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Recent Advances in Techniques & Technology Transform Adult Spine Stabilization Surgery

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Recent Advances in Techniques & Technology Transform Adult Spine Stabilization Surgery

Advancements in fixation techniques and technology are revolutionizing spine stabilization surgery for adults with spinal column deformities. Marc Agulnick, MD collaborates at Winthrop-University Hospital with neurosurgeon Benjamin Cohen, MD to correct adult spine deformities that cause progressive, debilitating pain in the back or lower extremities.

With ongoing advanced training and a clear understanding of the surgical innovations transforming their specialty, Drs. Agulnick and Cohen are at the forefront of their field, tailoring their approach to each patient's unique condition. "Every deformity is different, and every surgical approach varies to accommodate that difference," explained Dr. Cohen. "But our goals are the same for patients: to eliminate pressure on spinal nerves, stop the deformity's progression, minimize back pain and neurogenic leg symptoms and finish with a balanced spine."

Full text of this article can be found on pp 10-11 of the Fall 2009 issue of Winthrop University Hospital's Progressive Neuroscience

** (pp 12-13 of PDF: WUH-Neuro-Fall09-FINAL 10-28-09.pdf)

 
 

Lateral Extracavitary Corpectomy for Spine Tumors is Effective & Safe

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Lateral Extracavitary Corpectomy for Spine Tumors is Effective & Safe

A patient presented with persistent, progressive back pain unrelated to level of activity and refractory to medication. An X-ray and MRI revealed the presence of a tumor on his spine. To stabilize the spine and resect the tumor, Dr. Benjamin Cohen and Dr. Marc Agulnick performed a lateral extracavitary corpectomy — which allows for the simultaneous exposure of the posterior bony elements and anterior vertebral column through the same, small incision.

This minimally invasive procedure is a technically challenging surgery requiring extraordinary skill, experience and thorough knowledge of the thoracic and retroperitoneal anatomy, but allows the surgeon to access the anterior lateral aspects of the spine and dura without exposing the anterior thoracic or abdominal cavity, and without the need for a much lengthier and involved two-stage procedure. After stabilizing the spine posteriorly with pedicle screws and hooks linked together with rods on either side of the spinal column, they accessed the front of the spine by resecting a section of the posterior rib on one side. Through that one small portal, the diseased vertebra was removed, the stabilizing instrumentation was affixed, and an expandable, titanium mesh cage filled with the resected rib was placed to produce a bone graft, facilitate spinal fusion and create a new, cancer-free "vertebra."

Full text of this article can be found on pp 7-8 of the Fall 2010 issue of Winthrop University Hospital's Progressive Neuroscience

** (pp. 9-10 of PDF: WUH-Neuro-Text-Fall10 FINAL PROOF 11-12-10.pdf)

 
 

Pilot Study Explores Efficacy of Hypothermia for Spinal Cord Injury

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Pilot Study Explores Efficacy of Hypothermia for Spinal Cord Injury

One of the latest approaches to treating traumatic brain injury, hypothermia has been gaining increasing attention for its potential use after spinal cord injuries.

Recent media reports featured the remarkable recoveries of a young gymnast and professional football player who sustained serious spinal cord injuries that left each of them with near complete motor and sensory failure. Hypothermia affects many aspects of the body's responses to injury by changing the rates of activity in numerous biochemical pathways and lowering metabolic activity. It can also slow the post-injury inflammation cascades and reduce the post-injury permeability of the blood brain barrier. Other treatment regimens — like methylprednisolone — work on a single mechanism, and might not provide all the benefits of hypothermia.

Full text of this article can be found on p. 2-3 of the Spring 2012 issue of Winthrop University Hospital's Progressive Neuroscience

** (pp. 4-5 of PDF: Neuro-text-PDF #2 v4n3-Spring12 5-15-12.pdf)

 
 

A Novel Approach to Revision of Anterior Cervical Instrumentation

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A Novel Approach to Revision of Anterior Cervical Instrumentation

Following a motor vehicle accident, a man in his 40s presented with bilateral facet fractures. He had undergone an anterior cervical discectomy and fusion (ACDF) nearly a decade earlier.

An MRI showed that his spinal cord was being stretched; flexion and extension X-rays revealed instability. This was causing a loss of function in his arms and legs. A candidate for surgical treatment, his operation consisted of an ACDF using the innovative, less invasive, ALTATM half-plate hybrid system without removing the old plate. The hybrid design enabled the placement of two screws in the superior vertebra, since a screw could not be placed inferiorly due to his prior surgery. Four weeks post—op, the patient is doing very well, with symptom resolution and no problems with voice or dysphagia.

Full text of this article can be found on p. 4-5 of the Fall 2014 issue of Winthrop University Hospital's Progressive Neuroscience.

** (pp.4-5 of PDF: FINAL PDF 9-9-14.pdf)

 
 

Resection of Lumbar Giant Cell Tumor

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Resection of Lumbar Giant Cell Tumor

After failing all means of conservative treatment for back pain, a man in his 40s presented with neurological deficits and spinal instability as well as intractable, worsening pain that traveled from his right hip and buttock down the posterolateral aspect of his right leg to the foot.

A needle biopsy confirmed that the lesion was a benign giant cell tumor (GCT) that needed to be excised. The surgery consisted of an intricate two-stage procedure conducted over two days. Stage one involved a complete posterior laminectomy with stabilization and fusion; stage two involved an anterior corpectomy for resection of the remaining tumor with reconstruction using an expandable cage. Near complete resection of the tumor was completed.

Full text of this article can be found on pp 6-7 of the Fall 2015 issue of Winthrop University Hospital's Progressive Neuroscience

** (pp. 8-9 of PDF: FINAL Neur Mag pdf 9-3-15.pdf)

 
 
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