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Biomedical subjects

Steven Vanni

Publications and source records attributed to Steven Vanni.

5 recordsLinked to original sources
PubMed2005

Acute traumatic central cord syndrome--experience using surgical decompression with open-door expansile cervical laminoplasty.

BACKGROUND: Open-door expansile cervical laminoplasty (ODECL) is an effective surgical technique in the treatment of multilevel cervical spondylotic myelopathy. In the present study, we reviewed the safety and short-term neurological outcome after expansile cervical laminoplasty in the treatment of acute central cord syndrome. METHODS: We retrospectively reviewed our database over a 3-year period (January 1997-January 2001) and identified 69 surgically treated cervical spinal cord injuries, including 29 cases of acute traumatic central cord syndrome (ATCCS). Fifteen of these patients underwent expansile cervical laminoplasty, whereas 14 did not because of radiographic evidence of sagittal instability. We collected data on the preoperative and the immediate postoperative and 3-month neurological examinations. Neurological function was assessed using the Asia Spinal Injury Association (ASIA) grading system. We also reviewed the occurrence of complications and short-term radiological stability after the index procedure. RESULTS: The median age was 56 years. All patients had hyperextension injuries with underlying cervical spondylosis and stenosis in the absence of overt fracture or instability. The average delay from injury to surgery was 3 days. The preoperative ASIA grade scale was grade C, 8 patients, and grade D, 7 patients. There were no cases of immediate postoperative deterioration or at 3 months follow-up. Neurological outcome: 71.4% (10/14) of patients improved 1 ASIA grade when examined 3 months post injury. CONCLUSIONS: Surgical intervention consisting of ODECL can be safely applied in the subset of patients with ATCCS without instability who have significant cervical spondylosis/stenosis. Open-door expansile cervical laminoplasty is a safe, low-morbidity, decompressive procedure, and in our patients did not produce neurological deterioration.

Acute Disease↗
PubMed2005

Anterior correction of cervical spine lordosis using an adjustable depth tap: technical note.

OBJECTIVE: In cases of multilevel anterior cervical spine decompression where intervening vertebral bodies need to be incorporated into the anterior plate construct, it may be difficult to apply the plate flush against the entire anterior cortical surface of the spine segment. Some have suggested using the levering property of bicortical screws to "pull" the body against the plate. Others have recommended contouring the anterior cervical plate with a plate bender. The objective of this work was to describe a novel technique using the adjustable depth tap provided in the Atlantis plating system for achieving cervical spine alignment against the lordotic plate after multilevel anterior decompression. METHODS: We describe an illustrative case of a 14-year-old girl with complex cervical spine fractures after trauma. We used the 4.0-mm adjustable depth tap in the Atlantis plating system to lever the C4 body against the premachined lordotic plate. RESULTS: Cervical lordosis and anterior cervical plate placement were accomplished after multilevel anterior cervical decompression with the use of an adjustable depth tap. CONCLUSIONS: Bicortical screw placement and plate bending have drawbacks in trying to apply the anterior cervical plate firmly to the anterior surface of the cervical spine. We describe a new and safe technique of using an adjustable depth tap for achieving that same goal without any obvious drawbacks.

Adolescent↗
PubMed2003

Complications associated with lumbar stenosis surgery in patients older than 75 years of age.

OBJECT: An aging population will require that surgeons increasingly consider operative intervention in elderly patients. To perform this surgery safely will require an understanding of the factors that predict successful outcomes as well as complications. METHODS: Records of patients older than the age of 75 years who underwent lumbar spinal stenosis surgery were retrospectively reviewed. Preexisting medical illnesses were analyzed using the Charlson Weighted Comorbidity Index. Ambulatory function was rated on a four-point scale. Statistical analysis was performed using a one-tailed t-test with unpaired variance. Eighty-eight patients treated between 1994 and 2001 were identified. Forty-five percent were women and 52 patients underwent spinal fusion. The follow-up period averaged 21 months. Back pain was present preoperatively in 89%; after surgery 43% experienced complete relief and 33% partial improvement. Leg pain was present preoperatively in 98%; after surgery 43% experienced complete relief and 42% partial improvement. Of the 33 patients with preoperative gait disturbances, 61% improved at least one point on the ambulatory scale. Wound complications and systemic complications were demonstrated in 24 and 16 patients, respectively. There were no deaths. Age (p = 0.322), number of fused levels (p = 0.371), and the number of laminectomy levels (p = 0.254) were not predictive of complications. Length of operative time (p = 0.003) and the Charlson Weighted Comorbidity Index score (p = 0.088) were associated with both systemic and wound complications. CONCLUSIONS: Surgery in patients older than age 75 years can be conducted safely and with similar outcome rates as in younger patients. The Charlson Weighted Comorbidity Index score and operative time were predictive of the risk of complications.

Age Factors↗
PubMed2003

Internet-based image analysis quantifies contractile behavior of individual fibroblasts inside model tissue.

In a cell-populated collagen gel, intrinsic fiber structure visible in differential interference contrast images can provide markers for an in situ strain gauge to quantify cell-gel mechanics, while optical sections of fluorescent protein distribution capture cytoskeletal kinematics. Mechanics quantification can be derived automatically from timelapse differential interference contrast images using a Deformation Quantification and Analysis software package accessible online at http://dqa.web.cmu.edu. In our studies, fibroblast contractile machinery was observed to function entirely within pseudopods, while GFP-alpha-actinin concentrated in pseudopod tips and cortex. Complex strain patterns around individual cells showed instances of both elastic and inelastic strain transmission, suggesting a role in observed long-range alignment of cells.

3T3 Cells↗