efficacy of coflex Interlaminar Stabilization compared with PSF to treat low-grade spondylolisthesis with spinal stenosis. Methods. This is a prospective, randomized, multicenter FDA investigational device exemption (IDE) trial comparing coflex Interlaminar Stabilization with laminectomy and PSF. A total of 322 patients from 21 sites in the US were enrolled between 2006 and 2008 for the IDE trial. The current study evaluated only the subset of patients from this overall cohort with Grade 1 spondylolisthesis (99 in the coflex group and 51 in the fusion group). Subjects were randomized 2:1 to receive decompression and coflex interlaminar stabilization or decompression and posterolateral spinal fusion with spinal instrumentation. Data collected included perioperative outcomes, Oswestry Disability Index (ODI), back and worse leg visual analog scale (VAS) scores, 12-Item Short Form Health Survey, Zurich Claudication Questionnaire (ZCQ), and radiographic outcomes at a minimum of 2 years. The FDA criteria for overall device success required the following to be met: 15-point reduction in ODI, no reoperations, no major devicerelated complications, and no postoperative epidural injections. Results. At a minimum of 2 years, patient follow-up was 94.9% and 94.1% in the coflex and fusion control groups, respectively. There were no group differences at baseline for any demographic, clinical, or radiographic parameter. The average age was 63 years in the coflex cohort and 65 years in the fusion cohort. Coflex subjects experienced significantly shorter operative times (p < 0.0001), less estimated blood loss (p < 0.0001), and shorter length of stay (p < 0.0001) than fusion controls. Both groups experienced significant improvements from baseline at 2 years in ODI, VAS back, VAS leg, and ZCQ, with no significant group differences, with the exception of significantly greater ZCQ satisfaction with coflex at 2 years. FDA overall success was achieved in 62.8% of coflex subjects (59 of 94) and 62.5% of fusion controls (30 of 48) (p = 1.000). The reoperation rate was higher in the coflex cohort (14 [14.1%] of 99) compared with fusion (3 [5.9%] of 51, p = 0.18), although this difference was not statistically significant. Fusion was associated with significantly greater angulation and translation at the superior and inferior adjacent levels compared with baseline, while coflex showed no significant radiographic changes at the operative or index levels. Conclusions. Low-grade spondylolisthesis was effectively stabilized by coflex and led to similar clinical outcomes, with improved perioperative outcomes, compared with PSF at 2 years. Reoperation rates, however, were higher in the coflex cohort. Patients in the fusion cohort experienced significantly increased superior and inferior level angulation and translation, while those in the coflex cohort experienced no significant adjacent or index level radiographic changes from baseline. Coflex Interlaminar Stabilization is a less invasive, safe, and equally efficacious clinical solution to PSF to treat low-grade spondylolisthesis, and it appears to reduce stresses at the adjacent levels. Clinical trial registration no.: NCT00534235 (ClinicalTrials.gov). © 2013 AANS.
Prospective, randomized, multicenter food and drug administration investigational device exemption study of the ProDisc-L total disc replacement compared with circumferential arthrodesis for the treatment of two-level lumbar degenerative disc disease: Results at twenty-four months
Delamarter R.,Spine Institute |
Zigler J.E.,The Texas Institute |
Balderston R.A.,Pennsylvania Hospital |
Cammisa F.P.,Hospital for Special Surgery |
And 2 more authors.
Journal of Bone and Joint Surgery - Series A | Year: 2011
Background: Disc replacement arthroplasty previously has been shown to be an effective alternative to spine fusion for the treatment of single-level lumbar degenerative disc disease. The purpose of the present study was to determine the twenty-four-month results of a clinical trial of the ProDisc-L total disc replacement as compared with spinal fusion for the treatment of degenerative disc disease at two contiguous vertebral levels from L3 to S1. Methods: A total of 237 patients were treated in a randomized controlled trial designed as a non-inferiority study for regulatory application purposes. Blocked randomization was performed with use of a 2:1 ratio of total disc arthroplasty to circumferential arthrodesis. Evaluations, including patient self-assessments, physical and neurological examinations, and radiographic examinations, were performed preoperatively, six weeks postoperatively, and three, six, twelve, eighteen, and twenty-four months postoperatively. Results: At twenty-four months, 58.8% (eighty-seven) of 148 patients in the total disc replacement group were classified as a statistical success, compared with 47.8% (thirty-two) of sixty-seven patients in the arthrodesis group; non-inferiority was demonstrated. The mean Oswestry Disability Index in both groups significantly improved from baseline (p < 0.0001); the mean percentage improvement for the total disc replacement group was significantly better than that for the arthrodesis group (p = 0.0282). An established clinical criterion for success, a ≥15-point improvement in the Oswestry Disability Index from baseline, occurred in 73.2% (109) of 149 patients in the total disc replacement group and 59.7% (thirty-seven) of sixty-two patients in the arthrodesis group. The Short Form-36 physical component scores were significantly better for the total disc replacement group as compared with the arthrodesis group (p = 0.0141 at twenty-fourmonths). Visual analog scale scores for satisfaction significantly favored total disc replacement from three to twenty-four months. At twenty-four months, 78.2% (111) of 142 patients in the total disc replacement group and 62.1% (thirty-six) of fifty-eight patients in the arthrodesis group responded "yes" when asked if theywould have the same surgery again. Lumbar spine range ofmotion on radiographs averaged 7.8° at the superior disc and 6.2° at the inferior disc in patients with total disc replacement. Reduction in narcotics usage significantly favored the total disc replacement group at twenty-four months after surgery (p = 0.0020). Conclusions: Despite the relatively short duration of follow-up and design limitations, the present study suggests that two-level lumbar disc arthroplasty is an alternative to and offers clinical advantages in terms of pain relief and functional recovery in comparison with arthrodesis. Longer-term follow-up is needed to determine the risks for implant wear and/or degenerative segment changes. Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence. Copyright © 2011 by The Journal of Bone and Joint Surgery, Incorporated.
Bae H.,Spine Institute |
Zhao L.,Spine Institute |
Zhu D.,Spine Institute |
Kanim L.E.,Spine Institute |
And 2 more authors.
Journal of Bone and Joint Surgery - Series A | Year: 2010
Background: Demineralized bone matrix is an osteoinductive allograft derived from processed bone that is commonly mixed with autogenous bone in fusion procedures to treat diseases of the spine. An increasing number of demineralized bone matrix-based products are commercially available for spinal fusion procedures, but osteoinductive variability has been found not only across different products but also among production lots from the same demineralized bone matrix formulation. The purpose of this study was to assess the lot-to-lot variability across a single demineralized bone matrix-based product in terms of both extracted bone morphogenetic protein (BMP) concentrations (in vitro) and fusion performance in rats (in vivo). The goal was also to determine whether the in vitro measures could sufficiently and accurately predict the in vivo fusion performance of different demineralized bone matrix-based product lots. Methods: BMP-2 and BMP-7 were extracted from ten production lots of InterGro DBM Putty and quantified with use of ELISA (enzyme-linked immunosorbent assay). A posterolateral lumbar spinal fusion was performed on forty athymic rats with implantation of a demineralized bone matrix-based product. Fusion success was determined at eight weeks with use of radiographs and manual palpation of the segments. Logistic regression was used to determine the predictive abilities of BMPs. Results: Significant lot-to-lot variability was found in terms of both BMP concentrations (22 to 110 pg of BMP-2 per milligram of product and 44 to 125 pg of BMP-7 per milligram of product) and in vivo rates of fusion (0% to 75%; p < 0.04 for all). BMP-2 and BMP-7 concentrations correlated positively with each other across lots (r = 0.77, p < 0.0001). Most notably, extracted amounts of BMP-2 and BMP-7 each predicted in a dose-dependent manner the in vivo fusion performance in rats (R2 = 0.32, p < 0.01 for BMP-2, and R2 = 0.22, p < 0.009 for BMP-7). Conclusions: Assays for demineralized bone matrix-extracted BMP-2 and BMP-7 levels may be feasible and sufficient for predicting spinal fusion performance of individual production lots from the same demineralized bone matrix-based product. Clinical Relevance: In order to improve the consistency and efficacy of demineralized bone matrix-mediated fusions in clinical settings, it may be valuable to perform simple terminal screenings for BMP-2 and BMP-7 on demineralized bone matrix-based product lots prior to their commercial distribution. Copyright © 2010 by The Journal Of Bone and Joint Surgery, Incorporated.
Parent S.,University of Montréal |
Dimar J.,Spine Institute |
Dekutoski M.,Mayo Medical School |
Roy-Beaudry M.,University of Montréal
Spine | Year: 2010
Study Design. Systematic review. Objective. The objective of this systematic review was to identify the unique features associated with pediatric spinal cord injury (SCI) with the intention of determining the most effective spinal stabilization methods and identifying the optimum treatment for post-traumatic spinal deformity in pediatric patients with a SCI. Summary of Background Data. Spinal injuries occur in 1.99/100,000 children, 10% are under 15 years, 60% to 80% occur in the cervical spine, and 5.4% to 34% in the thoracolumbar spine. The most frequent incident of spinal injury (50%-56%) occurs during motor vehicle accidents. Methods. A systematic review of the English language literature explored articles published between 1950 and 2009. Electronic databases (Medline and Embase) and reference lists of key articles were searched to identify unique features of pediatric SCI based on 2 questions: (1) "What is the most effective means to achieve spinal stabilization in pediatric patients with a SCI?" and (2) "What is the most effective treatment of post-traumatic spinal deformities in pediatric patients with a SCI?" Three Spinal Trauma Study Group faculty members assessed the level of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria and disagreements were resolved by a modified Delphi consensus. Results. No Level 1 or 2 evidence articles were discovered. Question 1 was addressed by 417 abstracts; from those 15 were selected for inclusion. This literature proved to be controversial, mostly focused on the adult population, pediatric series were retrospective, and most treatments were based on adult experience. The evidence supporting stabilization of the spine in the pediatric SCI population is very low for both the cervical and thoracic spinal regions. Question 2 was discussed in 517 abstracts; 8 relevant articles were selected. The principal key points, regarding the most effective treatment of post-traumatic spinal deformity in the pediatric SCI patients, suggest that the deformity should be prevented before the age of 10 to 12 years, younger SCI patients are unfavorable, nearly 100% of patients with SCI will develop a deformity, and brace treatment is generally recommended. Current evidence in support of brace use is very low. Conclusion. Despite the lack of well-designed prospective studies to establish the efficacy of instrumentation in these cases, there remains very low evidence that supports the use of instrumentation in unstable pediatric spines to prevent neurologic injury and maintain spinal alignment. The very low evidence of benefits from early bracing clearly outweighs the risks and complications associated with its use. Close monitoring should be initiated early so as to delay surgical correction as late as possible. There is very low evidence to support the use of surgery for the treatment of deformity triggered by a SCI. There may be evidence suggesting that the correction techniques used for neuromuscular deformities are useful for SCI patients. In conclusion, there is a strong recommendation for the use of instrumentation in the unstable pediatric spinal injured population, and there is a strong recommendation for traditional neuromuscular spinal deformity treatment techniques to be adopted as a treatment of progressive spinal deformities after a neurologic injury. © 2010, Lippincott Williams & Wilkins.
News Article | November 22, 2016
BOTHELL, WA, November 22, 2016-- Steven E. Levine, MD, Founder and Medical Director of Midwest Pain and Spine recently found himself in extreme lower back pain and in need of care. In seeking treatment for his own back pain, Dr. Levine says he wanted to avoid traditional back surgery which would address the immediate problems but would inevitably lead to more problems in the future."I did not want a traditional surgery because I knew it would make me feel better, but within five to seven years ... [my vertebrae] would collapse, and nine times out of ten in the traditional sense requires a fusion surgery," Levine says. "With a fusion, in five years the spine segments above and below begins to degenerate. The point is, you can't fix back pain with surgery, so you want to avoid surgery."Dr. Levine looked all over the world to find doctors who specialized in minimally invasive spine surgery."The difficulty (as doctors) is finding good surgeons or good physicians to take care of us," he says. "Some of the best people who can do this are not in America. They're in China, they're in France, they're in Korea, they're in England, they're in Germany."Dr. Levine sought out Dr. Kamson at the Spine Institute Northwest in Seattle, WA. Dr. Kamson offered a less invasive surgical decompression procedure to treat Dr. Levine's back without destabilizing it and causing further problems such as stenosis, disc degeneration, or more back pain."Dr. Kamson is one of the few physicians that I know in the United States that can do what needs to be done less invasively," Dr. Levine says. "He cares about his patients, and has taken the time to travel the world to educate himself."Dr. Levine says he is very satisfied with his procedure and would recommend Dr. Kamson wholeheartedly to any other doctor or person who needs help with their back pain."My trip out here to see Dr. Kamson was to have a less invasive surgical decompression of my spine that would allow me to get up the same day and walk, with a band aid on my back," says Dr. Levine. "The approach Dr. Kamson took didn't destabilize my spine."The physicians at the Spine Institute Northwest strive to remain at the forefront of pain management, engaging in continuous research and pursuing further educational opportunities to stay up-to-date on best practices and new developments. For example, Dr. Kamson used regenerative medicine to help Dr. Levine's spine to accelerate healing and provide lasting recovery."Dr. Kamson applied some of the latest stem cells therapy to help regenerate my disc," says Dr. Levine, "which helps maintain the integrity of the joint space and grow a little bit more cartilage to help the joint pain as well."Spine Institute Northwest has been providing quality healthcare services since 2000. The medical team at Spine Institute Northwest strives to deliver excellent medical service and care with an emphasis on minimally invasive procedures such as laser spine surgery. The Institute's philosophy places a strong emphasis on early intervention, starting with an accurate diagnosis and initiation of proper treatment. At Spine Institute Northwest, the focus is on preventing the kind of chronic disability often associated with untreated or poorly managed, intractable pain. Learn more at www.spineinstitutenorthwest.com