The spine journal : official journal of the North American Spine Society
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To date, many studies have examined the effects of one or several factors on blood loss during lumbar spine surgery. The nature and extent of the operation, patient position, blood pressure, and a variety of factors related to patient size have been touted as predictors of blood loss. ⋯ This is the first study to build a successful multivariable predictive model of blood loss during spine surgery. The Jackson table was effective in supporting patients with different body sizes and shapes, thus removing raised intra-abdominal pressure as an important factor.
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Signal intensity changes observed in magnetic resonance imaging (MRI) do not reveal the actual severity of axonal damage incurred in spinal cord injuries. Diffusion tensor imaging (DTI) is an imaging technique with a potential to track individual nerve fiber tracts. ⋯ The study shows that DTI tractography is useful for structural imaging of the spinal cord. Fractional anisotrophy, RA, and VR parameters were found to be more sensitive than ADC and E1 values in assessing the severity of compression.
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There are limited data analyzing radiological and clinical factors for the functional outcomes of surgery for spinal metastasis. Also, there are few studies to investigate the relationship between the functional outcome and the patients' survival. Thus, analysis of both functional outcomes and the survival with their relationship in a possibly homogenous group of patients is worth being reported. ⋯ Single-stage PDS with or without corpectomy effectively improved the functional status of patients with MSCC of the thoracic spine and also afforded the patients to have more chances of postoperative adjuvant therapy, which was significant for patients' survival. Therefore, we suggest that the role of surgery in the management of MSCC could be not only a symptomatic palliation but also a strategy to prolong patients' survival.
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Neuropathic pain after nerve injuries is characterized by positive and negative sensory symptoms and signs. The extent of sensory fiber loss after nerve injuries has been demonstrated to correlate with symptoms of neuropathic pain by quantitative sensory testing and confirmed by biopsies of small nerve fibers. However, the relationship between the pathologic changes of large nerves on injuries and resulting pain symptoms remains unclear. ⋯ Transient injuries on sensory fibers can produce either positive or negative symptoms of neuropathic pain, and the different extent of sensory fiber loss after different degrees of injuries might account for the varied resulting symptoms of neuropathic pain.