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Cheerag D. Upadhyaya, Paul Park and Frank La Marca

Chronic chylous drainage can lead to nutritional deficiencies and immunosuppression, with a reported mortality rate as high as 50%. 2–5 , 13 In addition, a large fluid collection can lead to mechanical compression of adjacent structures. Lymphedema is usually a concomitant manifestation of disrupted lymphatic drainage and can persist until alternate draining pathways are established. Intraoperative diagnosis of lymphatic vessel injury is rare, given that the fasting status of most patients undergoing spinal surgery decreases lymphatic flow to less than 1 ml

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Sangala Jaypal Reddy, Frank La Marca and Paul Park

that Hsp70 is among the most frequently produced proteins after SCI. In a similar model using gene expression, Tachibana and coworkers found that Hsp27 showed a > 2-fold increase 24 hours after SCI. The role of HSPs is complex: they can be proinflammatory and yet they may also have significant antiinflammatory and cytoprotective actions. 7 , 37 Studies have shown that HSPs have a multifaceted modulatory role in inflammation. These proteins have been shown to promote inflammation initially and then exert an antiinflammatory effect, thereby limiting chronic sequelae

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William R. Stetler Jr., Paul Park and Stephen Sullivan

produce significant further reduction of cytochrome a,a 3 , suggesting that there is a chronic inability of mitochondria to efficiently produce adenosine triphosphate in the tethered cord. The trend toward normal redox ratio changes following release suggests that there is potential for normal mitochondrial function following surgery. These effects were further studied in an experimental cat model, in which a progressive amount of traction was placed on the filum terminale in a controlled setting, and reduction of cytochrome a,a 3 was determined. It was found that

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Huina Zhang, Sushan Yang, Lin Wang, Paul Park, Frank La Marca, Scott J. Hollister and Chia-Ying Lin

– 22 , 1983 2 Chandrasekhar S , Esterman MA , Hoffman HA : Microdetermination of proteoglycans and glycosaminoglycans in the presence of guanidine hydrochloride . Anal Biochem 161 : 103 – 108 , 1987 3 Chubinskaya S , Kawakami M , Rappoport L , Matsumoto T , Migita N , Rueger DC : Anti-catabolic effect of OP-1 in chronically compressed intervertebral discs . J Orthop Res 25 : 517 – 530 , 2007 4 Gruber HE , Johnson T , Norton HJ , Hanley EN Jr : The sand rat model for disc degeneration: radiologic characterization

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Corrado Lucantoni, Khoi D. Than, Anthony C. Wang, Juan M. Valdivia-Valdivia, Cormac O. Maher, Frank La Marca and Paul Park

et al. 3 noted an improvement in 87% of patients complaining of radicular pain, 90% of patients with sensory disturbances, and 100% of patients with a motor deficit or bowel/bladder dysfunction. Neulen et al. 21 suggested that radicular symptoms are less likely to benefit from surgery, probably because of the permanent impairment of the nerve itself, resulting in chronic pain due to deafferentation. In statistical terms, the numbers in the present report are too small to draw any definitive conclusions. However, several authors have suggested some indications

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Anne Louise Oaklander

thought to be partially causal because of additional at-level pathology, and 13% were judged to be totally causal. 4 The Park et al. 7 study, which cited a 0% prevalence of symptomatic TCs, was a radiological survey that did not actually measure patient symptoms, so it should not have been included in Lucantoni and coworker's analysis. Conversely, a key surgical series was omitted. Van de Kelft and Van Vyve found TCs to be responsible for symptoms in 75% of patients (15 of 20) with otherwise unexplained chronic perineal pain, with 10 of 12 (83%) surgically treated

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purpose of our study was to determine the number of patients who continued chronic narcotic usage (>3 months) following spinal surgery, and to evaluate the preoperative factors that predicted chronic use. Methods: We evaluated 117 consecutive patients, 43 males, 74 females, with a mean age of 55 (range 22–86), that underwent spinal surgery at a single institution. Seventeen items of demographic data, clinical data, and narcotic prescription data were collected and analyzed, including the amount of preoperative narcotic usage. The narcotic usage data was collected

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34 3 Cranial Nerve Surgery A5 A6 Copyright held by the American Association of Neurological Surgeons. You may not sell, republish, or systematically distribute any published materials without written permission from JNSPG. 2013 Introduction: GRASSP was developed to capture subtle changes in neurological impairment of the upper extremity after cervical spinal cord injury (SCI) during the acute, sub-acute, and chronic phases. Psychometric properties of reliability and validity are well established. Responsiveness testing is required to

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fusion in the management of severe, chronic low back pain; 2) total disc replacement (TDR) versus arthrodesis for single level cervical degenerative disc disease; 3) bone morphogenic protein versus autograft in posterolateral lumbar spinal fusions; and 4) the use of vertebroplasty in osteoporotic vertebral compression fractures. Results Cost sustaining technologies are defined as innovations that optimize value by improving outcomes or reducing cost over time. Cost-utility analyses show circumferential fusion and TDR with ProDisc-C to be cost

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Darryl Lau, Adam Khan, Samuel W. Terman, Timothy Yee, Frank La Marca and Paul Park

, Gudbrandsdottir G , Hjelle KM , Sand KE , Bostad L , Beisland C : Obesity is associated with an improved cancer-specific survival, but an increased rate of postoperative complications after surgery for renal cell carcinoma . Scand J Urol Nephrol 46 : 348 – 357 , 2012 29 Rosen DS , Ferguson SD , Ogden AT , Huo D , Fessler RG : Obesity and self-reported outcome after minimally invasive lumbar spinal fusion surgery . Neurosurgery 63 : 956 – 960 , 2008 30 Sami Walid M , Zaytseva NV : The impact of chronic obstructive pulmonary disease