Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_
Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_ Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_
Poster Topic: Spine Abstract number: 25473 CENTRAL NERVOUS SYSTEM EFFECTS OF NUCLEUS PULPOSUS EXPOSURE Anna ERMUND 1 , Elin NILSSON 1 , Helena BRISBY 2 , Ingela HAMMAR 1 1 Neuroscience and Physiology, Göteborg (SWEDEN), 2 Clinical Sciences, Göteborg (SWEDEN) Changes in central nervous system neuronal responses may play an important role in low back pain (LBP). Neuronal activity in the thalamus increases after acute application of nucleus pulposus (NP) onto a dorsal root ganglion (DRG). We present data on thalamic effects after NP leakage followed by compression of the DRG and changes in synaptic plasticity in the ventral hippocampus (VH), a region involved in pain perception. Rats and mice were subjected to experimental disc herniation. After 24 hours, neuronal responses in the thalamus evoked by electrical stimulation of sciatic A fibres were recorded during DRG compression. Thirty minutes later NP was reapplied onto the DRG. Neuronal responses in VH slices were investigated by current pulses (50 ms interval, 20 s between pairs). The hippocampus was further studied 3 and 7 days after NP application onto the DRG. Compression of the DRG decreased the number of evoked responses in both NP and sham animals. A repeated application of NP resulted in increased thalamic responses. In the VH 24 and 72 hours post surgery, the second pulse in a pair gave a larger response. In naïve animals, both pulses gave responses of the same magnitude. Depression of neuronal responses following mechanical dislocation may not contribute to increased pain transmission but seems to counteract NP effects. Changes in the VH were detected, indicating this area in low back pain modulation. These findings need further investigation to identify signaling pathways involved in the establishment and maintenance of LBP. 428
Poster Topic: Spine Abstract number: 25539 COMPLICATIONS ASSOCIATED WITH AXIAL LUMBAR INTERBODY FUSION Evalina BURGER, Matthew MCCULLOUGH, Emily LINDLEY, Courtney BROWN, Vikas PATEL University of Colorado Denver, Aurora (UNITED STATES) Introduction: Axial Lumbar Interbody Fusion (AxiaLIF) is a novel minimally invasive approach for fusion of the L5 vertebra to the sacrum. This technique uses the presacral space for percutaneous access to the anterior sacrum. AxiaLIF has the potential to decrease patient recovery time, length of hospital stay, and overall occurrence of surgical complications. The purpose of this study was to evaluate complications of the AxiaLIF procedure. Methods: Patients who underwent AxiaLIF surgery between October 2005 and June 2009 were identified. We retrospectively reviewed these charts to determine what complications were encountered. Results: Of the 66 patients, 14 experienced complications (21.2%). These complications included superficial infection (4.5%), deep infection (1.5%), pseudoarthrosis (4.5%), sacral fracture (1.5%), pseudoarthrosis and sacral fracture (3%), pelvic hematoma (3%), failure of wound closure (1.5%), and rectal perforation (1.5%). Conclusions: The complication rate in the present study was relatively low (21.2%) and was lower than previously published rates for transforaminal lumbar interbody fusion (33.6%) and anterior lumbar interbody fusion (38.3%). The most common complications were superficial infection and pseudoarthrosis. We had one case of rectal perforation that required exploratory laprotomy and a loop colonoscopy. It is important for surgeons to be aware of these potential complications as many of them can likely be avoided with proper patient selection and operative planning. Pre-operative MRI, detailed physical and history, adequate bowel preparation, improved access instrumentation, and the use of live fluoroscopy can all help prevent complications with AxiaLIF surgery. 429
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Poster<br />
Topic: Spine<br />
Abstract number: 25473<br />
CENTRAL NERVOUS SYSTEM EFFECTS OF NUCLEUS PULPOSUS EXPOSURE<br />
Anna ERMUND 1 , Elin NILSSON 1 , Helena BRISBY 2 , Ingela HAMMAR 1<br />
1 Neuroscience and Physiology, Göteborg (SWEDEN), 2 Clinical Sciences, Göteborg<br />
(SWEDEN)<br />
Changes in central nervous system neuronal responses may play an important role<br />
in low back pain (LBP). Neuronal activity in the thalamus increases after acute<br />
application of nucleus pulposus (NP) onto a dorsal root ganglion (DRG). We present<br />
data on thalamic effects after NP leakage followed by compression of the DRG and<br />
changes in synaptic plasticity in the ventral hippocampus (VH), a region involved in<br />
pain perception. Rats and mice were subjected to experimental disc herniation. After<br />
24 hours, neuronal responses in the thalamus evoked by electrical stimulation of<br />
sciatic A fibres were recorded during DRG compression. Thirty minutes later NP was<br />
reapplied onto the DRG. Neuronal responses in VH slices were investigated by<br />
current pulses (50 ms interval, 20 s between pairs). The hippocampus was further<br />
studied 3 and 7 days after NP application onto the DRG. Compression of the DRG<br />
decreased the number of evoked responses in both NP and sham animals. A<br />
repeated application of NP resulted in increased thalamic responses. In the VH 24<br />
and 72 hours post surgery, the second pulse in a pair gave a larger response. In<br />
naïve animals, both pulses gave responses of the same magnitude. Depression of<br />
neuronal responses following mechanical dislocation may not contribute to increased<br />
pain transmission but seems to counteract NP effects. Changes in the VH were<br />
detected, indicating this area in low back pain modulation. These findings need<br />
further investigation to identify signaling pathways involved in the establishment and<br />
maintenance of LBP.<br />
428