Biomedical subjects

Jonathan Grauer

Publications and source records attributed to Jonathan Grauer.

3 recordsLinked to original sources

PubMed2006

Chronic low back pain.

Low back pain (LBP) is one of the most prevalent medical problems in society today. In addition to the profound effect LBP can have on patients, it has an exceedingly high societal cost. Although most acute episodes of back pain will ultimately resolve, this condition will become chronic for many. Those with chronic LBP are a challenge to treat. Nonetheless, with a better understanding of the underlying pathophysiology and treatment options, our management of these patients is gradually improving. Conservative therapy remains the mainstay treatment of chronic LBP. If this has failed, surgical options may be considered in the carefully selected patient. Fusion is the most established treatment option for this condition. Disc arthroplasty is being increasingly considered. Class I studies critically evaluating established and evolving technologies continue to help shape our understanding of the surgical options for this condition.

Chronic Disease↗

PubMed2003

Postoperative wound infections of the spine.

Postoperative spinal wound infections occur in 1 to 12% of patients. The rate of infection is related to the type and duration of the procedure, comorbidities, nutritional status, and various other risk factors. Antibiotic prophylactic therapy has been clearly shown to decrease the rate of infection dramatically after lumbar surgery. These infections typically manifest with signs and symptoms of wound swelling, erythema, and drainage. Laboratory-detected values such as the erythrocyte sedimentation rate and C-reactive protein can be elevated beyond what is normal for the uncomplicated postoperative course following lumbar surgery, and combined with the clinical symptoms should alert the physician to the possibility of infection. When detected, these infections should be managed aggressively with operative debridment and irrigation, including the deep subfascial layer in all cases except those with clearly demarcated superficial infection. The choice of one versus multiple debridments can be made based on the appearance of the wound, patient factors, and nutritional status. Hardware and incorporated bone graft can be left in place in the majority of cases, adding to stability. Outcomes following aggressive treatment of this complication can be excellent, with no long-term loss of function and complete eradication of the infection.

Anti-Bacterial Agents↗

PubMed1998

Critical load of the human cervical spine: an in vitro experimental study.

OBJECTIVE: To determine the critical load of the osteoligamentous cervical spine in frontal plane. DESIGN: Whole human cervical spine specimens were loaded in axial compression with increasing force until the point of buckling. BACKGROUND: The osteoligamentous cervical spine and the surrounding muscles support the weight of the head and the external loads applied to it. Critical load is the maximum compressive force that the spinal column can sustain before buckling. Critical loads have been obtained for the osteoligamentous thoracolumbar spine (without the rib cage) and the lumbar spine. Critical load of the cervical spine has not yet been determined. METHODS: When a compressive force is applied to the cervical spine, it bends in the sagittal plane producing greater lordosis. The determination of critical load in Euler's sense requires blocking of this sagittal plane bending. A special apparatus was developed that constrained such bending in the sagittal plane, but allowed complete freedom of the spine motion in the frontal plane. Experiments were conducted to determine the axial force-lateral bending curves of whole cervical spine specimens. Critical load values were obtained from these curves. As an alternative to this method, bending stiffness in the frontal plane was experimentally determined and the critical load was computed using Euler's theory of columns. RESULTS: Based upon the study of seven spine specimens (CO-T1), the critical load for the human cervical spine was found to be 10.5 (3.8) N obtained by direct experimentation. The average critical load calculated with the Euler theory using bending stiffness data, was 11.9 (2.0), but there were large individual differences when compared with the experimental results. CONCLUSIONS: The critical load of the osteoligamentous human cervical spine is about one-fifth to one-quarter the weight of the average head.

Journal Article↗